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 clinical elective course and its effects on medical students and graduates of Jordanian medical schools

BACKGROUND

The elective course is part of the 6th-year medical school curriculum in Jordan. Students choose the specialty in which they wish to spend 8 weeks and choose their location even if it is outside their university's affiliated hospitals. In this study, we try to understand student choices regarding the country of elective, chosen specialty, type of placement (observership/clerkship), and elective general value from participants' perspectives.

METHODS

This paper used a cross-sectional study. The survey was distributed through social media platforms (mainly Facebook and WhatsApp) targeting 6th-year medical students and doctors who graduated from one of the 5 Jordanian medical schools (the University of Jordan, Jordan University of Science and Technology, Mutah University, Yarmouk University, and Hashemite University).

RESULTS

The majority of participants had an international elective (69.6%), mainly in the USA, followed by the UK. Internal medicine was the primary field of interest for 14.8%, followed by general surgery. Of these, 241 (62.6%) actively participated in work at their chosen hospitals as they had a clerkship/hands-on experience. In contrast, 142 (36.9%) were observers. The majority indicated that the elective is worth the time, money, and effort. Moreover, they had adequate supervision throughout the course and could achieve their preset objectives.

CONCLUSIONS

The elective course gives a unique experience to our students. General satisfaction is an indicator of the success of the course in actively exposing medical students to clinical practice.

Diabetic foot ulcer in Southern Jordan: A cross-sectional Study of Clinical and Microbiological Aspects

Background

Materials and methods

Results

Conclusion

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Diabetic foot ulcer is a common complication of diabetes.

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This study is first of its kind in southern Jordan that combined clinical and microbiological aspects of diabetic foot ulcer.

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The most frequent bacterial isolates from diabetic foot ulcers are gram negative bacteria.

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Inappropriate previous use of antibiotics is the main determinant of multi-drug resistant isolates.

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High rates of multi-drug resistant isolates in this study reflect the loose implementation of antibiotics dispensing regulations in Jordan.

Screening of Glypican-6 Expression in Benign, Primary and Metastatic Colon Cancers

Background:

The development of colon cancer has been described as a multistep process of carcinogenesis. Understanding molecular and cellular changes underlying this process is required to determine potential biomarkers and therapeutic targets in colon cancers. Several molecular entities, including glypicans, are implicated in cancer development. Among these is glypican-6, which is overexpressed in a limited number of cancers. This study aims to characterise the glypican-6 expression in different types of colon cancer.

Methods:

Immunohistochemistry was used to characterise glypican-6 expression in a panel of archived formalin-fixed, paraffin-embedded colon tissue types. These types included 39 normal colon tissues, 10 colon tubular adenomas, 60 colon adenocarcinomas without metastasis and 60 colon adenocarcinomas with metastasis. Glypican-6 expression relation to demographic and clinicopathologic features was also examined.

Results:

Glypican-6 was strongly expressed in benign, primary and metastatic colon tumours. Normal tissue samples exhibited low to undetectable levels of glypican-6. A significantly high glypican-6 expression was displayed in colon cancers with lymph node metastasis, high depth of invasion, distant metastasis, high histological grades and late stages of the disease (P < 0.05). Importantly, a significant differential in glypican-6 expression was found between normal tissues and different types of colon cancer tissues. Moreover, the highest glypican-6 expression was more frequently found in metastatic tumours, followed by primary tumours and the least in benign tumours (P < 0.05).

Conclusions:

Selective expression of glypican-6 may establish a basis for potential use as a tissue biomarker or as a novel therapeutic target in treatment of colon cancer.

Burnout Syndrome during Residency Training in Jordan: Prevalence, Risk Factors, and Implications

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.

A cross-sectional study of basic education influence on the clinical training: Attitudes and perception among Jordanian medical students

BACKGROUND

Over the past century, the medical educational model has been static with no significant improvement. Studies show that students are leaning towards a more active, dynamic, learner-centered education model that fits their needs and encourages them to be more responsible for their learning. Thus, we conducted this study to investigate Jordanian medical students' perceptions and attitudes towards the value of basic sciences in their clinical training.

METHODOLOGY

This was a cross-sectional study that utilized an online, self-administered questionnaire targeting medical students in their clinical years. The questionnaire comprises 5 domains targeting students' perceptions, attitudes, and suggestions of the medical educational system in general and basic sciences in specific.

RESULTS

Overall, 578 medical students completed the survey with a male to female ratio of 0.7, and 56% of participants studied were studying at Mutah University, while 42% were at the University of Jordan. Approximately three-fourth (73.9%) of the students reported that basic medical sciences are critical to their development as physicians. Approximately, 82% believe that it is vital to integrate the clinical practice into basic science teaching. Besides, 82.4% of students agreed that faculty members' teaching style influences the educational content's delivery at the basic level. Moreover, 73% of students lean towards the inclusion of problem-based learning into their curriculums. On the other hand, 41.7% of students reject basic science questions in their written clinical exams.

CONCLUSION

Our study highlights the positive attitudes of Jordanian medical students towards basic medical sciences. It also demonstrates that students are more comfortable with an active and dynamic educational model that fits their needs and qualifications. Thus, we recommend a student-centered medical educational model trail to maximize learning and teaching efficiency and develop competent medical practitioners.

The Association Between Personality Traits and Specialty Preference Among Medical Students in Jordan

Aim

To assess the association between personality traits by the five-factor model and specialty choice preference among medical students and immediate medical graduates in Jordan and to identify if there were any significant differences in personality profiles between those planning to pursue different career pathways.

Methods

This is a cross-sectional study including fifth- and sixth-year medical students and post-graduate internship doctors at five universities in Jordan. An online survey was used to collect data from participants, which included their general characteristics, their personality profile using the Big Five Inventory–2, and questions about their most preferred specialty choice.

Results

One thousand and twelve participants were enrolled in this study. Only 4.9% were interested in pursuing a specialty in basic medical sciences, and about 12% wanted to be non-practicing medical doctors. Almost half of all participants wanted to pursue a career in surgery-oriented specialties. Those were more extraverted, more conscientious, and had less negative emotions than students who chose medicine-oriented specialties. Students who decided to pursue clinical specialties and students who wanted to be practicing doctors were more extraverted and more conscientious.

Conclusion

Medical students and fresh medical graduates from Jordan who exhibited higher extraversion and conscientiousness and lower negative emotions preferred to be practicing clinicians. They were more inclined to pursue a career in surgery-oriented specialties. These findings might be helpful in understanding the preferences of young doctors and in counseling them about their career paths. Medical educators may wish to incorporate personality trait evaluation in planning post-graduate programs.

Inflammatory bowel disease and prostate cancer risk: A systematic review

Objective: To evaluate the risk of prostate cancer (PCa) in patients with inflammatory bowel disease (IBD), focussing on ulcerative colitis (UC) and Crohn's disease (CD) separately. Methods: A systemic search was carried out using PubMed and Web of Science databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We retrieved a total of 349 articles. All the articles were in the English language and investigated the incidence of PCa in patients with IBD. Results: Nine studies met our inclusion criteria, with a total of 205 037 men. Two studies reported an increase in the risk of PCa in men with IBD in general. Five other studies reported an increased risk of PCa in men with UC or with CD specifically. On the other hand, two studies reported a decreased risk of PCa in patients with UC and patients with IBD treated with aminosalicylates. Conclusions: While men with UC appear to have higher risk of developing PCa, data on patients with CD are inconclusive. Therefore, patients with UC may benefit from earlier PCa screening. Our findings confirm a complex interplay between IBD and PCa, including factors such as genetic predisposition, systemic inflammation and treatment effects. The modulatory effect of treatment strategies for IBD on the development and progression of PCa might be of clinical significance. Abbreviations: CD: Crohn's disease; CRP: C- reactive protein; FOLH1: folate hydrolase 1; GIT: gastrointestinal tract; IBD: inflammatory bowel disease; IL-6: interleukin 6; NOS: Newcastle-Ottawa Scale; PCa: prostate cancer; PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses; PSMA: prostate-specific membrane antigen; UC: ulcerative colitis.