The effect of type of hospital and health insurance on hospital length of stay in Irbid, North Jordan.
The study aimed at examining the effects of type of hospital and health insurance status on hospital length of stay for three identified medical and surgical conditions. Medical records of 520 patients for the year 1991 were reviewed in one public and one private hospital. Comparison of hospital length of stay for the private (n = 185) versus public sector patients (n = 335) was carried out. The effect of presence of health insurance (n = 189) and the lack of it (n = 325) was also studied. It was found that the average length of stay in the public hospital was significantly longer than the private one (3.3 versus 2.7 days). In addition, insured patients had significantly longer hospital length of stay (3.3 versus 3.0 days). The results of the multi-variate analysis showed that after socioeconomic factors and clinical conditions of patients were adjusted for, the influence of hospital type and health insurance on hospital length of stay was about one day. The paper also discusses the need to base hospital cost-containment strategies on studies of hospital behaviour and performance. (+info)
Anaemia during pregnancy as a risk factor for iron-deficiency anaemia in infancy: a case-control study in Jordan.
BACKGROUND: A high prevalence of 50-65% iron-deficiency anaemia in mothers and infants in Jordan was reported by the United Nations Relief and Works Agency (UNRWA) in 1990. Iron-deficiency in infancy has been shown to delay cognitive and psychomotor development with long-term consequences. While socioeconomic deprivation and inadequate nutrition are known underlying factors, it is unclear whether iron endowment at birth is compromised when mothers are anaemic, further jeopardizing iron status during infancy. A prospective case-control study of infants from birth to one year was conducted in a lower middle-class urban setting in Amman, Jordan. The study objective was to examine the relationship between maternal anaemia and iron-deficiency anaemia during infancy. METHOD: A sample of 107 anaemic (Hb < 11 g/dl) and 125 non-anaemic mothers was selected at 37 weeks' gestation and matched for age and parity, and infant data at birth obtained. The infants were reviewed at 3, 6, 9 and 12 months, to assess growth, current nutrition, infection rates and iron status. The main outcome measure was the incidence of iron-deficiency anaemia in the two groups of infants, defined in the study as Hb < 11 g/dl and either plasma ferritin < 12 mcg/l or zinc protoporphyrin > 35 mcg/dl. RESULTS: Iron endowment in cord blood samples appeared similar between the two groups. The incidence of iron-deficiency anaemia was very high in these infants, at 72% by research criteria, (51% if Hb < 10.5 g/dl), but significantly higher in the infants born to anaemic mothers at all stages of the year, with overall incidence of 81% (n = 91), compared to 65% in controls (n = 112). This was not explained by differences in environmental risk factors. Anaemic mothers had not recovered adequate iron status at 6 months' postpartum, with implications for future pregnancy iron demands. CONCLUSIONS: Anaemia during pregnancy compromises the health of mothers in traditional cultures, where women tend to have several children close together after marriage, with an inadequate interval to replenish nutritional stores. Their infants also appear to be at increased risk of developing iron-deficiency anaemia, undetected at birth. (+info)
Mortality and causes of death in Jordan 1995-96: assessment by verbal autopsy.
Mortality indicators and causes of death in Jordan were assessed by verbal autopsy. A random sample of 100 clusters of ca. 300 households each were monitored for one year by notification assistants selected from the study area itself. Registered deaths were reported to research assistants who visited the family to complete the verbal autopsy form, which was structured and contained about 100 questions. Causes of death were determined by two physicians according to preset algorithms. A total of 965 deaths were reported among 198,989 persons, giving a crude death rate of 5 per 1000 population per year. The three leading causes of death were diseases of the circulatory system, malignancies and accidents. In the absence of a health information system, verbal autopsy as implemented in Jordan can serve as a reliable substitute. (+info)
Salivary gland tumors in Jordan: a retrospective study of 221 patients.
AIM: To evaluate the types and clinical outcome of salivary gland tumors in Jordan. METHODS: Hospital records of 221 patients (85 women and 136 men) with salivary gland tumors, diagnosed from January 1988 to December 1997 were reviewed. The patients were analyzed according to sex, age, histopathological type and site of the tumor. Survival curves for patients with malignant tumors were constructed using Kaplan-Meier's method. RESULTS: Of the total 221 salivary gland tumors, 155 (70.2%) were parotid tumors, 42 (19%) minor salivary gland tumors, 23 (10.4%) submandibular gland tumors, and a single (0.4%) sublingual gland tumor. Most of the tumors (151, or 68.4%) were classified as benign and 70 (31.6%) were malignant. Men to women ratio was 1.6:1, and the age of the patients ranged from 2 to 81 years. The overall 5 and 10 year-survival rates for the 70 malignant tumors were 67% and 53%, respectively, for all tumor stages. Mucoepidermoid carcinoma had the best, and squamous cell carcinoma the worst 10-year survival rate. Patients treated with surgery and subsequent radiation therapy had better survival rates than those treated with surgery or radiation therapy alone. CONCLUSION: The principal site for salivary gland tumors in Jordan population was the parotid, and the pleo- morphic adenoma the most common pathological finding. Tumor characteristics and survival data for the Jordanian population are comparable to those from western countries. (+info)
Familial Mediterranean fever in children: the expanded clinical profile.
The clinical picture of familial Mediterranean fever (FMF) has been appreciably expanded in the last 10 years. Over 8 years, we studied the expanded clinical profile of FMF in 476 children. Of these, 81% had abdominal pain, 41% chest pain, 42% arthritis, 12% severe myalgia, 12% skin manifestations, 4% scrotal swelling, 3% recurrent episodic fever, and one child (0.2%) developed recurrent hyperbilirubinaemia. Two (0.4%) children developed renal complications which were reversed by colchicine; however of 19 probands, 36 family members suffered from chronic renal failure. Our study indicates a familial predisposition to nephropathy in certain families with FMF. This study is the first to report the expanded clinical profile of FMF in a large group of Arab children, giving an opportunity to compare the findings with those in children with FMF in other ethnic groups, and to help in the study of genotype-phenotype correlation. (+info)
Glucose-6-phosphate dehydrogenase deficiency in Kuwait, Syria, Egypt, Iran, Jordan and Lebanon.
A total of 3,501 male subjects from six Arab countries living in Kuwait were investigated for quantitative and phenotypic distribution of red cell glucose-6-phosphate dehydrogenase (G6PD). The ethnic origins of those investigated were Kuwait, Egypt, Iran, Syria, Lebanon and Jordan. The distribution of G6PD deficiency among the different ethnic groups varied widely, ranging from 1.00% for Egyptians to 11.55% for Iranians. The activity of the normal enzyme was remarkably similar, with values ranging from 6.1 +/- 0.8 to 6.5 +/- 1.1 IU/g Hb. A low frequency of the Gd(A) allele was found in two ethnic groups, Egyptians (0.019) and Iranians (0.014). Gd(A-) was present at the very low frequency of 0.006 in another two ethnic groups, Kuwaitis and Jordanians. (+info)
Homozygosity mapping identifies an additional locus for Wolfram syndrome on chromosome 4q.
Wolfram syndrome, which is sometimes referred to as "DIDMOAD" (diabetes insipidus, diabetes mellitus, optic atrophy, and deafness), is an autosomal recessive neurodegenerative disorder for which only insulin-dependent diabetes mellitus and optic atrophy are necessary to make the diagnosis. Researchers have mapped Wolfram syndrome to chromosome 4p16.1, and, recently, a gene encoding a putative transmembrane protein has been cloned and mutations have been identified in patients. To pursue the possibility of locus heterogeneity, 16 patients from four different families were recruited. These patients, who have the Wolfram syndrome phenotype, also have additional features that have not previously been reported. There is an absence of diabetes insipidus in all affected family members. In addition, several patients have profound upper gastrointestinal ulceration and bleeding. With the use of three microsatellite markers (D4S432, D4S3023, and D4S2366) reported to be linked to the chromosome 4p16.1 locus, we significantly excluded linkage in three of the four families. The two affected individuals in one family showed homozygosity for all three markers from the region of linkage on chromosome 4p16.1. For the other three families, genetic heterogeneity for Wolfram syndrome was verified by demonstration of linkage to chromosome 4q22-24. In conclusion, we report the unique clinical findings and linkage-analysis results of 16 patients with Wolfram syndrome and provide further evidence for the genetic heterogeneity of this disorder. We also provide data on a new locus that plays a role in the etiology of insulin-dependent diabetes mellitus. (+info)
Oral cancer in Jordan: a retrospective study of 118 patients.
AIM: To evaluate clinical features, diagnosis, and treatment of oral cancer in Jordan. METHOD: We retrospectively analyzed the medical records 118 consecutive patients treated for oral cancer from 1989 until 1998. RESULTS: The age of the patients ranged from 35 to 90 years (median 62.5 years); three quarters were men. Ninety patients (76%) were smokers and 6 (5%) drank alcohol. The floor of the mouth was the most common site for oral cancer, followed by the tongue. The male/female ratio was 3.1:1. The majority of T1 tumors were treated by surgical excision, T2 tumors by surgery or radiotherapy, and T3 and T4 tumors without evidence of nodal disease by radiotherapy. Patients with nodal disease were treated primarily by surgery. In the absence of nodal disease, T1, T2, T3, and T4 tumors had 5-year survival rates of 95%, 95%, 81%, and 25%, respectively, whereas the patients with nodal disease had a poorer prognosis, with survival rates of 37%, 29%, 12% and 0% for T1, T2, T3, and T4, respectively. The 5-year survival rate decreased from 80% to 20% as the stage of disease progressed from I to IV. The overall 5-year survival for all stages of disease was 62/118 (53%). Patients treated with surgery alone (5-year survival rate 62%), and those treated with postoperative radiotherapy (5-year survival rate 81%) did better than patients treated with radiotherapy alone (31%). CONCLUSION: Complete surgical resection combined with radiotherapy results in the best therapeutic outcome. (+info)