Role of Intraoperative Neurophysiological Monitoring in Predicting Postoperative Delirium in Patients Undergoing Carotid Endarterectomy Surgeries.

Introduction: This study aimed to evaluate the diagnostic utility of electroencephalography (EEG) and somatosensory evoked potentials (SSEP) as modalities of intraoperative neurophysiological monitoring (IONM) in predicting postoperative delirium (POD) in patients who underwent carotid endarterectomy (CEA) surgery.

Methods: A total cohort of 425 patients was included in this study. Medical record data were reviewed retrospectively and their documented significant IONM data were analyzed and integrated into the study for each patient.

Acquisition of Prehospital Stroke Severity Scale is associated with shorter door-to-puncture times in patients with prehospital notifications transported directly to a thrombectomy center.

Background: We sought to identify systemic factors influencing door-to-puncture times (DTP) among patients with pre-arrival notifications presenting directly to a comprehensive stroke center (CSC) and undergoing emergent mechanical thrombectomy (MT).

Methods: In this retrospective analysis of a prospectively maintained registry of acute ischemic stroke (AIS) patients undergoing MT at two CSCs between January 2021 and October 2023, we included consecutive AIS patients presenting directly to the CSC with pre-arrival notifications via emergency medical services (EMS) and who underwent emergent MT. We excluded patients with known confounders to DTP and divided this cohort into two groups: DTP ≤75 min and >75 min.

Microsurgery of Cerebral Arteriovenous Malformations in a Resource-Limited Setting: The First Case-Series from Iraq.

Background: Cerebral arteriovenous malformations (AVMs) can lead to significant morbidity and are particularly challenging to manage in resource-limited settings where endovascular treatment modalities are unaffordable for most patients.

Objective: To describe the first case series of AVM from Iraq with an analysis of the related clinicoradiologic characteristics, operative features, and outcomes.

Methods: A single-center database from October 2018 to December 2022 was reviewed to analyze the characteristics of cerebral AVMs who underwent surgical treatment in Baghdad, Iraq.

Role of Intraoperative Electroencephalography in Predicting Postoperative Delirium in Patients Undergoing Cardiovascular Surgeries.

Objective: To determine the utility of electroencephalography (EEG) in predicting postoperative delirium (POD) in patients who underwent cardiovascular surgeries with EEG monitoring.

Methods: A total of 1161 patients who underwent cardiovascular surgeries with EEG monitoring were included in the study, and their data were retrospectively reviewed. POD assessment was done utilizing Intensive Care Delirium Screening Checklist (ICDSC).

The prevalence of fibromyalgia in adults at Al-Karak Jordan: a cross-sectional study.

Introduction: Fibromyalgia is a chronic and intricate musculoskeletal disorder characterized by widespread pain, fatigue, and tenderness in specific anatomical regions. Although its prevalence varies among populations, understanding the prevalence in different geographical areas is crucial for healthcare planning. This cross-sectional study aims to determine the prevalence of fibromyalgia in adults residing in Al-Karak, Jordan.

Intraoperative neuromonitoring as real-time diagnostic for cerebral ischemia in endovascular treatment of ruptured brain aneurysms.

Objective: To evaluate the diagnostic accuracy of intraoperative neurophysiological monitoring (IONM) during endovascular treatment (EVT) of ruptured intracranial aneurysms (rIA).

Methods: IONM and clinical data from 323 patients who underwent EVT for rIA from 2014-2019 were retrospectively reviewed. Significant IONM changes and outcomes were evaluated based on visual review of data and clinical documentation.

Transcarotid Arterial Revascularization of Symptomatic Internal Carotid Artery Disease: A Systematic Review and Study-Level Meta-Analysis.

Background: Transcarotid artery revascularization (TCAR) is an interventional therapy for symptomatic internal carotid artery disease. Currently, the utilization of TCAR is contentious due to limited evidence. In this study, we evaluate the safety and efficacy of TCAR in patients with symptomatic internal carotid artery disease compared with carotid endarterectomy (CEA) and carotid artery stenting (CAS).

Intravenous Thrombolysis for Acute Ischemic Stroke in Patients With Recent Direct Oral Anticoagulant Use: A Systematic Review and Meta-Analysis.

Background: Intravenous thrombolysis (IVT) is an effective stroke therapy that remains underused. Currently, the use of IVT in patients with recent direct oral anticoagulant (DOAC) intake is not recommended. In this study we aim to investigate the safety and efficacy of IVT in patients with acute ischemic stroke and recent DOAC use.

CT-based generation of synthetic-pseudo MR images with different weightings for human knee.

Synthetic MR images are generated for their high soft-tissue contrast avoiding the discomfort by the long acquisition time and placing claustrophobic patients in the MR scanner's confined space. The aim of this study is to generate synthetic pseudo-MR images from a real CT image for the knee region in vivo. 19 healthy subjects were scanned for model training, while 13 other healthy subjects were imaged for testing.

Role of Intraoperative Neuromonitoring to Predict Postoperative Delirium in Cardiovascular Surgery.

Objective: Postoperative delirium (POD) can occur in up to 50% of older patients undergoing cardiovascular surgery, resulting in hospitalization and significant morbidity and mortality. This study aimed to determine whether intraoperative neurophysiologic monitoring (IONM) modalities can be used to predict delirium in patients undergoing cardiovascular surgery.

Design: Adult patients undergoing cardiovascular surgery with IONM between 2019 and 2021 were reviewed retrospectively.

Aggressiveness of Cancer Care at End of Life in Patients with Metastatic Breast Cancer in Jordan.

Background: Contrary to Western societies, more than 15% of patients with breast cancer in Jordan are diagnosed with stage IV disease. In this study, we evaluate the value of early palliative care integration in the end-of-life care of such patients.

Methods: All consecutive adult patients who died between 2014 to 2018, while under the care of our institution, with a confirmed diagnosis of breast cancer at the time of death, irrespective of place of death, were retrospectively reviewed.

A Case Report of a Maxillary Second Molar with Two Distinct Palatal Canals, Confirmed by CBCT.

Cases of unusual and complex root canal morphology could be difficult to diagnose and treat. This report describes the diagnosis and management of a rare maxillary right second molar (tooth #17) with two distinct palatal canals. The tooth was diagnosed with irreversible pulpitis and symptomatic apical periodontitis.

Diagnostic Accuracy of Somatosensory Evoked Potentials and Electroencephalography During Endovascular Treatment of Unruptured Cerebral Aneurysms.

Objective: Endovascular treatment (EVT) of unruptured cerebral aneurysms (UCA) offers a safer alternative to clipping. However, it is still associated with an increased risk for Postprocedural Neurological deficit (PPND). Prompt recognition using intraoperative neurophysiologic monitoring (IONM) and intervention can reduce the incidence and impact of new postoperative neurological complications.

Outcome of Regenerative Endodontic Procedures in Nonvital Immature Permanent Teeth Using 2 Intracanal Medications: A Prospective Randomized Clinical Study.

Introduction: This randomized clinical trial aimed to assess and compare the long-term clinical and radiographic outcomes of regenerative endodontic procedures (REPs) in treating nonvital immature permanent teeth using 2 intracanal medicaments.

Methods: Forty-five patients yielding a total of 50 anterior and posterior nonvital immature teeth were randomly divided into 2 groups. REPs using either nonsetting calcium hydroxide (Ca[OH]) (n = 25) or modified triple antibiotic paste (TAP) (n = 25) as intracanal medicaments were performed.

Root and canal morphology of third molar teeth.

Restorative and prosthetic considerations usually necessitates endodontic treatment of third molars in order to retain them as a functional component of the dental arch. However, the anatomy of third molars has been described as unpredictable. To date, there has been little published work on root and canal morphology of third molars, with an adequate sample size.

The association between antihypertensive medications and mental health outcomes among Syrian war refugees with stress and hypertension.

Background: Little is known about the association between antihypertensive drugs with mental health outcomes. We examined the association between the antihypertensive classes and other clinical patient features with symptoms of depression, anxiety, insomnia, and Post-Traumatic Stress Disorder (PTSD) in a cohort of Syrian war refugees with stress and hypertension residing in Jordan.

Methods: This cross-sectional study recruited hypertensive Syrian refugees with stress.

Periapical Status of Non-Root-Filled Teeth With Amalgam, Composite, or Crown Restorations: A Cross-Sectional Study.

Objectives: This study aimed to evaluate the periapical status (PAS) of restored non-root-filled (RNRF) teeth amongst a group of patients attending dental teaching clinics at Jordan University of Science & Technology. It also aimed to assess the association of type and quality of coronal restorations and periapical disease.

Methods: This was a cross-sectional study.

Feasibility of a Hospital Information System for a Military Public Organization in the Light of the Multi-Criteria Analysis.

The healthcare environment presents a large volume of personal and sensitive patient data that needs to be available and secure. Information and communication technology brings a new reality to healthcare, promoting improvements, agility and integration. Regarding high-level and complex decision-making scenarios, the Brazilian Navy (BN), concerning its healthcare field, is seeking to provide better management of its respective processes in its hospital facilities, allowing accurate control of preventive and curative medicine to members who work or have served there in past years.

Modulation of salivary ICAM-1 and SIRT1 by disease modifying drugs in undepressed relapsing-remitting multiple sclerosis patients.

Background: The pathophysiology of Multiple Sclerosis (MS) is multifactorial where the correlation between inflammation and MS is evident. Adhesion molecules such as Intercellular adhesion molecule-1 (ICAM-1) are implicated in MS. SIRT1 is a member of surtins family that play a protective role in neurodegenerative and inflammatory diseases.

Impact of Social Distancing on Geriatric Hip Fractures Among Jordanian Population During COVID-19 Pandemic.

Background: There were serious concerns about delivering the care and support to the elderly population in Jordan during the full lockdown period. In turn, this raised concerns about how this group of population will care for themselves and if this change in the situation will increase the risk of falls and related geriatric hip fractures. Hip fractures are a significant cause of morbidity and mortality in the geriatric population.