Obstructive sleep apnea (OSA) is a common disorder that includes an intermittent mechanical obstruction of the upper airway during sleep, which can occur either during rapid eye movement (REM) phase or non-REM (NREM) phase. In this study, we aim to evaluate the differences in demographic and polysomnographic features between REM- and NREM-related OSA in a Jordanian sample, using both the broad and the restricted definitions of REM-related OSA. All patients who were referred due to clinical suspicion of OSA and underwent sleep study were screened. We included patients with a diagnosis of OSA who had Apnea-Hypopnea Index (AHI) greater than or equal to five. We classified patients into REM-related OSA according to either the broad definition (AHI_REM/AHI_NREM ≥ 2) or the strict definition (AHI_REM > 5 and AHI_NREM < 5 with a total REM sleep duration of at least 30 minutes), and patients with AHI_REM/AHI_NREM less than two were classified as NREM-related OSA. A total of 478 patients were included in this study with a mean age of 55.3 years (±12.6). According to the broad definition of REM-related OSA, 86 (18%) of OSA patients were classified as having REM-related OSA compared to only 13 (2.7%) patients according to the strict definition. Significant differences were found between both NREM-related OSA and REM-related OSA according to the broad and to the strict definitions for arousal index (p<0.001 and p<0.032), respectively, duration of saturation below 90% (p<0.001 for both), and saturation nadir (p<0.036 and p<0.013), respectively. No significant differences were found between this group and other OSA patients regarding age, BMI, ESS, and snoring. Our study showed that the stricter the definition for REM-related OSA, the milder the associated clinical changes.

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a progressive disease that causes long-term breathing problems. The reliable monitoring of respiratory rate (RR) is very important for the treatment and management of COPD. Based on inkjet printing technology, we have developed a stretchable and wearable sensor that can accurately measure RR on normal subjects. Currently, there is a lack of comprehensive evaluation of stretchable sensors in the monitoring of RR on COPD patients. We aimed to investigate the measurement accuracy of our sensor on COPD patients. Methodology: Thirty-five patients (Mean ± SD of age: 55.25 ± 13.76 years) in different stages of COPD were recruited. The measurement accuracy of our inkjet-printed (IJPT) sensor was evaluated at different body postures (i.e., standing, sitting at 90°, and lying at 45°) on COPD patients. The RR recorded by the IJPT sensor was compared with that recorded by the reference e-Health sensor using paired T-test and Wilcoxon signed-rank test. Analysis of variation (ANOVA) was performed to investigate if there was any significant effect of individual difference or posture on the measurement error. Statistical significance was defined as p-value less than 0.05. Results: There was no significant difference between the RR measurements collected by the IJPT sensor and the e-Health reference sensor overall and in three postures (p > 0.05 in paired T-tests and Wilcoxon signed-rank tests). The sitting posture had the least measurement error of −0.0542 ± 1.451 bpm. There was no significant effect of posture or individual difference on the measurement error or relative measurement error (p > 0.05 in ANOVA). Conclusion: The IJPT sensor can accurately measure the RR of COPD patients at different body postures, which provides the possibility for reliable monitoring of RR on COPD patients.

There are serious concerns regarding the effectiveness of medical education in its current format during serious crises like the COVID-19 pandemic. To explore academic, financial, psychological, & hygienic impact on medical students. A cross-sectional, questionnaire-based study of students at different medical schools in Jordan. It included both basic and clinical years. There were 415 responses. Females constituted 51.8%. Around 50% of the participants were from the 6th year (n = 194, 46.7%). University of Jordan students represented around 40% of the responders. 60% of the students have GPA (Grade Point Average) of less than 3 points. Nearly half of the students indicated that their academic grades were affected during the pandemic. Clinical years’ students (51.0%) were more likely to be negatively affected than students in basic years (36.1%), P value 0.026. Sixty three percent reported that they sanitize their hands before touching eyes, nose, or mouth. More than two thirds (70.4%) of students indicated that their mental health was affected in the pandemic. Financial influence was a major aspect in around 53% of students and 34% of students were not able to pay the university fees due to the pandemic. The pandemic affected the elective training course location of 70.9% of respondents. Mental health was affected in 70.9% of students and 65.1% became more anxious or depressed with no significant difference among gender and academic years (P values 0.256 and 0.516, respectively). Students in the clinical years were more afraid of getting the infection than students in the basic years, however this difference was not statistically significant (p = 0.084). Covid-19 Pandemic negatively affected the academic course of the medical students especially at the clinical training years’ level across Jordanian universities. COVID-19 pandemic left a negative impact on psychological & mental health of the students, too, rendering them more anxious, depressed, and afraid of coming to the hospital and handling patients.

Asthma is a chronic respiratory disease that significantly impacts quality of life. Pulmonary rehabilitation has been shown to improve lung function and symptoms in asthma, but its adoption is limited due to accessibility and patient engagement challenges. Virtual reality (VR) and videogaming technologies have emerged as potential tools to enhance pulmonary rehabilitation by providing an engaging and interactive environment. This systematic review aimed to evaluate the effectiveness, feasibility, safety, and patient engagement of VR and videogaming in pulmonary rehabilitation for individuals with asthma. A comprehensive search of seven electronic databases (PubMed, Embase, CINAHL, Cochrane, AMED, SPORTDiscus and PEDro) was conducted to identify studies that included VR and videogaming interventions. Studies included participants with asthma and used VR or videogaming as part of pulmonary rehabilitation. Data extraction focused on intervention types, clinical outcomes, patient engagement, and safety. Five studies were included in the final review and involved 104 participants. The studies implemented different digital tools, including the InSpire System, and games such as “Reflex Ridge” and “Serious Games”. VR and videogaming interventions improved asthma control, lung function, and exercise capacity. High levels of patient engagement and adherence were reported, with no adverse events across the trial. VR and videogaming show promise as effective, feasible, and safe tools to enhance pulmonary rehabilitation in individuals with asthma. However, the heterogeneity of studies limited the ability to draw definitive conclusions, with further research needed using standardized outcomes.

Background and Objective: H1N1 infection carries an increased risk in pregnancy. Our aim was to study the fetomaternal outcome and the effect of early initiation of therapy. Methods: This is a retrospective descriptive study. Confirmed infected cases were included. Maternal age, parity, gestational age at diagnosis, presenting symptoms, time between presentation and starting therapy, ICU admission, and maternal and perinatal outcome were evaluated. Results: Nineteen confirmed patients were included. Most patients are 31 years old or more. Multiparous patients were 73.68% and 57.89% were in the third trimester. Most of our patients presented with cough, fever, and chills. Two patients were admitted to the ICU. One of them was a case of maternal mortality. 42.10% of patients were started on therapy only one day after clinical onset of symptoms. 26.31% delivered before 37 completed weeks. 73.68% delivered beyond term. Around one third delivered vaginally. 45% of babies weighed more than 3 kg. Four babies weighed less than 2 kg. Ninety percent had APGAR scores more than 8 at 1 and 5 minutes after delivery. Twenty five percent were admitted to the NICU with no neonatal mortalities. Conclusions: H1N1 influenza A infection in pregnancy is associated with adverse maternal and perinatal outcomes. Medical and public awareness, low threshold for testing suspected pregnant patients, very early initiation of antiviral therapy, and multidisciplinary approach in our series decreased the overall adverse effects of this infection.

Objectives: This study aims to evaluate the clinical phenotypic features of sarcoidosis in a single-center academic hospital in Jordan. Patients and methods: A retrospective file review was performed at an academic medical center in Jordan that included all patients diagnosed with sarcoidosis between January 2000 and December 2018. A total of 150 patients with sarcoidosis (38 males, 112 females; mean age 47.8±11.7 years; range, 17 to 79 years) were evaluated. Clinical data extracted from the files included the sex of the patient, the age at time of diagnosis, diagnosis date, the season during which the diagnosis was established, and smoking history. Biopsy histopathology, spirometry, nerve conduction, echocardiography, and imaging reports including plain radiographs, ultrasonographic, magnetic resonance and computed tomography reports were reviewed. Data including laboratory values, medication usage, clinical outcomes, and morbidity/mortality were collected. Pulmonary function tests including spirometry and lung volumes along with the diffusing capacity for carbon monoxide were reviewed for the presence of restriction, obstruction or reduction in the diffusion capacity of carbon monoxide. Identification of extra-thoracic organ involvement was determined in each patient in accordance with the criteria suggested by the updated World Association of Sarcoidosis and Other Granulomatous Disorders. Results: A total of 77.3% of the patients were diagnosed by biopsy. One case of Lofgren’s syndrome was identified. Of the patients, 18.0% had isolated pulmonary sarcoidosis, 75.3% had pulmonary and extra-pulmonary sarcoidosis and 6.7% had isolated extra-pulmonary sarcoidosis while 81.3% had respiratory symptoms, mostly shortness of breath and cough. Extra-thoracic organ involvement mostly involved the musculoskeletal system (33%) followed by the skin (20%). Female patients had more extra-thoracic involvement but the sex difference was only statistically significant for cutaneous involvement. Of the patients, 84% received treatment while 20% had disease remission during the first two years after diagnosis and 70% required treatment beyond two years after diagnosis. Conclusion: Various sarcoidosis clinical phenotypes are seen among Jordanian patients. Jordanian females are more affected by the disease and have more extra-thoracic involvement compared to male patients. A large number of the study patients received treatment.