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Objective This study examined health-related quality of life (HRQoL) and factors associated with poor HRQoL among hemodialysis (HD) patients. Methods A multicenter cross-sectional study was conducted on HD patients with anemia in Jordan (n = 168). Validated questionnaires were utilized to collect data on HRQoL using EQ-5D-5L, psychiatric symptoms using Hospital Anxiety and Depression Scale (HADS), and comorbidities score using the modified Charlson Comorbidity Index (mCCI). Multiple linear regression analysis was conducted to identify the variables which are independently associated with HRQoL among patients. Results The mean (± SD) age of study participants was 52.2 (± 14.6) years. The mean utility value of EQ-5D-5L was 0.44 (± 0.42). Participants reported extreme problems mostly in pain/discomfort domain (19.6%). Increased age, increased mCCI and patient complains, more years under dialysis, decreased exercise, and low family income were significantly associated with poor HRQoL ( p  < 0.05). Conclusion The study findings revealed poor HRQoL among HD patients with anemia. Various dimensions of health were negatively affected among HD patients. Development and implementation of appropriate approaches with adequate education and psychosocial support to HD patients by healthcare professionals targeting improved HRQoL and clinical outcomes would be necessary.

Hip fractures have several adverse effects on patients' morbidity and mortality. Postoperative Acute kidney injury (AKI) is one of the complications that have a significant impact on the patient's overall prognosis. We aimed to identify AKI risk after hip fracture surgery and the preoperative and intraoperative risk factors. We conducted a retrospective cohort study in a tertiary care hospital on adult patients who underwent surgery for hip fractures between January 2015 and August 2021. All clinical data were reviewed. A total of 611 patients were included (age = 76.44 ± 9.69 years). 126 (20.6%) of them developed AKI postoperatively. In multilinear logistic regression analysis, factors associated with postoperative AKI included eGFR [odds ratio (OR): 0.98; 95% confidence interval (CI): 0.97-0.99 with a p value .01], spinal anesthesia [OR: 1.78; 95% CI: 1.1-2.9 with a p value .01], and partial hip replacement (PHR) type of surgery [OR: 0.56; 95% CI: 0.32-0.96 with a p value .036]. The development of postoperative AKI was the strongest factor that increase mortality of the patients as the (HR = 2.42, CI 95% [1.57-3.74]; p value <.001). In this study, we highlight that lower eGFR, and spinal anesthesia were associated with a higher risk of AKI, and PHR surgery has lower odds to develop AKI. Postoperative AKI is associated with a higher mortality rate after hip fracture surgery.

The adherence to antihypertensive therapy plays a significant role in determining the clinical outcomes of hypertension. We aim to evaluate the level of adherence to antihypertensive medications among patients and to assess the effect of different sociodemographic factors on the level of adherence using the Hill-Bone scale for indirect assessment. In this cross-sectional study, we utilized a validated, face-to-face interview questionnaire to collect data on sociodemographic characteristics, participants' attitudes, and disease knowledge. The Hill-Bone questionnaire was employed to assess treatment adherence. The statistical analysis was conducted using SPSS version 28.0, where mean, standard deviation, and range were utilized for variability analysis. A total of 390 patients were included in this study. The sample comprised 56.9% of females and 56.4% of participants aged 60 years or older. Approximately 80% of participants were currently married, and 46.7% had a higher education level. The average Hill-Bone CHBPTS score was 21.23± 4.95 and indicated good adherence in 63.8% of participants. The findings showed that several factors were significantly associated with higher adherence rates, including older age (COR = 3.41, 95% CI = 1.10-10.54, p = 0.03), higher educational level (COR = 1.72, 95% CI = 1.05-2.83, p = 0.03), regular blood pressure monitoring (COR = 1.90, 95% CI = 1.10-3.30, p = 0.03), and knowledge about their medications (COR = 2.12, 95% CI = 1.14-3.94, p = 0.02). The medication adherence within our population falls below the desired level. Enhanced counselling and further research are necessary to identify additional factors influencing adherence and develop effective strategies for promoting adherence to antihypertensive medications.

The aim of this study was to assess postacute coronavirus disease 2019 (COVID-19) syndrome (PACS) symptoms according to the onset of the infection while evaluating the effect of COVID-19 vaccination on the symptoms of PACS. We conducted a retrospective single-center cohort study in which nonhospitalized COVID-19 survivors and healthy controls were compared for the occurrence of PACS. The total number of patients in this study was 472. At 6–12 and > 12 months after the infection, COVID-19 survivors had a significantly higher incidence of posttraumatic stress disorder (PTSD) and anxiety than the non-COVID-19 cohort. Furthermore, depression, cognitive deficit, tics, impaired quality of life and general health impairment were significantly more prevalent among COVID-19 survivors at < 6 months, 6–12 months and > 12 months than in the non-COVID-19 cohort. However, respiratory symptoms were significantly more prevalent among COVID-19 survivors only in the first 6 months after infection. In addition, cognitive deficit (OR = 0.15; 95% CI 0.03–0.87) and impaired quality of life (B = − 2.11; 95% CI − 4.21 to − 0.20) were significantly less prevalent among vaccinated COVID-19 survivors than among nonvaccinated survivors. Longitudinal studies are needed to establish the time that should elapse after COVID-19 infection for the symptoms of PACS to appear. Randomized clinical trials are needed to assess the possibility that COVID-19 vaccines might relieve PACS symptoms.

(1) Background: Earthquakes are natural disasters that often result in significant loss of life and property. The objective of this study is to explore the frequency of symptoms associated with posttraumatic stress disorder (PTSD), levels of meaning in life (ML), and perceived social support (SS) among university students in the aftermath of the earthquake that occurred in Turkey and Syria in 2023. (2) Methods: This study utilizes a cross-sectional correlation design to achieve its objectives among 603 university students from two public universities using an online survey (via Google Forms). The survey was launched one month after the earthquake in Turkey and Syria and concluded on 6 April 2023. (3) Results: The results indicate that a total of 158 university students, constituting 26.20% of the sample, reported extreme symptoms of PTSD. The results also indicate that 184 students (30.51), and 140 students (23.22%) reported low levels of ML and SS, respectively. Female students were significantly more vulnerable to experiencing PTSD symptoms, as well as difficulties in finding ML and SS. Finally, results revealed that students who were pursuing postgraduate studies had a greater likelihood of exhibiting symptoms indicative of PTSD. (4) Conclusions: It is recommended that universities provide support services and resources for students experiencing PTSD symptoms.

Objectives The clinical course of coronavirus disease 2019 (COVID-19) infection is often aggressive, with unfavorable outcomes for those with comorbidities such as type 2 diabetes mellitus (T2DM). We aimed to assess the prevalence and risk factors of COVID-19 infection, mortality, and post-infection lung fibrosis in patients with COVID-19 infection who had T2DM. Methods In this cross-sectional study, we included adult patients with T2DM who attended an endocrinology clinic and underwent testing for COVID-19 infection. Results Among 1039 included patients, the mean age was 59.5 ± 11.0 years and 429 (41.3%) were men. Overall, 87.1% of patients had received COVID-19 vaccination and 32.3% had confirmed COVID-19 infection. The COVID-19-related mortality was 3.0% and rate of post-COVID-19 lung fibrosis was 19.1%. Vaccination was associated with lower COVID-19-related mortality (odds ratio [OR]: 0.03, 95% confidence interval [CI]: 0.0–0.3) and post-COVID-19 lung fibrosis risk (OR: 0.3, 95% CI: 0.1–0.9). Conclusion Patients with T2DM exhibited a high prevalence of COVID-19 infection and associated mortality. However, COVID-19 vaccines were beneficial in reducing the risks of COVID-19-related mortality and post-infection lung fibrosis in these patients. COVID-19 vaccines and boosters are recommended for patients with T2DM. Further studies involving larger study populations are necessary to validate these findings.

Aims This study compared the 2009 versus 2021 chronic kidney disease (CKD) Epidemiological Collaboration (CKD-EPI) equations to calculate estimated glomerular filtration rate (eGFR) among Jordanian patients with T2DM to assess their agreement and impact on CKD staging. Methods This cross-sectional study included 2382 adult Jordanian patients with T2DM. The 2009 and 2021 CKD-EPI equations were used to calculate eGFR. Patients were reclassified according to kidney disease-Improving Global Outcomes (KDIGO) categories. Agreement between the equations was assessed using Bland–Altman plots and Lin’s concordance correlation. Results The 2021 equation significantly increased eGFR by a median of 2.1 mL/min/1.73 m 2 (interquartile range: 0.6–3.6 mL/min/1.73 m 2 ). However, there was significant agreement between equations (Kappa: 0.99; 95% confidence interval: 0.95–1.00), independent of age, sex, and the presence of hypertension. In total, 202 patients (8.5%) were reclassified to higher KDIGO categories using the 2021 equation, with category G3 being most affected. The overall prevalence of patients in the high to highest risk categories decreased (28.0% vs. 26.5%). Conclusions Although there was significant agreement with the 2009 equation, the 2021 equation increased eGFR and resulted in the reclassification of a subset of subjects according to KDIGO criteria. The uncertain impact of reducing high-risk category patients raises concerns about potential delays in referral and intervention, while holding the potential to enhance high-risk patient categorization, thus alleviating healthcare burden.

Aim. To determine the prevalence and frequency of different pathological patterns of glomerulonephritis (GN) in adolescent (age ≥ 11 years) and adult Jordanian patients. Materials and Methods. A retrospective analysis of all clinical and pathological reports of Jordanian patients who had native renal biopsies at the University of Jordan hospital between January 2007 and March 2018 to assess the prevalence and pathological pattern of GN. The data were analyzed statistically using descriptive statistics, the chi-squared test, and Fisher's exact tests. The level of significance was set at P<0.05. Results. Two hundred and nine patients (88 males and 121 females) had native kidney biopsies diagnosed as having GN; the mean age at the time of biopsy was 36.0±14.9 years. Primary GN (51.2%) was more common than secondary GN (48.8%). The most common GN was lupus nephritis (LN) (33.5%), followed by membranous nephropathy (MGN) (15.3%), and diabetic nephropathy (DN) (11.0%). Furthermore, IgA nephropathy was noted in 8.1% of cases. LN was the most common among the secondary GN and occurred in 49.6% of females; MGN was the most common primary GN and occurred in 22.7% of males. There was a statistically significant difference between males and females in the prevalence of LN and MGN (P<.001 and P=.011, respectively). LN was also dominant in all age groups expect for the ≥60 years group, which tended to exhibit DN (40%). Conclusion. LN is the most common GN type in Jordan, followed by MGN and DN. MGN is the predominant primary GN with a higher prevalence among males; LN is the predominant secondary GN and tends to occur in Jordanian females. The GN patterns in this study shifted from membranoproliferative GN to MGN in Jordan, which revealed a shift towards similar patterns exhibited in developed countries. Furthermore, DN is the most frequent GN in the elderly.

Objectives To measure the prevalence of diabetic retinopathy in patients with type 2 diabetes, to define their characteristics, and identify the associated risk factors. Methods We performed a cross sectional study of 1316 adult patients with type 2 diabetes mellitus who attended an ophthalmology clinic. Demographic, clinical, and laboratory data were analyzed. Diabetic retinopathy (DR) was diagnosed using a complete ophthalmic evaluation, including a fundic examination. Two regression models were constructed to identify the risk factors associated with DR and the parameters associated with the stage of retinopathy. Results Men accounted for 774 (58.8%) of the participants. The prevalence of DR was 28.2% (371 participants). DR was significantly more common in participants who were ≥60 years old, were women, had had diabetes for >10 years, were taking insulin, were not taking metformin, had a body mass index >30 kg/m2, were current smokers, or had a history of hypertension. Advanced stages of DR were more common in participants in the later stages of nephropathy and with albuminuria. Conclusions Poor glycemic control, smoking, and advanced diabetic kidney disease are most closely associated with retinopathy. Further longitudinal studies are necessary to identify the mechanisms underlying these relationships and to guide community-based interventions.

Aim Diabetic kidney disease (DKD) is a major long-term complication of diabetes mellitus (DM). Given the paucity of data on DKD in Jordan, we aimed to evaluate the prevalence, characteristics and correlates of DKD in Jordanian patients with type 2 DM. Methods This cross-sectional study included 1398 adult patients with type 2 DM who sought medical advice in the endocrinology clinic between March and September 2019. Demographic, clinical and laboratory data were reviewed. DKD was defined as reduced eGFR, and/or albuminuria. Three regression models were constructed to identify factors associated with CKD stages, albuminuria and DKD. Results Overall, 701 (50.14%) patients had DKD, with a median age of 59.71 ± 11.36  years. Older age, high triglycerides, and low high-density lipoprotein were associated with DKD (multivariable odds ratio [OR]: 1.02, 95% confidence interval [CI]: 1.01–1.03, p  < 0.01; OR: 1.1, 95% CI: 1.01–1.2; and OR: 0.98, 95% CI: 0.97–0.99, p  < 0.01 respectively). Metformin and renin-angiotensin system blockers were negatively associated with albuminuria and chronic kidney disease stages ( p  < 0.01). Conclusion Our study demonstrated that approximately one half of patients with type 2 DM had DKD. Further studies are necessary to understand this high prevalence and the underlying factors. Future research are needed to assess implementing targeted community-based intervention.