Mahmoud Al-Salem

Consanguinity in north Jordan: prevalence and pattern

The rate of consanguineous mating in north Jordan was 63.7% with an average inbreeding coefficient of 0.0283. First cousin marriages were the most predominant type (58.5%); villagers showed higher levels than city dwellers. The level of female education did not influence consanguinity rate.

Pattern of Childhood Blindness and Partial Sight Among Jordanians in Two Generations

A study of 260 Jordanians who became blind or visually impaired (according to World Health Organization standards) before the age of 15 years showed the dominant effects of genetically determined causes in two generations. Genetic causes were responsible for the visual impairment in 122 (77.7%) of 157 subjects in the group born after 1970 and for 69 (67%) of 103 in the group born before 1970. There was a statistically significant change in the overall pattern (genetic and acquired causes) of blindness between the two generations, and there was also a significant change in the pattern of acquired blindness alone. A decrease in corneal infections leading to blindness or visual disability in the younger generation was accompanied by an increase of trauma in the same age group. Parental consanguinity in those with genetically determined causes of visual impairment was high compared with those with nongenetic causes (79% vs 33.3%, P < .05). The autosomal recessive mode of inheritance was the most common pattern encountered (53.9%).

Autosomal recessive ectopia lentis in two Arab family pedigrees.

Nineteen patients with bilateral ectopia lentis and no other ocular abnormalities in two Arab families are described. The two family pedigrees demonstrate an autosomal recessive inheritance in contrast to the majority of reported family pedigrees with this condition which show dominant inheritance. The early onset of the condition, its natural course and its consequences on visual function are described.

Ocular manifestations of sickle cell anaemia in Arab children.

A complete ophthalmic examination was carried out of 46 Arab children with various forms of sickle cell disease. Mild and infrequent signs in anterior and posterior segments were found, but no cases of sickle cell retinopathy of any kind were detected. These results were compared with the reported findings in black American children of African origin with the same disease. The probable explanations were the high prevalence of fetal haemoglobin in Arab sicklers, the rarity of sickle cell disease among the Arabs and the possible existence of a different gene.

Eye injuries among children in Kuwait: pattern and outcome.

One hundred and ninety four children with ocular injuries were admitted to the Eye Department at Ibn Sina Hospital, Kuwait during a 1-year period (1983). They represented 8.7% of total admissions and 56% of all ocular injuries admitted in the same period. These figures are higher than any previously reported figures in comparable series. The risk of severe ocular injury to children was found to be 0.35% per 1000 per year. There were 47 (24%) perforating injuries and 111 (57%) concussion injuries. Catapulted missiles were the commonest cause of injury (26%). Early presentation to hospital accounted for a low rate of secondary infection. Visual outcome of 6/12 or better was achieved in 78.5% of concussion injuries and 27.3% of perforating injuries. Education in organized school programmes has been recommended to reduce the incidence of ocular injuries in children.

Causes of blindness in Irbid, Jordan.

To determine the most common causes of blindness and the age of onset of these conditions among Jordanians of Irbid, a study of all registered members in two societies for the care of the blind was carried out. Of all registered members, 185 individuals were blind according to the World Health Organization definition and satisfied our inclusion criteria. It was found that genetically determined causes made up 41% of the total causes. In 57% of the subjects, blindness occurred in the first two decades of life. The specific leading causes of blindness, in the order of their frequencies, were tapetoretinal degenerations as different variants of retinitis pigmentosa (17.6%), glaucomas (16%), diabetic retinopathy (13%), post-infection corneal scarring (11.5%), congenital cataract (8.8%) and uveitis (8%). The results reflect the satisfactory achievements in primary health care levels and the challenge to make specialized tertiary health care more accessible.

THE EFFECTS OF DICLOFENAC ON CRYO-INDUCED MIOSIS

The maintenance of pupil dilation is necessary for the success of scleral buckling procedures and in prophylactic transconjuctival cryopexy. To assess the miotic effect that is induced by cryotherapy and the ability of diclofenac sodium 0.1% (a potent prostaglandin synthetase inhibitor) to overcome such an effect, we conducted a randomized, masked and controlled experiment on 18 rabbits. These were divided into three groups; each group had their eyes treated by cryotherapy in a controlled fashion. Two groups were treated preoperatively with dilating drops: a solution without diclofenac in one group and one with diclofenac drops in the second. Pupil diameters were measured with Castroviejos calipers by an independent observer at regular intervals. A third group had no drops and were treated as a control. A highly statistical difference was observed in the reduction of the miotic effect of cryotherapy in those eyes treated by diclofenac.

Aetiology and management of proptosis in young Jordanians

Sixty-two cases of proptosis in children and adolescents were prospectively evaluated in a specialized practice at Irbid, North Jordan, during the period between 1990 and 1994. Inflammatory orbital conditions were seen in 27 patients (43.5%). The causes of orbital cellulitis were identified in 15 out of 25 cases. Predisposing factors and outcome were analyzed. Vasculogenic lesions were encountered in 15 cases, five of which were subperiosteal orbital haematomas. Twelve cases with structural lesions ranging from a benign cystic dermoid to craniostenosis were managed in various ways. A rare case of primary hydatid disease in the orbit was also seen. Results of surgical treatment and outcome in each condition were assessed. Eight cases (14%) were neoplastic in nature. A rare case of retinoblastoma which presented as orbital cellulitis is included. Orbitotomies were performed for excision biopsy, mass removal and decompression or exenterations of the orbit, with no serious complications. No cases of proptosis owing to thyroid ophthalmopathy or systemic diseases were seen. The relatively low frequency of secondary orbital retinoblastoma among Jordanian children is compared with that in related reports from other countries.

Cataract, Diabetes, and Risk of Cataract Extraction Among Arabs in Kuwait

ABSTRACT The prevalence of diabetes among 352 Arab patients of two ethnic constitutions (Kuwaiti and non-Kuwaiti) who had cataract extraction in the year 1983 was found to be 21%. The highest preva...