Osama A. Samara

Prevalence of Temporomandibular Joint Disorders among Students of the University of Jordan

Background This study aimed to investigate the prevalence of temporomandibular disorder (TMD) among students of the University of Jordan. Methods Information about the symptoms of TMD and the possible risk factors were collected using specifically designed questionnaires. The collected data sets were treated statistically using the SPSS release 14 package. Results The results of the present investigation showed that pain in or about the ears or cheeks was the most prevalent symptom whereas locking of the temporomandibular joint (TMJ) was the least prevalent. Nearly one-third of the investigated sample (31.4%, 346/1103) had no symptoms of TMD whereas 68.6% (757/1103) had at least one symptom. Students of health science studies had significantly the highest risk in developing TMJ clicking compared to students studying pure science or humanitarian studies. Conclusions TMD is of a high prevalence among students of the University of Jordan, particularly among students of health and science studies, which signify the role of stress in the development and/or progression of TMD. The findings of this study are alarming and entailing further investigations to identify risk factors associated with TMD in order to establish measures for prevention and treatment. Keywords TMD; Clicking; Health sciences; Humanitarian studies

Safety and Efficacy of Autologous Intra-articular Platelet Lysates in Early and Intermediate Knee Osteoarthrosis in Humans: A Prospective Open-Label Study.

Objective:To explore the safety and benefit from intra-articular autologous platelet lysate (PL) injection in early and intermediate knee osteoarthritis. Design:Open-label prospective study. Setting:Laboratory. Patients:Adult patients, aged 35 to 70 years, with a history of chronic pain or swelling on one or both knees and imaging findings (radiograph or magnetic resonance imaging) of degenerative changes in the joint of grade I or II on the Kellgren scale were included. Interventions:Autologous PL was given in the knee joint by percutaneous intra-articular route every 3 weeks for a total of 3 injections. Main Outcome Measures:Response was evaluated by nonnormalized Knee Osteoarthritis and Disability Outcome Score (KOOS). Results:There was a significant improvement in the 5 aspects evaluated at weeks 32 and 52 compared with baseline. Symptoms score significantly improved at weeks 32 and 52 from a mean of 11.1 at baseline to 9.0 (P < 0.0001) and 8.7 (P < 0.0001). Stiffness score significantly improved at weeks 32 and 52 from 2.2 at baseline to 1.7 (P < 0.022) and 1.6 (P < 0.016). Pain score improved at 32 weeks and at 52 weeks from a baseline of 14.2 to 9.8 (P < 0.0001) and 9.2 (P < 0.0001). Daily Living score improved from 25.0 to 18.7 at 32 weeks (P < 0.0001) and to 15.6 at 52 weeks (P < 0.0001). Sport score improved from 10.7 to 8.4 at 32 weeks (P < 0.0001) and to 8.1 at 52 weeks (P < 0.0001). Conclusions:Intra-articular PL significantly improved score of all aspects evaluated by KOOS. Platelet lysate seems to be a safe product. Clinical Relevance:To the best of our knowledge, this is the first clinical study addressing the use of autologous PL as a treatment measure for knee osteoarthrosis (KOA). There are no studies published regarding the treatment of KOA by intra-articular injections of PL. The previous studies were on the use of platelet-rich plasma (PRP) treatment for KOA. Platelet-rich plasma use has been in place for several years, however, a standardized protocol has not yet been established. Platelet lysate represents a safe, economical, easy to prepare, and easy to apply source of growth factors in the treatment of KOA. A head-to-head study is needed to compare PRP with PL in KOA.

Fatal encephalitis due to BK virus in a patient with common variable immunodeficiency: a case report.

Encephalitis due to BK virus is a rare condition. Here, we describe a young male patient with common variable immunodeficiency who developed fatal encephalitis due to BK virus. The patient presented initially with ocular symptoms that were followed by behavioral changes and spastic quadriparesis. Diagnosis was made by the compatible clinical findings and detection of viral DNA by polymerase chain reaction in the cerebrospinal fluid. To the best of our knowledge, this is the first report of BK virus encephalitis in a patient with common variable immunodeficiency. We suggest that BK virus should be suspected in cases of encephalitis; particularly in patients with immunodeficiency.

Myelopathy Associated with Age-Related Cervical Disc Herniation: A Retrospective Review of Magnetic Resonance Images

BACKGROUND Cervical intervertebral disc herniation can lead to myelopathy. Aging is an established variable related to spondylotic myelopathy. Studying this association will help in controlling the increase in spondylotic myelopathy with age. OBJECTIVES To study the association between cervical disc level, its direction, and the frequency of myelopathy with age, and to assess the epidemiology of age-related cervical disc herniation and myelopathy. DESIGN Retrospective review of magnetic resonance (MR) images. SETTING Tertiary referral hospital. PATIENTS AND METHODS We studied the MR images of adults patients (>18 years of age) referred to our department between 2001 and 2012 for suspected cervical spondylopathy. The direction and severity of herniation and the presence of myelopathy was determined for spinal levels C2 to C7. MAIN OUTCOME MEASURE(S) Relationship between age-related cervical disc herniation and myelopathy. RESULTS We studied 6584 patient MR images, which included 2402 males (39.1%) and 3737 females (60.9%). The frequency of myelopathy increased with age from 0.6% in patients <20 years of age, reaching 9.1% in patients >70 years of age. The most common level affected by myelopathy was C5–C6. In elderly patients (>60 years), the C3–C4 level became the predominant level affected by myelopathy. Likewise, the frequency of central disc herniation increased significantly (P<.001) with age at all cervical levels. Furthermore, upper cervical levels showed a higher frequency of central disc herniation than lower cervical levels in the elderly. CONCLUSION The increased frequency of central disc herniation with age suggest an important, and probably a cause-effect relationship, between herniation and myelopathy. LIMITATIONS We were unable to access clinical data or electrophysiological studies to correlate with MR image findings.

Giant Spontaneous Femoral Artery Pseudoaneurysm Treated with Covered Stents: Report of a rare presentation and review of literature.

We report the case of a 62-year-old woman who presented with a one-month history of a pulsatile mass, with no antecedent trauma or intervention. Imaging showed a large pseudoaneurysm (PSA) of the distal portion of the left superficial femoral artery. The PSA was treated successfully with endovascular placement of covered stents.

Postpartum Enterobacter Pyogenic Sacroiliitis

Postpartum pyogenic sacroiliitis is a rare condition. Accurate diagnosis is frequently delayed because of poor localization of initial symptoms and the rarity of this disorder. Pyogenic sacroiliitis has been related to trauma, intravenous drug abuse, and gynecological infections1-3, but it is rare without a predisposing factor. We report the case of a thirty-one-year-old woman with postpartum pyogenic sacroiliitis caused by the Enterobacter species, and we also provide a review of the pertinent literature. The patient was informed that data concerning the case would be submitted for publication, and she provided consent. A thirty-one-year-old woman (gravida 4, para 4) presented to our emergency department with symptoms of fever and pain in the right buttock for three days. The pain had begun two hours after a normal vaginal delivery. The past medical history noted sclerotherapy for varicose veins on both lower extremities two years earlier. The patient denied any recent history of intramuscular drug injection. Vital signs included a temperature of 38.8°C and a pulse rate of 99. On physical examination, there was limitation of right hip motion and a positive test for flexion, abduction, and external rotation (FABER). The right leg had normal muscle strength, with no swelling, warmth, or erythema. Laboratory studies, including complete blood-cell count as well as kidney and liver function tests, were normal except for leukocytosis (white blood-cell count: 14 × 109/L; lymphocytes: 9%; neutrophils: 84%), an elevated C-reactive protein level of 132 mg/L (normal, less than 5 mg/L), and an elevated erythrocyte sedimentation rate of 110 mm/h (normal, 0 to 15 mm/h). The urinalysis and the subsequent urine culture specimen were negative. The rose bengal test for Brucella was also negative. The patient was admitted to the hospital with a diagnosis of postpartum pyrexia and was administered ceftriaxone (1 gm …

Prostatic Abscess MRI Findings: Case Report

Prostatic abscesses are a rare complication of acute prostatitis, and an uncommon clinical entity in the antibiotic era. Despite their rarity, untreated abscesses still remain potentially life-threatening, and require formal drainage to permit resolution. Here in, we report the MRI findings in 73 – years old man who presented with severe dysurea of two weeks duration . He was found to have multiple prostatic abscesses which was surgically drained.