The Middle East Journal of Internal Medicine

In this issue a number of papers came from Jordan dealing with various aspects of health. A Retrospective study of patients diagnosed to have obstructive sleep apnea syndrome between 2013 and 2015. Epworth Sleepiness Scale score and Apnea-Hypopnea Index of 118 patients were compared. Of the 118 patients diagnosed to have Obstructive Sleep Apnea Syndrome, 65 patients had a score of >10 on the Epworth Sleepiness Scale, which translates to 55% of the patients studied. 100% of patients with severe OSAS had an ESS score >10. However, in patients with moderate and mild OSAS, 46.5% and 36% scored >10 on the ESS respectively. The authors concluded that Epworth Sleepiness Scale is sensitive in patients with severe OSAS. However, the accuracy of the ESS becomes less in mild and moderate OSAS, making it a poor and non-accurate screening method for OSAS.

A paper from Jordan assed the pregnancy course and perinatal bleeding in women with sever autoimmune thrombocytopenic purpura. Data was collected for 38 pregnancies in 24 women, who were on treatment for autoimmune thrombocytopenic purpura early in pregnancy. Indication for treatment was platelets count 50.000/mm3 or less. We looked for premature rupture of membranes, premature delivery, intrauterine growth restriction and significant blood loss at delivery. Those women were the study group, (group 1). Same variables were looked for in 100 healthy pregnancies taken as control (group 2). Data was compared between the two groups. Women who had thrombocytopenia secondary to other conditions such as, systemic lupus, bone marrow diseases and other causes were not included in the study. The results showed that study group 1 had nine premature rupture of membranes in 38 pregnancies, whereas only ten women ruptured their membranes out of 100 in control group 2 with an odds ratio 2.9. Four women had significant blood loss at delivery in group 1 and eight women in group 2 which presents marginal increase for group 1 (odds ratio 1.3). No increase in growth restricted babies nor in premature delivery was noticed. The authors concluded that pregnant women with autoimmune thrombocytopenic purpura on treatment, have significant higher risk to rupture their membranes prematurely. No increase in growth restricted babies and premature deliveries. With good care they can deliver safely with minimum hazard of bleeding.

A paper from the ENT department studied 54 patients ages between 12 & 46 years ,with mean age of 21.3 years, who proved to have ACP investigated by CT-Scan during 3 years period (between may 2009 & feb..2012 ) were retrospectively evaluated and follow up imaging CT-Scan was performed for this group of patients. The aim of this study was to evaluate the common radiological features in initial and post operative follow up imaging of patients proved to have antrochoanal polyposis, and who were treated surgically ,and to evaluate post operative clinical improvement of this sample. Unilateral polyposis was found in 38 patients ( 70.4%) and bilateral in 16 patients ( 29.6%). All patients were operated by Functional Endoscopic Sinus Surgery (FESS).The patients were followed up by CT-Scan axial and coronal views at 4-6 weeks post operatively and only in 7 patients we recorded a post operative inflammatory findings of which in 2 patients the diagnosis was recurrent antrochoanal polyp. The authors concluded that CT-Scan was very accurate in diagnosing antrochoanal polyp in pre and post operative assessment and the recurrence of this disese was very minimal according to follow up clinical and imaging results.The Functional Endoscopic Sinus Surgery (FESS) was very effective in preservation of normal antral mucosa with minimal complications in post operative follow up.