Mohammad Abu-Jeyyab

Background: Surgical site infections (SSIs) are a major cause of complications during orthopedic surgeries. These infections increase the morbidity of patients. Although many studies have been conducted on SSI complications during lower limb surgeries, there is limited information on upper limb surgeries. Therefore, this paper sought to assess the incidence of SSI complications during upper limb surgeries and identify the associated risk factors. In addition, the impact of SSI complications was also assessed. Methods: This was a retrospective cohort study conducted at a tertiary hospital from January 2024 to December 2025. In total, 546 patients who underwent upper limb surgeries were recruited into the study. Data was extracted from patients’ medical records and analyzed using IBM SPSS Statistics software. SSI complications were defined as superficial or deep wound infections. Descriptive, bivariate, and stratified incidence analyses of the data was conducted. In addition, Chi-square and independent t-tests were used to test the associations at a significance level of 0.05. Results: The total incidence of SSI was 5% (n = 28). No significant correlation was noted between SSI and age (p = 0.62), sex (p = 0.19), duration of surgery (p = 0.54), and overall antibiotic use (p = 0.07). Significant correlations were observed between SSI and surgical factors, including type of surgery (p < 0.0001), surgery classification (p < 0.0001), and wound classification (p = 0.004). The highest incidence of SSI was noted in emergency procedures (7.7%) and open wounds (5.1%). A significant correlation was also found between the type of prophylactic antibiotic used and SSI occurrence (p = 0.04). SSI was not significantly associated with prolonged hospital stay (p = 0.12) or increased admissions (p = 0.71). Conclusion: The present study indicates that SSI is an uncommon but clinically relevant complication in upper limb surgeries, with an overall incidence of 5%. Emergency procedures and open wounds were strongly associated with infection risk, while patient related factors such as age and sex, as well as surgical duration, were not significant predictors. Although SSI was not linked to prolonged hospital stay or increased admissions in this cohort, the type of prophylactic antibiotic demonstrated a significant association with infection occurrence. Keywords: Surgical site infection, upper limb surgery, orthopedic infections, incidence, risk factors, wound classification, prophylactic antibiotics

Background: The preoperative anesthesia assessment requires rapid synthesis of complex patient data, a process prone to cognitive fatigue and inter-provider variability. While large language models (LLMs) show promise in medical education and exam preparation, their efficacy in generating safe, localized clinical management plans remains unvalidated. This study proposes the development of a "Digital Fellow"—a specialized LLM fine-tuned on institutional data to draft comprehensive anesthesia plans. Methods/Design: We outline a single-center, retrospective observational study utilizing 3,000 historical anesthesia records from Istishari Hospital (Amman, Jordan). Phase 1 involves manual, structured extraction and strict de-identification of preoperative variables and human-executed anesthesia plans. In Phase 2, a HIPAA-compliant enterprise LLM (Google Vertex AI/Gemini 1.5 Pro) will be fine-tuned using this dataset. Phase 3 consists of a "Clinical Turing Test," wherein senior consultant anesthesiologists blindly evaluate AI-generated plans against the historical human-executed plans. Primary endpoints include clinical safety (absence of critical errors), completeness, and accuracy of pharmacological and airway management choices. Discussion: By grounding the LLM in 3,000 real-world, localized cases, this protocol aims to mitigate the "hallucination" risk associated with generic AI models. If the AI-generated plans are deemed clinically equivalent to human expert plans, this technology could significantly reduce administrative burden, standardize care, and serve as an advanced educational simulator for postgraduate trainees.

Precision medicine is a new discipline of medicine that attempts to deliver individualized therapy and prevention based on each individual's clinical, genetic, genomic, and environmental data. Precision medicine treats each patient as an individual rather than as a general case of a disease. By offering the appropriate medication to the right patient at the right time, precision medicine has the potential to enhance health outcomes and quality of life. However, there are certain problems and limits to precision medicine, such as high prices, privacy concerns, ethical concerns, and impediments to integration into clinical practice. The text examines precision medicine's history, applications, technology, and future possibilities. It recounts the history of precision medicine from ancient times to the present, emphasizing some of the field's milestones and successes. It examines genetics, molecular diagnostics, environmental exposures, lifestyle habits, societal influences, and microbiome composition, among other elements and areas of precision medicine. It also investigates the role of precision medicine in the COVID-19 pandemic, as well as the obstacles and prospects for continued precision medicine research and application in health systems. It finishes by identifying potential future research and innovation paths in the realm of precision medicine.

Background: While there have been studies indicating a connection between insufficient levels of vitamin D and persistent low back pain (LBP), there is still a lack of definitive evidence. The primary objective of this study was to evaluate the correlation between vitamin D intake, and associated factors with chronic lower back pain. Methods: This research utilized a cross-sectional study design. Data were collected from the records of patients presenting with LBP at our institute from February 2024 to June 2024. We included patients who were presented at our institute with chronic LBP and no associated comorbidities. Data were collected from the records of the patients, including age (years), weight (kg), height (cm), hips (cm), duration of sun exposure (hours/day), areas of the skin exposed to the sun (% body), dietary vitamin D supplementation, and pain severity using a numerical rating scale. The Oswestry low back disability questionnaire was utilized to assess the disability and pain originating from the low back. Results: A total of 392 participants were included in the present retrospective study with a median (range) age of 37 years (10–86). Their median (range) weight, height, and hips were 79 (25–110), 168 (130–190), and 36 (26–65), respectively. The presence of low back disability and discomfort was discovered to have a positive correlation with parameters such as older age, increased body weight, broader hips, longer duration of sun exposure, larger surface area of the body exposed to the sun, and higher reported levels of pain severity. Moreover, a significant link was found between inadequate intake of vitamin D and higher degrees of impairment in patients with LBP. Conclusion: Insufficient vitamin D intake was prevalent among individuals with chronic LBP and was significantly associated with higher levels of disability. Factors such as older age, increased weight, and greater pain severity are also correlated with greater functional impairment. These findings suggest a potential role of vitamin D in the assessment and management of chronic LBP.

Background Surgeons are actively seeking ways to enhance operating room ergonomics. A comprehensive report on surgeon job-related disease and injuries could raise awareness, encourage workplace improvements, and emphasize the importance of ergonomic practices such as body posture awareness, appropriate operating room setup, and exercise to lessen discomfort and improve general health. Purpose To address the ergonomic challenges that surgeons in Jordan face during their work and to investigate how demographic variables may impact a surgeon’s ability to perform open and laparoscopic procedures proficiently. Methods This cross-sectional observational study investigated the ergonomics of surgical practice and evaluated the impact of demographic factors on the proficiency of surgeons performing both open and laparoscopic procedures. Using a self-administered questionnaire, data were gathered from 150 Jordanian doctors who had completed more than six months of surgical training and were employed by the government, the military, or the private sector. Results In this study involving 150 surgeons in Jordan, demographic characteristics were assessed, revealing that male respondents, particularly from the military sector, had higher mean scores in both laparoscopic and open surgical approaches. Multiple linear regression analysis identified private institutions and military affiliation as significant positive predictors for achieving high scores in laparoscopic procedures, while exclusive military affiliation emerged as the sole significant predictor for open procedures. Conclusion The study highlights surgical ergonomics’ role in reducing pain and improving outcomes. Prioritizing appropriate ergonomic training, encouraging discomfort reporting, and raising awareness of official recommendations are critical for the longevity of surgeons’ careers, well-being, and, ultimately, better patient outcomes.

Background: Female surgeons face various challenges that may affect their career and lifestyle satisfaction, such as sex bias, work-family conflict, and lack of mentorship. However, little is known about the situation of female surgeons in Jordan, a developing country with limited resources and a high demand for surgical services. Aim: The aim of this study was to assess the career and lifestyle satisfaction among female surgeons in Jordan, and to explore the relationship between income level, family stability, job security, and job satisfaction. The study also aimed to identify the variation of the challenges that surround female surgeons in different regions of Jordan. Methods: This was a cross-sectional study that used a self-administered questionnaire to collect data from 244 female surgeons working in Jordan. The questionnaire was adapted from the National Lifestyles in Surgery Today Survey, which was previously used to assess career and lifestyle satisfaction among surgeons in the United States. The questionnaire consisted of four sections: demographic and practice characteristics, career satisfaction, work-life balance, and perceived challenges and improvement areas. The data were analyzed using descriptive and inferential statistics. Results: The study polled 340 surgeons, the majority of whom were female, young, and general surgeons, to investigate the variables influencing their job satisfaction. Working hours were shown to be related to residence (P=0.000, χ ²2=163.749) and to have an influence on health (4.40%), pay (64.12%), hobbies (46.76%), and family (55%). Female surgeons suffered increased sex bias (68.85%), disrespect (31.56%), inadequate mentorship (35.25%), and harassment (16.00%), according to the research. Quite similarly, 30.21% of male corespondents agreed to the presence of sex discrimination, with 10.42 and 21.88% conjoining on the evidence of lack of respect and incompetent mentoring, respectively. According to the survey, professional happiness varies by speciality, with ENTs being the most satisfied (97.10%) and OBGYNs being the least satisfied (25%). The survey also discovered that male students (36.76%) were more likely to be recommended to pursue a career in surgery than female students (31.18%). According to the survey, salary, leave, and sector are also variables impacting job happiness, with the majority of satisfied surgeons earning 1000 JOD or less, having 30 days of leave, and working in the MOH or the private sector. Conclusions: Female surgeons in Jordan are generally satisfied with their careers but face several challenges that affect their work-life balance and professional development. There is a need for more advocacy and support for female surgeons in Jordan to address these challenges and improve their career and lifestyle satisfaction.

Monkeypox (MPX), an orthopoxviral disease endemic in Africa, is now a public health emergency of international concern (PHEIC) as declared by the World Health Organization in July 2023. Although it is generally mild, the overall case fatality rate was reported to be 3%, and the basic reproduction number (R0) is > 1 in men […] Abstract Monkeypox (MPX), an orthopoxviral disease endemic in Africa, is now a public health emergency of international concern (PHEIC) as declared by the World Health Organization in July 2023. Although it is generally mild, the overall case fatality rate was reported to be 3%, and the basic reproduction number (R0) is > 1 in men […]

Family visits are an essential part of patient care, particularly for critically ill patients in intensive care units (ICUs). Many health care professionals in the Middle East, including Jordan, are, nevertheless, hesitant to introduce open visiting rules for ICU patients, citing a variety of problems and concerns. We give a physician's viewpoint on the advantages and challenges of regular family visits for ICU patients in Jordan in this research. We contend that family visits can improve patient outcomes, strengthen communication and trust, and reduce stress and exhaustion for patients and health care personnel alike. We also explore cultural norms, infection control, staff education, and family support as potential barriers and answers for establishing open visiting policy in Jordan.

Septic shock stands for a group of manifestations that will cause a severe hemodynamic and metabolic dysfunction, which leads to a significant increase in the risk of death by a massive response of the immune system to any sort of infection that ends up with refractory hypotension making it responsible for escalating the numbers of hospitalized patients mortality rate, Organisms that are isolated most of the time are Escherichia coli, Klebsiella, Pseudomonas aeruginosa, and Staph aureus. The WHO considers sepsis to be a worldwide health concern; the incidence of sepsis and septic shock have been increasing over the years while being considered to be under-reported at the same time. This review is a quick informative recap of the recent studies regarding diagnostic approaches using lactic acid (Lac), procalcitonin (PCT), Sequential Organ Failure Assessment (SOFA) score, acute physiology and chronic health evaluation II (APACHE II) score, as well as management recommendations for using vasopressors, fluid resuscitation, corticosteroids and antibiotics that should be considered when dealing with such type of shock.

A previous surgical incision can lead to an abdominal wall defect known as an incisional hernia. The protrusion of abdominal viscera, particularly bowel loops, through this defect can result in various complications and affect organ function. Bowel loops are frequently involved and can lead to incarceration, obstruction or even strangulation. A 38-year-old male with a history of open reduction internal fixation for the left iliac wing presented with abdominal pain, vomiting and obstipation. Abdominal examination revealed a tender, distended abdominal area with swelling on the left hip. Radiological examination revealed bowel obstruction at the previous surgery site. During surgery, an incisional hernia was confirmed, and the bowel was found viable. Incisional hernias can occur even many years after primary surgery and may remain asymptomatic until complications arise. Elective hernial repair is recommended in some cases, such as the one presented here, as complications can be fatal.