Nathir Obeidat - Academia.edu (original) (raw)

Papers by Nathir Obeidat

Psychology Research and Behavior Management, May 1, 2023

Background: The COVID-19 pandemic has had a large impact on global mental health including anxiet... more Background: The COVID-19 pandemic has had a large impact on global mental health including anxiety and depression rates, many factors affected the vulnerability to these psychological conditions amongst university students. Aim: To explore the level of anxiety and depression of university students living in Jordan. Methods: A cross-sectional study design was conducted in which an electronic survey was created and distributed, university students residing in Jordan participated in the study. Results: A total of 1241 students were enrolled in the study. The mean anxiety score among males and females was (9.68 (SD = 4.10)) and (10.46 (SD = 4.14)), respectively. 42.1% of males had "abnormal" anxiety score compared to 48.4% females. The mean depression score among males (7.77 (SD = 4.31)) was similar to that for the females (7.64 (SD = 4.14)), and 26.0% of the males had "abnormal" depression score compared to 22.6% of the females. Factors affecting anxiety scores included younger age, being a female, taking medication/s, or drinking two cups of coffee or more a day. Conclusion: With 46% and 24% of students suffering from abnormal anxiety and depression respectively, it is important for education policy makers to take immediate measures to allocate students in need of psychological assessment and help to deliver suitable interventions.

The Egyptian Rheumatologist, Jul 1, 2019

follow-up although the radiological picture was unchanged.

Journal of The Saudi Pharmaceutical Society, Dec 1, 2018

Objectives: To investigate the effect of inhaler technique education delivered by a clinical phar... more Objectives: To investigate the effect of inhaler technique education delivered by a clinical pharmacist to patients hospitalised for asthma, on inhaler technique scores and asthma control at three months postdischarge. Methods: This pre-post interventional study in Jordan enrolled patients who had been admitted for asthma and were using controller medication by Accuhaler [Diskus] (ACC), Turbuhaler (TH) or Pressurized metered dose inhalers (pMDI). Inhaler technique was assessed using published checklists (score 0-9). Asthma symptom control was assessed by Asthma Control Test (ACT, range 5-25). Patients were assessed on admission (baseline), pre-discharge, and 3 months later. All patients received a 'Show-and-Tell' inhaler technique counseling service prior to discharge. Results: Baseline data were available for 140 patients, 71% females, mean age 52.7 (SD 16.64) years, mean ACT score 10.0 (SD 4.8). Mean inhaler score was 7.5 (SD 1.52) with no significant difference between the inhaler groups (p = 0.174). After pre-discharge training, all patients had correct technique (score 9/9). After 3 months, mean inhaler scores were significantly higher than at baseline (8.14 (SD 0.87, p < 0.001), with mean change significantly higher for TH 1.21 (SD 2.25) and ACC 0.85 (SD 0.97) than pMDI (0.16; SD 0.72), p = 0.001. Symptom control improved significantly for all patients, with a mean increase in ACT score of 7.54 (SD 8.18), with no significant difference between the inhaler device groups (p = 0.326). Conclusions: Patients hospitalized for asthma achieved correct inhaler technique after training by a pharmacist, and maintained better technique at 3 months than on admission. Significant improvements in ACT scores were documented for all inhaler groups.

International Journal of Tuberculosis and Lung Disease, May 1, 2016

To investigate associations between technique with pressurised metered-dose inhalers (pMDIs) and ... more To investigate associations between technique with pressurised metered-dose inhalers (pMDIs) and dry powder inhalers (DPIs) used as controller medication and asthma control variables measured using Asthma Control Test (ACT) scores. D E S I G N : In this cross-sectional study, the inhaler technique of asthma patients using pMDIs or DPIs (Turbuhaler w [TH] and Accuhaler Diskuse [ACC]) were assessed against published inhaler technique checklists. ACT scores (maximum 25, higher score corresponding to better asthma control) were assessed. R E S U LT S : Of the 130 subjects enrolled in the study (41 TH, 54 ACC and 35 pMDI), inhaler technique scores (out of nine for all devices) were low for TH (4.4 6 0.9) and ACC (5.4 6 1.0) compared with pMDI (8.1 6 0.9) (P , 0.001, one-way analysis of variance). Older age

Pharmacy Practice (internet), Dec 1, 2022

Background: Patients' adherence to medication can be assessed by several subjective or objective ... more Background: Patients' adherence to medication can be assessed by several subjective or objective methods. The Global Initiative for Asthma (GINA) has recommended the use of both measures simultaneously. Objective: To assess patients' adherence to medication using a subjective or an objective method separately, and via using a combination of both methods. As well as identifying the degree of agreement between the two methods. Methods: Participants who met the study inclusion criteria completed the Adherence to Asthma Medication Questionnaire (AAMQ). A retrospective audit was conducted in order to extract pharmacy refill records for the previous twelve months. The patients' pharmacy refill records were expressed using the Medication Possession Ratio (MPR). Data were analyzed using the Statistical Package for Social Science. The degree of agreement was determined by Cohen's kappa coefficient (κ). Results: In terms of the difference in the ability of each method to identify non-adherent patients, a higher percentage of non-adherent patients were identified using the self-reported AAMQ (61.4%) compared to the pharmacy refill records (34.3%). When both methods, in combination, were used to assess adherence, the percentage of non-adherent patients was 80.0%, which is higher than each method when used separately. Twenty percent of the patients were considered adherent on both assessment methods, while 15.7% were considered non-adherent via both methods. Consequently, the AAMQ and pharmacy refill records agreed on 35.7% of the patients. The degree of agreement analysis showed a low correlation between the two methods. Conclusion: The combination strategy resulted in a higher percentage of non-adherent patients, compared to using a subjective (the AAMQ) or an objective (the pharmacy refill records) method. The GINA guideline proposition may be supported by the present study's findings.

Pharmacy Practice

Archives of Rheumatology, Feb 7, 2020

Objectives: This study aims to evaluate the clinical phenotypic features of sarcoidosis in a sing... more Objectives: This study aims to evaluate the clinical phenotypic features of sarcoidosis in a single-center academic hospital in Jordan. Patients and methods: A retrospective file review was performed at an academic medical center in Jordan that included all patients diagnosed with sarcoidosis between January 2000 and December 2018. A total of 150 patients with sarcoidosis (38 males, 112 females; mean age 47.8±11.7 years; range, 17 to 79 years) were evaluated. Clinical data extracted from the files included the sex of the patient, the age at time of diagnosis, diagnosis date, the season during which the diagnosis was established, and smoking history. Biopsy histopathology, spirometry, nerve conduction, echocardiography, and imaging reports including plain radiographs, ultrasonographic, magnetic resonance and computed tomography reports were reviewed. Data including laboratory values, medication usage, clinical outcomes, and morbidity/mortality were collected. Pulmonary function tests including spirometry and lung volumes along with the diffusing capacity for carbon monoxide were reviewed for the presence of restriction, obstruction or reduction in the diffusion capacity of carbon monoxide. Identification of extra-thoracic organ involvement was determined in each patient in accordance with the criteria suggested by the updated World Association of Sarcoidosis and Other Granulomatous Disorders. Results: A total of 77.3% of the patients were diagnosed by biopsy. One case of Lofgren's syndrome was identified. Of the patients, 18.0% had isolated pulmonary sarcoidosis, 75.3% had pulmonary and extra-pulmonary sarcoidosis and 6.7% had isolated extra-pulmonary sarcoidosis while 81.3% had respiratory symptoms, mostly shortness of breath and cough. Extra-thoracic organ involvement mostly involved the musculoskeletal system (33%) followed by the skin (20%). Female patients had more extra-thoracic involvement but the sex difference was only statistically significant for cutaneous involvement. Of the patients, 84% received treatment while 20% had disease remission during the first two years after diagnosis and 70% required treatment beyond two years after diagnosis. Conclusion: Various sarcoidosis clinical phenotypes are seen among Jordanian patients. Jordanian females are more affected by the disease and have more extra-thoracic involvement compared to male patients. A large number of the study patients received treatment.

Clinical and Experimental Obstetrics & Gynecology, 2016

Sub-diaphragmatic extralobar pulmonary sequestration (PS) is an extremely rare malformation defin... more Sub-diaphragmatic extralobar pulmonary sequestration (PS) is an extremely rare malformation defined as a portion of lung tissue that is totally discontinuous from the tracheobronchial tree and usually has its own pleural covering with an anomalous systemic blood supply. It is usually associated with other congenital malformations. The authors present an extremely rare case of isolated sub-diaphragmatic PS which was antenatally detected and followed up with postnatal ultrasound, where it masqueraded as a suprarenal mass; it was totally asymptomatic with spontaneous resolution at age of two years. This case emphasizes to add a differential diagnosis of malformation in congenital supra-renal masses, which remain stable in size and appearance, with possible spontaneous resolution and hence avoid immediate intervention and surgery.

Journal of Thrombosis and Thrombolysis, Nov 21, 2008

A 14- year-old boy developed acute pulmonary edema post upper airway obstruction. This complicati... more A 14- year-old boy developed acute pulmonary edema post upper airway obstruction. This complication of acute upper airway obstruction is not very rare. The cause of obstruction in this case is suffocation by a piece of meat during a barbeque party. The piece of meat was removed from the upper airway; however, he continued to be in respiratory distress, which was relieved only after intubation with mechanical ventilation. In this type of acute pulmonary edema, the leading mechanism is increased negative intrapleural pressure due to the forceful inspiration against the obstructed airways. Treatment modalities include relieving the obstruction, mechanical ventilation with Positive End Expiratory Pressure (PEEP) and diuretic. Knowledge of this complication increases the vigilance of the emergency physicians and helps to identify patients at risk and then start helpful treatment for these patients.

Jordan Medical Journal, Sep 1, 2015

Background Aims: To establish and validate the method used to analyze cholinesterase in blood and... more Background Aims: To establish and validate the method used to analyze cholinesterase in blood and to establish a baseline level among Jordanians living in a heavy agricultural activity area and as well as among those living in an urban non-agricultural area. Materials and Methods: Modified Ellman procedure was used to analyze 851 and 1033 blood samples from heavy agricultural activity and urban area for cholinesterase activity in erythrocytes and Plasma. Results: sample collected from heavy agricultural activity showed low cholinesterase level average 1037U/L ± 279 and 23 U/gHb ± 7.9 compared with urban area average 1616 U/L ± 662 and 31 U/gHb ± 13 for plasma and erythrocyte respectively. The levels in workers living in heavy agriculture activity showed 52% inhibition in plasma and 41.1% in erythrocyte when compared to the established normal levels that were observed in urban area. Conclusions: Clinicians using cholinesterase for clinical diagnosis and management should be aware that baseline levels are different according to the residence of their patients.

Infectious Diseases and Therapy, Mar 22, 2021

Implementing vaccination programmes at the national level is key to managing vaccinepreventable d... more Implementing vaccination programmes at the national level is key to managing vaccinepreventable diseases (VPDs) in the overall population. Although paediatric immunization

Asian Pacific Journal of Cancer Prevention, Apr 29, 2015

Background: Methylenetetrahydrofolate reductase (MTHFR) is involved in amino acid synthesis and D... more Background: Methylenetetrahydrofolate reductase (MTHFR) is involved in amino acid synthesis and DNA function. Two common polymorphisms are reported, C677T and A1298C, that are implicated in a number of human diseases, including cancer. Objective: The association between MTHFR C677T and A1298C genotype and haplotype frequencies in risk for lung cancer (LC) was investigated in the Jordanian population. Materials and Methods: A total of 98 LC cases were studied for MTHFR C677T and A1298C polymorphisms, compared to 89 controls taken from the general population, employing the PCR-RFLP technique. Results: The frequency of the genotypes of MTHFR C677T among Jordanians was: CC, 59.6%, CT, 33%; and TT, 7.4% among LC cases and 49.4%, 40.2% and 10.3% among controls. No significant association was detected between genetic polymorphism at this site and LC. At MTHFR A12987C, the genotype distribution was AA, 29.5%; AC, 45.3%, and CC 25.3% among LC cases and 36.8%, 50.6% and 12.6% among controls. Carriers of the CC genotype were more likely to have LC (OR=2.5; 95%CI: 1.04-6; p=0.039) as compared to AA carriers. Smokers and males with the CC genotype were 9.9 and 6.7 times more likely to have LC, respectively (OR smokers =9.9; 95%CI: 1.2-84.5, p=0.018; OR men =6.6; 95%CI: 1.7-26.2, p=0.005). Haplotype analysis of MTHFR polymorphism at the two loci showed differential distribution of the CC haplotype (677C-1298C) between cases and controls. The CC haplotype was associated with an increased risk for lung cancer (OR=1.6; 95% CI: 1.03-2.4, p=0.037). Conclusions: The genetic polymorphism of MTHFR at 1298 and the CC haplotype (risk is apparently lower with the C allele at position 677) may modulate the risk for LC development among the Jordanian population. Risk associated with the 1298C allele is increased in smokers and in males. The results indicate that a critical gene involved in folate metabolism plays a modifying role in lung cancer risk, at least in the Jordanian population.

Journal of Infection in Developing Countries, Mar 31, 2016

Introduction: This study investigated the role of Chlamydia pneumoniae in the etiology of communi... more Introduction: This study investigated the role of Chlamydia pneumoniae in the etiology of community-acquired pneumonia (CAP) in Jordanian adults. Methodology: Eighty hospitalized CAP patients and 110 healthy adults were enrolled. Overall prevalences of C. pneumoniae IgG antibodies in sera and the rate of acute infection were estimated, using the microimmunofluorescence method (MIF), at titers of 1:16 and 1:512, respectively. Moreover, a nested polymerase chain reaction (PCR) was used to detect C. pneumoniae DNA in nasopharyngeal and blood Buffy coat samples. Results: Overall chlamydial IgG prevalence was higher in CAP cases than controls (70% versus 61.8%). Similarly, higher rate of acute infection was found in patients than in controls (16.3% versus 5.5%). By focusing on subjects testing positive at 1:16, acute infection was detectable in 23.2% of CAP cases, compared with 8.8% of seropositive controls. Chlamydial DNA was confirmed in 8.2% and 8.8% of nasopharyngeal specimens from controls and patients, respectively. Moreover, 10.9% and 7.5% of Buffy coats from controls and cases, respectively, were PCR-positive. When performances of both assays for detection of the pathogen were assessed, the sensitivities of MIF and PCR were low and comparable. However, MIF demonstrated higher specificity, positive predictive value, and negative predictive value than PCR. Conclusions: MIF-based data indicate that C. pneumoniae could be a potential causal agent of CAP in Jordan. This study may serve as a basis to elucidate the exact role C. pneumoniae and other co-infecting pathogens in the etiology of respiratory tract disease.

Journal of Clinical Medicine, Apr 2, 2023

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Canadian Respiratory Journal, Aug 12, 2018

Obstructive sleep apnea (OSA) is a common disorder that includes an intermittent mechanical obstr... more Obstructive sleep apnea (OSA) is a common disorder that includes an intermittent mechanical obstruction of the upper airway during sleep, which can occur either during rapid eye movement (REM) phase or non-REM (NREM) phase. In this study, we aim to evaluate the differences in demographic and polysomnographic features between REMand NREM-related OSA in a Jordanian sample, using both the broad and the restricted definitions of REM-related OSA. All patients who were referred due to clinical suspicion of OSA and underwent sleep study were screened. We included patients with a diagnosis of OSA who had Apnea-Hypopnea Index (AHI) greater than or equal to five. We classified patients into REM-related OSA according to either the broad definition (AHI REM /AHI NREM ≥ 2) or the strict definition (AHI REM > 5 and AHI NREM < 5 with a total REM sleep duration of at least 30 minutes), and patients with AHI REM /AHI NREM less than two were classified as NREM-related OSA. A total of 478 patients were included in this study with a mean age of 55.3 years (±12.6). According to the broad definition of REM-related OSA, 86 (18%) of OSA patients were classified as having REM-related OSA compared to only 13 (2.7%) patients according to the strict definition. Significant differences were found between both NREM-related OSA and REM-related OSA according to the broad and to the strict definitions for arousal index (p < 0.001 and p < 0.032), respectively, duration of saturation below 90% (p < 0.001 for both), and saturation nadir (p < 0.036 and p < 0.013), respectively. No significant differences were found between this group and other OSA patients regarding age, BMI, ESS, and snoring. Our study showed that the stricter the definition for REM-related OSA, the milder the associated clinical changes.

Jordan Medical Journal, Jan 24, 2011

Objectives: To identify the recurrence rate of Pulmonary Embolism (PE) during the first 6 months ... more Objectives: To identify the recurrence rate of Pulmonary Embolism (PE) during the first 6 months of the diagnosis of the patients while they were on anticoagulation therapy in order to study the impact of hereditary risk factors on the recurrence rate in patients with acute pulmonary embolism during the same period. Methods: A prospective study was conducted at Jordan University Hospital, from January 2005 to the end of December 2007. A follow up was conducted till July 2008. Ninety (90) patients with acute PE were investigated; only 72 patients were included in the study due to the loss of follow up of other patients. All patients were investigated for the genetically related thrombophilic factors (FVL, FII and MTHFR), plasma level of free protein C, protein S, and antithrombin III. The patients were divided into two groups: first group those who have recurrence of PE and the second group those who have no recurrence. Results: Seven patients (9.7%) out of 72 who met the inclusion criteria, had a recurrent episode of PE within the first 6 months of diagnosis. There was a significant correlation between the recurrence rate of PE and protein C deficiency p value 0.025. There was no significant correlation between the recurrence of PE and the rest of the hereditary thrombophilic factors. Conclusion: The results of our study necessitate the need to test patients with unprovoked vein thrombosis for the presence of deficiencies of natural anticoagulants; especially protein C level. Other potential risk factors for the recurrence of Venous Thromboembolism (VTE) have to be individualized. Further studies with a larger number of patients are needed to clarify the significance of these risk factors in the recurrence of PE.

Health Economics Review, Feb 5, 2022

Background: Public providers in Jordan are facing increasing health demands due to human crises. ... more Background: Public providers in Jordan are facing increasing health demands due to human crises. This study aimed to benchmark the unit costs of hospital services in public providers in Jordan to provide insights into the outlook for public health care costs. Methods: The unit costs of hospital services per admission, inpatient days, outpatient visits, emergency visits and surgical operations were estimated using the standard average costing method (top-down) for the fiscal year 2018-2019. The unit costs per inpatient day were estimated for nine specialities and staff in Jordanian dinars (exchange rate JOD 1 = USD 1.41). Results: The average unit cost per admission in Jordan was JOD 782.300 (USD 1101.80), the per inpatient day cost was JOD 236.600 (USD 333.20), the per bed day cost was JOD 172.900 (USD 244.90), the per outpatient visit cost was JOD 58.400 (USD 82.30), the per operation cost was JOD 449.600 (USD 633.20) and the per emergency room visit cost was JOD 31.800 (USD 44.80). The specialities of ICU/CCU and OB/GYN presented the highest unit costs per inpatient day across providers: JOD 377.800 (USD 532.90) and JOD 362.600 (USD 510.70), respectively. The average salaried unit cost of staff depended mainly on year of employment. Nonetheless, the unit costs varied depending on the service utilization, type of service and organizational outlet. Conclusions: Knowledge of how unit costs vary across public providers in Jordan is essential to outline cost control strategies and inform future research. Institutionalization of the cost information system and high-level governmental support are necessary to generate a routine practice of collecting and sharing cost information.