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This study aimed to evaluate the effect of the stress management interventional program in reducing occupational stress and improving coping strategies among public health nurses.A double-blind, cluster-randomized approach was used as a randomization method for this study to evaluate the stress management interventional program.A cluster-randomized controlled trial was carried out in eight comprehensive healthcare centres in Amman city, Jordan; four centres were randomly assigned to each experimental and control group. One hundred and seventy nurses were selected randomly from March 2019 - August 2019 and data were collected by using the Nursing Stress Scalebrief COPE over three data collection times. Both descriptive and inferential statistics (repeated measure ANOVA, Independent t test, and chi-squared) were used to answer the research questions of this study.The results showed that both the levels of occupational stress and coping strategies were significantly different between the two study groups over the three data collection points (p 0.05).Based on the findings of this study, the stress management program is an effective non-invasive method that can be used to reduce stress levels and improve coping strategies for public health nurses. The implementation of stress management interventions in health care is likely to help nurses manage occupational stress in practice.Nurses suffer from a high level of occupational stress. In particular, approximately74% of nurses experience severe occupational stress, which can lead to many mental and physical disorders. However, nurses were less able to utilize the correct stress preventive strategies due to gaps in knowledge, skills, and awareness. This study contributed to the provision of empirical evidence of the effectiveness of the stress management program in reducing occupational stress and improving coping strategies among public health nurses. A stress management intervention program is a valuable non-invasive method that can be used by healthcare organizations to reduce stress levels and improve coping strategies for nurses in practice.NCT03833986.目标: 本研究旨在探讨压力管理干预计划对降低公共卫生护士职业压力及优化应对策略的效果。 设计: 本研究采用双盲、集群随机方法,对压力管理干预方案进行评估。 方法: 在约旦安曼市的8个综合医疗中心进行了一项集群随机对照试验;每个实验组和对照组随机分配4个中心。从2019年3月至2019年8月,随机抽取170名护士,采用护理压力量表和简明应对量表进行三次数据收集。采用描述性和推断统计学(重复测量方差分析、独立t检验和卡方检验)来回答本研究中所研究的问题。 结果: 结果表明,在三个数据采集点上,两个研究组的职业压力水平和应对策略均存在显著差异(p0.05)。 结论: 基于本研究结果,压力管理计划是一种有效的非侵入性方法,可用于降低公共卫生护士的压力水平及优化应对策略。在卫生保健中实施压力管理干预措施可能有助于护士在实践中管理其职业压力。 影响: 护士面临职业的高压力。具体来说,约74%的护士承受着严重的职业压力,可能导致许多精神和身体疾病。然而,由于知识、技能和意识上的差距,护士不太能运用正确的压力预防策略。本研究有助于提供实验性证据,证明压力管理计划在降低公共卫生护士职业压力及优化应付策略方面的效果。压力管理干预计划是一种有价值的非侵入性方法,可被医疗机构用于降低压力水平和优化护士的应对策略。临床试验注册号:NCT03833986。.

Objectives: We report our experiences of brain tumors management by surgery and radiotherapyWhether It has been used as adjuvant, radical or palliative therapy belonging to benign or malignant tumors over 2 years period at ENT, neurosurgery and radiotherapy departments royal medical services. Methods: We used a retrospective study design to review all brain tumor patients(benign, malignant or metastatic) operated in neurosurgical department and referred to radiotherapy after discussing each case in multidisciplinary clinic in 2018 and 2019. Patient files, radiological images computed tomography (CT) or magnetic resonance imaging (MRI) scans), histo-pathological reports and radiotherapy management plan were reviewed for patients. Results: In total, 137 patients with brain tumor managed byradiotherapy 64 patients were metastatic, 37 patients high grad glioma, 12 patients atypical meningioma, 7 patients medulloblastoma, rest of cases discussed in the study . Conclusions: Radiotherapy has been fulfilling crucial part in the treatment of CNS tumors, where it has been implemented as adjuvant therapy or even being the solitary resort where surgery is inapplicable or used as palliative therapy in different regimens according to histopathology, performance status and different sites.

The incidence of renal cell carcinoma in a pelvic kidney is rare, and has only been reported in a small number of cases. We report a 50-year-old male patient presented with vague abdominal pain and without hematuria. CT scan showed large heterogeneous soft tissue mass arising from a left pelvic kidney with areas of necrosis measuring 8.4×8.4×7.5 cm. Histopathology after radical nephro-ureterectomy showed grade II clear-cell renal carcinoma. Renal cell carcinoma of ectopic kidney is a rare disease. Even though the presentation might be atypical and challenging, the treatment strategy is still the same as for tumors of orthotopic kidneys.

Highlights • Mesenteric cystic lymphangiomas are rare benign lesions characterized by lymphatic vessels malformation with an unknown etiology. • Although, mesenteric cystic lymphangiomas are rare but should be included in the differential diagnosis of abdominal pain. • Surgical resection of mesenteric lymphangiomas should be performed as fast as possible to avoid many serios complications., Introduction and importance Mesenteric cystic lymphangiomas are rare benign lesions of the abdominal cavity characterized by lymphatic vessels malformation with an unknown etiology. Despite the silent clinical course of mesenteric cystic lymphangiomas, they are considered as clinically tricky lesions with an immense spectrum of presentations. Case presentation We present a case of abdominal mesenteric cystic lymphangioma in a 1-year 9-month-old female patient, who complained of fever and abdominal pain for 10 days duration. Laboratory investigations, abdominal X-ray, ultrasonography, computed tomography and histopathological examination were all used to establish the diagnosis. Clinical discussion A trial of true-cut biopsies performed by an interventional radiologist was not informative, so a multidisciplinary team decision was made to excise the mass. Intraoperative findings include multiloculated fused cystic lesion (8.0 × 5.0 × 4.0 cm) on the descending mesocolon. Histopathological examination revealed the diagnosis of a mesenteric cystic lymphangioma. The postoperative period was not complicated. Conclusion Mesenteric cystic lymphangiomas are mostly asymptomatic in nature, yet predisposed to life threating events. Surgical excision is the modality of treatment characterized by low recurrence rate and a non-complicated postoperative period.

The cake or lump kidney is a rare form of fusion. The pancake kidney is always found in the pelvic cavity, in the greater or lesser pelvis. However, we report a case of pancake kidney which was found inside abdominal cavity while investigating 32-year-old male for lower limb pain. CT scan with IV contrast reveals ‘fused mass situated in the right side of abdominal cavity with course uncrossed ureters opening separately into the urinary bladder found incidentally with patient work up’. Pancake kidney in this case was managed conservatively without any complication. This malformation is usually present in pelvic cavity, so blood supply is almost constant but in rare cases might be different and follows location of this anomaly.

Renocutaneous fistulae may occur as a result of chronic infection, especially in the setting of calculous disease.1 Spontaneous renocutaneous is rare.2 Usually nephrocutanous fistula developed in patient with previous renal surgery, trauma, tumors, and chronic urinary tract infection with abscess formation. We report a case of spontaneous nephrocutaneous fistula. A 37-year-old women previously well presented to ER department with purulent discharge and a palpable mass on the left lumbar area. CT scan with IV contrast fistulous tract seen within the subcutaneous plane in Left lumbar region tracking towards retroperitoneal space, and in continuity with of left kidney. The patient underwent ‘Left nephrectomy with excision of fistulous tract’ after long course of antibiotics.

Despite the success of the Biliopancreatic Diversion with Duodenal Switch procedure (BPD-DS) in weight loss and comorbidities resolution, reversal of BPD-DS is necessary in 0.2–0.6% of BPD-DS cases for vitamin, protein, and other micronutrient deficiencies. Different techniques are available to reverse the malabsorptive component of the BPD-DS. A retrospective chart review for a 37-year-old female patient who presented with lower leg edema and signs of malnutrition 5 years after a BPD/DS. The patient was not compliant with the required daily vitamin and protein intake. Thus, after extensive discussion with the patient, a decision was made to reverse the malabsorptive component of the BPD-DS. A laparoscopic reversal of the malabsorptive component of the BPD-DS was concluded by transecting the roux limb distally at the ileo-ileal anastomosis and reconnecting it to the proximal jejunum thus substantially lengthening the common channel for absorption. At 6 months follow-up, the patient normalized her vitamin deficiency and had a normal level of serum protein. Her weight, BMI, EWL%, and TBWL% were 72 kg, 27.5 kg/m2, 90%, and 45%, respectively. Proper nutrition and vitamin supplementation is essential to avoid nutritional complications. Different techniques are available to reverse the malabsorptive component of the BPD-DS. However, no standard approach is adopted by the surgical community. We demonstrate our preferred technique in reversing the malabsorptive component of the BPD-DS.

Oxidative stress interferes with the functional roles of the hippocampus and results in cognitive decline. Antioxidant supplementation has a cognitive enhancing activity through protecting hippocampus brain cells from the damaging effects of the reactive oxygen species. The dried methanolic extract of the aboveground parts of Moringa peregrina (Forssk.) Fiori (Moringaceae) was hypothesized to have memory-enhancing activity via its antioxidative properties. HPLC and LC-MS methods were used for qualitative analysis of the marker compounds. Six major compounds of the methanolic extract of M. peregrina were identified, namely, rutin, myricetin, ?-amyrin, ?-amyrin, lupeol acetate, and ?-sitosterol. Male Wistar rats were administered via oral gavage three dose levels (50, 100, and 500 mg/kg) of M. peregrina methanolic extract for 2 months. The radial arm water maze (RAWM) was used to test spatial learning and memory. In addition, ELISA was used to analyze the levels of brain-derived neurotrophic factor (BDNF) and to assess the level of some oxidative stress markers. M. peregrina (150 mg/kg) resulted in short- and long-term memory enhancement (P < 0.05). Moreover, M. peregrina administration elevated BDNF levels in the hippocampus (P < 0.05) and caused favorable changes in oxidative stress biomarkers. In particular, an increase in glutathione (GSH), a decrease in oxidized glutathione (GSSG), and an increase in the antioxidant enzyme glutathione peroxidase (GPx) levels in the hippocampus were elicited after treatment with M. peregrina. Taken together, our data show that oral administration of M. peregrina enhances both short- and long-term memory functions via combating oxidative stress and increasing BDNF levels in the hippocampus. Consuming this safe plant may thus help promote spatial learning and improve memory. Funding Information This research was supported by the Scientific Research Support Fund (project Agr/2/02/2010), Ministry of Higher Education and Scientific Research, Amman, Jordan. Scopus

Background Venous thromboembolism (VTE) is a feared complication after bariatric surgery. Biliopancreatic diversion with duodenal switch (BPD-DS) is a complex bariatric procedure that is offered typically to super morbidly obese patients. Scarce data exist in reporting VTE outcome and identifying the risk factors associated with it after BPD-DS. Objective To determine the risk factors for VTE after BPD-DS at 90-day follow-up. Setting A nonprofit regional referral center and teaching hospital in Pennsylvania. Methods A retrospective chart review was performed on prospectively collected data over 10 years, between January 1, 2006 and December 31, 2016. Patients who underwent laparoscopic or robotic BPD-DS were included. Preoperative variables, selected risk factors, and methods of VTE prophylaxis were analyzed. Results A total of 662 patients who underwent BPD-DS were identified. The mean age was 44.7 ± 10.4 (20–72) years; 474 patients were female (71.7%), and the mean body mass index of the cohort was 50.5 ± 7.5 (34–98) kg/m 2 . Overall, 16 patients (2.4%) experienced VTE complication at 90-days follow-up post–BPD-DS with 100% follow-up rate; deep vein thrombosis was experienced by 10 patients (1.5%), and 6 patients (0.9%) experienced pulmonary embolism (1 patient experience both). None of those patients had a previous history of VTE. Only operative time ( P value=.009) and length of stay ( P value ≤ .001) were associated with VTE events. Other factors such as age, sex, body mass index, previous history of VTE, preoperative heparin injection, preoperative inferior vena cava filter insertion, intermittent compressive device use, interval heparin time, and postoperative chemical prophylaxis did not show a statistical association. A logistic regression analysis showed a statistically significant increase of VTE outcome with length of stay; odds ratio of 1.161, (95% confidence interval, 1.048–1.285), P value=.004. Conclusion With proper preoperative evaluation and aggressive VTE prophylaxis protocol, the risk of VTE post–BPD-DS is comparable to other bariatric procedures. Every effort should be adopted to shorten the length of stay, and thus reduce VTE risk.

The biliopancreatic diversion with duodenal switch (BPD/DS), a modification of the classic Scopinaro procedure, carries the highest rate of success in terms of weight loss, comorbid resolution, and maintenance of weight loss. The substantial challenges, technical complexity, and expected roadblocks of adding BPD/DS option to the bariatric surgeon's resources are reflected in the number of BPD/DS procedure performed in the USA, being less than 1% of all bariatric surgeries. Adjustments to the length of the common channel and the size of the vertical sleeve would increase the pool of candidates for BPD/DS and offer comprehensive management of obesity and metabolic comorbidities. Proper educational programs and multiple proctoring to bariatric surgeons aid to implement BPD/DS to their practice.

Multiquadrant robotic surgery with single docking is a new feature that became available since the introduction of da Vinci XI® robotic platform. Laparoscopic Robotic assisted Biliopancreatic Diversion with Duodenal Switch (BPD/DS) was first described by Sudan et al in 2007. Robotic surgery advancement increased the interest in complex surgeries due to various advantages such as stable visualization, dexterity, ergonomic benefits and precise suturing. Described here is our technique of a total Robotic BPD/DS using single docking da Vinci XI® robotic platform, integrated table motion pairing, robotic stapling and robotic energy device.

Highlights • A 33-year-old woman presented with intermittent dull upper abdominal pain for two days. Abdominal computed tomography (CT) was performed showing a hyperdense mass in the antrum. Endoscopy and endoscopic ultrasound revealed a submucosal antral mass along the greater curvature, suspicious for a gastrointestinal (GI) stromal tumor (GIST), a laparoscopic antrectomy with Billroth I reconstruction was done. • Pathological examination revealed that the mass was a gastric glomus tumor. Gastric glomus tumors are fairly uncommon and mostly benign, with an estimated incidence of 1% of all GI soft tissue tumors. • This case may aid in improving the recognition and diagnosis of this rare entity and in differentiating it from more common GISTs and gastric carcinoids. • A built up knowledge between physicians is extremely necessary to avoid common confusion in taking the right medical approach., INTRODUCTION Gastric glomus tumors are fairly uncommon and mostly benign, with an estimated incidence of 1% of all GI soft tissue tumors. The most common GI site of involvement is the stomach, and in particular the antrum. Some cases have been discovered incidentally, but most are symptomatic presenting with GI bleeding, perforation or abdominal pain. Glomus tumors are submucosal tumors and hence mistaken with the more frequent gastrointestinal stromal tumors. PRESENTATION OF CASE A 33-year-old woman presented with intermittent dull upper abdominal pain for two days. Abdominal computed tomography (CT) was performed showing a hyperdense mass in the antrum. Endoscopy and endoscopic ultrasound revealed a submucosal antral mass along the greater curvature, suspicious for a gastrointestinal (GI) stromal tumor (GIST), a laparoscopic antrectomy with Billroth I reconstruction was done. Pathological examination revealed that the mass was a gastric glomus tumor. DISCUSSION The presented case report met all the usual standard criteria commonly used to identify glomus tumors, the uniqueness of the case lies in the occurrence of the glomus tumor in the stomach, first suspected as GIST, then confirmed as a gastric glomus tumor. The vast majority of glomus tumors of the GI tract have been described in the gastric antrum. They occur in adults of all ages with a significant female predominance (78%). CONCLUSION This case may aid in improving the recognition and diagnosis of this rare entity and in differentiating it from more common GISTs and gastric carcinoids. A built up knowledge between physicians is extremely necessary to avoid common confusion in taking the right medical approach.

Highlights • Injury to thoracic duct, and the formation of chyle leak, is a rare complication and carries significant metabolic and immunological consequences. • Thoracic duct injury during thyroid surgery is an uncommon event with an incidence rate of 0.5–1.8%. • High output chyle leak in a confined space was life threatening. • Surgeons must be familiar with thoracic duct anatomy., Background Injury to thoracic duct is a rare potential complication of time-honored conventional thyroidectomy. Nevertheless, it can be a cause of significant morbidity, and sometimes life-threatening. Patient findings A 78-year-old female patient with a previous surgical history of thyroid lobectomy for nodular disease presented with primary hyperparathyroidism, and a nodule in the remaining thyroid lobe. The patient underwent completion thyroidectomy and parathyroidectomy. Less than 24 h post operatively, the patient developed progressive shortness of breath and neck swelling requiring immediate intubation and re-exploration. A large amount of chyle was drained and an injured thoracic duct was identified and ligated. Summary In experienced hands thyroid surgery is safe. Nevertheless, factors such as the type of pathology and its extent, the level of surgery, and re-operative surgery increase the risk of postoperative complications. Immediate surgical exploration is necessary when patients present with neck swelling and respiratory distress. In our case, a high output chyle leak in a confined space was life threatening. Conclusion Timely re-exploration following thyroid surgery and thorough knowledge of the anatomy of neck structures is crucial in sparing patients potential morbidity and/or mortality.

Common bile duct exploration (CBDE) is an available option in the management of choledocholithiasis. We aimed to analyze outcomes comparing laparoscopic and open approaches to CBDE using the American College of Surgeons (ACS) NSQIP database.This was a retrospective cohort study of patients undergoing CBDE between 2008 and 2013, using the ACS NSQIP database. The cohort was split into 2 groups and compared based on operative approach: laparoscopic vs open CBDE.There were 2,635 patients who underwent CBDE during the study period, and 52% underwent an open approach. After adjusting for all confounding variables, open CBDE was associated with a statistically significant increase in mortality (adjusted odds ratio [AOR] 2.95; 95% CI 1.18 to 7.41; p = 0.02), composite morbidity (AOR 2.19; 95% CI 1.56 to 3.07; p0.0001), bleeding (AOR 1.86; 95% CI 1.11 to 3.12; p = 0.02), return to the operation room (AOR 1.90; 95% CI 1.16 to 3.12; p = 0.01), and readmission related to the first operation (AOR 1.55; 95% CI 1.00 to 2.39; p = 0.05). On the other hand, retained common bile duct stones were 2.8 times more likely to occur in the laparoscopic group. The mean operative time was longer by 73 minutes for patients who underwent open CBDE.Patients undergoing open CBDE suffer from a statistically significantly higher rate of mortality and overall complications compared with patients undergoing the laparoscopic approach. Laparoscopic CBDE should be considered as the preferred procedure whenever possible.

Median arcuate ligament syndrome (MALS) is a rare entity that occurs when the median arcuate ligament of the diaphragm is low-lying, causing a compression to the underlying celiac trunk. We reviewed the vascular changes associated with MALS in an effort to emphasize the seriousness of this disease and the complications that may result.This is a retrospective descriptive analysis of 23 consecutive patients diagnosed with MALS between January 1, 2012 and December 31, 2015 at a tertiary medical center. Computed tomographic (CT) scans, medical records, and patient follow-up were reviewed.The number of patients included herein was 23. The median age was 56 years (17-83). Sixteen patients (69.6%) had a significant arterial collateral circulation. Eleven patients (47.8%) were found to have visceral artery aneurysms; 4 patients (36.4%) bled secondary to aneurysm rupture. All ruptured aneurysms were treated with endovascular approach. The severity of the hemodynamic changes appears to be greater with complete occlusion, CONCLUSIONS: MALS causes pathological hemodynamic changes within the abdominal vasculature. Follow-up is advised for patients who develop a collateral circulation. Resulting aneurysms should preferably be treated when the size ratio approaches three. Treatment of these aneurysms can be done via an endovascular approach coupled with possible celiac artery decompression to restore physiologic blood flow.

Xanthogranulomatous reaction is uncommon non neoplastic reaction involving multiple organs, commonly kidney and gallbladder. Its rarely involve testicle. We report 69-year old man present to clinic with right testicular swelling for six month duration. Testicular markers within normal range. Us scrotum revealed right large avascular heterogeneous mass inside testicle. Right inguinal orchiectomy done and revealed Xanthogranulomatous orchitis.

The debate regarding the merits of routine use of intraoperative cholangiography (IOC) during laparoscopic cholecystectomy (LC) continues to rage. We aim to analyze the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database to identify patterns of utilization of cholangiography during LC as well as its impact on patient outcomes. This is a retrospective cohort study of patients undergoing LC with or without IOC in the 2012 and 2013 ACS NSQIP database. Only patients without any preoperative biochemical evidence of the CBD stone were included in the analysis. Comparison between two groups and data analysis focused on the following primary outcomes: 30-day mortality, readmission, return to operating room and NSQIP collected morbidity. Twenty-one percentage of patients undergoing LC without any biochemical abnormality are undergoing IOC. There were no statistically significant differences in thirty-day outcomes between two patient populations with regard to mortality, morbidity, cardiac, central nervous system, wound, deep vein thrombosis, sepsis, respiratory and urinary tract complications. Patients undergoing LC plus IOC were found to have statistically significant reduction in the rate of readmission related to the first operation (adjusted odds ratio 0.80, 95 % CI 0.70–0.92; P value = 0.002). Readmissions related to biliary complications including retained CBD following cholecystectomy were 1.61 times more likely in patients who underwent LC without cholangiography. The use of IOC at the time of LC appears to be associated with a statistically significant decrease in re-admission rates, especially readmissions related to biliary complications.

Upper tract urothelial carcinoma (UC) is an uncommon tumor. Ectopic kidney is also a rare entity. The combination of these two conditions is very rare. A 49-year-old male complained of right flank pain with hematuria. On CT scan he was found to have a malrotated right kidney with soft tissue seen in the upper calyceal group and a normal left kidney. Diagnostic cystoscopy was unremarkable. Radical nephroureterectomy with bladder cuff excision was performed. Pathology report revealed low grade urothelial carcinoma. Patient's symptoms disappeared postoperatively. Follow up showed no recurrence during the first two years in the bladder and upper tract in the contralateral kidney. Isolated UC of ectopic kidney is rare disease three cases were reported in literature. Although treatment of this tumor can be challenging due to its complex blood supply and position inside the pelvis, treatment strategy is still similar as for orthotopic kidneys.

/10.10 15 P ence: , AU i_ala Pancreatic pseudocysts (PP) are confined collections of fluid from the pancreatic gland surrounded by nonepithelialized granulation tissue containing pancreatic juices. PP are not common, but they are usually a complication of pancreatitis. At this time, numerous classification systems are being used depending on the origin of the PP, its relation to the pancreatic duct, and the presence or absence of a pseudocyst–duct communication [1]. Diagnosis is often made with a computed tomographic (CT) scan, endoscopic retrograde cholangiopancreaticography (ERCP), or ultrasound. The vast improvement in diagnostic modalities has assisted in the detection of PP with a high sensitivity and specificity [2]. There are several therapeutic operative and nonoperative interventions for the treatment of symptomatic or large PP. These consist of endoscopic transpapillary or transmural drainage, percutaneous catheter drainage, or surgical drainage [3,4]. Herein, we report a laparoscopic cyst-gastrostomy in a patient who had previously undergone a laparoscopic sleeve gastrectomy and then developed a symptomatic PP.

Objectives: The aim was to evaluate our experience in the retroperitoneal laparoscopic approach in total and partial nephrectomies in children. Materials and Methods: We retrospectively reviewed the medical records of 41 patients who underwent retroperitoneal laparoscopic total or partial nephrectomies performed in our center from 2004 to 2012. We looked at the demographic data, age at surgery, indication, operative time, surgical complications, conversion to open surgery and operative complications. Results: Thirty-five total and six partial nephrectomies (upper pole) were performed. The mean age was 84 months (7-175). Vesicoureteric reflux, pelviureteric junction obstruction, and multicystic dysplastic kidney disease were the main underlying pathologies. The mean operative time was 158 min (60-280). There were no intraoperative complications (surgical and anesthetic), and no significant blood loss was observed. Conversion to open surgery was necessary in two cases caused by failure to progress due to difficult anatomy during the partial nephrectomies. No major postoperative complications were noted. The mean hospital stay was 2.5 days (1-5). A drain was used in 12 cases and was removed after a mean of 2 days. Conclusions: Laparoscopic retroperitoneoscopic renal surgery can be carried out safely and effectively in children. Still, this procedure is more challenging and requires an excellent image of the retroperitoneal space, especially when partial nephrectomies are concerned.

A 48-year-old man known to have granulomatosis with polyangiitis was admitted for evaluation of an elevated blood creatinine level. Urinalysis was notable for 2+ protein. The patient, who was positive for antineutrophil cytoplasmic antibody, had taken azathioprine for 7 years before presentation.

Background and objectives Narghile is becoming the favorite form of tobacco use by youth globally. This problem has received more attention in recent years. The aim of this study was to investigate the prevalence and pattern of narghile use among students in three public Jordanian universities; to assess their beliefs about narghile's adverse health consequences; and to evaluate their awareness of oral health and oral hygiene. Methods The study was a cross-sectional survey of university students. A self-administered, anonymous questionnaire was distributed randomly to university students in three public Jordanian universities during December, 2008. The questionnaire was designed to ask specific questions that are related to smoking in general, and to narghile smoking in specific. There were also questions about oral health awareness and oral hygiene practices. Results 36.8% of the surveyed sample indicated they were smokers comprising 61.9% of the male students and 10.7% of the female students in the study sample. Cigarettes and narghile were the preferred smoking methods among male students (42%). On the other hand, female students preferred narghile only (53%). Parental smoking status but not their educational level was associated with the students smoking status. Smokers had also significantly poor dental attendance and poor oral hygiene habits. Conclusion This study confirmed the spreading narghile epidemic among young people in Jordan like the neighboring countries of the Eastern Mediterranean region. Alarming signs were the poor oral health awareness among students particularly smokers.