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Background Rheumatoid arthritis (RA) is a common rheumatological disease which can involve a variety of different renal manifestations. This may be explained by disease effect itself or by medications used for treatment that may lead to renal dysfunction and its complications. We aimed to identify the prevalence and factors that played a role in renal dysfunction among RA Jordanian patients. Method 285 patients with RA visiting outpatient clinic between March 2016 and March 2017 were included in a retrospective study design. Age, gender, comorbidities, duration of the disease, medications and laboratory results were gathered and scoring of RA activity was done. Results Data gathered from the 285 patients showed a female predominance with 88.4% female and 11.6% male. The average disease duration was 6.7 years. Age, DM, HTN, and serum CRP were associated with worse renal function on univariate analysis. 44 patients (18.8%) presented with microscopic hematuria, 16 (6.9%) with proteinuria and only 5 (2.1%) patients presented with both microscopic hematuria and proteinuria. Patients with eGFR 90 ml/min (P = 0.001). Conclusion Renal dysfunction is not common in RA Jordanian population and has variable presentations. Age and the duration of illness play a major role in the progression of CKD if present. Future prospective studies evaluating renal biopsies in RA patients are needed., Highlights • First study in the country to discuss the prevalence of renal involvement in rheumatoid arthritis. • Renal involvement is rare in rheumatoid arthritis patients. • Different drugs can affect renal outcome in a different ways.

Objective In this study, we aimed to explore the relationship between five selected proinflammatory and immune-mediated genes (TNF rs1800629G>A, rs361525G>A, rs1799964T>C, LTA rs1800683G>A, rs909253A>G, TNFAIP8 rs1042541C>T, LEPR rs1327118G>C, and LEP rs2167270G>A) and the risk and overall survival of DLBCL patients within the Jordanian Arab population. Methods One hundred twenty-five patients (125) diagnosed with DLBCL at the King Abdullah University Hospital (KAUH) between 2013 and 2018 and 238 healthy cancer-free control subjects with similar geographic and ethnic backgrounds to the patients were included in the study. Genomic DNA was extracted from the formalin-fixed paraffin-embedded tissues of the subjects and from peripheral blood samples of the controls. The Sequenom MassARRAY® sequencer system (iPLEX GOLD) was used. The analyses included assessments of population variability and survival. Results Our study showed significant differences in the distribution of the studied polymorphisms of DLBCL between the patients and controls for TNF rs1800629G>A, LTA rs909253 G>A and LEP rs2167270 G>A. TNF rs1800629G>A (p = 0.01), in which the G allele harbors a higher risk of DLBCL (GG and GA genotypes when compared with AA genotype) (p = 0.044). The LTA rs909253 A>G polymorphism is associated with a higher risk of DLBCL in the allelic model (p = .004). LEP rs2167270 G>A polymorphism is associated with a decreased risk of DLBCL in the recessive mode models (p = .03). Subjects with the dominant model for TNF-a rs1799964 (TT genotype in comparison with the combined TT/TC genotype) and patients with the homozygous genotype (GG) of rs361525 have better overall survival rates. Conclusion Our results confirmed the diversity and the heterogeneity of the disease. Although the study has a limitation because of its relatively small size, it clearly emphasizes the significance of ancestry and genetic composition as the determinants of DLBCL risk and behavior. .

Introduction Among the Jordanian population, brain tumors are the tenth most common type of cancers in both males and females, comprising 2.8% of all newly diagnosed neoplasms. Diffuse gliomas are the most prevalent and the most aggressive primary brain tumors in adults. The incidence of diffuse gliomas varies among different populations; this variation is partially linked to genetic polymorphisms. The purpose of the study is to examine the association between (BRCA1 rs799917G>A, rs1799966T>C, EXO1 rs1047840G>A, EME1 rs12450550T>C, ERCC2 rs13181T>G, rs1799793C>T, and XRCC1 rs1799782G>A) DNA repair gene polymorphisms and glioblastoma multiforme (GBM) susceptibility, and survival in the Jordanian Arab population. Methods Eighty-four patients diagnosed with glioblastoma multiforme at the King Abdullah University Hospital (KAUH) between 2013 and 2018 and 225 healthy cancer-free control subjects with similar geographic and ethnic backgrounds to the patients were included in the study. Genomic DNA was extracted from the formalin-fixed paraffin-embedded tissues of the subjects. The Sequenom MassARRAY® sequencer system (iPLEX GOLD) was used. The analyses included assessments of population variability and survival. Results This study is the first to address the relationship between BRCA1 rs1799966 and rs799917 SNP, and the risk of GBM among the Arab Jordanian population. The findings of the study show that BRCA1 rs799917 is associated with decreased risk of GBM in the recessive model (AA vs G/G-A/G: OR, 0.46, 95% CI, 0.26-0.82, p=0.01) and the same SNP is associated with increased risk of GBM in the overdominant model (AG vs G/G-A/A: OR, 1.72, 95% CI, 1.02-2.89, p=0.04).

The epidemic is an imminent danger that all humans fear, as it does not differentiate between anyone, whether small or old, rich or poor. It is characterized by its ability and super speed to conquer the world and its primary goal is to target humans and eradicate their lives. In this article, the authors decided to provide a brief historical overview of the Spanish flu pandemic, where it initiated and how it influenced the people of the earth and review a set of images about events that occurred in the United States of America in 1918. All facts in this article are collected from a group of published articles on websites. This article found that the Spanish flu is one of the deadliest diseases in human history, as it managed to kill 40 to 100 million people around the world in two years.

OBJECTIVES The aim of this study was to determine the rate of immune thrombocytopenia (ITP) in adult Jordanian patients diagnosed with cancer, to correlate this rate with the type of cancer and to assess the response of ITP in patients with cancer to treatment. METHODS All adult patients aged 16 years or older who had been diagnosed with cancer at King Abdullah University Hospital (KAUH) between September 2002 and October 2017 were included in this study. Their medical records were reviewed for the diagnosis of ITP. RESULTS The total number of patients diagnosed with cancer at KAUH between September 2002 and October 2017 was 8318. The majority of patients had solid cancers (87.0%), and hematological cancers constituted 13%. Fifteen (0.2%) patients with cancer had ITP. ITP was significantly more common in patients with lymphomas (1.3%) than in patients with solid cancers (0.1%) (P

B-cell lymphomas can be classified as Hodgkin and non-Hodgkin lymphomas. Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin Lymphoma (NHL). The incidence of NHL is variable and affected by age, gender, racial, and geographic factors. There is strong evidence that the immune-regulatory cytokines have a major role in hematologic malignancies. In this study, we analyzed the relationship between seven single nucleotide polymorphisms (SNPs) in two selected cytokines (IL-6 rs1800795G &gt, C, rs1800796G &gt, C, rs1800797G &gt, A, IL-10 rs1800871G &gt, A, rs1800872G &gt, T, rs1800890A &gt, T, rs1800896T &gt, C) and the risk and overall survival of DLBCL patients in a Jordanian Arab population. One hundred and twenty-five DLBCL patients diagnosed at King Abdullah University Hospital (KAUH) from the period 2013&ndash, 2018 and 238 matched healthy controls were included in the study. Genomic DNA was extracted from formalin-fixed paraffin-embedded tissues. Genotyping of the genetic polymorphisms was conducted using a sequencing protocol. Our study showed no significant differences in the distribution of all studied polymorphisms of DLBCL between patients and controls. The IL-6 rs1800797 was the only SNP to show significant survival results, DLBCL subjects with the codominant model (GG/AG/AA) genotypes and recessive model (AA genotype in comparison with the combined GG/GA genotype) had worse overall survival (p = 0.028 and 0.016, respectively).

Background Hodgkin lymphoma (HL) is a clonal B-cell hematologic malignancy usually affecting only the lymphoid tissue, as extra-nodal (EN) involvement (e.g., bone, lung or liver) is seen only in ~15% of cases, much less than what is observed in non-Hodgkin lymphomas. To date, a small number of studies worldwide have investigated the epidemiology and clinical characteristics associated with HL with EN manifestations. Aim To describe risk factors and prognosis of EN involvement in HL patients. Methods Patients diagnosed with HL at King Abdullah University hospital (KAUH) between January 2004 and April 2018 were retrospectively reviewed for EN involvement, confirmed by histopathology of involved tissues. Risk factors assessed in our cohort of EN HL patients were: age, gender, presenting symptoms, B Symptoms, LDH levels, histological subtypes, CBC with differential, CT scans and PET/CT scans. International prognostic score (IPS) was also calculated. Results Among 140 HL patients included in our study, 16 of them (11.4%) had EN involvement. The mean age at diagnosis was 30 years old, ranging from 14-59. As in classic HL, men with EN involvement were slightly more affected than female (M/F, 10/6; 62.5% vs. 37.5%). Most of patients (N=8; 50%) had HL with mixed cellularity (MC); 6 patients (37.5%) had nodular sclerosing (NS); and 2 patients (12.5%) were classified as lymphocyte depleted (LD) subtype. Bone was the most compromised extra-nodal tissue as shown by the observation that 8 patients (50%) had bone involvement. Lungs pleura were affected in 7 patients (43.8%) and liver in 4 (25%) patients. The remaining subjects (N=4; 25%) showed involvement in other sites (skin, CNS and muscles). Out of our 16 EN HL patients, 6 of them (37.5%) had two EN tissues involved. EN HL patients were younger than patients without EN involvement (mean age, 30 vs. 37 years old respectively, P=.036 by unpaired t-test).EN HL patients with bone involvement were younger than those with liver or lung localization (mean age, 23.1 vs. 30.8 vs. 30.6 years old, respectively; P = 0.018 by unpaired t-test). We also observed a significant association between liver involvement and MC subtype. (P =0.032 by chi-square test). There was significant association between positive B symptoms and EN involvement. (P=.006 by chi-square test). There was no significant association between gender, high LDH levels, anemia, leukocytosis, lymphocytosis, monocytopenia, low albumin levels and EN involvement. There was significant association between IPS and EN involvement (56.25% of patients with EN involvement have high risk IPS, P=.00002 by chi-square test). All patients received ABVD as a first-line treatment. Seven patients (43.75%) experienced disease relapse during the follow-up period. There was a significant relationship between disease relapse and the type of HL, as 6 patients who experienced relapse had NS (P=0.0004 by chi-square), while only one MC. Overall survival rate was 75%, and 5-years survival rate was 45%. Four out of 7 patients who had disease relapse (57.1%) died, suggesting that disease relapse in EN HL might be a poor prognostic factor (P =0.045 by Kaplan Meier). There was no significant association between EN involvement and overall survival rate (P=.35 by Kaplan Meier). Conclusion Prevalence of EN involvement in patient with HL in Jordan is 11.4%, higher than that in Western countries and United States. In our cohort, EN involvement frequently presented as MC histological subtype; however, patients with NS showed the highest relapse rate. According to previous observations, bone and lungs were the most involved sites in our cohort, and patients with bone involvement were younger than those with other extra-nodal sites. Of note, our study might suggest some differences in the primary disease site in patients with HL possibly due to some geographic and ethnic variations. We also showed that risk and prognostic factors of classic HL are well applicable to EN HL, highlighting possible roles of histological subtypes in prognostication of EN HL. However, our preliminary findings need further validation in larger prospective studies. Disclosures No relevant conflicts of interest to declare.