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The aim of this study is to compare the diagnostic accuracy of ultrasonography (US) with magnetic resonance cholangiopancreatography (MRCP) in the diagnosis of choledocholithiasis in context of laboratory blood test values.This retrospective study included patients who underwent both MRCP and US as part of their choledocholithiasis workup. MRCP findings, reviewed by two board-certified radiologists, laboratory findings, and US reports were collected.Our study included 243 patients. On US examination 74 cases were found dilated (30.5%), while 94 cases showed dilation (38.7%) by MRCP. The overall accuracy of US was 76.1%, where 185 patients had similar MRCP and US findings, 7.8% had false positive ultrasound, and 16% had false negative ultrasound finding. The accuracy of ultrasound was significantly higher in males (p = .013). In addition, a significant difference in duct dilatation as found by ultrasound and accuracy of diagnosis (p = .01).Although US has a relatively low accuracy, its properties of being cost-effective and non-invasive make it an ideal first step in the diagnosis of choledocholithiasis. If a patient has elevated liver enzymes or a high risk of choledocholithiasis, we recommend that MRCP be performed even no dilation was seen on US.

Due to the paucity of literature on COVID-19 and menstrual irregularities, this study aims to investigate the effect of COVID-19 infection on menstrual changes in premenopausal women within the Middle East and North Africa (MENA) region. A cross-sectional investigation utilizing a self-administered online questionnaire was conducted between July and August of 2021. A total of 499 females participated in our survey with a mean age of 35.2 ± 8.4 years. The majority of participants had regular periods (74.1%) and were disease free (81.6%). Mild, moderate, and severe symptoms were documented in 58.9%, 26.7%, and 3.0% of the studied cohort, respectively. Females experienced significantly more menstrual abnormalities after COVID-19 infection than during the pandemic prior to infection (p < 0.001). Those females were significantly older (p = 0.031), had more severe symptoms (p = 0.029), and were more likely to have experienced irregularities during the epidemic (p < 0.001). COVID-19 infection seems to induce menstrual abnormalities in premenopausal females. These abnormalities could manifest as increased frequency or severity and are associated with older women.

Glyphosate-based herbicides are the most used herbicides in the world. Despite being widely used, a dispute exists whether glyphosate-based herbicides have a negative effect on human health, particularly genotoxic effects. Therefore, the aim of this study was to investigate glyphosate genotoxicity on cultured human lymphocytes. Cultured human lymphocytes were treated with different concentrations of glyphosate (20, 40, and 200 µmol/L). Four toxicity measures were examined: frequency of chromosomal aberrations (CAs), frequency of sister-chromatid exchange (SCE), production of 8-OHdG, and cell kinetics analysis. The results show that glyphosate induced significant ( P < 0.05) increases in the levels of SCE at the highest used concentration (200 μmol/L). However, no significant elevation in SCE levels was observed at the lower examined concentrations (20 and 40 μmol/L). No significant changes in CA were detected at all examined concentrations ( P = 0.86). Also, glyphosate did not induce changes to the normal level of 8-OHdG at all examined concentrations ( P = 0.98). Last, no significant changes in either mitotic index or proliferative index were observed at any examined concentrations ( P > 0.05). The results collectively indicate a lack of genotoxicity and cytotoxicity of glyphosate in cultured human lymphocytes when dealing with environmentally relevant concentrations (20 and 40 μmol/L). However, being exposed to higher concentrations (200 μmol/L) led to slightly higher level of SCE. Therefore, we recommend cautionary measures when dealing with glyphosate-based herbicides for individuals, such as farmers, who may be extensively exposed to high concentrations of these herbicides.

Nadia Muhaidat,1 Mohammad A Alshrouf,2 Muayad I Azzam,2 Abdulrahman M Karam,2 Majed W Al-Nazer,2 Abdallah Al-Ani3 1Department of Obstetrics & Gynaecology, Jordan University Hospital, Amman, Jordan; 2The School of Medicine, The University of Jordan, Amman, Jordan; 3King Hussein Cancer Center, Amman, JordanCorrespondence: Nadia Muhaidat, Department of Obstetrics & Gynaecology, Jordan University Hospital, Queen Rania Street, Amman, 11942, Jordan, Tel +962 798385775, Email Nadiadat@hotmail.comBackground: Since the emergence of COVID-19 vaccinations, many women around the world are reporting abnormalities in their menstrual periods post-vaccination. The aim of this study is to investigate the prevalence and impact of menstrual abnormalities after the COVID-19 vaccine among females residing within the Middle East and North Africa (MENA).Methods: The study utilized a cross-sectional online self-administered survey from July 2021 to August 2021 targeting females living in the MENA region above the age of menarche who had received vaccine and were not pregnant or lactating, and do not have a history of primary ovarian insufficiency, hypothalamic menopause, or have undergone a hysterectomy. The survey was distributed regionally via social media.Results: A total of 2269 females were included in our study, with a mean age of 34.3 ± 8.5 years. About 66.3% of participants reported menstrual symptoms post-vaccination, of which 46.7% experienced them after their first dose. However, in 93.6% of participants, the symptoms resolved within 2 months. Vaccine type did not significantly influence the incidence of abnormalities (p > 0.05). Participants who had confirmed previous COVID-19 infection had a very similar percentage of menstrual abnormalities compared to people who did not have COVID-19 infection or symptoms suspected of COVID-19 infection and did not test (67.5%, 66.8%, respectively); nevertheless, those who had experienced the COVID-19 vaccine general side effects had significantly more abnormalities (p < 0.001). Compared to their pandemic status, females reported significantly more abnormalities post-vaccination.Conclusion: The study showed a possible link between the COVID-19 vaccine and menstrual abnormalities that have impacted their quality of life.Keywords: COVID-19, MENA, menstrual abnormalities, menstrual cycle, vaccine

Noninvasive follicular neoplasm with papillary-like nuclear features (NIFTP) is the term to describe what was previously known as encapsulated follicular variant of papillary thyroid carcinoma. This new paradigm shift was agreed upon by experts in the field. The objective of this study is to evaluate cases previously diagnosed as follicular adenomas, follicular variant of papillary thyroid carcinoma and hyperplastic nodules to be reclassified as NIFTP according to the new criteria. Furthermore, the clinical follow-up of these NIFTP cases is evaluated.This retrospective study reviewed potential NIFTP cases over the last 13 years, at Jordan University Hospital.A total of 811 thyroid surgery reports were identified and revised to identify the potential NIFTP cases. The review yielded 173 cases identified as potential NIFTP cases. Further pathological slide review resulted in a revised diagnosis of 32 cases of NIFTP according to the new criteria. The NIFTP cases comprised 4% of the total number of thyroidectomy cases and 16.1% of the total pool of previously diagnosed papillary thyroid carcinoma cases at our institution. While 111 cases retained their original diagnosis. Follow-up showed that all patients are alive and well with no evidence of disease.Patients with NIFTP are not uncommon and the diagnosis is made only after a thorough evaluation of excision. Therefore, initial conservative management of solitary thyroid nodules suspicious for NIFTP in the form of lobectomy is recommended to avoid unnecessary total thyroidectomies. Our follow-up of NIFTP cases is similar to all previous reports.