Type 1 Diabetes Mellitus (T1DM) is an autoimmune disorder characterized by the progressive destruction of pancreatic beta cells. Coxsackie B Virus (CVB), particularly CVB1, CVB3, and CVB4, has been identified as a key environmental trigger in the pathogenesis of T1DM, particularly in genetically predisposed individuals. This narrative review synthesizes two decades of evidence (2005–2025) to explore the mechanisms by which CVB contributes to autoimmunity and emerging prevention strategies. CVB induces beta cell autoimmunity through molecular mimicry, bystander activation, and persistent viral infections that promote chronic inflammation and immune-mediated beta cell damage. Specific serotypes, such as CVB3 and CVB4, have been shown to have stronger associations with T1DM onset, emphasizing the importance of targeted interventions for these serotypes. Recent advancements in prevention strategies include multivalent CVB vaccines, antiviral agents such as pleconaril, and immune-modulating therapies like tolerogenic vaccines and regulatory T cell (Treg) expansion. However, challenges remain regarding their safety, timing of administration, and immune cross-reactivity. Early diagnostic efforts focused on biomarkers such as CVB-specific antibodies, islet autoantibodies (e.g., GAD65, ICA, ZnT8), and HLA risk alleles are crucial for identifying individuals in the latent phase of T1DM. To mitigate the risk of CVB-induced T1DM, an integrated public health approach—combining virological surveillance, vaccination campaigns, and early immunological screening—is essential. We recommend prioritizing longitudinal cohort studies, the development of safe multivalent vaccines, and investment in community-based early detection programs. A collaborative, multidisciplinary approach is vital to prevent or delay T1DM onset in at-risk populations

Background: The recent attention highlighted on healthcare research has pressured researchers to publish high volume of articles to enhance personal benefits, forcing some of them to use unethical practices to withstand in a such competitive environment, falling in “publish or perish” pressure. Consequently, there was a global rise in the number of articles retractions, which is one of the parameters utilized in "RI² Research Integrity Risk Index". Most Jordanian universities were classified as red-flag according to RI². Our objective is to analyze retracted Jordanian-affiliated health-sciences articles to help Jordanian institutions to assess and prevent unethical practices and improve integrity policies. Methods: All retracted health-sciences articles with at least one affiliation with a Jordanian institute were extracted from the Retraction Watch Database. The articles were double screened for information about the number of Jordanian authors and their affiliations, along with information from the database. Retraction notes were reviewed to identify and classify the retraction reason(s). Authors were further classified by academic status. Descriptive statistics and data analysis were done using Microsoft Power BI. Results: A total of eighty-two articles were included; most were original research (n=62). Sixty-two papers involved international coauthors, and 48 were first-authored by Jordan-affiliated researchers. Out of total of 537 total authors, 143 were affiliated with Jordanian institutes. Retractions were heavily time-clustered, with 81.7% (n=67) occurring in 2021–2024. At the journal level, Cureus accounted for the largest single count (n=15), most (n=12) were case reports. Number of retractions per institution was as follows: Jordan University of Science and Technology (n=22), Amman Arab University (n=12), Ajloun National University (n=10), and the University of Jordan (n=9). We identified 16 retractions involving undergraduate authors without documented same-institution faculty supervision; 12 of which were case reports. Retractions were attributed to inadequate peer review (n=45), concerns about content/data (n=43), followed by paper-mill/authorship-for-sale (n=15), plagiarism (n=6), publisher error (n=4) and approval issues (n=2). And "others" (n=6). Conclusions: The study analyzed retracted health research in Jordan to uncover the main causes and suggest ways to strengthen research integrity. It found a marked rise in retractions after 2020 and highlighted links with student projects and open-access publishing. The authors recommend using the RI² index as an early warning tool (not a stigma) and encouraging quality-over-quantity rewards to reduce pressure on researchers and students.

Background: Coarctation of the aorta (CoA) is a congenital heart defect occurring in approximately 6–8% of live births with congenital heart diseases. It is characterised by narrowing of the aorta, and although often diagnosed during infancy or childhood due to its impact on blood pressure (BP) regulation, some cases may not be identified until adolescence. Case: We report a case of a 25-year-old male who presented to the ER with non-exertional chest pain, palpitations, and facial plethora. He has a history of undiagnosed hypertension, an average BP of 150/90, a significant BP gradient between upper and lower limbs (>40 mmHg), and radio-femoral delay on physical examination. Decision-making: Comprehensive tests were conducted; results included a negative troponin assay, an electrocardiogram (ECG) showing normal sinus rhythm with left ventricular hypertrophy (LVH) and a left bundle branch block (LBBB), an echocardiogram revealing a bicuspid aortic valve (BAV) and severe concentric hypertrophy of 1.7 cm with a low-normal ejection fraction, and a normal chest X-ray. Subsequently, a computed tomography angiography confirmed the diagnosis of severe CoA with extensive collaterals, which warranted catheterization. A covered Cheatham Platinum stent was implanted, and the patient was discharged on appropriate medications afterwards. Conclusion: This rare case of a BAV with CoA presenting in adulthood underscores the significance of timely detection, intervention, and long-term management. The late onset of symptoms is noteworthy, with the extensive collateral circulation accounting for it. Further follow-up is essential to monitor his chest pain and hypertension.

Introduction: Pediatric healthcare decision-making is influenced by intersecting and often conflicting factors. The coexistence of traditional parental beliefs and the modern digital landscape has altered this process and produced a novel paradigm which greatly impacts regions where cultural heritage guides medical practices and behaviors. This paper examines how parental attitudes built on traditional beliefs and social media affect healthcare decisions for pediatric patients aged twelve and below. Methods: The paper employs a structured 18-item questionnaire distributed to 200 Jordanian parents to gauge beliefs, digital health literacy, and online misinformation influence healthcare-seeking behavior. Results: The results indicated a considerable influence of traditional beliefs, as 48% of parents favored traditional remedies, and 35% consulted family elders before seeking professional advice. On the other hand, 62% stated they frequented social media for information on child healthcare, while 55% had followed online advice without medical consultation. Moreover, only 45% of the parents expressed confidence in their ability to distinguish credible information from misleading content. Discussion: The analysis through hypothesis testing indicated that lower education levels and higher social media usage rates significantly delayed medical consultations and were related to a reliance on unverified health advice. In contrast, high media literacy levels resulted in increased caution, leading to more professional-aligned decisions. Conclusions: The paper suggests enhancing the digital presence of pediatricians to increase the credibility of online information. The paper recommends the integration of evidence-based health messaging in popular platforms such as WhatsApp and Facebook.

Background and Aims: Pediatric patients are considered a special patient population for medication use. The study aims to assess the role of clinical pharmacists in the appropriate use of antibiotics among inpatient pediatrics and to evaluate some infection-related outcomes. Method: The study was designed as an interventional randomized controlled trial, where 132 patients from the internal pediatric ward in a main hospital in Jordan were included. Pediatric patients were divided into three age groups. Each age group was sub-grouped into control and intervention groups. All patients` caregivers were interviewed, and patients’ medical files were reviewed. All antibiotic-related problems and their side effects were documented. Recommendations to solve these problems were made to the treating physician or administering nurse in the intervention group. Follow-up data were collected for each group. Results: After a review of cases, the most frequent antibiotics-related problems found were administration errors. The antibiotic-related problems were reduced in the intervention group by 70.67% with a high response rate from the medical team. The mean length of stay in the control group and implemented intervention group was 8.02 days and 6.7 days respectively, with a significant difference (p=0.039). The incidence of side effects associated with the inappropriate use of antibiotics was also reduced. Conclusions: The clinical pharmacist interventions in our study resulted in enhancing the appropriate use of antibiotics among inpatients pediatrics and decreasing the mean length of stay as well as the incidence of side effects associated with the inappropriate use of antibiotics.

Artificial intelligence (AI) has revolutionized optical coherence tomography (OCT) imaging for the better detection of retinal diseases like diabetic retinopathy (DR), age-related macular degeneration (AMD), and glaucoma. Here, bibliometric analysis of AI in OCT is presented. We conducted a systematic search in the Web of Science Core Collection (WoSCC) database up to January 22, 2025 with the help of AI and OCT-related terms. The journal articles and reviews on the topic were examined based on publication trends, author productivity, institution affiliation, and keyword co-occurrence. Visualization was performed through VOSviewer software (1.6.20). A total of 765 articles were analyzed with an increasing trend in publications, led by the USA (30.7%), China (23.3%), and the UK (11.1%) in research production. The most cited institution was the Medical University of Vienna (9.0%), and the most productive journal was Scientific Reports (7.3%). The most common keywords were "Optical Coherence Tomography", "Deep Learning", and "Diabetic Retinopathy" with frequency of 469, 297, 221, respectively. Our review of AI-enhanced OCT for retinal diseases was both comprehensive and systematic, identifying key trends and current research hotspots. As research productivity in this field continues to grow, the focus is increasingly shifting toward developing more accurate AI-driven imaging techniques to improve the diagnosis of various retinal diseases. Future work should prioritize algorithm validation and clinical implementation to facilitate widespread adoption

Background: This study aimed to examine coronary artery bypass grafting (CABG) and its acute and chronic postoperative complications at Jordan University Hospital (JUH). Methods: JUH’s electronic health records (EHR) and surgery databases of 238 patients were reviewed from 1st January 2010 to 5th July 2024, regarding their relation to gender, techniques used in the surgery, and postoperative complications of CABG. Results: The study cohort included 238 patients undergoing CABG, comprising 52 females (21.85%) and 186 males (78.15%). Postoperative complications were analyzed by gender. Among females, 17.31% (9/52) experienced complications, while 82.69% (43/52) had none. In males, 10.22% (19/186) exhibited complications, and 89.78% (167/186) were complication-free, yielding a total of 210 patients (210/238, 88.24%) without complications. Chi-square analysis revealed no significant association between gender and complication incidence (χ²=1.35, p=0.246). Complications were further stratified into acute and chronic categories. Females demonstrated the following: 9.62% (5/52) with acute complications (e.g., nosocomial infection), 3.85% (2/52) with concurrent acute and chronic complications (e.g., nosocomial infection and cataract), and 3.85% (2/52) with chronic complications (e.g., cataract). Among males, 3.76% (7/186) presented with acute complications, 0.54% (1/186) with both acute and chronic complications, and 5.91% (11/186) with chronic complications. A Chi-square test evaluating gender-based differences in acute versus chronic complication susceptibility showed no significant association (χ²=6.84, p=0.077; Monte Carlo p=0.425), with Monte Carlo simulation applied due to low expected cell frequencies. These findings suggest no statistically significant relationship between gender and the development of post-CABG complications, either in overall incidence or subtype (acute vs chronic). Conclusion: Descriptive statistics showed that females had a higher incidence of complications than males overall and acutely, while males tend to develop their complications chronically. However, there is no significant association between gender and complications, either the total complications or the subclassified ones.

Background: The present study was established to investigate if there is any association between multiple sclerosis (MS) and toxoplasmosis using a combination of serological and MRI indices. Methods: 100 relapsing-remitting MS (RRMS) patients were recruited in the present study from the neurology clinic at Al-Bashir Hospital along with 34 age-matched healthy controls (HCs). MS patients as well as controls were tested for the presence of Toxoplasma IgG and IgM antibodies using ELISA technique. Magnetic resonance imaging (MRI) was performed on 1.5 T Siemens MR system. 3D T1 and T2 weighted images were acquired and processed to extract the white matter T2-lesion load. Results: 86 RRMS patients (86%) and 12 HCs (35.3%) were tested positive for the T. gondii IgG antibodies. This difference in IgG seropositivity between MS patients and HCs was statistically significant (p<0.05). On the other hand, 19 RRMS patients (19%) and 4 HCs (11.7%) were tested positive for the Toxoplasma gondii IgM antibodies, and this difference was statistically insignificant (p >0.05). Neither IgG nor IgM concentration levels showed any significant association (p >0.05) with MS disease’s indices. Conclusions: A strong significant association between the presence of anti-toxoplasma IgG antibodies and MS disease was found. Serum antibodies for T. gondii should be tested regularly among MS patients and anti-parasitic therapy should be provided, when necessary to prevent any reactivation and dissemination of the disease among these immunocompromised patients.

Objective: The objective of the study was to study the clinical profile, epidemiological profile, laboratory features, and outcomes among melioidosis patients. Methods: A retrospective observational study was conducted at a tertiary healthcare center and 30 patients diagnosed with melioidosis were included and their case records were retrieved. Data which included clinical profiles, laboratory details and health outcomes and follow up details were collected and analyzed. Results: All patients had a mean age of 49.93±12.79 years and included more male participants (86.67%). Abnormal SGPT, SGOT, GGT, and APT levels were also observed. Blood was the most common specimen used for diagnoses (83.3%) and most patients were diabetic (83.33%). Common symptoms included fever (93.33%) followed by breathlessness (43.33%) with lung involvement in 53.33% of patients. Of all patients, 26.67% were deceased over the course of the study. Conclusion: Abnormal liver function tests along with presence of symptoms of fever, lung involvement, and possible diabetic state can be indicated for diagnostic tests for melioidosis while meropenem, septran, and ceftazidime showed high sensitivity toward melioidosis isolates.

Background: Pharmacists are essential in treating MS. Pharmacists' involvement and patient consultation may improve patient adherence and satisfaction. Aim: To evaluate the influence of pharmacist-led interventions (PLI) on medication adherence and satisfaction in patients with multiple sclerosis receiving disease-modifying therapies (DMTs). Methods: This study was conducted on patients with relapsing-remitting multiple sclerosis who were receiving DMTs and attended a neurological consultant clinic in the medical city of Baghdad. It was a pre-post-intervention study. Each patient underwent two educational sessions: the first session took place at the beginning of the study, after completing the Arabic version of the treatment satisfaction questionnaire for medication (TSQM-14item) and the Arabic version of the Morisky, Green, and Levine (MGL-4item) medication adherence scales. The second session occurred one month later. The duration of each session ranged from 30 to 45 minutes, during which the patients received educational counselling. Each patient was provided with a formal Arabic pamphlet. This pamphlet contained medical information about the disease and treatment. Subsequently, after two months, the patient completed the identical questionnaires once again. Results: The participants' average age was 30.64±8.54. PLI had a substantial positive effect on adherence levels, but it did not have a significant impact on medication satisfaction. Significant variations in the educational level and type of treatment were only observed in the changes in treatment satisfaction scores. The degree of response to PLI was not correlated with sociodemographic factors. Conclusion: The implementation of an educational intervention led by a clinical pharmacist can enhance the adherence of patients with multiple sclerosis; however, the change in treatment satisfaction scores was only a minimal change.