Concerns about the safety and side effects of coronavirus SARS CoV2 vaccines have been raised among many communities worldwide. The aim of this study was to describe the side effects reported by vaccinated individuals in Jordan. A cross-sectional survey was used to recruit responses from participants who were vaccinated with either one dose or both doses of any of the administered vaccines in Jordan (AstraZeneca, Pfizer, Sinopharm). A total of 1,086 participants were enrolled in the study. Most of participants have not been infected with SARS CoV2 before receiving the vaccine (77.2%). Larger proportion of the study population received Pfizer vaccine (40.6%) followed by the AstraZeneca vaccine (33.0%), and Sinopharm vaccine (26.4%). Side effects after receiving the first dose of the vaccine were reported by most participants (89.9%) and included pain at the injection site (78.4%), fatigue (51.8%), myalgia (37.6%), headache (33.1%), and chills (32.3%). To a lesser extent, there were gastrointestinal side effects such as nausea (15.1%), loss of appetite (9.4%), and diarrhea (6.4%). More side effects were significantly associated with AstraZeneca vaccine (P < .001). Only one case for each of second dose of Pfizer and Sinopharm vaccines reported that their side effects required hospitalization. In this study, we found that people in Jordan experienced more side effects with AstraZeneca vaccine followed by Pfizer vaccine and the least one is Sinopharm vaccine. Our study showed that these side effects are not severe and should not be an obstacle against the successful control of the pandemic in Jordan.

Objective During in vitro fertilization (IVF) cycles, final oocyte maturation is usually triggered by human Chorionic Gonadotropin (hCG) for its known effect in mimicking Luteinizing Hormone (LH) surge; however, with the widespread use of the ‘antagonist protocol’, Gonadotropin Releasing Hormone agonist (GnRHa) is being more commonly employed as a trigger in order to minimize or eliminate the risk of ovarian hyper-stimulation syndrome (OHSS). Many studies proved its efficacy in inducing oocyte maturation and its safety in preventing OHSS in high-risk groups. Moreover, some studies showed that GnRHa trigger may improve oocyte yield. This study aimed to further explore any beneficial effect of adding GnRHa to hCG (dual trigger) on oocyte yield and fertilization rate in normal responder women. Methods We retrospectively reviewed and analyzed the data from 127 patients on antagonist protocol (67 dual trigger and 60 HCG trigger). Results The number of total oocytes, the number of MII oocytes and the number of fertilized oocytes were all significantly higher with the dual trigger protocol compared to hCG-only trigger. However, there is no significant difference in clinical pregnancy rate. Conclusions Using the dual trigger improved the number and quality of oocytes, and the fertilization rate in normal responders.

Anorectal melanoma (ARM) is a rare, aggressive disease. Given that it presents with local symptoms that resemble other common benign anorectal conditions, ARM is often low on the differential diagnosis. Delayed diagnosis and nonconsensus of treatment options lead to poor prognosis. Here, we report the case of an 85-year-old woman with a history of Irritable bowel syndrome who presented with altered bowel habits and bleeding per rectum. CT revealed a rectal mass with metastatic lesions to the bone, liver, and lungs. Immunohistochemical staining was positive for Human Melanoma Black-45, melanoma antigen recognized by T cells, and SRY-related HMG-box 10. A final diagnosis of ARM was made.

Wilson's disease (WD), a rare genetic disorder characterized by copper accumulation, leads to a spectrum of hepatic dysfunction including liver cirrhosis, fulminant liver failure, and chronic hepatitis. Its manifestations could involve musculoskeletal, hematologic, neuropsychiatric, or renal systems. We present the case of a 27-year-old female with a past medical history of alcohol use disorder who presented with acute confusion, worsening abdominal distension, bilateral lower limb edema, and jaundice. The initial presentation was concerning for acute alcoholic hepatitis and decompensated alcoholic cirrhosis attributed to ongoing heavy alcohol consumption. However, due to the patient's young age, the severity of presentation, and the pattern of liver enzyme elevation, further workup was conducted to rule out concurrent pathologies. Viral, autoimmune, and metabolic workups were unrevealing. Subsequently, low ceruloplasmin levels and elevated urinary copper levels led to a diagnosis of WD with concomitant alcoholic liver disease.The coexistence of WD and alcohol-associated liver disease (ALD) has not been well described in the literature. Laboratory testing including alkaline phosphatase (ALP), bilirubin, and serum aminotransferases provides the most rapid and accurate method for diagnosing ALD due to WD, given that the conventional screening tests such as ceruloplasmin are less sensitive and specific in identifying patients with acute liver disease secondary to WD.

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