The management of syndesmotic injury in ankle fractures is still controversial. Anterior inferior tibiofibular ligament (AITFL) primary repair is considered essential to reduce the risk of syndesmotic malreduction. This review examined the available literature on primary AITFL repair in ankle fractures. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Web of Science, Cochrane, and Google Scholar were searched up to July 15, 2021, for articles reporting on the repair of AITFL in acute ankle fractures with syndesmotic injury. The quality of the included studies was assessed using the Newcastle-Ottawa scale. Studies that investigated isolated syndesmotic injury without ankle fracture, reviews, cadaveric studies, case reports, and studies not published in English were excluded from the study. The search yielded 588 articles, of which three studies were included, with a total of 229 AITFL primary repairs. The articles were excluded due to different design, foreign language, irrelevancy, or no syndesmosis injury, including patients with isolated syndesmosis injury or used methods of repair other than anatomical repair. Early functional outcomes were found better after AITFL repair compared to syndesmotic screw fixation alone. Moreover, time to return to play/work was significantly lower in the anatomical repair compared to temporary screw fixation. Anatomical repair of the ankle syndesmosis is an effective and safe method with good functional outcomes and return to activity. However, the future prospective studies are required to assess the efficacy of the anatomical repair of the syndesmosis and its superiority over other treatments.

Polycystic ovary syndrome (PCOS) is a common reproductive disorder that is related to a number of health issues and has an influence on a variety of metabolic processes. Despite its burden on the health of females, PCOS is significantly underdiagnosed, which is associated with lack of disease knowledge among females. Therefore, we aimed to gauge the awareness of PCOS in both the male and female population in Jordan. A descriptive cross-sectional study was conducted, targeting individuals over the age of 18 from Jordan’s central region. Participants were recruited through stratified random sampling. The questionnaire consisted of two domains, including demographics and knowledge of PCOS domains. A total of 1532 respondents participated in this study. The findings revealed that participants have overall adequate knowledge regarding PCOS’s risk factors, etiology, clinical presentation, and outcomes. However, participants demonstrated subpar familiarity of the association between PCOS and other comorbidities and the effect of genetics on PCOS. Women had more knowledge than men about PCOS (57.5 ± 6.06 vs. 54.1 ± 6.71, p = 0.019). In addition, older, employed, and higher-income populations showed significantly better knowledge than younger, unemployed, self-employed, and lower-income populations. In conclusion, we demonstrated that Jordanian women demonstrate an acceptable yet incomplete level of knowledge towards PCOS. We recommend establishing educational programs by specialists for the general population as well as medical personnel to spread accurate medical information and clarify common misconceptions about signs, symptoms, management, and treatment of PCOS, and nutritional knowledge.

Background: Mental health disorders and low quality of life are considered common psychiatric problems resulting from the COVID-19 pandemic. Despite the significant importance of the knowledge and research about COVID-19 mental consequences, few studies are addressing it locally in Jordan. Therefore, the present study aims to investigate the effect of the coronavirus disease 2019 (COVID-19) pandemic on university students' mental health and life quality.   Method: A retrospective cohort study was undertaken for students in Jordanian universities using an online questionnaire. Our survey consisted of the Generalized Anxiety Disorder 2‐item (GAD-2), The Patient Health Questionnaire 2-item (PHQ-2), UCLA Loneliness Scale, and the COVID-19–Impact on Quality of Life (COV19-QoL) scale to examine students' quality of life, loneliness, besides examining the difference between depression and anxiety, independently, before and during COVID-19 pandemic among Jordanian universities students. We analyzed the data using SPSS Software version 26.   Results: The study included 537 participants, 371 (69.1%) of them were female, with a mean age of participants equal to 19.1 ± 0.84, with a range of 17 to 22 years. Most of the participants were second-year students 393 (54.6%) and more than half of the participants never weekly exercised. the prevalence of depression, anxiety, and loneliness after the COVID-19 pandemic were 305 (56.8%), 311 (57.9%), and 371 (69.1%); respectively. Chi-square analysis revealed that females with loneliness, depression, and anxiety were statistically predominant (p=0.014, p=0.023, p=0.000; respectively). In contrast, there was no significant difference among basic academic years students in terms of these mental outcomes. The impact of the Covid-19 pandemic on depression scores of singles was significantly higher than those who were in relationships (p= 0.008). The less depressed students were those who sleep at the night and those who have hobbies (p=0.02, p=0.007; respectively).   Conclusion: Our study results highlighted and supported a significant change in the participants’ scores regarding their mental status before and after the outbreak. Furthermore, several factors preserve the mental health of students against the consequences of the COVID-19 crisis, such as gender, having hobbies, being in a relationship, bedtime, and sleep hours. Additionally, the study found that loneliness, anxiety, and depression can predict life quality. Eventually, the government should provide more attention to the student’s psychological issues. Future research should investigate which group of students have more susceptibility to being mentally affected by similar outbreaks to develop specific and efficient actions that are targeted to these certain groups, thus improving the chance of the psychological benefits.

Introduction: A recent study aimed to investigate the usefulness of YouTube as an educational resource for medical students studying physical examination in Jordanian universities. The questionnaire aimed to determine the prevalence, effectiveness, and usefulness of YouTube in learning physical examination and to identify which medical topics were studied more through YouTube. Methods The study used a Google Forms questionnaire to survey 413 medical students in their 4th, 5th, and 6th clinical years. Results The study found that the majority (91%) of the students used YouTube as a learning tool, and most (96.4%) found it useful in their studies. Nearly all students (93.7%) reported learning additional information they did not previously have access to. Most students (88.4%) used YouTube to learn physical examination, and a vast majority (90.1%) found it useful for practicing before OSCE exams. Almost 80% of the students who used YouTube received higher marks in OSCE exams. Furthermore, the study also found that YouTube usage varied among students, with the majority using it in their 4th year. The two medical topics that students found most useful in YouTube videos were internal medicine and general surgery, with 82.8% and 69.5% of students finding them useful, respectively. Conclusion the study suggests that YouTube is a valuable educational tool for medical students studying physical examination and medical topics in Jordanian universities. The study recommends that educators encourage students to use YouTube and create updated physical examination videos and general clinical themes to supplement medical education.

Introduction: The subpectoral direct-to-implant (SP-DTI) surgical technique is the standard and most common for breast reconstruction which could reduce implant visibility and palpability, and it manipulates the pectoralis major muscle with some post-operative complications such as muscle spasm, animation deformities, and pain while the prepectoral direct-to-implant (PP-DTI) approach leaves the muscle intact. Therefore, we conducted this meta-analysis to assess the efficacy and safety of the PP-DTI procedure after mastectomies compared to the standard breast reconstruction.   Methods: We performed a comprehensive search for the following databases: PubMed, Cochrane (Medline), Web of Science, and Scopus. All studies published in English till February 2022 were included. These include randomized and non-randomized clinical trials comparing Operation Time, Duration of Hospitalization (DOH), Breast Animation Deformity (BAD), Implant loss, Wound infection and dehiscence, seroma as well as post-operative pain. The study’s quality will be assessed according to the Cochrane risk-of-bias tool for randomized trials (RoB2) and the ROBINS-I risk of bias tool to assess non-randomized studies of interventions.   Results: There were 28 comparative studies including 3851 patients carried out breast reconstruction surgeries. Post-operative complications were comparable between the two groups as follows: implant loss (OR 1.17, 95% CI [0.71-1.94]), wound dehiscence (OR 0.76, 95% CI [0.43-1.32]), wound infection (OR 1.09, 95% CI [0.78-1.53]), and seroma (OR 0.78, 95% CI [0.56-1.09]). The PP-DTI group was significantly less likely to develop BAD compared to SP-DTI group (OR 0.02, 95% CI [0.00-0.12]). Patients undergoing PP-DTI reconstruction had significantly reduced postoperative pain (SMD -0.55, 95% CI [-0.78 - -0.32]). Operation time and DOH were significantly lower among PP-DTI group ((SMD -0.35, 95% CI [-0.61 - -0.08]), (SMD -0.89, 95% CI [-1.48 - -0.30], respectively)).   Conclusion Following mastectomy, PP-DTI breast reconstruction significantly reduced post-operative pain, BAD, DOH, intra-operative time compared with SP-DTI reconstruction, although there was no significant difference in complication rate. A PP-DTI is a simple and safe alternative to the subpectoral technique allowing early discharge and improving patient's quality of life. Future well-designed multicenter randomized controlled trials that compare two approaches and discuss the cost-effectiveness are needed.   Keywords: PP-DTI, SP-DTI, Meta-analysis, cosmetics.