Objectives: The aim of this survey was to evaluate how aware diabetic patients about some facts of their chronic disease. Methods: A questionnaire was given to 169 diabetic (Type 2) patients presenting to the retina clinic in King Hussein Medical Center over a period of three months (1st of April 2012 till 1st of July 2012). The questions were read and answered by the patient or read for him by accompanying person or nurse. General information was collected: age, residence, type and duration of treatment. Questions were asked about how they joined the retina clinic, frequency of visits to endocrinologist and ophthalmologist, mode and satisfaction with management and how they check and control their blood sugar level. Results: This study included 169 patients, 58.6% were females and 41.4% were males, with the mean age of 61.9 years. The mean duration of diabetes was 15.9 years and 75% were using insulin. Mean of follow up period was 3.3 years. Ischemic heart disease was found in 21.3% of the patients, 35% were hypertensive, 13.6% were smokers, 11.2% suffer from diabetic foot and 9.5% had renal impairment. Thirty-nine percent were sent to ophthalmologist by the internist, 28% by a general practitioner, 32% advised by non-medical others, and 37% visited the clinic because of ocular/visual complaint. The main factor blamed for diabetic retinal changes was the duration of diabetes. More than half of the patients believed that no other diseases affect the diabetic retinal changes. Less than a quarter of the patients could mention at least one extraocular organ affected by diabetes mellitus. Eighty percent of the patients were compliant to their clinic appointments. More than half depended on symptoms rather than blood test to judge their diabetes mellitus control. Forty-six percent thought they have a controlled diabetes mellitus, 54% of them were satisfied with the laser treatment they received, while only 31% of the uncontrolled diabetes mellitus group were happy with the laser. Only 29% gave an acceptable range of fasting blood sugar when asked about the normal level, while 55.6% did not know about HbA1c. Eating habits were blamed by 55.6% for disturbed blood sugar level, but 28.3% could not find a reason for it. Conclusion: A large proportion of patients were not well educated about their disease. This mandates a national campaign to enlighten diabetics as well as non-diabetics about this prevalent disease, since educating diabetic patients about their chronic disease is mandatory to decrease the severity of complications, postpone or even prevent them.

Objectives: To assess the presentation of patients diagnosed already to have Diabetes Mellitus (DM), in terms of source of referral, eye condition on first visit, and minimal awareness of diabetic eye complications and treatment. Methods: Ninety-five patients (all patients visiting the clinic for the first time and found to be diabetics) attending the ophthalmology clinic and diagnosed to be diabetics during a period of 3 months (April-June 2009) were included in the study. A questionnaire was filled by patients. Items asked about the duration since the patients were diagnosed to have Diabetes Mellitus, cause of presentation to ophthalmology clinic (including referral from other clinics), knowledge about blood sugar and blood pressure control effect on retinal complications of Diabetes Mellitus as well as Laser effect on the eye. Results: More than a third (35%) of the patients visited the eye clinic after more than 11 years of DM. Quarter (25%) of them presented in the latest stage of diabetic retinopathy (proliferative diabetic retinopathy PDR). Despite that a high percentage (67%) was followed up by internists, their eye complaint was the major cause for them to come to clinic rather than referral from the DM treating doctor for regular check up. The majority know the effect of blood sugar level but not hypertension on the diabetic retinopathy. Most of them lack adequate knowledge about Laser. Conclusion: All doctors dealing with diabetic patients especially those practicing in peripheral hospitals should establish a fixed protocol of sending the diabetic patients for eye check up routinely at the time of diagnosis of DM. Dietician and educators are mandatory compliment to diabetes clinics. Media and local institutes should be involved more actively in spreading education and advice for the continuously increasing number of diabetic patients.

Objectives: To describe the demographic characteristics and clinical presentation of 37 patients with Wilson's disease followed up at the Pediatric Gastroenterology Clinic. Methods: A specially designed data collection form was used to collect the relevant data; Medical history and a thorough clinical examination for patients who were diagnosed with Wilson's disease during the period between February 2000 and October 2010 at King Hussein Medical Center, Amman, Jordan was done. Laboratory investigations include ceruloplasmin level, liver enzymes, albumin, prothrombin time, partial thromboplastin time, international normalized ratio, complete blood count, urine analysis, abdominal ultrasound and liver biopsy. Simple descriptive statistics (frequency and percentage) were used to describe the study variables. Results: A total of 37 patients diagnosed as Wilson's disease with age ranges between two and 13.5 years were included in this descriptive review. Out of 37 patients, 19 (51%) were males and 18 (49%) were females. Patients with affected siblings were 29 (78%). Central nervous system involvement was found among 9 (24.3%) patients. The commonest presenting symptoms were jaundice (n=16, 43%), abdominal distension (n=13, 35%), fatigue and delayed school performance (n=12, 32.4%). The most common clinical findings were hepatomegaly (n=26, 70%), jaundice (n=16, 43%), splenomegaly (n=14, 37.8%), Kayser-Fleischer ring (n=11, 29.7%), and lower limb edema (n=11, 29.7%) respectively. Low ceruloplasmin level was found in 34 (92%) patients, high liver enzymes in 23 (62%) patients, hemolytic anemia in 13 (35%) patients successively. Twenty-four hour urine collection average copper post Dpenicillamine challenging test was above 230µg/dl. The most common ultrasound findings were hepatomegaly, abnormal echogenecity, splenomegaly and ascitis. Liver biopsies commonly showed liver fibrosis, however fatty liver changes, hepatosteatosis and liver cirrhosis were the least common finding. Conclusion: Family screening is needed once a child in the family is diagnosed. Full investigations to rule out Wilson's disease should be performed in any patient with unexplained elevation of liver enzymes, hepatomegaly, hemolytic anemia, jaundice or neurological/behavioral disturbances.