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Objectives: Stroke represents a health care challenge to most parts of the world including the Middle East and North Africa (MENA) region. The MENA represents 6% of the world population with an age-standardized stroke rate of 87.7 (78.2-97.6) per 100,000 population. This number is subject to increase given that the cause of morbidity has recently shifted from infectious diseases to non-communicable diseases. Thus, in the coming years, treatment of stroke will pose a major burden on MENA countries which mostly lie in the low to middle income economies. Accordingly, we need to study the state of MENA stroke services in order to recognize and further inform policy makers about any gaps that need to be bridged in this domain., Methods and Results: Stroke specialists representing 16 countries filled an online survey that included: screening for risk factors, acute management, diagnostics, medications, post-discharge services, and stroke registries. Results showed that 11 countries screen for risk factors, 16 have neuroimaging studies, 15 provide intravenous thrombolysis (IVT), 13 mechanical thrombectomy (MT) while medications for secondary prevention are available in all countries. However, stroke units are not equally available and even absent in 4 countries, and despite the availability of IVT yet, the rate of administration is still low in 6 countries (<5%), and ranges from 5-20% in 7 countries. Stroke registries and training still need to be implemented in most countries., Conclusion: Although imaging, revascularization therapies and medications for secondary prevention are available in most MENA countries, yet the rate of revascularization is low, so is the number of stroke units insufficient in some countries. Additionally, registries and structured training are still defective. Further field studies are required for more accurate determination of the status of stroke services in the MENA region., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Aref et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: The impacts of the COVID-19 pandemic on health services offered to patients with non-communicable diseases, including chronic neurological illnesses, are diverse and universal. We used a self-reported questionnaire to investigate these impacts on neurology patients in Jordan and assess their knowledge and attitudes towards the pandemic., Results: Most respondents had positive attitudes towards the COVID-19 pandemic, with 96% reporting they believed in the seriousness of the pandemic and adhered to prevention measures. Nearly 97% resorted to the internet and media outlets for medical information about the pandemic. About one in five clinic visitors had their appointments delayed due to interruption of health services. A similar portion of patients with MS, epilepsy, and migraine or tension headache reported medication interruptions during the pandemic. One in two patients reported new events or worsening illness since the start of the pandemic, and sleep disturbances were reported by nearly one in three patients who had epilepsy or headache., Conclusion: The COVID-19 pandemic's impacts on patients with neurological illnesses in Jordan were deep and diverse. Meanwhile, the majority of surveyed neurology patients demonstrated a positive attitude towards the pandemic., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s) 2021.)

Background: There is debate about the most effective method for teaching evidence-based medicine (EBM) in medical schools. This study was conducted to evaluate the effect of integration of EBM training seminars into the curriculum of the community medicine course in changing the knowledge and attitudes of the fourth year medical students towards EBM., Methods: This is a quasi-experimental study conducted on the fourth year medical students who joined the community medicine mandatory summer course at Jordan University of Science and Technology in the period between July 1 and August 31, 2008. We measured medical students' self-reported attitudes about and knowledge of EBM before the integration of EBM seminars into the community medicine course and at the end of course., Results: A high proportion of students had positive attitude towards EBM before and after the course. After the course, the vast majority (91.8%) became aware of the presence of guidelines and protocols for diseases compared with 59.0% who were aware of that before (P < 0.005). Only small proportion of students reported that they understand and able to explain the common epidemiological concepts that are used in EBM before the training. After the training, a significantly higher proportion of students reported understanding the epidemiological concepts., Conclusion: Integration of EBM training course into community course for the fourth year students improved their EBM knowledge. Longitudinal studies are needed to evaluate the long-term effects of EBM curriculum in changing behaviours, practice patterns and patient care outcome., (© 2010 Blackwell Publishing Ltd.)

Background: The prevalence of Parkinson's disease (PD) in Jordan is not known. This study describes the prevalence and clinical characteristics of PD in Northern Jordan., Methods: Patients with the diagnosis of PD seen at neurology clinics in three major hospitals in Northern Jordan during the period of March 2007 to April 2008 were enrolled. PD diagnosis was established using predefined clinical diagnostic criteria., Results: A total of 102 patients were included in the analysis (64 males; 63%, 38 females 37%). The mean age (SD) of patients was 63.3 (10.1) years and the mean age for onset of symptoms (SD) was 59.5 (12.1) years. The crude prevalence rate of PD was estimated to be 59/100,000. Clinical presentations of PD at onset of disease included; rest tremor (79.2%), bradykinesia (28.7%), rigidity (6.9%), gait problem (5%), and postural instability (2%). Eleven patients (10.9%) had a family history of PD. There was no association between the age of symptom onset, the presence of tremor, bradykinesia, or rigidity at onset, with stage of PD measured by Hoehn and Yahr scale., Conclusion: PD is a moderately prevalent disease in Jordan. The clinical characteristics of PD patients are similar to those reported in other countries.

Objective: To translate Diabetes-39 (D-39) into Arabic language and assess its psychometric properties among patients with type 2 diabetes in Jordan., Methods: A sample of 368 subjects (162 men and 206 women) was randomly selected from patients with type 2 diabetes attending outpatient clinics in King Abdullah University Hospital (KAUH). D-39 was translated using backward forward translation method. Individual D-39 items were recoded, summed and transformed to a 0 to 100-scale. Acceptability, item level validity, scale level validity and reliability were evaluated., Results: The mean (SD) of D-39 subscales ranged from 26.9 (22.4) for 'Social burden' to 50.5 (21.1) for 'Energy and Mobility'. Inter item correlations within each scale were moderate to strong. All item-scale correlations exceeded the minimum correlation of 0.40 for adequate item internal consistency. Item discriminat validity was demonstrated since items correlated higher with their own scale than with other scales. For all scales, Cronbach's alpha coefficient exceeded the minimum criterion of 0.7., Conclusions: Arabic version of D-39 is a reliable and valid instrument to measure quality of life among patients with diabetes in Jordan.