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BACKGROUND: The education and training of healthcare workers (HCWs) about pandemic response plans, infection control protocols (ICP), and precautions are critical for breaking the virus transmission chain. This study aimed to assess the knowledge of HCWs regarding the COVID-19 pandemic response plan and the ICP. Concomitantly, evaluating the effectiveness and impact of institutional measures, policies, and training programs. METHODS: A cross-sectional study using an electronic questionnaire was used to collect data from 267 HCWs at a University-affiliated-hospital during April 2020. RESULTS: In this study, 90.7% of participants were nurses and 66% were females. 60.3% of participants received specific training about caring for COVID-19 patients while at least 94.3% reviewed the pandemic response plan and ICP for COVID-19. 47.5% and 29.2% of participants provided direct care for suspected or confirmed COVID-19 patients, respectively. Between 85.7% and 100% of the participants answered all items correctly regarding the COVID-19 pandemic response plan, measures, and precautions. Furthermore, the correct answers were above 95% for each item. CONCLUSION: HCWs have a high level of knowledge about the COVID-19 pandemic response plan and ICP. Training and disseminating updated plans and protocols in different methods such as an intranet and onsite training in addition to regular methods were very effective.

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BACKGROUND: Limited information is available about COVID-19 infections among health care workers. Sensitive detection of COVID-19 cases in health care workers is crucial for hospital infection prevention policy, particularly for those who work with vulnerable patients. The aim of this study is to describe the prevalence of positive COVID-19 among asymptomatic health care workers who took care of patients with COVID-19 during the pandemic. METHODS: This retrospective study included all health care workers at King Abdullah University Hospital who take care of patients infected with COVID-19 patients from March 18, 2020 to April 29, 2020. They were tested for COVID-19 infection by use of real-time reverse-transcriptase rRT-PCR on samples from nasopharyngeal swabs. RESULTS: A total number of 370 health care workers were screened. The majority were nurses followed by physicians and other personnel. This study showed that all asymptomatic health care workers were tested negative for COVID-19Q. CONCLUSION: Unexpectedly, the prevalence of positive COVID-19 among asymptomatic health care workers who take care of patients infected with the novel coronavirus was 0%. This result must be cautiously interpreted. Further studies are needed in order to find effective strategy of screening health care workers to insure a safe working environment.

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To assess the immuno-histochemical expression of various markers in, endometrial biopsies of patients with endometrial cancer, and to correlate their expression with the final pathologic findings. Sixty-two patients with primary endometrial cancer who underwent surgical treatment were included in this study. Immuno-histochemical expression of estrogen receptor (ER), progesterone receptor (PR), p53, bcl-2, Her-2/neu and Ki-67 were assessed in curettage specimens, and review of the final pathology report from hysterectomy specimens was carried out. The expression of these markers in curettage was correlated with the final tumor characteristics obtained on hysterectomy specimens. Both ER and PR were significantly more expressed in endometrioid type (EC) than non- endometrioid type (NEC) (P value of 0.004 and 0.012). On the contrary, P53, Her-2 and Ki-67 showed higher positivity in NEC than EC (P value of 0.005, 0.025 and 0.002). Positive expression of ER and PR was significantly associated with low grade tumors and superficial myometrial invasion, whereas positive expression of Her-2 and Ki-67 was significantly associated with higher grade lesions, and deep myometrial invasion. Moreover, a statistically significant inverse relationship was observed between the positivity of P53, Her-2 and Ki-67 and the positivity of ER, PR. We found that determination of immuno-histochemical markers in curettage specimens might be helpful in predicting the final pathologic findings in patients with endometrial cancer. This might be helpful in planning the extensivity of the surgery.

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This cross-sectional study was carried out to assess the association between consanguineous marriages and adverse pregnancy outcome in the north of Jordan. Women delivered in four major hospitals in the north of Jordan between April 2007 and May 2007 were included in the study. Non-Jordanian women and women with multiple pregnancies were excluded. Mothers answered a pilot-tested structured questionnaire administered by trained personnel in the maternity ward. Data regarding pregnancy outcomes were obtained from the patients' individual records. A total of 3,269 women with a mean age of 27.2 (SD 6.6) years were included. About 49% of women had consanguineous marriages. Consanguineous marriages were significantly associated with low birth weight delivery (13.9% vs. 10.1%), preterm delivery (19.9% vs. 12.3%), and births with congenital anomalies (4.1% vs. 0.8%) compared with non-consanguineous marriages. In the multivariate analysis, consanguinity was significantly associated with preterm delivery (OR = 1.5, 95% CI 1.2, 1.9), and congenital malformations (OR = 6.5, 95% CI 2.8, 15.3). In conclusions, this study supports the association between consanguinity and some adverse pregnancy outcomes.

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BACKGROUND: Schwannomas (peripheral nerve sheath tumors) of the female genital tract are extremely rare. CASE: A 31-year-old woman developed a benign schwannoma involving the anterior vaginal wall. CONCLUSION: Schwannomas of the female genital tract are extremely rare. They are generally benign, and simple excision is adequate treatment.

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OBJECTIVE: The purpose was to determine the impact of the amniotic fluid index on the perinatal outcome of patients admitted for induction of labor at term. STUDY DESIGN: Patients (n=180) included in the study were those admitted for induction of labor at 37-42 weeks' gestation, with unfavorable cervix and intact membranes. The amniotic fluid index (AFI) was determined in all patients using the four-quadrant technique within 24 h of the induction of labor. Patients were divided into two groups based on their AFI: the oligohydramnios group with AFI < or = 5 cm (n = 66) and a normal group with AFI > 5 cm (n = 114). The perinatal outcomes of the two groups were compared. RESULTS: The two groups were similar with regard to maternal age, gestational age, and birth weight. Meconium staining of the amniotic fluid was significantly higher in the group with AFI < or = 5 cm (p = 0.040). The number of cesarean deliveries due to fetal distress was significantly higher even after adjusting for other confounding factors in the group with AFI < or = 5 cm (adjusted OR 6.52 [95% CI 1.82, 23.2]; p < or = 0.0001). There was no significant difference between the two groups with regard to Apgar scores or neonatal admission. CONCLUSION: Induction of labor at term in patients with oligohydramnios is associated with an increased risk of cesarean delivery due to fetal distress.

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OBJECTIVES: To evaluate the postoperative patency rates of microsurgical vasovasostomy and vasoepididymostomy at various vasectomy reversal time intervals, and to assess the implications of anti-sperm antibodies on results. METHODS: Three hundred and eighty-two patients underwent unilateral or bilateral vasectomy reversal between January 1997 and April 2001 at the Health Clinic, Highgate and Manor House Hospitals, London, United Kingdom. Patients were divided into 4 groups according to the time interval between vasectomy and reversal; less than 5 years, 5-10 years, 10-15 years, and more than 15 years. Data collected included patient's age at time of vasectomy reversal, seminal fluid analysis at 3, 6 and 12 months after surgery, and the presence or absence of anti-sperm antibodies before vasectomy reversal. RESULTS: Mean patient age at the time of reversal was 44.6 years. The mean vasectomy reversal time interval was 12.8 years. Overall patency rate of the patients groups was 62.9% with positive sperm in the ejaculate in 85.3% in the less than 5 years group, 75.3% in the 5-10 years group, 50.3% in the 10-15 years group and 26.9% in the more than 15 years group. Anti-sperm antibodies were positive in 31 patients (9.1%), of whom 12 patients (38.7%) were positive for sperm in the ejaculate. CONCLUSION: Microsurgical vasectomy reversal produces satisfactory patency rates to couples that consider reestablishing their fertility even more than 15 years after vasectomy. The presence of anti-sperm antibodies is associated with negative effects on sperm count, motility, and percentage of abnormal forms.

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OBJECTIVE: This study assessed the value of delayed intracytoplasmic sperm injection after failure of initial in-vitro fertilization in patients with normal seminology. METHODS: A case series analysis was conducted on 82 couples who underwent delayed intracytoplasmic sperm injection after failure of initial in-vitro fertilization at Fakeeh Hospital, Jeddah, Kingdom of Saudi Arabia between January 1995 and January 2001. RESULTS: Seventy-eight couples had 616 unfertilized metaphase II mature oocytes after initial in-vitro fertilization. Second day "rescue" reinsemination by intracytoplasmic sperm injection (ICSI) resulted in 174 embryos that were suitable for transfer. This resulted in 4 clinical pregnancies (5.1% per started rescue ICSI cycle). CONCLUSION: The limited success rate in this study provides confirmatory data that rescue ICSI is not an efficient adjuvant laboratory procedure.

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OBJECTIVE: To evaluate the efficacy of two clinical methods of post-embryo transfer protocols in patients undergoing in vitro fertilisation. DESIGN: Prospective, randomised clinical trial. SETTING: Hospital-based clinic for reproductive medicine. SAMPLE: Women under 40 years of age who were undergoing in vitro fertilisation with GnRH pituitary down-regulation and controlled ovarian hyperstimulation. METHODS: Patients were randomised to rest for either 1 or 24 hours after embryo transfer. MAIN OUTCOME MEASURE: Clinical pregnancy per cycle rate (the percentage of cycles started that demonstrated a live fetus on ultrasound examination performed at six or seven weeks of gestation). RESULTS: The clinical pregnancy rates were 21.5% for the 1-hour and 18.2% for the 24-hour post-embryo transfer groups. The implantation rate per embryo was significantly higher in the 1-hour group (14.4%) than in the 24-hour group (9%). CONCLUSION: One-hour and 24-hour rest post-embryo transfer result in comparable rates of clinical pregnancy. However, 24-hour rest results in reduced implantation rate per embryo.

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