bluuebunny/crossref_metadata_2025 huggingface dataset:
Judgment No. 238 – 2014 (IT. Const. Ct.)
Authors: Chechi Alessandro
Published: February 2016

On October 22, 2014, the Italian Constitutional Court rendered a decision on the constitutional legitimacy of certain domestic norms that required Italy’s compliance with the rule on state immunity sanctioned by the International Court of Justice (ICJ) with the Judgment Jurisdictional Immunities of the State (Germany v. Italy: Greece Intervening). The Constitutional Court declared that the international customary obligations on state immunity from jurisdiction can be applied automatically within the Italian legal order only as long as they are in conformity with the fundamental rights contained in the Constitution.
World Health Organization and United Nations Documents on the Ebola Outbreak in West Africa
Authors: Burci Gian Luca , Quirin Jakob
Published: February 2016

The United Nations (UN) Security Council, for the first time in its history, declared a disease outbreak as “a threat to international peace and security” on September 18, 2014. An outbreak of Ebola in West Africa, the most harmful outbreak of this disease ever recorded, gave it cause to do so. The Ebola outbreak also marked the first time that the UN Secretary-General deployed, under his authority, a “United Nations emergency health mission”—neither a peacekeeping operation, nor a “political mission.” Finally, the Ebola outbreak motivated the World Health Organization (WHO) to make use of its authority to declare a “public health emergency of international concern” under the International Health Regulations (IHR) for the third time since their entry into force and induced the WHO Director-General to convene, for the third time in WHO’s history, a special session of the WHO Executive Board to reform WHO’s role in disease outbreak response. The materials presented below form essential background to these important developments in international health law and in the institutional practice of the United Nations system.
Al Nashiri v. Poland (Eur. Ct. H.R.)
Authors: Cerna Christina M.
Published: February 2016

The European Court of Human Rights (European Court), increasingly known as “the conscience of Europe,” together with the Council of Europe’s Parliamentary Assembly, were the first intergovernmental organizations to reveal information about the U.S. Central Intelligence Agency’s (CIA) “black sites.” These “black sites” were secret prisons established around the world, outside of U.S. territory, by the George W. Bush administration and run by the CIA to detain suspects termed “high value,” and their existence was repeatedly denied by the U.S. and Polish Governments. The Soros funded Open Society Justice Initiative, filed the application with the European Court on behalf of Abd al-Nashiri on May 6, 2011, arguing that Poland had been complicit in his rendition, detention, and torture at a CIA black-site prison within the state.
Final Report on the Obligation to Extradite or Prosecute (Aut Dedere Aut Judicare) (Int’l L. Comm’n)
Authors: Moyo Monica P.
Published: February 2016

At its sixty-sixth session in 2014, the International Law Commission completed its final report on the obligation to extradite or prosecute and submitted it to the United Nations General Assembly for consideration at its sixty-ninth session.1 The report concluded the Commission’s work on a topic the General Assembly had long considered important in states’ efforts to cooperate in the prevention of impunity for crimes of international concern.2 The Commission addressed the implementation of the obligation; gaps in the existing conventional regime; the priority between the obligation to prosecute and the obligation to extradite, and the scope of the obligation to prosecute; the relationship between the obligation with erga omnes obligations or jus cogens norms; the customary international law status of the obligation; and other matters of relevance from the general framework created in 2009 for the Commission’s consideration of the topic.
Response of viral hepatitis B and C to interferon alpha treatment: Possible role of MGP-Positive lymphoid cells
Authors: Ejeckam G. , Joseph M. , Abdulla F. , El Dweik N.
Published: February 2016

Fifty-six needle liver biopsies from 28 patients with viral hepatitis B (15 cases) and hepatitis C (13 cases) treated with Interferon alpha for a minimum of six months were studied with the aim of determining the role of MGP-positive lymphoid cell infiltrates in the response to treatment with interferon. Besides assessing the MGP-positive cells, the following parameters were assessed and graded: (i) Inflammation in and around the portal tracts, (ii) fibrosis, nodularity and cirrhosis, (iii) piece-meal necrosis (inter-face hepatitis), (iv) lobular activity, (v) stainable iron. Sec-tions were stained with H&E, PAS, PASD, Perl, Masson Trichrome and MGP (Methyl Green Pyronin). All the parameters were graded 1 to 3 except stainable iron which was noted as present or absent.

Fourteen patients (50%) demonstrated histological evidence of a response to treatment. Seven of these showed a very pronounced response with the post treatment liver bi-opsies returning almost to normal. Five of the seven, 27.8% of all MGP stained cases and 71% of all brisk responses, contained ten or more MGP-positive lymphoid cells in the portal tracts.

In contrast, the non-responsive and worsened cases con-tained less than five MGP-positive cells as well as a pre-dominantly small mature lymphocytic infiltrate in the por-tal tracts.

Severity of piece-meal necrosis, lobular activity, portal tract inflammation, the presence or absence of stainable iron, were not of predictive value in the response of viral hepatitis to treatment with interferon alpha.

It appears that MGP-positive lymphoid cells, most prob-ably immune competent activated lymphoid cells, have a positive influence on, and are of predictive value for, the response to treatment of viral hepatitis B and C with inter-feron alpha.
Changes in serum lipids and chemistry profiles in type 2 diabetes mellitus during ramadan fasting
Authors: Matar I. , Abdulrahman M. O. , Ishaq S.
Published: February 2016

A prospective study of 34 Type 2 diabetic patients was carried out to determine the effect of Ramadan fasting on the lipid profiles; serum cholesterol, triglycerides, HDLcholesterol, LDL-cholesterol, Apo A-1, Apo B, Lp (a), and HbAjc. The comparison analysis of the pre-fasting with fasting and post-fasting samples did not reveal any statistically significant changes in the value of the lipid profiles. In the biochemical profile there was a slight change in the serum albumin but otherwise there was no change in the other biochemical values. The study was conducted in the Outpatient Department at Hamad Medical Corporation from November 1999 to February 2000.
The value of percutaneous fine needle aspiration cytology under ultrasound guidance in the diagnosis of pancreatic masses
Authors: Salih H. , Hatam H. , Al Hadithi R. , Al Kaysi A.
Published: February 2016

Between September 1996 and May 1999 twenty six pa-tients with a pancreatic mass were studied. In 24 patients (92.3%) the masses could be detected by ultrasound but were not detectable in the other two cases. In the 24 pa-tients percutaneous FN AC under u/s guidance produced only one complication.

The accuracy of this test in diagnosing pancreatic ma-lignant tumours was 90.4%. Laparotomy was not neces-sary in three cases with advanced pancreatic carcinoma (11.5%) and the material aspirated was not suitable for di-agnosis in three cases. No benign lesions were found and so it was not possible to estimate the reliability of FN AC in their diagnosis.
The rational use of a local scoring system to differentiate between septic arthritis & transient synovitis in children
Authors: Kuda E. , Al Wahadneh A.
Published: February 2016

In order to study the specificity and the sensitivity of a locally produced scoring system to differentiate between septic arthritis and transient synovitis at initial presentation, the records of 33 cases of irritable hip, 24 males and nine females, in the Pediatric departments of King Hussein Medical Center and Prince Rashid Military Hospital, Jordan, were reviewed retrospectively. Septic arthritis was diagnosed in nine patients all of whom scored nine or above; none were missed with false low scores. The sensitivity and specificity for this local scoring system were calculated to be 100% and 91.66% respectively. The positive predictive value was 81.81%.

Conclusion: There is a significant overlap in the temperature; erythrocyte sedimentation rate and WBC count in children with toxic synovitis and septic arthritis of the hip. We found our local scoring system useful in predicting the patients at high or moderate risk of septic arthritis thus avoiding unnecessary invasive investigations and unjustified prolonged admissions and antimicrobial treatment.
Obesity in pregnancy
Authors: Sharief M. , Tarik A.
Published: February 2016

This prospective study was carried out in Basrah ma-ternity hospital (Basrah-Iraq) during the eight months of Dec.1997-Aug.1998 to study the obstetrical performance and outcome of pregnancy in 20 (>90kg) obese patients compared to 20 non-obese controls.

The incidence of obesity in their infants was also com-pared. There was no significant increase in the incidence of urinary tract infection, diabetes, caesarean section and forceps delivery.

There was a significantly increased incidence of hyper-tensive disorders of pregnancy (P < 0.01 odds ratio 0.33), and also inadequate weight gain (P < 0.01).

Apgar scores and perinatal mortality were not signifi-cantly different in the two groups.
Percutaneous fluoroscopic guided gastrostomy: 6 Years experience in Jeddah, Saudi Arabia
Authors: Al Rawas M.
Published: February 2016

Purpose: To assess the local experience with the percutaneous fluoroscopic gastrostomy (PG) with regard to indications, outcome, limitations and complications of the procedure.

Method: Retrospective analysis of 33 patients in whom PG was requested and performed over a period of 6 years.

Results: All 33 patients had successful catheter placement. Six patients had their catheters advanced to the jejunum (transgastric jejunostomy). Two patients had PG after failed endoscopic gastrostomy (EG). No major complications were encountered within the first 30 days. Minor complications were noted in seven patients (21%). Three patients (9%) had local infection at the stoma. The other four patients (12%) had catheter occlusion (use-related complications) that required catheter change. Longterm follow-up in eight patients showed a pericatheter leak at the stoma in three patients that was managed by change and step-up in the feeding catheter; French size. There was no 30-day mortality.

Conclusion: The results indicate that PG is a safe and effective method for enteral feeding. It is useful for short and long-term feeding. Failed EG can be considered an indication for PG.
Bullard laryngoscope: Management of difficult airway in maxillofacial surgery
Authors: Faraj J. H. , Darwish A. A. , Salinis P. , AI Kaabi M.
Published: February 2016

Difficult intubation has an incidence of 1.5-8.5%. Failed intubation occurs in 0.13-0.3% of general anaesthetics and it has been found that 30% of the mortality attributed to anaesthesia is related to difficulties in the management of the airway(1). Many techniques and instruments have been advocated in the management of difficult airways; one of these being the Bullard laryngoscope (BL). We report the management of two cases of difficult airway due to limited mouth opening using the Bullard laryngoscope.
Thyrotoxic hypokalemic periodic paralysis
Authors: Al Khaledy E. H. , Ashour N. , Al Mutairi S.
Published: February 2016

Hypolalemic periodic paralysis is an uncommon complication of thyrotoxicosis. It usually affects men of Oriental origin and presents with acute and profound muscle weakness especially of the lower extremities. We report a 46 year old man from Kuwait with sudden paralysis of both legs. Physical examination showed signs of thyrotoxicosis and laboratory tests revealed severe hypokalemia, very low serum thyroid-stimulating hormone and very high free thyroxin. The motor deficit regressed within 8 hours of 80 mmol ofKCI infusion. Awareness of such a problem is essential to avoid life threatening cardiac arrhythmia. Once recognized the treatment is simple and the prognosis is excellent.
Cystic fibrosis and the gulf states
Authors: Dawson K. P. , Al Whadneh A.
Published: February 2016

Advances in molecular genetics have now established that Cystic Fibrosis (CF) is due to DNA variations which modify the sequence, structure, function and/or expression of the CF transmembrane conductance regulator (CFTR) gene. To date over 885 such variations have been described. However, worldwide 65% of all CFTR gene mutations are a result of the DF508 mutation.
Al Raz's book on smallpox and measles
Authors: Kaadan A. N.
Published: February 2016

Al Razi was the first physician in history to describe in detail the symptoms and signs of smallpox and measles based upon clinical examination. He was the first to dis-tinguish between the two diseases by what is called now ’the differential diagnosis'in “The Book on Smallpox and Measles”. A manuscript of this book is kept now in Lieden University, Netherlands (manuscript #656) and a micro-film copy is in our institute at Aleppo. This book of four-teen chapters was twice translated into Latin in the 18th century. The third chapter on the symptoms suggesting the exacerbation of smallpox and measles is considered the most important The aim of this study is to reveal the im-portance of this book in the history of Islamic medicine.
The Tuberculin Test in Children with Tuberculosis in the State of Qatar
Authors: Al Marri M. , Al Qatami M. , Al Janahi M.
Published: February 2016

To correlate standard tuberculin skin test (TST) results in children diagnosed with active tuberculosis (TB), data was collected retrospectively from the tuberculosis treatment unit, State of Qatar, during the period 1992 to 1996. Sixtysix patients with confirmed tuberculosis included 42 (64%) with pulmonary TB, 24 (36%) with extra-pulmonary TB, 34 Qatar nationals (52%) and 36 females (55%). Mean TST was 13.5 mm ± 9.8mm. TST was negative in 18 (27%), 5-10 mm in three (5%), 10-15 mm in eight (12%) and 15mm or more in 37 (56%) patients. Lower false negative (reaction less than 10mm) was found in five (18%) of the older children (10 to 14 years).

It is concluded that, since one-third of the children with confirmed active tuberculosis had a false negative TST, clinical judgement remains the essential determinant. However, TST remains a potent aide for epidemiological and diagnostic purposes and periodic assessment of this is highly recommended.
Adult Still's Disease in Qatar Clinical & Laboratory Features and Treatment
Authors: Al Ani A. M. , Hammoudeh M. , Khanjar I.
Published: February 2016

Adult-onset StilVs disease remains a clinical diagnosis and a diagnosis of exclusion: its prompt recognition will avoid unnecessary diagnostic procedures and delay in ini-tiating therapy.

The clinical and laboratory features and treatment of 16 patients with Adult-onset StilVs Disease (AOSD) at Hamad General Hospital (HGH) were studied and com-pared with 62 patients of G. Pouchot.

Eight patients were female (50%), ten (62.5%) hadpoly-arthritis and rash, fourteen (87%) had fever > 39°C. Leu-kocytosis, thrombocytosis and hyperferritinemia were present in most of the patients.
Effect of Dexamethasone in Acute Laryngotracheitis
Authors: Al Khaldi O. , Raggad M. , Aldhanhani M. S.
Published: February 2016

Fifty eight patients between the ages of six months and five years were studied in a randomized double-blind trial to determine whether dexamethasone has a role in the outpatient management of patients with acute viral croup of moderate severity. For various reasons, twelve were excluded from the final results. In the 46 patients who completed the study (32 males, 14 females) the only significant differences detected between the treatment groups were that the duration ofrhinorrhea was longer in the dexamethasone group compared with placebo (median 2,5 days vs 1,5 day) and the pre-discharge croup score was higher in the dexamethasone group compared with placebo (2 vs 0).

Conclusion: The use of dexamethasone in the outpatient management of viral croup is associated with a reduction in the severity of illness within 24 hours of treatment. Patients with viral croup of moderate severity should be considered candidates for the use of dexamethasone before discharge from the paediatric emergency clinic.
Bone Metastasis in Hepatocellular Carcinoma
Authors: Latif A. , Muzrekchi A.
Published: February 2016

We report a case of hepatocellular carcinoma in a forty five year old man with Hepatitis C virus and liver cirrhosis. He presented with headache, double vision and leftsided facial numbness. MRI and a CT scan of his head revealed metastasis at the base of the skull
Acute Anterior Myocardial Infarction Following Electrocution
Authors: Omer A. A. , Khalid M. K. , Gehani A. A.
Published: February 2016

Electrocution is a well known cause of cardiac arrest, mostly secondary to ventricular fibrillation. Acute myocardial infarction has been reported in a few cases although the pathogenesis is not clear. We report two cases of acute myocardial infarction after electrocution, both confirmed by electrocardiography and markedly elevated cardiac enzymes. Echocardiography showed cardiac damage evidenced by hypokinesia.
Pregnancy in a Patient with Non-Hodgkin Lymphoma
Authors: Habib F. A.
Published: February 2016

The overall incidence of lymphoma during pregnancy has not been established accurately. Hodgkin's disease is the fourth most frequently diagnosed cancer in pregnancy (1 in 1000 to 1 in 6000 pregnancies). In contrast, the incidence of non-Hodgkin lymphoma during pregnancy is rare, with fewer than one hundred cases reported(2). A case of small intestinal lymphoma in association with pregnancy is presented, with emphasis on the major clinical issues involved in the approach to the management of such cases.
Selected Abstracts From Other journals
Authors: Gehani A. A. , Hammoudeh M.
Published: February 2016

Background: The analgesics used for pediatric tonsillectomy may be associated with side-effects such as sedation, respiratory depression and vomiting (opiods) or increased bleeding [non-steroidal anti inflammatory drugs (NSAIDs)]. In our institution, we employ a combination of paracetamol, NSAID and opioid, although there is no published evidence of analgesic benefits from adding NSAIDs to paracetamol in children.
The impact of the human genome project clinical care and ethical challenges
Authors: Kennedy S. , Shuman C.
Published: February 2016

June 2000 heralded the first draft of the human genome and with it a tremendous amount of public attention to this monumental achievement Amidst the excitement regarding the potential impact on clinical medicine and anticipating uthe development of rational strategies for minimizing or preventing disease phenotypes altogether” there has also arisen concern about the ethical use of this new technology as well as a healthy dose of skepticism about its ultimate application to clinical care. Clearly, as technology continues to elucidate new genes and theirfunction, both in normal development and pathology, questions and concerns about practical applications of this information will continue to arise. The goal of this article is to review the impact of the discoveries of Human Genome Project (HGP) on the practice of genetic counselling and clinical care as well as to discuss the potential ethical dilemmas, which may arise.
Changes in Testosterone Levels During the Fasting Month of Ramadan
Authors: Mira S. A.
Published: February 2016

During the month of Muslim fasting (Ramadan) many people alter their sleeping habits and stay awake most of the night In this study I looked into the effect of this alteration as well as the effect of fasting on testosterone and its circadian variation in fifty-eight (58) healthy adults. Fortysix (46) of the subjects showed alteration of the diurnal variation during the third week of fasting. Thirty-eight (38) males showed significant increase in evening testosterone level and eight (8) females showed significant decrease of morning testosterone level (P <  0.001 in both). These findings suggest that alteration in sleeping pattern during Ramadan has a significant effect on testosterone levels.
Pre-Operative Versus Post-Operative Peritonsillar Infiltration with Local Anesthetic on Post-Tonsillectomy Pain
Authors: Nawasreh O. , Momani O. , Tawalbeh M.
Published: February 2016

To compare the efficacy of either preoperative or postoperative peritonsillar infiltration of local anesthetic upon posttonsillectomy pain, 70patients aged 15/40 years scheduled for elective tonsillectomy under general anesthesia were divided into three groups. Six patients were excluded for failure to complete the postoperative data, two patients had post-operative bleeding and two patients developed otitis media on the second day postoperatively.

Twenty patients received peritonsillar infiltration with 0.25% bupivacaine, twenty received 0.9% saline and a third group of twenty had peritonsillar infiltration with 0.25% bupivacaine after completion of surgery but before being awakened from anesthesia. Significant changes occurred with bupivacaine infiltration in reducing pain during the first 24 hours after surgery.

It is concluded that preoperative and postoperative blocking of nociceptive impulses reduces postoperative pain but causes no reduction in the intake of analgesics. It is further suggested that the timing of peritonsillar infiltration with bupivacaine is not of clinical importance and does not affect the quality of postoperative analgesia in a patient undergoing tonsillectomy.
The Effect of Obesity in Pregnancy on Perinatal Outcome in Qatar
Authors: Abu Yaacob S. , Saad F. A. , Sharara H. A. , Khalifa L. , Manther A. A. , Rashed Y. A.
Published: February 2016

To determine the prevalence of obesity amongst pregnant women in Qatar and to compare pregnancy complications and perinatal outcome among obese and non-obese women, a retrospective controlled study was conducted at the Women's Hospital, Doha, during the period from 1st January to the end of June 2001. We compared 75 obese and 75 non-obese women matched for age and parity.

Maternal demografic variables included maternal age, parity, race and body mass index. The antepartum variables were gestational diabetes, pregnancy-induced hypertension (PIH), abruptio placentae and intrauterine growth restriction. Intrapartum variables were preterm labor; mode of delivery and meconium in labor. Neonatal variables included low birth weight, macrosomia, low Apgar score, stillbirth and admission to the Neonatal Intensive Care Unit (NICU).

Compared to non-obese women, obese pregnant women had significantly adverse perinatal outcomes including gestational diabetes (34.7% vs. 12%, P < 0.001), PIH (16% vs. 2.7%, P = 0.012), macrosomia (20% vs. 6.7%, P = 0.031), cesarean section (29.3% vs. 13.3%, P = 0.038) and admission to NICU (17.3 vs. 5.3%, p = 0.039). Other adverse outcomes were higher in the obese group but the differences were not statistically significant.

Obesity in pregnancy appears to be an independent risk factor for adverse perinatal outcome. Maternal obesity may be one of the most important preventable risk factors for perinatal morbidity and mortality.
A Review of Eclampsia in Qatar 1991: 2000
Authors: Sharara H. A. , Othman S. Y.
Published: February 2016

Objective: To measure the incidence and risk factors of eclampsia, establish how often it is preceded by preeclampsia, detect the clinical characteristics of women developing eclampsia, document the morbidity associated with eclampsia, determine the maternal case fatality rate and review the clinical features and management of this condition.

Method: A retrospective review of all cases of eclampsia which were managed in the Women's Hospital in the State of Qatar in the period between January 1991 to December 2000. Details were collected by reviewing the files of the patients from the medical record. Data were analyzed by either x2 analysis or the unpaired student “t” test as appropriate.

Result: Thirty nine cases of eclampsia were notified. The incidence of eclampsia in Qatar was 4.1 /10,000 maternities. Fourteen women (36%) had no antenatal care (ANC). However most convulsions occurred despite ANC (64%) and within one week of the woman's last visit to a doctor (58%). Thirty nine percent of the first seizures occurred in hospital, of which 23% developed before both proteinuria and hypertension had been developed. Twenty three percent of eclampsia occurred postpartum (PP), 51% antepartum (AP), and the remainder (26%) intrapartum (IP). There was no maternal fatality in Qatar but 23% of all women had at least one major complication. The rate of still birth (SB) andfirst week neonatal death (NND) was 76.2/1000 and 83.6/1000 respectively and the perinatal mortality rate (PNMR) was 153.8/1000. Preterm eclampsia was more common than term eclampsia (74% V 26%). Preterm eclampsia occurred more commonly AP (66%) and was associated with more maternal complications (26%) and fetuses that were small for gestational age (34%) as well as with higher rates of SB (10%) and first week NNDs (14%).

Conclusion: Eclampsia occurs in nearly one in 4000 maternities in Qatar and is associated with high incidence of maternal and neonatal morbidity and mortality. Antepartum onset carries greater risks and preterm eclampsia is particularly dangerous to both mother and fetus.
Pyomyositis in Qatar: Report of a Case Presented as Back Pain and Sciatica and Review of the Literature
Authors: Al Yazidi S. M. , Maqdassy E. G. , Bakdash M. M.
Published: February 2016

Pyomyositis is a bacterial infection affecting the large muscle groups and is usually accompanied by abscess formation; the term “tropical myositis” being an alternative as it is more common in the tropical regions, and has become an increasingly recognized entity in temperate climates. Normally skeletal muscle is resistant to metastatic infections but it seems likely that more than one specific factor can remove this barrier. The most common organism being Staphylococcus aureus found in about 90% of the cases, while Streptococcal spp. are next in frequency. Other bacterial species have been incriminated; fungal infection can also cause local destruction and abscess formation, while viral infection (notably Coxsackie viruses) may result in acute rhabdomyolysis. The spread is hematogenous except in those cases in which there is direct extension, as from osteomyelitis, and the muscles commonly affected are the glutei, quadriceps, shoulder and axial. The abscess forms deep inside such muscles.
Continent Gastric Pouch Bladder Replacement
Authors: Ismail A. , El Zamer J. , Hamad B.
Published: February 2016

The use of the stomach for bladder enlargement and replacement has been known since Sinaiko's work in a canine model. Mitchell et al later showed that the use of the stomach for bladder replacement and enlargement had many advantages especially in situations of acute acid loading and azotaemia. The advantages of using the stomach included protection against hyperchloraemic acidosis (due to net excretion of chloride), reduced mucus production and decreased urine infection rate, plus the elastic properties of the stomach. We report the use of part of the stomach as a continent urinary reservoir to replace a missing urinary bladder and we discuss the advantages and disadvantages of using the stomach in the urinary tract
Selected Abstracts From Other Journals
Authors: Hammoudeh M. , Gehani A. A.
Published: February 2016

Objective: To define forces of youth soccer ball heading (headers) and determine whether heading causes retinal hemorrhage.

Setting: Regional Children's Hospital, youth soccer camp.

Patients: Male and female soccer players, 13 to 16 years old, who regularly head soccer balls.

Measurements: Dilated retinal examination, after 2-week header diary, and accelerometer measurement of heading a lofted soccer ball.

Results: Twenty-one youth soccer players, averaging 79 headers in the prior 2 weeks, and 3 players who did not submit header diaries lacked retinal hemorrhage. Thirty control subjects also lacked retinal hemorrhage. Seven subjects heading the ball experienced linear cranial accelerations of 3.7±1.3g. Rotational accelerations were negligible.

Conclusions: Headers, not associated with globe impact, are unlikely to cause retinal hemorrhage. Correctly executed headers did not cause significant rotational acceleration of the head, but incorrectly executed headers might.
Methacholine Challenge Test in the Diagnosis of Airway Hyperresponsiveness in the State of Qatar
Authors: Mobayedh H. M. S. , Sattar H. A. , Saif A. S. , Al Mohammad A. A. , Al Langawi M. , Bener A. , Balamurugan P. , Mary V. P.
Published: February 2016

We retrospectively analyzed the results of263 consecutive Methacholine challenge tests (MCTs) done in our laboratory between July 2000 and June 2003, in symptomatic adult patients with no history of bronchial asthma or chronic lung disease, who presented with chronic nonproductive cough, shortness of breath (subjective dyspnea), or both. All of these patients had normal results of chest physical examination, chest radiographs and screening spirometry measurements (FEVl >80% of predicted). We considered a 20% fall in the forced expiratory volume in the first second (FEVJ as the primary outcome measure (MCT PC 20-FEV1X and a 35% fall in the specific conductance (sGaw) as the primary outcome in patients who cannot perform acceptable spirometry. Out of263 patients, 79 patients (30%) were positive for bronchial hyper-responsivenes (BHR), 20 patients (25.3%) of the positive patients had sever BHR, 18 patients (22.8%) had moderate BHR, and 41 patients (51.9%) had mild BHR.
Atypical Serpiginous Chorioditis Treated by Posterior Subtenon Methylprednisolone
Authors: Al Laftah F. A. M.
Published: February 2016

A 37 year-old Asian man with an infection of the upper respiratory tract experienced sudden visual changes suggestive of acute multifocal posterior placoid pigment epitheliopathy (AMPPPE). Extensive examination showed this to be serpiginous choroidopathy that was treated successfully with a single subtenon injection methylprednisolone. It is suggested that this method of treatment needs further investigation and evaluation.
Epidemiology of Breast Cancer in Qatar 1999-2002
Authors: Bujassoum S. M. , Gehani A. A.
Published: February 2016

This is retrospective study of breast cancer in Qatar during period 1999-2002, using cancer registry data A total 214 patients were diagnosed with breast cancer; with incidence of5/10,000 of population per year; account-ing for 13.3% of new cancer cases and 29.9% of all female cancer. Male breast cancer is rare accounting for 3.2% of total number. Qatari patients were 23% and non-Qatari patients were 36.2%. The disease more common in ages between 46-55years old accounting for 64% of total breast cancer; patients usually presented beyond or equal to Stage II and with distant metastasis in 7% of cases, patients com-monly present with invasive ductal carcinoma and histo-logical Grade 2 & 3, it has been noticed that were decrease in incidence of Stage III & IV and decrease in Stage I & II which reflect improvement in patient awareness of this problem.
G6PD Deficiency
Authors: Al Muzrakchi A. , Gehani A. A.
Published: February 2016

G6PD deficiency is the most common enzyme deficiency disease worldwide, affecting 10% of the world's population. It is an X linked recessive disease therefore it affects males more than females (females are usually carriers of the disease).
Selected Abstracts From Other Journals
Authors: Gehani Abdurrazak A.
Published: February 2016

Background: It has been suggested that an oxidative mechanism is involved with the impaired endothelium-dependent vasodilatation that occurs after a high-fat meal.

Hypothesis: The study was undertaken to evaluate the effect of a single oral dose of vitamin C (2g) on postprandially impaired endothelium dependent vasodilatation in patients with coronary heart disease (CHD).

Methods: This study included 74 patients with CHD and 50 subjects without CHD with risk factors. The two groups were divided into two subgroups that did or did not receive 2g of vitamin C (CHD/VitC and CHD/control, n=37; non-CHD/VitC and non-CHD/control, n=25) after a high-fat meal (800 calories, 50g fat). Serum levels of triglyceride, total cholesterol, low-density lipoprotein cholesterol, and high-density liporotein cholesterol in the fasting state and at 2,4,5 and 7 h after the high-fat meal were measured. Endothelial function was assessed in the brachial artery by high-resolution ultrasound at baseline and at 4h postprandially.
Presentation and Management of Post-partum Choriocarcinoma in Qatar
Authors: Al Sakka M. , Rasul K. I. , Dauleh W. , Al Tamimi H. , Al Taher F.
Published: February 2016

Post-partum choriocarcinoma is a rare complication of pregnancy. We have analyzed a series of six consecutive patients presenting with choriocarcinoma after a fullterm non-molar pregnancy. The incidence was calculated to be 1 in 19,000 births. Five patients were managed at the Hamad Medical Corporation between 1991 and 2001. All presented with persistent primary or secondary post-partum hemorrhage. Treatment with chemotherapy was successful in all cases. Early diagnosis is important because this rare condition is potentially curable with appropriate chemotherapy.
Pregnancy Outcome in Grand and Great Grand Multiparity
Authors: Ahmed B. I. , Kenyab N. , Saleh N. , Azzam A. , Almohandi H.
Published: February 2016

Objective: To study the obstetric performance and neonatal outcome of patients of extreme multiparity, Para 10 and more, compared to control group of Para 2 to 4.

Study Design: It is a retrospective comparative study. Data were collected from Medical Records ofpatients during the period from January-December 2000. The total number of deliveries during that period was 10,999. 240 patients records were reviewed, 120 records in each group.

Result: The incidence of great-grand multiparity was 1.09%. The incidence of lack of perinatal care among great grand multipara was statistically significant. However; there are no differences in the perinatal morbidity and mortality; also there was no difference in the rate of instrumental delivery and mal-presentation in the two groups. The duration of pregnancy is similar in the two groups. There was no difference in incidence of antepartum hemorrhage, rate of caesarean section rate. However; the only statically significant difference in the two groups was the increased incidence of large babies (macrosomia).

Conclusion: This study showed that extreme grand multiparity carry the added risk of macrosomia (> 4000mg), this was not reflected on any adverse perinatal outcome. However, the number of patients in this study is limited and it is difficult to draw firm conclusion.
Antibiotic Resistance Pattern Among Aerobic Gram Negative Bacilli Isolated from Patients in Intensive Care Units
Authors: El Shafie S. , Mohsin Z. , Mohsin T. , Al Soub H.
Published: February 2016

To study the antimicrobial resistance pattern of aerobic Gram-negative bacilli isolated from patients in intensive care units in Hamad Medical Corporation, 108 non-duplicate isolates from 60 patients with nosocomial infections were determined by Vitek machine. The minimal inhibitory concentration of 14 antimicrobials was determined by E-test and results were interpreted according to the National Committee for Clinical Laboratory Standards guidelines. The most common species was Pseudomonas aeruginosa High levels of resistance were seen to second and third generation cephalosporins, piperacillin, fi-lactam Ji-lactamase inhibitors combinations, and gentamicin. The most active agents were amikacin, meropenem and imipenem (resistance 19%, 19%, 20% respectively). We conclude that second and third generation cephalosporins, piperacillin, fi-lactam/fi-lactamase inhibitors combinations and gentamicin are not suitable drugs for empirical monotherapy for aerobic Gram-negative infections in intensive care units in Qatar.
Browns Tumor - A Rare Cause of Pathological Fracture Neck of Femur: Problems in Diagnosis and Treatment
Authors: Arun K. P. , Wozniak A. P. , Rysavy M. , Al Emadi E.
Published: February 2016

Pathological fractures in primary hyperparthyroidsm are usually seen in the late stages of the disease. It is extremely rare to see such fractures in asymptomatic hyperparathyroidsm. We present such a case and discuss the diagnostic difficulties and problems in treatment.
Xanthogranulomatous Cholecystitis: A Surgical Challenge
Authors: Kamel H. A. M. , Omar A. J.
Published: February 2016

In this article(1), the authors reviewed an interesting topic of which all Radiologists and Surgeons need to be aware. The pathology of the condition was well reviewed as well as the clinical presentation and the management in the four cases presented.
Prevalence of Human Papilloma Virus with Intraepithelial Lesions and Cervical Cancer in Qatar
Authors: Afifi N. , Altaher F. T. , Abushareeda W. M. S.
Published: February 2016

Cervical cancer is the third most common cancer worldwide and the leading cause of death from cancer amongst women in developing countries. A study in Qatar in 1997 found that the cancer of the cervix was the most common type of cancer in the female genital tract. In order to further assess the relevance of various risk factors, the records were reviewed of 100 women diagnosed with cervical cancer and intraepithelial lesions between January 2000 and October 2002. There was a highly significant association between detection of human papilloma viruses and increasing incidences of cervical intraepithelial lesions especially with low grade squamous intraepithelial lesions. Young women were more likely to have mostly low grade intraepithelial lesions whereas older women were more likely to have adenocarcinoma and there was a significant relation between parity and risk of the disease. Human papillomaviruses infections, early marriage andfrequent coitus started early in life and an increasing number of pregnancies were predisposing factors for the genesis of cancer of the cervix in Qatar. Older women do not realize that the risk of developing cervical cancer is not reduced as they age and it is important for them to continue having pap smears.
Distribution of Risk Factors in Patients with Colorectal Cancer in Saudi Arabia
Authors: Al Ahwal M. S. , Al Ghamdi A. A.
Published: February 2016

Objective: To identify the risk factors for Colorectal Cancer (CRC) at King AbdulAziz University Hospital (KAUH) in the western region of Saudi Arabia.

Methods: Clinical, pathological and risk factors data of all patients with CRC managed at KAUH, over a 10 years period (1993-2002) were collected and analyzed retrospec-tively. Risk factors, were then correlated with sex and race (Saudis vs Non- Saudis).

Results: Out of 90 patients evaluated, 5 were excluded because of incomplete data. Out of 85 patients, 45 (52.9%) patients were males, 40 (47.1%) females, 33 (38.8) Saudis and 52 (61.2%) were Non-Saudis. The Majority were Asians; 81 out of 85patients (95.3%) and4African (4.7%). Comparisons between males and females revealed no dif-ference for all the following risk factors; familial causes, polyps, Inflammatory bowel disease (IBD), High fat low fiber diet, Non steroidal anti inflammatory drugs (NSAIDS) use and Obesity. Comparisons between Saudis and Non-Saudis revealed no difference in all mentioned risk factors except for familial causes which was found higher among Saudis versus Non-Saudis (15.2% vs 1.9%, P = 0.031).

Conclusions: Risk factors for CRC are present in this study population especially dietary habits and obesity. Fa-milial risk factors were higher among Saudis than Non Saudis. The relative high frequency of some risk factors calls for family screening and surveillance.
Evaluation of Once Daily Tobramycin Versus the Traditional Three Time Daily for the Treatment of Acute Pulmonary Exacerbations in Adult Cystic Fibrosis Patients
Authors: Al Ansari N. A. , Foweraker J. , Mackeown D. , Bilton D.
Published: February 2016

Once daily tobramycin is convenient to use and achieves higher tissue levels that should kill Pseudomonas aeruginosa more rapidly. Small trials of OD compared with TDS aminoglycosides in CF patients have shown no dif-ference in efficacy or toxicity. No one has looked in detail at the impact on sputum microbiology. In a prospective, randomized study at Papworth Hospital, UK, we compared OD with TDS tobramycin, each plus a second anti-pseudomonal, for the treatment of acute infective exacer-bation in 15 adult cystic fibrosis patients colonized with Pseudomonas aeruginosa. Using the patients as their own control, the same individuals received the alternate treat-ment regime for the next exacerbation. We aimed to com-pare the clinical and bacteriological efficacy, toxicity>, and the effects on susceptibility of the organism among patients in both treatment groups. Isolates were identified, and the Minimum Inhibitory Concentration (MIC) of the antibi-otic in each patient was performed. Patients were assessed for clinical improvement, toxicity and the total viable count in their sputum on days 0\ 7 and 14. In both treatment groups there was a significant clinical improvement, and toxicity did not occur in either group. There was no differ-ence in clinical outcome, adverse events, or time to the next exacerbation. No difference was seen in the selection of antibiotic resistance. OD tobramycin appeared more ef-fective in reducing the number of bacteria in the group overall at day 7 and in two individuals, at day 14.
A Social Profile on a Sample of Obese Adults in Baghdad City
Authors: Lafta R. , Hayyawi A. H.
Published: February 2016

Background: Obesity should be recognized as a primary medical condition that is progressive, chronic and relaps-ing. Simply, obesity refers to an excess of body fat or adi-posity. The aim of this study is to explore some variables of social aspect of Iraqi obese.

Methods: A cross-sectional study was conducted in four medical centers in Baghdad city from 15th October 2002 through February 2003. A sample of (400) adult obese aged (20-60)years of both sexes with inclusion and exclu-sion criteria was studied. A socio-demography data were collected by direct interview technique. Height and weight were measured, Body mass index (BMI) was calculated and subject of 30kg/m2 and more were considered as obese. Obese were classified into three classes.

Results: The peak of obesity (34%) was found at age (40-49) years. BMI distribution significantly associated with educational level of male but not of female. Marital state showed significant relationship with different classes of obesity for female but not for male. Obesity has no sig-nificant association with social relationships. The feeling of social acceptance was strongly associated with the de-gree of obesity. There was a significant difference between both sexes in their trials for dieting.

Conclusion: Both sexes of different age groups are affected with increased prevalence in middle age group. Obese have ordinary social relationship with others and a normal sexual relationship with partners. The obese con-sider obesity as being unwanted or dangerous status, still their trials to lose weight are not convincing. There are many barriers for not exercising in Iraqi obese.
Challenges and Controversies in the Management of Hepatitis C Virus Infection (Part 2)
Authors: Bel Haj N. B. , Giaffer M. H.
Published: February 2016

Patients with HCV-related cirrhosis are frequently seen in clinical practice when the diagnosis is established either clini-cally when signs of chronic liver disease are evident, or histo-logically when liver biopsy is performed as part of the assess-ment of patients with HCV infection. It continues to be debat-able whether cirrhotic patients should receive antiviral therapy. Those who propose treatment state that eradication of HCV is the main goal of antiviral therapy thus limiting the spread of HCV infection and stress that cirrhosis is not a permanent in-jury that cannot be reversed. Opponents of antiviral therapy in patients with cirrhosis state that such treatment produces very low virological response rates in the face of a reportedly high incidence of side effects.
Medical Treatment of Benign Prostatic Hyperplasa Where do we stand in 2004?
Authors: Al Ansari A. , Al Said S. , Al Rubaiai A. , Ardalan G. , Shaat A.
Published: February 2016

The three factors responsible for the lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) are the prostate itself, the bladder and the central nervous sys-tem. The prostate is responsible for obstruction through its physi-cal mass (static component) and its smooth muscle contraction (dynamic component). The bladder and spinal cord are mainly responsible for irritative (storage) symptoms.
Arthroscopy of the Wrist Joint
Authors: Dahabra I. A.
Published: February 2016

Arthroscopy is widely used nowadays for the diagnosis and treatment of increasing numbers of disorders of the knee, shoul-der, elbow, ankle, wrist and hip. Arthroscopy of wrist joint has also been developed as a useful diagnostic device as well as a successful surgical tool in managing disorders of the wrist joint. Wrist arthroscopy has a high diagnostic score which bough some wrist surgeons to contemplate the need for wrist arthroscopy in the majority of patients presenting with significant wrist disor-ders.
The Effect of Collagen Removal on Penetration Depth of Dentin Adhesive System
Authors: Hieaway A. T. , Al Rubayi A. , Al Kaisy K.S.
Published: February 2016

Thirty sound human upper premolars were used to evaluate the in vitro effect of collagen removal from the acid-etched dentin surface on the penetration depth of three types of dental adhesive systems. Standardised buccal and lingual class V cavities were made and the teeth were then subdivided randomly into six groups five teeth each. Three types of dental adhesive systems were used (syntac sprint, Vivadent-Liechtenstein. Syntac single component, Vivadent-Liechtenstein. PQ1> Ultra Dent-USA). The bonds were used with and without deproteinization (10% Sodium hypochlorite for one minute). The highest mean of penetration depth (10.15 jl) was recorded in the group where the PQ1 bond was used on acid-etched and NaOCl-treated dentin. The lowest mean of penetration depth (5.77jl) was recorded where the Syntac Single Component bond was used on the acid-etched dentin surface.

Conclusion: A one minute application of 10% sodium hypochlorite on conditioned dentin significantly increases the penetration depth regardless of the type of adhesive system used. Alcohol-containing systems showed the greatest penetration.