bluuebunny/crossref_metadata_2025 huggingface dataset:
Aortic Origin Reconstruction of Major Arterial Occlusions in Takayasu's Arteritis
Authors: Fares A.
Published: February 2016

Takayasu's arteritis is a rare inflammatory arteriopathy that affects predominantly young females and segmentally involves the aorta and its major branches. Infectious, hereditary, and autoimmune causes of Takayasu's arteritis have all been suggested; yet there is no consensus regarding its cause.
Successful Treatment of Traumatically Intruded Permanent Anterior Tooth
Authors: Yacoub A. A.
Published: February 2016

Traumatic intrusion of permanent teeth is rare, as with many things in dentistry often treatment has been empiri-cal in nature. This article will review the available research data as well as present a case study showing successful treatment of an eight year-old Qatari who sustained such an injury.
An Egyptian Infant with Cystic Fibrosis Mutation N1303K
Authors: Wahab A. A. , Janahi I. A. , Marafia M. M.
Published: February 2016

An Egyptian infant with the common CFTR mutation N1303K in exon 21 developed alkalosis, electrolyte disturbance and pancreas insufficiency. The need is emphasized to consider the possibility of cystic fibrosis (CF) in the Arab world. The frequency of N1303K mutation in the Middle East and its distribution are both reviewed.
Oxygen - Hemoglobin Dissociation Curve
Authors: Mubarak N. M. , Gehani A. A.
Published: February 2016

The delivery system of oxygen in the human body consist of lungs and CVS, which it depends by it self on the:

1 Amount of O2 entering the lung.

2 Adequacy of pulmonary gas exchange.

3 Blood flow to the tissue: witch depends on the degree of the constriction of the vascular bed in the tissue, and on the cardiac output.

4 Capacity of blood to carry O2: which depends on the amount of dissolved O2, amount of Hb in the blood, and affinity of Hb for O2
Tutorials in Therapeutics Should Cholesterol Level be lowered below “Normal”?: Insights from the Heart Protection Study
Authors: Salam A. M. , Gehani A. A.
Published: February 2016

The benefits of cholesterol-lowering with statins has been established for patients with high cholesterol levels as well as for patients with prior occlusive coronary heart disease. However; substantial uncertainty has existed about the long-term benefits of these agents in certain groups, including patients with “normal” cholesterol levels pretreatment, women, the elderly, as well as those with prior occlusive non-coronary disease. The Heart Protection Study 1 was designed to resolve these uncertainties and to provide substantially more safety information of statins. We present its significance and practical implications.
Epidemiology and Etiology of Intractable Epilepsy in Qatar
Authors: Al Hail H. , Sokrab T. , Hamad A. , Kamran S. , Hamad A. A. R. , Khalid A.
Published: February 2016

The medical records of 219 epileptic patients seen over a period of eight years were reviewed to determine the incidence and causes of intractable epilepsy amongst adults in Qatar: The incidence rate of hospital admission with uncontrolled epilepsy was calculated as 25per 100,000persons. Thirty-nine patients (18%) fulfilled the criteria for IE and the incidence of IE could be approximated at 4.5 per 100,000 persons. In the native Qatari population the approximated incidence of IE would be 1 in 100,000 persons per year, while in the expatriate population the rate would be 3.5 per 100,000 persons per year. The most common type of IE was idiopathic generalized epilepsy (75%) followed by symptomatic epilepsy (19%) and temporal lobe epilepsy (6%). To calculate the crude incidence of epilepsy in Qatar, the records were reviewed of 1217patients (aged 13-85 years) visiting the outpatient department or admitted to hospital because of a newly diagnosed epilepsy during the calendar year, 1st January-31st December 2001. These figures were extrapolated to an approximation of an incidence of 174 in 100,000 persons per year.
Management of Brain Abscess and Lateral Sinus Thrombosis of Otogenic Origin: A Multidisciplinary Team Approach and Review of Literature
Authors: Ganesan S. , Kamal H. A. , Bashir E. , Raza A. , Al Soub H. , Al Juffairi A. A. , Al Qahtani A. S. , Al Ansari A. , Abbas F. K. , Larem A. Y.
Published: February 2016

In this era of antibiotics the incidence of brain abscess and lateral sinus thrombosis (LST) secondary to chronic suppurative otitis media (CSOM) should not be underestimated and the management still remains a clinical challenge. We review the clinical records of patients who presented with temporal lobe abscess (Case 1), cerebellar and extradural abscess (Case 2) and LST (Case 3) of otogenic origin and discuss the importance of multidisciplinary team approach in the management of these high-risk cases. We review the literature in detail and discuss the epidemiology, clinical presentation, diagnostic modalities, treatment options and controversies in the management of brain abscess and LST.
Phyllodes Tumors
Authors: Al Mashat F. M. H.
Published: February 2016

The purpose of this study is to formulate guidelines for proper surgical management ofphyllodes tumours. It is a disease often misdiagnosed by the pathologist and undertreated by surgeons. We have retrospectively studied 12 patients with histologically proven cystosarcoma phyllodes (CSP). There were 4 benign and 8 malignant lesions, with an incidence of 33.33% vs 66.66% respectively. The treatment was surgical in all patients. The extent of surgery ranged from wide local excision to Modified Radical Mastectomy (MRM). One patient with malignant CSP developed lung metastases (12.5%) and three had recurrences (37.5%). The exact recurrence rate can't be calculated because 5 patients lost follow-up. The results of this study indicates that local excision is safe for benign CSP and all patients with malignant CSP should be treated by mastectomy since there is a high recurrence rate with local excision (37.5 %).
The Clinical and Immunological Picture of Primary Sjogren's Syndrome in Qatar
Authors: Hammoudeh M. , Mahdi S.
Published: February 2016

Background: Primary Sjogren's Syndrom(SS) is an autoimmune disease with diverse clinical presentation. This study was conducted to describe the clinical and immunological picture of SS in patients seen in the main hospital in Qatar.

Methods: We reviewed all the medical records of patients seen at Hamad medical corporation between 1997 and 2002 who met the classification criteria for primary SS. Eighteen patient met these criteria.

Results: Female to male ratio were 9:1. The average age at the time of diagnosis was 40.6 (range from 24-61) with a period of 2.3 years before the diagnosis was established. Dry eyes and/or dry mouth were the presenting symptoms in 66%. Parotid swelling alone or with other symptoms were the presenting symptoms in 17%..Renal tubular acidosis were seen in 17% and fatigue in 44%. Shirmer test was positive in 85% and lip biopsy in 80% of patients in whom the tests were done.Anti-SS-A/Ro were positive in 71% and Anti-SS-B/La were positive in 50%.

Conclusion: Our results are almost similar to other studies in the west.
Splenic Abscess Due to Salmonella Infection
Authors: Hussain A.A. , Allam H.I. , Almahdy H. , Kassem H.
Published: February 2016

A rare case of splenic abscess due to salmonella infection in a teen-age non-Qatari male was treated unsuccessfully by antibiotic therapy and percutaneous drainage. The patient recovered uneventfully after the spleen was removed laparoscopically.
Successful Transthoracic Drainage of a Large Pneumatocele in a Premature Infant
Authors: Masoud A. A. , Chalabi M. , Omer F. , Bhat V.
Published: February 2016

Pulmonary pneumatocele is an unusual complication of bacteria Pneumonia in the neonatal period. They usually develop during the recovery phase, and generally resolve spontaneously within seeks to months [1], We present a premature newborn that developed a large pneumatocele secondary to staphylococcus aureus pneumonia that was treated successfully with a test tube inserted into the pneumatocele. This resulted in complete resolution of the pneumatocele in four days.
“From Qatar to the World” Abstracts Presented at International Conferences /or Published in Medical Journals
Authors: Hammoudeh Mohammed , Gehani A.A.
Published: February 2016

This abstract was presented in 1st Gulf Scientific Dental Meeting inAl Khobar, Saudi Arabia, 30th September, 2004.
Paralyzing the Renin-Angiotensin System to Retard the Progression of Diabetic Nephropathy: A bench-to-bedside review
Authors: Asim M.
Published: February 2016

In the early 1980s, patients with diabetic nephropathy (DN) had a doomed prognosis. Severe renal failure developed within five years of the onset of proteinuria.[1] The mortality was 53%, with 59% of deaths attributable to renal failure. There is no doubt that this devastating complication of diabetes has caused immeasurable human suffering and enormous healthcare costs.
How well do GP's and Hospital Consultants in Qatar Interacts? A Survey of the Professional Relationship
Authors: Mohammed H. , Al Lenjawi B. , Buabbas A. , Al Shaar I. , Ali J. , Al Kozaai D. , Khalil R. , Almasseh F.
Published: February 2016

The study involved 196 participants, 83 (42.3%) of which were consultants and 113 (57.7%) were General Practitioners (GP's).

Background: The way that GP's and hospital consultants or specialists interact has important implications for any health care system in which a GP is the first contact health professional person for patients and the point of access to relatively scarce and expensive hospital services, for this reason, the relationship between the two main branches of the medical profession has received a considerable amount of interest.

Objectives: To test out some professional issues on a random sample of both parties to determine their ability to work together productively.

Methods: We conducted a lickert-style survey based upon statements made in qualitative questionnaire sent to GP's and specialists working at Hamad Medical Corporation and health centers in state of Qatar. The questionnaire was modified and validated during a multistage pilot and was distributed to a stratified random sample of 196 clinicians.

Results: GP's and consultants demonstrated a good level of agreement, mutual understanding and respect (Significant difference in opinion only in four statements out of 13).

Conclusion: The ability of GP's and specialists to work together has been tested out and confirmed with acceptable significance and it may be repeated to assess the relationship which is central to an efficient and effective operation of health care delivery.
Consanguinity and Associated Socio-Demographic Factors in Qatari Population
Authors: Al Ali K.A.
Published: February 2016

A multi-stage sampling design was used between January and May 2004 to explore the association between sociodemographic factors and consanguineous marriages in the Qatari population using a sample of 1800 Qatari females aged 15 years and above. Data on 1515 (85.8%) Qatari national families who gave their consent for the study were obtained. The socio-demographic factors considered were: husband's age, her own age, husband's and own educational levels, husband's occupationher own occupation, housing conditions, husband's parental kinship, her own parental kinship and kinship between the spouses. The rate of consanguineous marriages in the sample was found to be 54% with 95% estimated population confidence limits 52.4% to 55.6%. Consanguinity was more common for women with educated husbands (secondary or university / high) and the frequency of consanguineous marriage significantly increased when the husband's educational level was higher (p = 0.003). The results of stepwise multiple logistic regression analysis for the occurrence of consanguineous marriages showed that the wife's education, the husband's education and parents’ consanguinity status were the only significant associated variables.
Knowledge, Attitudes and Practices of Patients Attending West Bay Health Center Towards Upper Respiratory Tract Infections
Authors: Bashwar Z. , Malik M. A. , Fawaz M. , Said H.
Published: February 2016

Upper respiratory tract infections (URI) are very com-mon in general practice. Although viruses cause the ma-jority of URI, many patients expect antibiotic treatment. At one Primary Health Care Center in Qatar; during October - November 2004, eleven hundred and eleven adult patients completed a short questionnaire on demographics, knowl-edge, attitudes, practices towards URI, and patient satis-faction. Four hundred and forty eight (40.3%) recognized viruses as the most common cause of URI; seven hundred and eighty-eight (70.9%) chose consulting a physician as the first line of action when contracting URI; 721 (64.9%) stated that management should be based on physician's diagnosis while 28% expected antibiotics. A majority of participants acknowledged the importance of counseling in their satisfaction but 49.6% reported dissatisfaction if antibiotics were not prescribed and 31.6% reported seek-ing antibiotics when not prescribed. Participants expect-ing antibiotics differed significantly regarding knowledge of causes of URI (p = 0.004). There was no significant dif-ference regarding factors affecting satisfaction based on antibiotic expectation. Results highlight the need for public education and counseling on etiology, course, and management of URI by physicians.
Knowledge, Attitudes and Practices of Patients Attending West Bay Health Center Towards Upper Respiratory Tract Infections
Authors: Bashwar Z. , Malik M. A. , Fawaz M. , Said H.
Published: February 2016

Upper respiratory tract infections (URI) are very com-mon in general practice. Although viruses cause the ma-jority of URI, many patients expect antibiotic treatment. At one Primary Health Care Center in Qatar; during October - November 2004, eleven hundred and eleven adult patients completed a short questionnaire on demographics, knowl-edge, attitudes, practices towards URI, and patient satis-faction. Four hundred and forty eight (40.3%) recognized viruses as the most common cause of URI; seven hundred and eighty-eight (70.9%) chose consulting a physician as the first line of action when contracting URI; 721 (64.9%) stated that management should be based on physician's diagnosis while 28% expected antibiotics. A majority of participants acknowledged the importance of counseling in their satisfaction but 49.6% reported dissatisfaction if antibiotics were not prescribed and 31.6% reported seek-ing antibiotics when not prescribed. Participants expect-ing antibiotics differed significantly regarding knowledge of causes of URI (p = 0.004). There was no significant dif-ference regarding factors affecting satisfaction based on antibiotic expectation.

Results highlight the need for public education and counseling on etiology, course, and management of URI by physicians.
Measurement of Adherence to Anti-Hypertensive Medication as Perceived by Doctors and Patients
Authors: Fahey M. , Abdulmajeed A. , Sabra K.
Published: February 2016

Introduction: In the absence of objective evidence, doc-tors frequently overestimate the level of their patient's ad-herence to medication and there is no published work look-ing at what factors influence the doctor's perceptions of medication adherence by hypertensive patients. Therefore, the aim of this study to determine the doctor's perceptions of adherence to antihypertensive medication and to com-pare this with their perceptions of the clinical situation and with the patient's self -reported medication adherence.

Methods: An English self reporting measure (7-item questionnaire) was adapted and translated to Arabic and used to determine the adherence to hypertensive medica-tion. Also, a 10-item questionnaire was developed to elicit the doctor's perception of adherence (taking > 80% of doses) and the treatment and overall condition. This de-scriptive study was conducted in across 2 primary health centers in Abu-Dhabi, UAE.

Results: About 40 % of them were controlled regard-ing BP and 30% of hypertensive patients were diabetics. The doctors estimated adherence to be high (taking more than 80% of doses) in 143 (71%) of patients compared with 103(52%) patients who reported high adherence by using Morisky score where, there was a statistically significant relationship between them. Of the 143 subjects perceived by their doctors as having high adherence, only 64 (45%) succeeded to achieve the target blood pressure (p <  0.001) while 55 (52%) of the adherent patients from the self-reported point of view achieved their target BP (p <  0.001). The doctor evaluation was not as good as expected for treatment effectiveness and quality of communication (57% only were evaluated as good). Only the doctor's evaluation of the seriousness of the medical situation showed a sig-nificant correlation with the self-reported adherence and this was in the opposite direction (gamma = - 0.32, p < 0.05). 71% of the adherent patients perceived by doctors were estimated to have effective treatment (p <  0.0001) while 81% of patients achieved their target BP were estimated to have effective treatment by their doctors.

Conclusion: The practical assessment of adherence and drug management would have been greatly enhanced if the results of the Arabic/English self-reporting measure had been available to the doctors in the course of routine practice.
Vitamin D Defficiency in Rheumatology Clinic Practice in Qatar
Authors: Siam A. R. , Hammoudeh M. , Khanjer I. , Bener A. , Sarakbi H. , Mehdi S.
Published: February 2016

In order to assess the prevalence ofvitamin-D deficiency in patients attending the rheumatology outpatient clinic at Hamad Medical Corporation, Qatar; 360 consecutive pa-tients (97% female) were tested for fasting levels of 25-hydroxyvitamin D, parathyroid hormone, calciumphos-phorus, albumin and alkaline phosphatase. Two hundred and three patients (56%) showed vitamin D levels below 20 ng/ml. From the results obtained it is concluded that lev-els of serum calcium, phosphorus, and alkaline phos-phatase are of limited value in predicting vitamin-D sta-tus. The difficulty of skin synthesis in heavily-robed women is discussed and it is concluded that hypovitaminosis D is frequent in such women and that routine assays of vitamin D and parathyroid hormone and vitamin D supplementa-tion would be beneficial.
Evolution of Community Based Rehabilitation Concept in Qatar
Authors: Bobinac-Georgievski A. , Al Sulaiti E. , Zafa Z. , Farran C. , Travia A.
Published: February 2016

A community based rehabilitation (CBR) project was initiated in Qatar on September 2001 and the CBR service was introduced at the beginning of2003. Until December 2004,189 patients with primary physical disabilities were included 49% Qatari and 51% non-Qatari nationals; 81% male, 19% female; 6% children; 94% adults, aged 37 ± 18 years. The main interventions were training for involve-ment in life situations, job site training and providing fam-ily counseling and support. Rehabilitation conferences were held for 132 individuals of whom 25% were with traumatic brain injuries (TBI), 23% with spinal cord injuries (SCI), 20% with stroke, 9% with cerebral palsy (CP), 4% with neu-romuscular dystrophy (NMD), and 19% with other physi-cal disabilities (amputee, trauma etc.). The project demonstrated that CBR could successfully evolve using available resources and that patients present-ing with favorable predictors for reintegration could ben-efit from CBR programs. It was found that health and com-munity participants involved in CBR activities were able to collaborate on common goals but there is room for im-provement in the services available for people with disabili-ties (PwD). Implementation of CBR is sustainable only if people from the community take a leading and active role and work together with the experts and with the disabled people themselves
Tuberculosis Presenting as Immune Thrombocytopenia: A case report and review of the literature
Authors: Kakil I. R. , Mubarak A. A. , Al Suob H. , Burney M. A. , Al Azawi S. H. , Aboudi K.
Published: February 2016

Various hematological abnormalities commonly occur in active tuberculosis (TB) but thrombocytopenia is exceed-ingly rare and immune thrombocytopenic purpura (ITP) is reported in only a few cases. A 28-year-old male pre-sented with thrombocytopenia-induced epistaxis and gen-eralized purpura that did not respond to intravenous im-munoglobulin but did resolve after antituberculous treat-ment The characteristics of this rarely documented asso-ciation are reviewed.
Hypokalemia and Uncontrolled Hypertension
Authors: Darwish S. , Zirie M. , Bozom I. , Al Hassan M. S.
Published: February 2016

In a 45-year-old female with chronic uncontrolled hy-pertension complicated by hypokalemia, laboratory and radiological findings were consistent with an aldosterone producing adenoma (APA). Diagnosis of Conn's syndrome was confirmed by histopathology. The hypokalemia re-solved and her hypertension improved after laparoscopic adrenalectomy. Discussion of the case, diagnosis and treat-ment are presented.
Selected Abstracts From Other Journals
Authors: Hammoudeh M. , Gehani A. A.
Published: February 2016

Background: A consensus has emerged that angiotensin-converting-enzyme (ACE) inhibitors and angiotensin-II receptor blockers (ARBs) have specific renoprotective effects. Guidelines specify that these are the drugs of choice for the treatment of hypertension in patients with renal disease. We sought to determine to what extent this consensus is supported by the available evidence.
Evaluation of the Demographics, Prevalence of Risk Factors and Treatment Strategies of Erectile Dysfunction in Qatar
Authors: Prasad K. V. , Al Ansari A. , Al Kadhi S. , El Malik E. F.
Published: February 2016

Records of patients attending the Andrology Clinic, Hamad Medical Corporation, Qatar; over a period often years were analyzed to determine the demographic features, contributory risk factors, and best methods of treatment for erectile dysfunction (ED). Of1,245patients with ages ranging from 19-78 years (mean 49 years) 45% were Qataris. Most complained of weak erections, a few reported ejaculatory dysfunction. Diabetes mellitus was the most frequent risk factor (53%) followed by hypertension (28%), smoking (27%) and coronary artery disease (14%). Oral Sildenafil given to 310 patients gave overall satisfaction to 75 (49%) of the 152 patients in whom satisfaction could be assessed; intracorporal injection given to 413 patients resulted in overall satisfaction to 107 (68%) of 157 in whom satisfaction could be assessed; penile prosthesis implantation in 64 patients remained an effective therapeutic modality with 31 (84%) of the 37 patients in whom satisfaction could be assessed being satisfied with the results.

Conclusion: Erectile dysfunction is as common in Qatar as it is in the rest of the world. The higher incidence of diabetes mellitus in the ED. population in the region forms the major risk factor and might reflect the need for the implementation of preventive strategies.
New Chemotherapy Protocol (P-CAN) for Treatment of Aggressive Non-Hodgkin's Lymphoma
Authors: Kakil I. R. , Awidi A. S. , Kelta M. , Al Homsi U. , Mubarak A. , Al Hassan A. , Chong-Lopez A. , Bener A.B.
Published: February 2016

Background: this work aims at determining the efficacy of modified CHOP combination in which Vinorelbine (Navelbine) replaces Vincristine for the treatment of aggressive Non-Hodgkin's Lymphomas (NHL).

Patients and methods: This open label pilot study included 19 patients with aggressive NHL and one patient with low grade NHL who were treated with the new combination which we abbreviated as P-CAN (Prednisolone 100 mg/day PO day 1-5, Cyclophosphamide 750 mg/m2 i.v day 1, Adriamycin (Doxorubicin) 60 mg/m2 i.v day 1, Navelbine (Vinorelbine) 30 mg/m2 i.v day). The patients1 were 13 males and 6 females, mean age 50 years (34-65), performance state 0-2, International Prognostic Index (IPI) 0-3. Seven patients Stage I, one patient Stage II, eight patients Stage III and 3 patients in Stage IV. 14 patients with nodal disease and five patients with extra-nodal disease. They received total of 97 cycles of the chemotherapy (3-7 cycles).

Results: 18 out of 19 patients achieved complete response (CR). In one patient the response could not be assessed, one patient progressed while on treatment. Toxicity was mainly hematological. The 3 years overall survival (OS) and disease free survival (DFS) was 83%.

Conclusion: P-CAN is an effective, well tolerated combination in chemo-naive aggressive NHL. The addition of Vinorelbine to steroid, Adriamycin, and Cyclophosphamide seems improve the response. Further larger trials are needed to study this combination and its impact on longer overall survival.
Body Mass Index (BMI) and Neck Circumference (NC) in Diagnosing Obstructive Sleep Apnea
Authors: Al Ansari A. , Al-Saey Hamad , Al-Sulaiti Mansour , Ganesan S. , Abdul Sattar H. , Balamurugam P. , Philipose M. V.
Published: February 2016

Obstructive sleep apnea (OSA) is a common disorder for which obesity is a major risk factor. It has been suggested that the circumference of the neck (NC) is more predictive of OS A than general obesity assessed by the Body Mass Index (BMI). In the National Tertiary Center for Sleep Study, Hamad Medical Corporation, Qatar; 187 patients were studied to evaluate the usefulness of NC and BMI in diagnosing OSA and in selecting patients for overnight polysomnography (PSG). Eighty patients (42.8%), 69 males and 11 females with higher mean age, had evidence of significant OSA (RDI > 15 events/h sleep). OSA was found more in the non-Qatari (n = 57, 553%) than the Qatari's (n = 23, 27.4%). NC mean levels were more in OSA group (41.51 ± 3.12) than non OSA group (39.57 ± 4.35) but, classifying obese as BMI = 30, there was no significant difference in the BMI of apneic and non-apneic groups. The study suggest that OSA is more common in males and NC correlates well in predicting OSA compared to generalized obesity/BMI has no clinical relevance in diagnosing OSA.
Crossed Testicular Ectopia: Suprapubic Approach
Authors: Asghar M. , Al Hindi S. , Hassan A. A.
Published: February 2016

A child with a left non-palpable testis underwent surgery for an incarcerated right inguinal hernia. During the operation a left crossed ectopic testis was found at the internal ring and was brought down into the left hemiscrotum through a suprapubic tunnel. The literature is reviewed and this approach of orchidopexy of crossed testis is discussed.
Critical Illness Polyneuropathy in an Obstetric Patient: A case report and review
Authors: Shaikh N. , Nasser S. H. , Kettern M. A.
Published: February 2016

Recently it has been found that many critically ill patients develop secondary neuromuscular disorders following admission to intensive care units (ICU). One of these is critical illness polyneuropathy (CIP), a widespread symmetrical disorder affecting the peripheral nervous system and often associated with sepsis and multi-organ dysfunction. Two percent of all intensive care patients and as many as 80% of septic patients develop critical illness polyneuropathy which leads to a considerably increased risk of in-hospital mortality. The exact etiology of the condition is not known but various risk factors, differential diagnosis, treatment, management and prognosis are discussed in this report of ci woman who, following caesarian section, developed CIP, septic shock, multi-organ failure and subsequently died.
Epilepsy and Women: A difficult combination!
Authors: El Alamy O. R. , Gehani A. A.
Published: February 2016

Epilepsy is one of the commonest neurological disorders with increasing incidence over the last few decades.

As with many neurological disorders, the incidence of the disease is slightly higher in females than males and certain measures or precautions have to be addressed by the treating Physician(s) when treating females with epilepsy as failure to do so my involve medico-legal implications.
“From Qatar to the World” Abstracts Presented at International Conferences lor Published in Medical Journals
Authors: Hammoudeh M. , Gehani A. A.
Published: February 2016

Aim: To assess the exocrine pancreatic function among cystic fibrosis patients with cystic fibrosis trans-membrane conductance regulator (CFTR) 11234V mutation. METHODS: Cross-sectional study of 40 cystic fibrosis patients with homozygous CFTR 11234V mutation belonging to a large Arab kindred family and 25 healthy subjects as a control group over a period of 12 mo. Assessment of their exocrine pancreatic function was performed by measuring faecal elastase-1 (FE1) concentration with a commercial ELISA kit using polyclonal antibodies (BioServ Diagnostics) in CF patients compared to healthy subjects. The results were compared with those obtained from a second laboratory using another commercial ELISA (ScheBo; Biotech, Germany) that uses two monoclonal antibodies against different specific epitopes of human pancreatic elastase. RESULTS: All CF patients with CFTR 11234V mutation had normal levels of faecal elastase 1. No significant difference was found between the two methods for the CF groups or between the CF patients with and without pancreatic enzyme replacement.
Breast Self-examination Among Female Nurses
Authors: Abu Salem O. , Hassan M. A.
Published: February 2016

Objective: In the past 20 years, breast cancer incidence in the world has a dramatic increase of 50-100%, which strongly supports the need for breast cancer prevention, and screening programs.The purpose of this study was to identify and investigate the knowledge and practice of breast self examination (BSE) with the influencing factors on the compliance of (BSE) among female nurses.

Methods: A study was conducted between January and December 2002. Female nurses (80) from Prince Rashid Military Hospital constituted the study population. The questionnaire contained items on the demographic characteristics of the respondents, knowledge of breast cancer; attitudes toward BSE and questions regarding the practice of BSE. The analysis included descriptive statistics to examine the association between BSE and medical history, knowledge of BSE and attitudes toward BSE.

Results: The results of the study indicated that 52% of the sample performs BSE. Approximately 30% of those who perform BSE said they learned information regarding BSE during their work experience. The significant relation was found between higher levels in work experience and BSE practice. Except for age, no significant relation was found between the socio-demographic factors and BSE practice. The sample showed strong belief in breast lump as a causing factor of breast cancer and had significant correlation with BSE practice.

Conclusion: Positive correlations were found between nursing work experience and their practice in BSE as working nurses. Studies like these can enhance the knowledge regarding BSE among nurses and other medical professionals.
A Code of Practice is Overdue for Assisted Reproductive Technology in the GCC Countries: Some comments and suggestions
Authors: Eskandarani H. A.
Published: February 2016

Assisted reproductive technology (ART), employing in vitro fertilization (IVF) techniques, has been established as the most effective form of treatment for human infertility but despite its potential ART is regarded by many as undermining some important ethical issues and advocates of medical ethics and moralists worldwide have proposed legislative measures to regulate the practice. This paper attempts to explore any possible rules and regulations as well as guidelines to control the ART practice in the Gulf Cooperative Council (GCC) countries and surveys the reported compliance. There are fifty, mostly private, IVF licensed centers/ units in the GCC countries, most of which lack proper ART legislation. Certain recommendations are presented here to form a basis for regulating the procedures and for overseeing their implementation in assisted conception units/centers.
Streptococcus Pneumonia Serotypes in Newly Developed State of Qatar: Consideration for Conjugate Vaccine
Authors: Al Khal A. L. , El Shafie S. S. , Al Kuwari J. , Bener A.
Published: February 2016

Objectives: The objective of the study was to determine prevalent pneumococcal serotypes causing infections in different age groups, their susceptibility to fi-lactams and macrolides and whether these serotypes are covered by the conjugated pneumococcal vaccines.

Methods: Streptococcus pneumonia strains isolated from different patients at Hamad Medical Corporation, Microbiology Laboratory between September 1999 and July 2000 were sent to Statum Serum Institute in Denmark for serotyping. The strains were tested for their susceptibility to penicillin, ceftriaxone and erythromycin by Vitek 2 machine (bioMerieux, France) at Hamad Medical Corporation, Microbiology Laboratory.

Results: Predominant serotypes in children <  2 years were: 6A, 6B, 9V, 11 A, 14,19A, 19F and 23 F, predominant serotypes in children between 2-7years were: 3, 6B, 15B, 19A, 19F and 23F, while predominant serotypes in adults were: 3, 8, 9V, 14,15B, 20 and 22F. In children less than 2 years, the 7-valent and 9-valent conjugate vaccines covered 52% of serotypes. 33% of strains were moderately resistant to penicillin, 27% showed high-level resistance to penicillin, 30% resistant to erythromycin and 2% resistant to ceftrixone.

Conclusion: The 7-valent and 9-valent vaccines offer similar coverage of serotypes in children less than 2 years while the 11-valent vaccines offers 55% coverage. This difference is not statistically significant. Resistance to penicillin was high which leaves ceftriaxone as the drug of choice for empirical treatment of invasive pneumococcal diseases.
A Comparison Study in the Management of Ectopic Pregnancy between State of Qatar and Kingdom of Bahrain
Authors: Afifi N. , El Taher F. , Al Tamimi H. , El Sayed N.
Published: February 2016

Ectopic pregnancy is of increasing concern to gynecologists since it is a major cause of maternal mortality and morbidity in reproductive age women. It occurs when the conceptus implants in an abnormal position other than the uterus. Although the incidence of ectopic pregnancy during the 20 years studied increased five-folds, the risk of death from ectopic pregnancy declined by 90%. This decline might be related to the increase awareness of this condition that accompanied improved diagnostic technology and thus improved management and care. However, ectopic pregnancy remains the leading cause of maternal mortality in first trimenster. This study was to evaluate the management of ectopic pregnancy in the State of Qatar and the Kingdom of Bahrain in a time period from January I, 2000 to August 31, 2003. Statistical analysis showed high incidence of ectopic pregnancy with increase in age and abortion. Etiological factors including contraceptive usage, infertility treatment and previous ectopic pregnancy were shown to increases ectopic pregnancy rates. In the Kingdom of Bahrain, management of ectopic pregnancy was carried by surgical salpingectomy and Laparoctomy and to a lesser extend medical Methotrexate management was also carried on. While in the State of Qatar it was the opposite as Methotrexate was mainly used rather than the surgical treatment. It is recommended that further investigations are needed to enhance this data and to prove the benefits of medical management over the surgical management.
Epidemiology of Kawasaki Disease in Qatar (An Arabian Gulf Country)
Authors: Eltohami E. A. , Ahmed H. M. , Numan M. T. , Gendi S. M. , Salam M. A. , Al Hroob A. , Al Soufi M. , Dilawar M.
Published: February 2016

Case records were reviewed retrospectively of 49 patients admitted between January 1992 and December 2002 to evaluate the epidemiologic pattern of Kawasaki disease (KD) in Qatar. Ages ranged from three months to nine years with a median of 28 months and a male/female ratio of 2.3:1. During the eleven years, the annual incidence varied from 2.5/100,000 to 20/100,000 and appears to be increasing. Most cases occurred in the cooler season (January-May) affecting predominantly males and children under five years of age with no apparent predilection for any section of the ethnically varied population.
A Novel Syndrome Complicating Sickle Cell Disease: Generalized Bone Marrow Necrosis
Authors: Hilali A. , Abdel Razeq H.
Published: February 2016

Three adults with sickle cell disease (SCD) presented in the span of less than two years with pancytopenia, signs of Disseminated Intravascular Coagulation (DIC) and no localizing pain to suggest vaso-occlusive crisis (VOC). Bone marrow examination showed almost complete necrosis of the whole series of marrow cells, thus explaining the pancytopenia. Some necrotic leukocytes were noted also in the peripheral blood. The condition was self-limiting with marrow regeneration occurring in all three patients after transfusions of red cells and platelets.
Catheter-Induced Left Main Coronary Artery Spiral Dissection: Stenting or Bypass? (Case Report and Literature Review)
Authors: Al Khulaifi M. , Gehani A. A. , Arafa S. O. , Al Mulla A. A. , Hajar A. H.
Published: February 2016

Catheter-induced Left Main Coronary Artery (LMCA) dissection is a very uncommon but life-threatening complication of coronary intervention and requires urgent management. We report one such patient whose risk factors appear to be Coronary Artery Disease (CAD), smoking and a prior Myocardial Infarction (MI).
Hypertensive Encephalopathy Treated by Percutaneous Nephrostomy
Authors: Al Zamer J. , Hamad B. , Al Yamani Y. , Al Kaaabi A. , Ismail A.
Published: February 2016

Although hypertension is a known complication of hydronephrosis, it is never severe enough to cause encephalopathy. Here we report a baby boy with unilateral hydronephrosis who presented with hypertensive encephalopathy and whose condition was cured by the insertion of percutaneous nephrostomy followed by pyeloplasty.
Mixed Hypercholesterolemia and Hypertriglyceridemic Xanthomatosis: Four classic types of Xanthomas in one patient at the same time
Authors: Al Harmozi S. A. , Al Naama K. A. , Al Ansari H. I.
Published: February 2016

Xanthomas are localized infiltrates oftipid-containing cells found within the dermis. Cutaneous xanthomas are mostly cosmetic disorders but xanthomas can indicate the presence of an underlying generalized disturbance in lipid metabolism possibly associated with coronary artery disease. Because hyperlipidemia may present as xanthomatosis, a dermatologist might be the first to diagnose these associated lipid abnormalities, We report a 36-year-old male who presented with four classic types of xanthomas (Xanthelasma, Tuberous, Eruptive and Plane xanthomas) at the same time. Laboratory tests confirmed hypercholesterolemia and hypertriglyceridemia of dysbetalipoprotein Type III of the Fredrickson classification. The occurrence of four clinical types of xanthomas simultaneously in the same patient is rarely reported in the literature. The clinical, histopathology, laboratory investigation and management of hyperlipidemia and cutaneous lesions is fully discussed together with a review of the literature.
An Elderly Man with Non-Resolving Fever and a Pulmonary Infiltrate
Authors: Khan F. Y. , Ibrahim A. S. , Al Ani A.
Published: February 2016

A 62-year-old Pakistani man presented with fever and chest pain of five-day duration. He was non-smoker and he had no history of hemoptysis, wheezing, loss of weight or exposure to tuberculosis. Other history was unremarkable. Physical examination revealed a heart rate of 116 beats/min, BP of 121/ 58 mm Hg, temperature of 38.5°C, and a room air oxygen saturation of 92 %. There was no cervical, axillary, or inguinal lymphadenopathy. Chest examination revealed bronchial breath sounds in the right middle and lower zones. Cardiac examination revealed tachycardia with no gallops or murmurs. Abdomen was nontender without hepatosplenomegaly. Extremities were free of cyanosis, edema, and clubbing. There were no skin lesions
“From Qatar to the World” Abstracts Presented at International Conferences /or Published in Medical Journals
Authors: Gehani A. , Hammoudeh A. M.
Published: February 2016

Heart failure (HF) is a major killer. Many die due to uncontrolled HF, but many die even when HF is well controlled, principally due to major ventricular arrhythmia. In Framingham study, one third of patients with HF died suddenly (SCD). While diuretics have made a major impact on the main symptoms of HF, edema and breathless, they did no change mortality. It was only with introduction of vasodilators and ACE Inhibitors that the total mortality was altered as shown by many trials like VHeFT and CONSENSUS etc. However, sudden cardiac death (SCD) remained unreduced. This is because HF is not only a syndrome of excess fluids. Hopes were transiently raised by Angiotensin-II Blockers (AT-II blockers) when ELITE-I trial showed reduced SCD as compared to ACE-Inhibitors. These hope soon vanished by ELITE -II, which confirmed that neither ACE-Inhibitors nor AT- II blocker reduced SCD. The major impact on SCD was only consistently shown with Implantable Defibrillators (ICD) that have become a cornerstone in management of selected patients at risk of SCD.
Evidence-Based Medicine: An Overview
Authors: Shakir D. K. , Faidhi B. A. , Gehani A. A. , Hussain S. A.
Published: February 2016

Knowledge is the corner stone of teaching, and this is built upon by reading. The word “doctor” in Latin means, “to teach”. Hence reading comes with the difficulty of selecting the appropriate material. What to read and how to read? There are more than 65,000 medical articles published each day, and it is impossible to keep up-to-date by reading them all (which could take 40 years). So, one needs to be highly selective in reading by applying the first rule in evidence-based medicine; PICO (Population, Intervention, Comparability and Outcome of the study)
Hematopoietic Stem Cell Transplantation
Authors: Al Hijji I.
Published: February 2016

About 30 years ago bone marrow transplantation was an experimental procedure carried out as a last resort in terminally ill patients. Nowadays hematopoietic stem cell transplantation (HSCT) has become a standard procedure for many severe malignant or non-malignant disorders of the hematopoietic system. It is well known that HSCT is associated with transplant related mortality and morbidity (TRM), the risk of which in allogeneic transplantations can reach 40%; in contrast the risk is less than 5% in autologous transplantation. However; HSCT outcome has been improved significantly over the past decade both in terms of reduced TRM and reduced risk of relapse of the original disease.
Prognostic Value of Pre-operative Assesment of Serum Carcino-embryonic Antigen and Carbohydrate Antigen 19-9 Levels in Colorectal Carcinoma
Authors: Abel Rahman E. M. , El Gonimy A. A. , Farouk S.
Published: February 2016

Colorectal cancer (CRC) is one of the most frequent and aggressive neoplasms. It is the second leading cause of death from cancer in the United States and is a significant overall health problem. Tumor markers are substances synthesized and excreted by tumor tissues that can be detected in abnormal concentrations in serum, urine, and other body fluids. Two such markers, Carcinoembryonic antigen (CEA) and Carbohydrate antigen 19-9 (CA 19-9), are useful in the diagnosis, prognosis and management of colorectal carcinoma. This study attempted to evaluate the clinical and prognostic value of the two markers using forty patients with CRC and ten healthy persons as a control group. All patients with CRC showed highly significant increases in CEA and CA-19-9 compared to the control group (p <  0.001), and there was a highly significant increase in the level of CEA in more advanced tumor stages, (p <  0.01). Regression analysis showed a significant correlation between CEA and CA-19-9 (p <  0.05; r = 0.35) and significant increases in CEA in rectal tumors compared to those located in the colon; in males compared to females (p <  0.05); and also a highly significant increase in patients over 60 years of age (p < 0.01) but no relation between CA 19-9 level and age, sex, and site of tumor. These data suggest that serum levels of CEA and CA-19-9 can be clinically useful in the diagnosis and staging of colorectal carcinoma.
Adult T-cell Leukemia/Lymphoma: First case report from Qatar
Authors: Rasul K. I. , Abbas M. T. , Binali A. S. , Murad N.
Published: February 2016

In what appears to be the first case of Adult T-cell Leukemia|Lymphoma (ATLL) reported in Qatar and Middle Eastern Arab countries, a 39-year-old lady presented first with Pneumocystis carinii pneumonia and hypercalcaemia and later showed the full picture of ATLL, splenomegaly leukocytosis, skin rash, and bone marrow infiltrations. She responded well to chemotherapy, with complete remission after four cycles of combination chemotherapy but the prognosis of patients with ATLL is poor. Although patients may respond initially to treatment with combination chemotherapy regimens devised for advanced, aggressive Non-Hodgkin's Lymphoma (NHL), relapses are common with a median survival of eight months and a four-year survival of 12 percent.
Mesenteric Panniculitis: MDCT Diagnosis A report of two rare cases
Authors: Garg K. C. , Kumar R.
Published: February 2016

Mesenteric Panniculitis (MP) is a rare benign inflammatory condition of the adipose tissue of the mesentery often diagnosed during multidetector CT studies of the abdomen. Two cases of MP are reported with a brief discussion of the differential diagnosis, the association with other conditions and a review of the literature
Anaplastic Myeloma with Deposits in Three Different Sites: Case report and literature review
Authors: Al Hijji I. , El Ayoubi H. , Rasul K. I. , Abboudi K. , Yasin M. , Al Rikabi A.
Published: February 2016

Anaplastic myeloma is a rare aggressive disease that is resistant to most chemotherapeutic agents and radiotherapy. It develops usually after a diagnosis of classical multiple myeloma and is associated with at least one extramedullary plasmacytoma site. We report a case of this rare disease in a patient who had no previous illness and presented to us with more than one extramedullary plasmacytoma site: a mass in the right anterior chest wall, a swollen scrotum and multiple nodular skin lesions mainly in the legs.
An Update on Inflammatory Myopathies
Authors: El Alamy O. , Al Emadi A.
Published: February 2016

Inflammatory myopathies are heterogeneous groups of immune mediated myopathies that present as pure form or in association with other auto-immune diseases or malignancy. There are three major subsets: dermatomyositis, polymyositis and sporadic inclusion body myositis. This review highlights our understanding of these disorders, their clinical aspects, diagnosis, pathogenesis and treatment. The idiopathic inflammatory myopathies occurring alone or in association with auto-immune disease and lor cancer have an overlapping clinical presentation with an overall incidence of 3.0 to 7.8 per million and a prevalence from 10 to 60 per million. Because of the variability in epidemiological studies, the interpretation of these results cannot be conclusive. Recent evidence indicates that polymyositis is over diagnosed and many reported cases are likely to be some other disorders. Decreasing the incidence of true polymyositis is due to reliance not only on clinical criteria but also on immunopathological changes in muscle biopsies. Polymyositis and inclusion body myositis occur primarily in adults, whereas dermatomyositis occurs in adults and children between five and fifteen years of age. Sporadic inclusion body myositis affects almost exclusively men over the age of 50 years.
Poverty and Health of Unborn
Authors: Ahmed B. , Abushama M. , Kurjak A.
Published: February 2016

It is clear that poverty cannot be defined solely in terms of lack of income. A person, a family, even a nation is not deemed poor only because of low economic resources. Little or no access to health services, lack of access to safe water and adequate nutrition, illiteracy or low educational level and a distorted perception of rights and needs are also essential components of poverty