bluuebunny/crossref_metadata_2025 huggingface dataset:
How to Select and Develop International Law Case Studies: Lessons from
Comparative Law and Comparative Politics
Authors: Linos Katerina
Published: February 2016

To develop international law claims, it is often critical to compare different countries’ laws. This essay explores how methods drawn from comparative law and comparative politics research can help international lawyers make comparative inquiries more simply and straightforwardly.

International lawyers recognize three main sources of legal authority: treaties, custom, and general principles. Cross-national comparisons are deeply embedded in the very definitions of two of these three sources. To establish international custom, an international lawyer must show that a broad range of states consistently engage in a certain practice out of a sense of legal obligation. To establish a general principle, an international lawyer must show that it is “recognized by civilized nations”; in practice this requires that the principle be found in diverse legal families. Treaty interpretation does not necessitate cross-country comparison as a matter of definition: in theory, the text of the treaty itself could provide the requisite answers. However, in practice, international and domestic courts are typically faced with ambiguous treaty terms. To interpret them, they often turn to the jurisprudence of diverse states and to subsequent state practice, thus implicitly beginning a comparative inquiry. in sum, comparative international law is useful for identifying and applying international law, as this volume’s introduction explains.
The Executive’s Misplaced Reliance on War Powers “Custom”
Authors: Glennon Michael J.
Published: February 2016

Historical practice, or custom, has long been seen as a source of authority in the resolution of separation-of-powers disputes. In two recent cases assessing the limits to the president’s power regarding the recognition of foreign nations and the making of recess appointments, the Supreme Court heavily emphasized past practice. Historical practice, the Court said, reflects “the compromises and working arrangementsth at the elected branches of Government themselves have reached.” in the realm of war powers, the executive branch has long relied on custom to justify military initiatives that were carried out without congressional approval. In essence, the executive has argued that because force has been used in the past without congressional approval, the same is permissible in various other situations (for example, in the Dominican Republic, Grenada, Haiti, Kosovo, and Panama).
Protocol on the Establishment of the African Monetary Fund & Statute of the African Monetary Fund
Authors: Ofodile Uche Ewelukwa
Published: February 2016

On June 27, 2014, at the 23rd Ordinary Session of the Summit of the African Union held in Malobo, Equatorial Guinea, member states of the Africa Union adopted the Protocol on the Establishment of the African Monetary Fund (Fund).

Plan for the Fund is not new but dates back to the 1963 Charter of the Organization of African Unity (the predecessor to the Africa Union) as well as to the 1991 Abuja Treaty—the agreement that established the African Economic Community and put in place a framework for continental integration. The Constitutive Act of the African Union (Constitutive Act) adopted in 2000 also envisaged the establishment of the Fund. Annexed to the Protocol is the Statute of the African Monetary Fund (Statute). As envisioned in the Abuja Treaty, the Fund, together with continental institutions such as the Africa Investment Bank and the African Central Bank that are still in the pipeline, are critical to efforts to create a continental economic and monetary union in Africa.
United Nations Convention on Transparency in Treaty-based Investor-State Arbitration
Authors: Bergman Neale H.
Published: February 2016

On December 10, 2014, the United Nations General Assembly adopted the United Nations Convention on Transparency in Treaty-based Investor-State Arbitration, also known as the Mauritius Convention on Transparency, which was prepared by the United Nations Commission on International Trade Law (UNCITRAL). The Mauritius Convention is intended to provide states with an efficient mechanism for applying the UNCITRAL Rules on Transparency in Treaty-based Investor-State Arbitration (Transparency Rules) in investor-state arbitrations arising under investment treaties concluded before the Transparency Rules’ effective date of April 1, 2014. The Mauritius Convention was opened for signature on March 17, 2015, in Port Louis, Mauritius.
Use of bullard laryngoscope in anesthesia for cervical spine surgery: Our experience in Qatar
Authors: Faraj J. H. , Al Hamadi T.
Published: February 2016

There is great concern about the risks inflicted by intubation of patients with a potential instability of the cervical spine, as in trauma cases and in patients scheduled for elective cervical spine surgery. Some of these patients may have neurological manifestations of cord compression and limited neck movement, which can range from severe to mild. Intubation requires flexion and extension of the head and neck “Sniffing Position” to achieve optimum visualization of the vocal cords. In our institute the care given to ensure the stability of the cervical spine during intubation is either by Manual In-Line Axial Stabilization (MIAS) or by the use of Intubating-Laryngeal Mask Airway (LMA) or Bullard Laryngoscope or awke intubationin the operating theatre. All of these techniques put a minimal burden on the cervical spine and reduce the chances of neurological deficits or aggravation of an existing one. In this study we relate our experience with the Bullard Laryngoscope in these cases.
Validity of diagnostic indicators in liver cirrhosis
Authors: Altaee M.Y.
Published: February 2016

Forty five patients with liver cirrhosis were compared with 60 other chronically ill patients in an attempt to evaluate the use of leading symptoms, leading signs, laboratory tests and various combinations of the three, in the accurate diagnosis of liver cirrhosis. It was found that a combination of leading symptoms and leading signs gave a high sensitivity rate but with an increased likelihood of false positives which needed to be mitigated by certain laboratory tests. It is recommended that the prevalence of the disease within the community is also taken into account when interpreting results.
Prevalence of hepatitis c virus infection among multitransfused thalassemic children in Basrah – Iraq
Authors: Al Wtaify A. S. , Hassan M. K.
Published: February 2016

Between November 1998 and May 1999 a prospective study for HCV antibodies was conducted on 200 patients (113 males and 87 females), with B-thalassemia major and sickle cell-thalassemia, who were attending the thalassemia center at Basrah Maternity and Children Hospital. Their ages ranged from 1-18 years with a mean age of 9 years.

Nineteen patients (9.5%) were found to have antibodies in comparison to only one (0.5%) amongst the 200 children of a control group. The risk of exposure to HCV was higher than for HBs antigen and HIV amongst the same patients.

Anti-HCV seropositivity was significantly higher amongst patients with B-thalassemia major than patients with sickle cell-thalassemia and patients older than 10 years.

The study showed also that anti-HCV seropositivity was directly related to the frequency of blood transfusion and there were significant elevations of serum bilirubin and aminotransferase levels amongst seropositive thalassemic patients compared to seronegative patients.
Erectile dysfunction: An update of diagnosis and management
Authors: El Malik E. M. A.
Published: February 2016

Erectile dysfunction (ED) is a common problem in males. About half of all men over 40 years of age suffer from some degree of ED and in half of them the dysfunction is moderate or complete. More than 90% of men with ED do not seek treatment either because they are not comfortable with the subject or because, until very recently, the effective treatments available were invasive. Recent publicity about male sexual health and the availability, for the first time, of an oral medication which is specific and effective in the management of ED have made male patients more vocal about their sexual problems, especially to their doctors. These developments have also made doctors more aware of the magnitude of this problem.
The Pattern and Severity of Primary Glaucoma in Qatar
Authors: Al Mansouri F.
Published: February 2016

Purpose: To describe the pattern of both types of pri-mary glaucoma in Qatari adult patients and to outline the main problem related to its management.

Material and Methods: A random sample of Qatari patients with primary glaucoma either open angle or angle closure glaucoma in whom the diagnosis was made after the age of 30 years was studied over the last 2 years (1997-1998) by standard questionnaire as regards their personal and medical profile, and assessed ophthalmologically both subjectively and objectively.

Results: 195 patients were studied, of whom 29.7% had angle closure glaucoma. Early presentation was clearly shown in both type of glaucoma. Legal blindness was present in significant proportion of patients.

Comment: Glaucoma in Qatari patients presents at an early age, with substantial loss of visual function at presentation. Poor compliance is an obstacle for manage-ment in both types of glaucomas. The need for an educa-tional campaign and a program for early detection is highly advised.
Opsoclonus Myoclonus Syndrome A Case Report of Two Patients and Review of the Literature
Authors: Elsaid M. F. , Bessisso M. , Nazal M. I.
Published: February 2016

Opsoclonus myoclonus syndrome (OMS) is a very rare syndrome which presents with ataxia, opsoclonus and myoclonus. We report the combined treatment of immunoglobulins and prednisolone compared to prednisolone alone in two patients. The diagnosis was based on the clinical findings. Work up for neuroblastoma was negative in both patients. Prednisolone treatment in the first patient was associated with slow response, relapses and toxic side effects. Immunoglobulins combined with prednisolone in the second patient were effective with neither relapse nor drug side effect. The clinical findings, differential diagnosis and the management are discussed. It appears that combined therapy with prednisolone and immunoglobulin gives better results. To the best of our knowledge this is first paper from the Middle East reporting this syndrome.
False Positive Results in the Capillary Tube Fluorescent Staining Method for Malaria
Authors: Al Hilali A. , Fawzi Z. O. , Fakhroo N. A.
Published: February 2016

Howell-Jolly bodies (HJB) are composed ofDNA which will apparently take the fluorescent dye used to stain the chromatin bodies of the malarial parasites (MP). While evaluating a capillary tube/fluorescent staining technique for malaria we came across this previously unreported false positive effect of HJB in ten cases, all negative microscopically for MP and not originally requested for that test All gave positive results, the degree of which correlated well with the frequency of HJB. The positivity concentrated in the upper red cell layer of the capillary tube where MP rings also concentrate.
Occult Celiac Disease Presenting as Non-alcoholic Chronic Calcific Pancreatitis
Authors: Tariq Butt M. , Al Dweik N. , Al Kaabi S.
Published: February 2016

This report describes a diabetic Yemeni male with pancreatic exocrine insufficiency and calcification. Persistent diarrhea and weight loss led to further investigation and a diagnosis of celiac disease with an excellent response to a gluten free diet
Bilateral Adrenal Enlargement Due to Disseminated Histoplasmosis in a Bangladeshi Patient
Authors: Al Ani M. A. , Al Soub H. , Al Azawi S. , Al Muzrakchi A. , Azadeh B. , Al Muraikhi A.
Published: February 2016

Human infection with Histoplasma capsulatum is largely asymptomatic but disseminated disease is fatal if left untreated. We report a case of bilateral adrenal enlargement due to disseminated histoplasmosis in a Bangladeshi male who was successfully treated.
“From Qatar to the World” Abstracts Presented at International Conferences
Authors: Hammoudeh Mohammed
Published: February 2016

Objective: To identify the incidence of ocular injury in Qatar from January 1999 to December 2000 and the related factors.

Methods: Retrospective study of all patients who suffered ocular injury requiring hospitalization during the mentioned period. Data was collected from medical records and the statistical analysis done using SPSS 7.5.

Results: The type of ocular injury and the effect on the Visual Acuity were determined, as well as the incidence relationship to age, gender and occupation. The main causative agents are outlined and the surgical procedures done and sequels reported.

Conclusions: This study provides data about the risk factors and visual outcomes of ocular trauma in Qatar, allowing recommendations that could decrease its incidence in the future.
Breast Reconstruction with the Latissimus Dorsi Musculocutaneous Flap: 12 Years Experience
Authors: Al Hetmi T. , Manassa E. , Makki A. , Olbrisch R. R.
Published: February 2016

One of the critical decisions during the preparative assessment of a patient who will have a breast reconstruction is whether a flap transfer will he necessary to supplement the anterior chest wall tissue. In our practice the material of choice for breast reconstruction is autologous tissue. The latissimus dorsi muscle flap (LDMF) is the most commonly used autogenous tissue flap for breast reconstruction. Few reports exist fro its use in oncologic breast surgery. The authors present 115 patients who underwent LDMF reconstruction to correct volume and contour abnormalities. This retrospective study demonstrates a method of breast reconstruction used LDMF as delayed reconstruction. This methods was used for patients who were diagnosed as having Stage 0, Stage 1 or Stage 2 breast cancer. This study covers a period of 12 years.
Myositis Ossificans of the Hand
Authors: Abuhadra K. , Dawd A. S. , Hamdani
Published: February 2016

Extraskeletal ossification may occur in muscle and other soft tissue, The phenomenon may be classified as follows: (1) progressive Myositis ossificans, (2) traumatic localized Myositis ossificans, and (3) nontraumatic localized Myositis ossificans. The literature suggests that 75% of the localized forms occur as a result of trauma. We report a case of non traumatic myositis ossificans which involved the hypothenar region of the hand.
Amiodarone-Induced Pulmonary Toxicity
Authors: Al Ani A. R. , Mobayedh H. M. , Mudather M. , Morad N. A.
Published: February 2016

An old lady with mitral regurgitation, and chronic atrial fibrillation, who was maintained on amiodarone 200 mg daily for five years, presented with fever and confusion due to septicemia and hepatic encephalopathy. Her chest radiograph and chest CT scan showed interstitial infiltrates. Histopathology of transbronchial biopsies suggested amiodarone-induced lung toxicity. The amiodarone was discontinued and the patient showed some improvement. The case, the presentation and the diagnosis are discussed.
Fetal Echocardiography Service in Qatar: Establishment, Challenges and Outcome
Authors: Ahmed B. , El Sisi A. , Khenyab N. , Saleh N. , Al Mansoori Z. , Gendi S. , El Said H. , Numan M.
Published: February 2016

A prospective observational study at the newly estab-lished Fetal Medicine Unit, Hamad Hospital, Qatar; evalu-ated the impact of the service on the detection rate of criti-cal congenital heart defects, patterns of referral and sub-sequent yield for structural congenital heart disease in a population with a significant proportion of high risk fac-tors.

Of 391 pregnant females examined between January 2003 and December 2004, 58 (14.8%) had fetal cardiac abnormalities of which 23 (5.8% of total referrals) had major structural malformations of the heart. Cases of fetal congenital heart disease had further evaluation us-ing real time three-dimensional echocardiography (RT3DE) which is new equipment in the paediatric cardi-ology department. All cases with cardiac defects whether minor or major had follow up fetal echocardiography. Neonatal echocardiography confirmed the diagnosis in all cases with major defects (100% specificity). False positive cases that were found to be normal post natal were 1% of the total cases referred (12% of cases with congenital mal-formation). False negative cases were 1% and all had a small ventricular septal defect (VSD) except for one Down's syndrome with a very large VSD.

Three patients needed urgent Caesarean section (CS) deliveries, one with complete heart block (HB) and two with supraventricular tachycardia (SVT). One patient traveled abroad as the fetus had left isomerism and major cardiac defects and complete HB. Fifteen newborns had to receive prostaglandin based on the fetal diagnosis before being seen by paediatric cardiologists. There was no termination of pregnancy due to major cardiac defects even in cases of HLHS.

The preliminary results of this clinic are very satisfac-tory and have affected favorably the outcome of the new-borns with congenital heart defects. It is hoped that the results of this study will encourage more referrals to the FMU.
Eosinophilic Pleural Effusion due to Cloxacillin and Piperacillin/Tazobactum
Authors: Ibrahim A. S. , Allangawi M. H. , Ghadban W. K. , Arrayes M.
Published: February 2016

A young male was treated for right-sided pneumonia with cloxacillin and piperacillin/tazobactam. As he was recovering from the pneumonia he developed left-sided pleuritic pain and pleural effusion. At thoracocentesis an exudative pleural effusion contained 16% eosinophils with a simultaneous 28% peripheral eosinophilia. An allergic reaction to penicllins was thought to be the cause. After withdrawal of those medications and institution of pred-nisolone a rapid resolution was seen of symptoms, signs, peripheral eosinophilia and radiological abnormalities.
Acute Pancreatic Nine Years of Surgical ICU Experience
Authors: Shaikh N. , Kettern M. A. , Louon A. , Ahmed A. H. A.
Published: February 2016

Acute pancreatitis has a variety of presentations from self-limiting abdominal pain to development of local and systemic complications resulting in sepsis, multi-organ dysfunction, extended intensive care stay and death. Very good quality of life in survivors justifies an optimal therapy in an intensive care setup. The records of 91 patients with acute pancreatitis were reviewed retrospectively. There was a significant difference (p < 0.001) between those with edematous pancreatitis and those with necrotic pancreati-tis as regards the length of ICU stay and severity scores: Ranson and SOFA (Sepsis-related Organ Failure Assess-ment). The most common cause of pancreatitis was biliary (70.3%) followed by hyperlipidemia (12.1%), post ERCP (5.5%), trauma (4.4%), idiopathic (6.6%) and in one case, ascariasis. Common associated diseases were hypertension (33%) and diabetes mellitus (25.3%). Six patients with necrotic pancreatitis died. It is concluded that acute pancreatitis treated in an in-tensive care unit has a favorable outcome and that a com-bination of Ranson and SOFA scores with CT index helps in establishing the prognosis.
Ultrasound Prediction of Fetal Macrosomia in Diabetic Women and its Effect on the Route of Delivery and the Outcome of Pregnancy
Authors: Seyam Y. S. , Ahmad Riad E. H. , Elzain S , Saleh N.
Published: February 2016

Objective: The purpose of this study is to review the maternal and neonatal outcome in pregnant diabetic women given a trial of labor and delivered macrosomic infants (>4000 grams) and to assess the accuracy of birth weight prediction by ultrasound examination at term.

Methods: One hundred and twenty-nine charts of pregnant diabetic women were reviewed, sixty eight women were given a trial of labor and delivered macrosomic fetuses (>4000 grams), fifty of them had vaginal delivery and the other eighteen had caesarean delivery. In the other group, 61 patients delivered by elective caesarean section, for 41 of them the indication was fetal macrosomia (>4000 grams) as estimated by ultrasound examination and in the other 20, it was due to clinical estimation of big baby. Maternal and neonatal complications were reviewed in each group. Maternal complications included lacerations, hemorrhage and infection and the neonatal complications evaluated were shoulder dystocia and associated birth trauma, asphyxia, and mortality. The accuracy of ultrasound in estimating fetal weight was also evaluated.

Results: Sixty eight (52.7%) women attempted a trial of labor; 73.5% delivered vaginally and 26.5% had a caesarean delivery. All, except two, had macrosomic fetuses (>4000 grams). Only one woman, of those who delivered vaginally, had postpartum hemorrhage due to atonic uterus. The incidence of shoulder dystocia for infants weighing 4000-4499 grams was 6.3% and those infants had the same incidence (6.3%) of brachial plexus injury. There was no perinatal asphyxia or perinatal mortality among those infants who were delivered vaginally. There were no maternal complications for women who had caesarean delivery after labor (18 patients) but there was perinatal asphyxia in two infants who were treated properly without any neurological sequele. Elective caesarean delivery was performed in 47.3% of the study population. There were no neonatal complications or perinatal mortality in this group of patients and only one woman had wound infection. The sonographic prediction of fetal weight was accurate in 52.4% of the cases. The over estimation was in 50.8% of the estimated fetal weights and 49.2% of them were underestimated when compared to actual birth weights.

Conclusions: Caution should be taken in the use of sonographic estimations of fetal weight to guide obstetric decisions concerning labor and delivery. Special consideration should be given to diabetic patients having fetuses with estimatedfetal weights between 4000 and 4500 grams. Flexibility in the management of these patients is best, taking in consideration their previous obstetric performance and if the estimated fetal weight is closer to 4500grams than to 4000 grams, it is perhaps, better to proceed to a primary caesarean delivery.
Selected Abstracts From Other Journals
Authors: Hammoudeh M. , Gehani A. A.
Published: February 2016

Contex: In assessing the patient with headache, clinicians are often faced with 2 important questions: Is this headache a migraine? Does this patient require neuroimaging? The diagnosis of migraine can direct therapy, and information obtained from the history and physical examination is used by physicians to determine which patients require neuroimaging.
Obesity in Children: A Sample from Baghdad
Authors: Lafta R. K. , Al Saffar A. J. , Eisa S. A. , Hayyawi A. H. , Abdulhameed F. N.
Published: February 2016

Childhood obesity is associated with significant health problems in the age group and is also an important early risk factor for much of adult morbidity and mortality. It is a problem that is increasing. To asses the prevalence of overweight and obesity in primary school children (7-13 years of age) in Baghdad City a random sample of 5361 primary schoolchildren from different schools in Baghdad city was studied for obesity. Risk factors were assessed by a questionnaire specially prepared for this purpose then weight and height were measured for every child to obtain the BML Overweight and obesity were defined by adopting the cut-offs obtained from the WHO International Task Force on Obesity (ITOF). In this sample the prevalence of obesity was 4.1% and of overweight was 12.4%; the prevalence increasing with age in a significant linear correlation. The risk factors that significantly influenced the occurrence of obesity were gender; physical activity, parental obesity and family size. On the basis of this sample it is concluded that the prevalence of obesity in Baghdad is high compared to many other countries. This could be due to many contributing factors, the rapidly growing trend of sedentary life, incorrect nutritional education and habits, and the lack of exercise.
The Prevalence and Characteristics of Community Acquired-Methicillin Resistant Staphylococcus Aureus (CA-MRSA) in Abha, KSA
Authors: Bello C. S. S. , Al Azraqi T.
Published: February 2016

We carried out a study on the prevalence of CA-MRSA in Abha and found a rate of 16% in an environment where nosocomial MRS A rate is 46%. We believe that the rate of CA-MRSA could be much lower if the patients had been interviewed with a view to eliminate obvious risk factors
The Role of Anti-Phospholipid Auto Antibodies Syndrome in Cerebrovascular Diseases
Authors: Ali H. Y. M. , Abdullah Z. A.
Published: February 2016

Objectives: The aims of the study are to determine the role of anti-phospholipid autoantibodies (APLAs) among patients with stroke and/or transient ischaemic attacks (TIAs), to identify the types and effective isotype of some important APLAs which are lupus anticoagulant (LA), anticardiolipin (aCL), anti∼fi2 glycoprotein I dependent (afi2-GPI), and anti-phosphatidyl serine (aPS). Also, to find out any concomitant effect of non-APLAparameters not specific to antiphospholipid syndrome (APS).

Subjects and Methods: This study was carried out on 50 patients attending mainly the Teaching and General Hospitals in Mosul, Duhok, and Erbil Cities, Iraq during the period between 1st March 2004 and 1st March 2005. The studied cases were under 50 years of age, and had no recognizable risk factors. The activated partial thromboplastin time (APTT) was used for LA estimation and ELISA assay was used to test for IgG& IgM isotypes ofaCL, aJ32-GPI, and aPS. The ANA, RF, VDRL, CRP, and C4 complement were tested by different immuoserological methods. The thrombocytopenic (TP) status was diagnosed by estimation of platelets counts.

Results: The strokes and!or TIAs related to APS were diagnosed in 22/50 (44%) of patients and a significant correlation was reported among patients with IgG plus IgM aCL (p <  0.05), IgG afi2-GPI (p <  0.05), and IgG aPS (p <  0.05). In APLAs positive patients, raised CRP concentrations were reported in 36.4%, TP status in 22.7%, ANA in 22.7%, RF positive in 13.6%, and low C4 levels in l3.6%. Finally,the FP-VDRL test was found in 50 % of APLAs positive cases.

Conclusions: The aCL, afi2- GPI, and aPS antibodies were shown to play a significant role in the development of stroke and!or TIAs among the studied cases.
Pravastatin Induced Myopathy
Authors: Yassin M. A. , Shaukat A. , Errayes M. M. , Saleh M. M.
Published: February 2016

Lipid-lowering agents such as HMG-CoA reductase inhibitors (also known as statin drugs) are generally well tolerated. But a recognized side effect still can happen, We report a case of 47-year-old Iraqi male patient previously known hypothyroid, was not on replacement therapy, as he did not appear after his thyroid functions was checked came in with severe body pain for 10 months got worse in the last three months, started on lipostat (ten months ago) found to have myopathy as evident by high CPK which improved gradually clinically and biochemical after stopping lipostat.
A Cautionary Case of Female Genital Mutilation
Authors: Ahmed B. , Abushama M.
Published: February 2016

We report a case of a tightly circumcised woman who bled irregularly throughout her first year of marriage but failed to conceive. The detection and management of a large but hidden cervical polyp solved her problems. We suggest that such cases, especially in immigrant women, require deeper investigation than might at first appear to be needed.
MICU: Unusual Cause of Low Back Pain
Authors: Kamha A.
Published: February 2016

A sixty years old patient, known case of chronic renal failure on regular hemodialysis through long term intravascular catheter was admitted with fever. Blood culture revealed staphylococcus aureus bacteremia (MSSA).
Selected Abstracts From Other Journals
Authors: Gehani A. , Hammoudeh M. A.
Published: February 2016

Objective: To investigate cross-sectional associations among blood pressures (BPs), arterial stiffness, and open-angle glaucoma (OAG). Methods: Study participants came from the population-based Rotterdam Study. The baseline examination phase took place after an extensive home interview from March 20, 1990, to June 17,1993, and the third phase between March 19,1997, and December 16,1999. Cases were classified into high-tension OAG (htOAG) and normal-tension OAG (ntOAG), according to an intraocular pressure greater than 21 mm Hg or 21 mm Hg or less. Pulse pressure was the difference between systolic and diastolic BP. Diastolic perfusion pressure was the difference between diastolic BP and the intraocular pressure; indicators of arterial stiffness were carotidfemoral pulse wave velocity and carotid distensibility. Associations were evaluated with logistic regression analysis, adjusted for age, sex, body mass index, smoking, diabetes mellitus, serum cholesterol level, and BPlowering treatment.
Periodontal Conditions in Rheumatoid Arthritis: Clinical and Radiographic Investigations
Authors: Abbas D. K. , Salman S. , Al Kaisi F. A.
Published: February 2016

Periodontal conditions in 100 dentate adults with rheumatoid arthritis (RA) were compared with those of age and gender matched individuals without rheumatoid arthritis. The clinical parameters for periodontitis included probing pocket depths, attachment loss, gingival inflammation scores, plaque scoresand radiographic bone loss scores. The rheumatoid arthritis group had more missing teeth than the control group and a higher percentage of them had deeper pocketing and loss of periodontal attachment There were no significant differences between the two groups for gingival inflammation and bleeding. There was a tendency to adverse periodontal conditions amongst the rheumatoid arthritis patients with severe periodontal bone loss occurring more frequently than in the controls. The rheumatoid arthritis patients had more dental plaque deposits than the control group, a finding which could indicate a difference in periodontal care. It is suggested that this study provides evidence of a significant association between periodontitis and rheumatoid arthritis.
Esophageal Candidiasis: An Endoscopic and Histopathologic Study
Authors: Shakir N. F. , Salih H. A.
Published: February 2016

To determine the frequency of endoscopic esophageal candidiasis and to compare the results with histopathological findings while assessing the relationship between Positive oral swabs and stool examinations for Candida and esophageal candidiasis, a study was conducted on 778 patients in Iraq-Baghdad lAlyarmuk Teaching Hospital, Department of Medicine, from January 1999 to December 2000. The major presenting symptom was hematamesis. During upper GI endoscopy 22 (2.8%) had lesions suggestive of esophageal candidiasis but this could be confirmed histopathologically in only fourteen. Oral candidiasis was found in 10 of the 22 patients (45.4%); stool examinations for Monilia were positive in only two (9%) who also gave positive oral swabs. Twenty control Patients gave negative oral swabs and only three (15%) Positive stools.
Evaluation of the Universal Screening Strategy in Qatar for the Management of Pregnant Women Carrying Group B Streptococci
Authors: Al Taher F. T. , Afifi N. A. , Hassan N. S. , Asker B. A. , Habboub L.
Published: February 2016

Group B Streptococcus infection (GBS) has emerged as a serious disease, infecting 18,000 people in the United States annually including life-threatening illness in about 8,000 newly-born infants. To evaluate the efficiency of the current universal screening strategy for the management of GBS carriers a retrospective analysis was made of the records of 1,620 pregnant women in Qatar, 550 of whom were found to be carriers. These latter were then used as a group to be compared with 450 uninfected pregnant women in terms of nationality, parity, age, treatment, and outcome. Young and nullipara pregnant women had a high incidence of GBS but there was no significant effect on birth mortality and morbidity regardless of whether or not they received treatment with antibiotics. It is suggested that the cost of screening for GBS at the 35 th week of gestation cannot be justified.
Immunocompromised Patient with Bilateral Pulmonary Infiltrates (Docetaxel Induced Hypersensitivity Interstitial Pneumonitis)
Authors: Al Azawi S.H. , Rasul K.L. , Bujassoum S.M. , Al Najjar N.M.
Published: February 2016

A middle-aged lady admitted with metastatic breast cancer developed acute respiratory problems with bilateral pulmonary infiltrates after five days of cytotoxic administration, as an acute adverse drug reaction to the docetaxel that resolved completely after high dosage of dexamethasone.
Abstracts From Qatar to the World
Authors: Hammoudeh M. , Gehani A.A.
Published: February 2016

A great variety of procedures have been proposed for the cure of sacrococcygeal pilonidal disease. A bilobed fasciocutaneous flap, based on the parasacral perforators, is described. This retrospective study was conducted to evaluate our experience with bilobed fasciocutanous flaps and to review current publications about flap surgery for the treatment of sacrococcygeal pilonidal sinus. Eight bilobed fasciocutanous flaps have been performed between February 2004 and September 2006. Eight males, aged 19 to 35 years (mean age: 26.2 years), presented with chronic and recurrent pilonidal disease. The duration of the disease was ranged from 2 to 6 years (mean age: 3.8 years). The sinuses were excised in a vertical, elliptical fashion and the defect closed using a bilobed fasciocutanous flap. This flap was designed using the parasacral perforators and tailored to obliterate the midline defect. Primary wound healing was achieved in all patients. Large defects after excision can easily be closed using the bilobed fasciocutaneous flap. The flap provides a tensionless wound closure. Hospitalisation is brief, and the postoperative course is comfortable. No recurrence was seen in any of the eight cases. This procedure is indicated in patients in whom wide skin resection is required, because of the tension-free skin closure in such cases. This technique enabled regional reconstruction, conserved tissues, and provided satisfactory aesthetic results. Therefore, this procedure can be considered an additional, useful tool in the treatment of pilonidal sinus.
Critical Care of Gynecological and Obstetric Patients: A decade of surgical intensive care experience
Authors: Khawaga S. , Ei Sayed N. , Shaikh N. , Mustafa G. , Kettern M.A. , Hafiz A.
Published: February 2016

Despite the emergence of therapeutic advances, the morbidity and mortality still occur in the obstetric patients, although intensive care utilization by obstetric and gynecological patient, are still rare compared to the general population. Majority of obstetric patients needed the intensive care therapy compared to gynecological patients. The aim of our study was to know the indications for the intensive care admission by obstetric and gynecological patients, length of stay and outcome of these patients.

Methods: We retrospectively reviewed the medical records of all obstetric and gynecological patients admitted to our Surgical and Trauma Intensive Care Units (SICU and TICU) from February 1995 to March 2005. Indication for admission, nationality, age, and length of stay in ICU, severity of disease and outcome of these patients were recorded. Data analyzed with SPSS program.

Results: A total of 182 patients were admitted to the SICU of the Hamad Medical Corporation in Doha, Qatar, from the Women's Hospital. 159 (87%) patients were obstetric patients and 23 (13%) patients gynecological patients, 126 (69.6%) patients were admitted post Lower Segment Caesarean Section (LSCS). The most common indication for admission was 73 (39.3%) patients obstetric hemorrhage and Disseminated Intravascular Coagulation (DIC), and then 44 (25.3%) patients of hypertensive disorder of pregnancy. The major anesthesia related indication was scoline apnea, 21 (11.6%). Total three obstetric patients died, two due to severe sepsis and multi-organ failure and one due to cerebral sinus thrombosis, giving mortality rate of 1.66%.

Conclusion: Intensive care therapy required by gynecological and obstetric patient is less than the general population. The commonest indication for admission was obstetric hemorrhage, DIC, and hypertensive disorders of pregnancy. The mortality was due to septic shock with multi-organ failure, and cerebral venous sinus thrombosis.
Common Bile Duct Schwannoma Associated with a Choledochal Cyst
Authors: Zarour A.M. , Al Sulaiti M. , Morad N.
Published: February 2016

Myelin sheath tumors are neurogenic tumors which include schwannoma, neurofibroma, neurofibromatosis and neurogenic sarcoma. They are most commonly present during middle age and 90% are benign. It has been reported that, they are twice as common in women as in men, but there are few reports of neurogenic tumors in the biliary tract and fewer than 10 cases of schwannoma of the extrabiliary tract.
Blind Nasogastric Tube Insertion: Be careful
Authors: Shaikh N. , Patil P. , Mudali I.N. , Gafoor M.T. , Ummunnisa F.
Published: February 2016

Nasogastric tubes are used in all specialties of medical practice. In critically ill patients, these feeding tubes provide enteral nutrition, which maintains enteric mucosal integrity as well as the immune system of the body, less risk of sepsis and decrease in length of intensive care stay. The insertion of nasogastric tube (NGT) is being considered as a simple blind bedside procedure but this procedure is not free of complications and can be fatal as these tubes can be malpositioned into the respiratory tract or central nervous system. Critically ill patients with endotracheal and tracheostomy tube are at particular risk for malpositioning of the nasogastric tubes due to loss of protective reflexes. Here we report three cases, two intubated and one patient with tracheostomy, in whom the enteral feeding tube was malpositioned into the respiratory system, detected early and a new one inserted in correct position, confirmed by x-ray. The aim of this report is to increase awareness about malpositioning of gastric feeding tubes, proper confirmation of their positioning, risk factors for malpositioning and its prevention.
Biography
Authors: Al Battani Abu Abdullah
Published: February 2016

Abdullah Muhammad Ibn Jabir Ibn Sinan Al Battani Al Harrani was born around 858 CE in Harran, and according to one account, in Battan, a State of Harran. Battani was first educated by his father Jabir Ibn San'an Al Battani, who was also a well-known scientist. He then moved to Raqqa, situated on the bank of the Euphrates, where he received advanced education and later on flourished as a scholar. At the beginning of the 9th century, he migrated to Samarra, where he worked until the end of his life in 929 CE. He was of Sabian origin, but was himself a Muslim.
Treatment of Refractory Diffuse Diabetic Macular Edema with Intravitreal Bevacizumab
Authors: El Shafei M.M , Pai A , Al Hashimi M , Warid F , Farouk M
Published: February 2016

To analyze the short term visual acuity and anatomic response after a single dose of off-label intravitreal injection of bevacizumab in diffuse diabetic macular edema (DME) not responding to conventionallaser photocoagulation.

Patients arid Methods: Prospective analysis of consecutive case series of 45 eyes of 38 patients with refractory diffuse DME who had one intra-vitreal injection of 1.25 mg of bevacizumab (Avastin) and followed up for 3 months. All patients passed at least six months since their last laser treatment before inclusion in the study. Patients underwent best corrected visual acuity determination, intraocular pressure measurement, stereoscopic biomicroscopy of the macula and measurement of the retinal thickness by optical coherence tomography (OCT) at base line and follow up visits.

Results: At 1 month post-injection, visual acuity improved by 1 line in 7 eyes, unchanged from the preinjection levels in 24 eyes and deteriorated in 14 eyes. At 3 months post injection, visual acuity improved in 18 eyes, it remained unchanged in 13 eyes and deteriorated in 14 eyes. The mean logMAR visual acuities were 0.60 (SD ± 0.34), 0.64 (SD ± 0.31) and 0.61 (SD ± 0.32) at pre-injection, at 1 month post-injection and at 3 months post-injection respectively; but this mean decrease in vision was statistically not significant (P value = 0.099). The foveal thickness on optical coherence tomography had decreased in 27 eyes and it increased in 18 eyes at 1 month post-injection. At 3 months following injection, foveal thickness was reduced in 34 eyes, but was increased in 11 eyes. The mean foveal thicknesses were 444.95 u (SD ± 127.36), 394.95 u (SD ± 138.03) and 378.32 u (SD ± 11 2.01) at pre-injection, 1 month post-injection and 3 months post-injection respectively. This decrease in the foveal thickness was statistically significant (P value <  0.001).

Conclusions: Intravitreal bevacizumab is effective in patients with diffuse DME which is refractory to treatment with conventional macular laser photocoagulation. Key words: bevacizumab, intravitreal, diffuse diabetic macular edema
Quality Care of Patients with Diabetes Mellitus in the Diabetic Clinic at Al Wakra Healthcare Center, Qatar
Authors: Nazar R , Al Ansari Y , Abdulmajeed A
Published: February 2016

Introduction: Diabetes mellitus is a chronic illness that requires continuous medical care. Patient health education and self-management aim to prevent acute complications and to reduce the risk of long-term complications. Care of diabetic patients is a complex process and requires many issues beyond glycemic control. This study is conducted to assess quality of care of diabetic patients in the diabetic clinic at Al Wakra Healthcare Center and to determine some factors that may affect the quality of this care.

Methodology: This is a descriptive, cross-sectional study. The target population was all diabetic patients (Type 2) that meet the inclusion criteria and registered at the center. Two checklists assessed the structure of diabetic care; the first checklist is for the essential items of care (thirteen items) and the second one is for the less essential items (ten items). The indicators of the process of diabetic care was assessed by a scoring system that depends on ten items for standard diabetic care by the primary care physicians in the past year. Assessment of the outcome was done according to an international quality assurance protocol and it includes: the degree of diabetic control, obesity, smoking among the diabetic patients and control of blood pressure. We added HbA1c to this list. Another questionnaire was designed to determine factors that may affect quality of diabetic care-related to patient's knowledge and attitude and it is divided into 4 sections: personal data, patient knowledge about diabetes, patient attitude toward care and clinical and biochemical assessments. A pilot study was carried out to test the questionnaires. Epi-info. Six statistical package was used for data entry and statistical analysis. Chi square or Fisher exact tests were used to test the significance, and P value <  0.05 was considered significant.

Results: The study showed that diabetic care at Primary Healthcare Centers (PHC) in Qatar represented by Al Wakra Primary Healthcare Center is better when compared to the care in other studies in different countries. 86.7% of physicians show that most of the structure items are good to fair except for the absence of chiropodist and identification cards for diabetic patients. Assessment of the process of care showed that there is good to fair recording in 91.75% of cases; foot examination is not recorded in most of cases; and fundus examination is not recorded in 31.7%. The outcome indicators showed that patient knowledge about diabetes is poor in 35% of cases, uncontrolled FBS in 75.6% of cases, uncontrolled HbA1 c in 57.8%; obesity in 63.5% and control of blood pressure is not achieved in 49% of cases.

Conclusion: Diabetic Clinic at Al Wakra Primary Healthcare Center provides good care for diabetic patients in terms of structure, process and outcome; however, more efforts are needed for refining these services.
TAC Protocol in Early Breast Cancer Al Amal Hospital Experience
Authors: Rasul K.I.
Published: February 2016

To assess the efficacy and the tolerability of TAC (docetaxel, doxorubicin, and cyclophosphamide) protocol in early breast cancer patients with node positive in the adjuvant treatment 64 patients (median age 46 years) with early node positive breast cancer were studied from October 2003 to May 2009 according to certain inclusion criteria. They received TAC protocol chemotherapy; Disease free survival (DFS), Overall Survival (OS) and toxicity profile were assessed. All except one received six cycles of chemotherapy according to TAC protocol. Median follows-up was 60 months. Disease free (DFS) and Overall Survival (OS) were 77% and 87% respectively. The chemotherapy was well tolerated and the toxicity profile was better in comparison to previously published studies. It is concluded that TAC protocol in the adjuvant treatment of early breast cancer is effective and well-tolerated as evident by the toxicity profile provided the G-CSF is started as primary prophylaxis from the first cycle.
CMV Infection in Adult-Onset Disease: An unusual presentation
Authors: Al Ajmi J.A. , Al Marri A.A , Wajdei N.
Published: February 2016

Adult-onset-still's disease is systemic inflammatory disorder of unknown origin, several reports have suggested a triggering infection in Adult-onset- still's disease, we describe a case of uncommon presentation of ASD associated with cytomegalovirus infection. A 25 year-old male was admitted to our hospital complaining of high fever. The physical examination showed Right basal crepitation, with pericardial rub. Although several antibiotics were administered, the spiking high fever was not alleviated. Two weeks after admission a macular rash appeared, and a high concentration of serum ferritin was observed. At this point, Still's disease was suspected. During the prescribed course of prednisolone, hepatic enzymes gradually increased accompanied by a positive test for cytomegalovirus (CMV) antigen. The symptoms disappeared after administration of gancyclovir and steroid. In this report, we attempt to portray the relation between the pathogenesis of adultonset Still's disease and the presence of CMV antigen.
Abstracts from Other Journals 2
Authors: Gehani A. A. , Hammoudeh M.
Published: February 2016

Background: Early detection and treatment of Hepatitis C can change the natural history of disease.

Aim: The primary aim of this study was to detect infection of hepatitis C using a rapid immunochromatographic assay in a community setting. The secondary aims included assessment of prevalence rate and disease characteristics; including liver function tests, viral load, grade and stage of disease on the liver biopsy.

Methods: Two cohorts of 4000 and 321 2 people (.004% of the population) were surveyed over a three week period each between December 2008 through August 2009. Qualitative detection of hepatitis C antibodies was done using a colloidal gold enhanced rapid immunochromatographic assay (Health Chem Diagnostics LLC, FL-USA).Viral load was calculated using RT PCR (Taqman) and those found positive underwent liver biopsy.28 and 33patients with proven chronic hepatitis C formed the controls for validation of the kit used in the first and the second cohort.
Treatment Role of Circumcision in Urinary Tract Infections in Children Less than Five Years of Age in Mosul City 2010
Authors: Al Jumaily D.A.D.
Published: February 2016

To investigate the possible role of circumcision in decreasing urinary tract infections in children less than five years of age the clinical and laboratory findings of 100 cases of urinary tract infection admitted to Al Khansaa Pediatrics Hospital were compared with a similar number of apparently healthy children. The results showed a strong relationship between circumcision and decreased incidence of urinary tract infections and that the risk of urinary tract infections in uncircumcised children was more than six-fold that of circumcised children of the same age.