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PubMed2003

Determination of benzo(a)pyrene by GC/MS/MS in retail olive oil samples available in Qatar.

A survey was carried out for the presence of benzo(a)pyrene (B(a)P) in olive oils following reports that some batches of Spanish olive-pomace oil and its products contained high levels of B(a)P. Three types of olive oils (1) virgin olive oil, (2) refined olive oil and (3) olive-pomace oil, originating from France, Greece, Italy, the Lebanon, Spain, Tunisia and Turkey, and available on Qatar market, were analysed for B(a)P. Determination was carried out by extraction from a cyclohexane solution with N,N-dimethylformamide: water (9:1), back extraction with cyclohexane, followed by clean-up on a silica gel column and quantification by GC/MS/MS. The recovery and limit of quantitation of B(a)P in olive oils by this method were estimated as 88% and 0.5 microg kg(-1), respectively. B(a)P was detected in amounts below the permitted level of 2 microg kg(-1) in all 31 virgin olive oil samples and in 13 refined olive oil samples. However, all seven samples of Spanish olive-pomace oil produced and packed in Spain and three samples of olive-pomace oil produced in Spain, but packed in Saudi Arabia, were found to be contaminated with B(a)P, the level ranging from 3.1 to 70.8 microg kg(-1). In two samples of olive-pomace oil originating from Greece, B(a)P was not detected.

Benzo(a)pyrene↗

PubMed2000

Cystic fibrosis in a large kindred family in Qatar.

We describe 45 patients with cystic fibrosis (CF), diagnosed between June 1987 and May 1999, seen at the Hamad Medical Corporation, Qatar in the Arabian Gulf. Twenty-six of 32 families in the study were related and belonged to the same Bedouin tribe. The parents of 98% of these cases were consanguineous. Metabolic alkalosis and/or hypo-electrolytaemia were found in a large proportion of infants with CF. Cystic fibrosis in Qatari children is phenotypically variable with mild to moderate respiratory symptoms, and none of them died during this study. Among the non-Arabic-Asian patients, pulmonary symptoms were more severe, Pseudomonas colonization was earlier, pancreatic insufficiency occurred in infancy and four died in early life.

Age of Onset↗

PubMed2000

Primary tuberculosis of the breast in Qatar: ten year experience and review of the literature.

OBJECTIVE: To present our experience of isolated tuberculosis of the breast, 1988-98. DESIGN: Retrospective study of case notes and radiographs. SETTING: Hamad General Hospital, Qatar. SUBJECTS: 13 multiparous women with tuberculosis of the breast. MAIN OUTCOME MEASURES: Objective confirmation of diagnosis and adequacy of treatment. RESULTS: We found an overall incidence of histologically confirmed tuberculosis to be 0.4%/year. All patients presented with a lump, 2 had nipple discharge and one had a palpable axillary node on the same side. 7 were treated by excision biopsy, 3 by incision and drainage, and 3 had fine needle aspiration (FNA) as their only procedure. All diagnoses were confirmed histologically. 2 patients developed recurrences during treatment but these were successfully treated. CONCLUSION: Although the incidence of the disease is low, the diagnosis should be suspected in young multiparous women with a breast lump in whom malignancy has been excluded. The minimum of surgical intervention (incision or excision biopsy) together with antituberculous drugs seems to be the most successful treatment.

Adult↗

PubMed2001

Heterogeneity of the cystic fibrosis phenotype in a large kindred family in Qatar with cystic fibrosis mutation (I1234V).

Twenty-nine subjects (17 families) with cystic fibrosis belonging to the same Bedouin tribe were screened for cystic fibrosis transmembrane regulator gene mutations (CFTR). Homozygous I1234V mutation in exon 19 was identified in all families with a relatively high rate of consanguinity (96.6 per cent). The homozygous I1234V mutation tended to present with a variable degree of pulmonary disease, pancreatic insufficiency and electrolyte imbalance. Homozygous I1234V was found to be a common mutation in the studied Bedouin tribe in Qatar.

Adolescent↗

PubMed2005

The globalization of education in medical ethics and humanities: evolving pedagogy at Weill Cornell Medical College in Qatar.

The authors discuss their experience in implementing a Medical Ethics and Humanities course for premedical students at Weill Cornell Medical College in the Arabian Gulf emirate of Qatar. The course, first offered in 2003, is designed to prepare these students for the medical school curriculum to follow and to make global medical knowledge meaningful for their local context. Pedagogical challenges included the cross-cultural tensions that could emerge when introducing themes from Western medical ethics and humanities into this overwhelmingly Islamic context. The authors outline the response to this challenge and strategies to broaden student inquiry without engaging in indoctrination. This seminar-based course was designed around seven thematic areas of increasing biopsychosocial complexity, from nature and biology, to the patient, the physician, and the family, to broader questions of hospital care, the health care system, and the place of law in modern medicine. Readings from the literature of the Western and Arabic traditions were used, including selections by Hippocrates, Thomas, Kafka, Mahfouz, and Pellegrino. It is too early to know the ultimate impact of the course, but students demonstrated enthusiasm for ethics and the medical humanities and a willingness to consider new and novel ways of knowing. The authors anticipate that this grounding in the humanities will complement the students' work in the sciences and help further develop their nascent professional identities in an increasingly global medical community.

Culture↗

PubMed2006

Consanguineous unions and child health in the State of Qatar.

The aim of the study was to estimate the prevalence and sociodemographic predictors of consanguineous unions in the State of Qatar and to assess the association between consanguinity, fertility and child health. A representative sample of 1800 Qatari women aged > or =15 years was approached for the study. Of these, 1515 (84.2%) women agreed to participate. The consanguineous marriage rate was 54.0% with estimated population confidence limits of 52.3-55.7%. First cousin unions were the most common form of cousin marriage. The level of parental consanguinity (both in the respondent's parents and her parents-in-law) was quite high. In a multivariable analysis, both education of the respondent and her husband as well as parental consanguinity were found to be strong predictors of consanguineous unions in the index generation. Although fertility was high in both groups, the mean number of pregnancies was somewhat higher in respondents with first cousin unions. Concomitantly they also had a slighter higher rate of livebirths than women in non-consanguineous unions. The occurrence of asthma, mental retardation, epilepsy and diabetes was significantly more common in offspring of all consanguineous than non-consanguineous couples.

Abortion, Induced↗

PubMed1991

Mycologic study of tinea capitis in Qatar.

The causative dermatophytic species of tinea capitis were identified in 91 patients in Qatar. Microsporum canis was the most common isolated organism (86.81%) followed by Microsporum ferrugineum and Trichophyton violaceum. A gray patch type of tinea capitis was the predominant presentation (87.91%), and the disease was more prevalent among Qatari boys.

Animals↗

PubMed1977

Pterygium in Qatar.

The incidence of pterygium in Qatar is 6.2%, which is less than expected. Laying stress on the climatic conditions, the etiological factors have been discussed. 450 cases of pterygia were operated on by a modified bare scleral technique followed by beta-irradiation. No recurrence occurred in 90% following the first operation. The final good result (98.8%) is in favour of the adopted surgical technique and post-operative care.

Adolescent↗

PubMed1998

Coronary angiography in Qatar: the first ten years.

Cardiac catheterization in Qatar was initiated in July 1982. In ten years, a total of 3900 procedures were performed at Hamad General Hospital. Computerized data registry has been maintained since 1982. Isolated coronary angiography was done in 2911 patients; of these, 2635 (90.5%) were men, and 276 (9.5%) were women, the average age of the patients was 47+/-9.2 years (range, twenty-five to eighty-eight). Patients' nationality was Qatari in 492 (17%), and other Arabs in 610 (21%), and 1512 (52%) were from the Asian subcontinent. Myocardial infarction was the most common indication (43%). Single-vessel disease was found in 638 (22%), two-vessel disease in 630 (22%), three-vessel disease in 950 (33%), and nonsignificant coronary artery disease in 693 (24%) patients. Morbidity related to the coronary angiography was reported in 147 (5%) patients, but there was no mortality related to the procedure. In 822 (28%) patients, the age was forty years or younger. The angiographic findings of these younger patients were compared with those of the older ones. Younger patients were usually men of Asian subcontinental origin with a recent myocardial infarction (MI). Often, they had normal coronary arteries or single-vessel disease. Patients of Asian subcontinent origin were usually young male patients with a recent MI, who receive streptokinase, and have single-vessel disease.

Adult↗

PubMedDate not supplied

Multiple endocrine neoplasia type iia: report of a family with a study of three generations in qatar.

OBJECTIVE: To study the pattern of multiple endocrine neoplasia type IIA (MEN IIA) and describe the clinical features and results of genetic testing and treatment in 21 members of the first reported family with MEN IIA in Qatar. METHODS: After identification of the proband, we screened all her family members (21 members) with genetic testing for the RET proto-oncogene mutation. Those subjects with the mutation were further assessed for pheochromocytoma by measurement of the 24-hour urinary vanillylmandelic acid, metanephrines, and catecholamines, and those with high levels underwent a metaiodobenzylguanidine scan and adrenalectomy. The serum calcium was measured in a effort to detect hyperparathyroidism. Those family members who had the mutation and were eligible for surgical treatment underwent total thyroidectomy and central compartment dissection. In those patients with high postoperative calcitonin levels, residual disease was sought with radiologic imaging, and follow-up was done with pentagastrin stimulation tests. RESULTS: Of the 21 family members screened, 10 had the RET proto-oncogene mutation (codon 634, TGC->GGC) (5 females and 5 males; 6 adults and 4 children). All the adults had bilateral medullary thyroid carcinoma (MTC); four of them had lymph node metastatic lesions, and one had metastatic involvement of the liver. Two adults had pheochromocytomas. Two family members were reported to have parathyroid hyperplasia, although both were normocalcemic. CONCLUSION: This family with MEN IIA showed classic mendelian autosomal dominant inheritance. All adult patients had MTC, two had pheochromocytomas, and two had parathyroid hyperplasia. Although one child had a high stimulated calcitonin level, the histopathologic findings were normal; another child with high stimulated calcitonin levels showed C-cell hyperplasia on histopathologic examination.

Adrenal Gland Neoplasms↗

PubMedDate not supplied

Emergency obstetric hysterectomy in Qatar--a 20-year review.

OBJECTIVE: To determine the incidence, indications, and predisposing factors for emergency hysterectomy in Qatar. METHODS: Retrospective chart review between January 1979 and December 1997 to determine the total number of emergency hysterectomies performed. We reviewed the case notes for all the patients (only 10 were not available). RESULTS: Of 17,535 deliveries, emergency hysterectomy was performed in 64 patients (0.04%). The indications were persistent bleeding from placenta previa in 19 patients (35%), ruptured uterus in 16 patients (29.6%), placenta accreta in 12 patients (22.2%), and atonic uterus in 7 patients (13.0%). Total abdominal hysterectomy was performed in 21 cases (38.9%), and subtotal hysterectomy was performed in 33 cases (61.1%). There were 3 maternal deaths (5.5%) due to severe bleeding. CONCLUSION: Even though emergency hysterectomy was rare in our study, the presence of an experienced obstetrician is important in high-risk patients to make an early decision to operate before the patient's condition deteriorates and to provide the technical skills required to minimize morbidity and mortality.

Adult↗

PubMed2001

Pattern of mycobacterial resistance to four anti-tuberculosis drugs in pulmonary tuberculosis patients in the state of Qatar after the implementation of DOTS and a limited expatriate screening programme.

OBJECTIVE: To determine the resistance pattern of Mycobacterium tuberculosis to four anti-tuberculosis drugs in pulmonary tuberculosis patients in the State of Qatar after the implementation of DOTS and an expatriate screening programme on arrival. METHOD: A state-wide, population-based, retrospective analysis of all cases of pulmonary tuberculosis with positive M. tuberculosis culture reported to the Division of Public Health TB Unit from January 1996 to December 1998. M. tuberculosis sensitivity testing was done by the Bactec method for isoniazid (INH), rifampicin (RMP), streptomycin (SM) and ethambutol (EMB). The results were interpreted as a daily change of the growth index of test vials (with drug) compared with controls. RESULTS: There were 406 isolates with positive M. tuberculosis culture. Sixty-one (15%) were resistant to one or more of the four anti-tuberculosis drugs, of which 58 (95%) were from newly diagnosed cases (primary) and three (5%) were from previously treated cases (acquired). Primary resistance was as follows: any resistance 15%, INH 12.4%, RMP 2%, SM 5.2%, EMB 0.8% and multidrug resistance (MDR, resistance to INH and RMP at least) was found in 0.8%. Acquired resistance was as follows: any resistance 15%, INH 15%, RMP 5%, SM 5% and MDR 5%. CONCLUSION: The prevalence of resistance to four anti-tuberculosis drugs is strikingly low due to the limited expatriate screening programme (chest radiography) and implementation of DOTS. The four-drug regimen is recommended for the initial phase of therapy until the results of sensitivity testing are known.

Adolescent↗

PubMed2001

Monospecific helminth and arthropod infections in an urban population of brown rats from Doha, Qatar.

Parasitic infections were studied for the first time in an urban population of brown rats (Rattus norvegicus) from Doha. Only one species of helminth was found, the cestode Hymenolepis diminuta, and one ectoparasite, the flea Xenopsylla astia, from a sample size of 136 rats (52 males and 84 females). The prevalence of H. diminuta was 17.6%, increasing with host age but not in relation to host sex nor season of capture. Host age was a key factor in influencing abundance of infection, although there was a significant three-way interaction with season and host sex arising through heavy infections in juvenile male rats in the summer. The prevalence of X. astia was 45.6%, although both prevalence and abundance of infestations were season and host age dependent. In the winter prevalence and abundance were similar in both host age and sex groups, but in the summer both parameters of infestation were markedly higher among juveniles compared with adults. We found evidence for some association between these two species: H. diminuta was more prevalent among rats with fleas than among those without, although this association was season-, and independently sex- and age-dependent. There were no quantitative interactions and reasons for this are discussed in relation to the foraging and breeding behaviour of the brown rat in Qatar.

Animals↗

PubMed1992

Childhood chronic renal failure in Qatar.

Thirty children below the age of 12 with chronic renal failure (CRF) were studied. In 21 patients (70%) the renal failure was secondary to congenital or familial aetiology. Obstructive uropathy (53.3%), mostly due to posterior urethral valves (40%), comprised the majority of cases. Four cases (13.3%) were secondary to reflux nephropathy. It is concluded that the majority of cases of CRF in the state of Qatar are secondary to potentially treatable or preventable conditions. Use of antenatal ultrasonography combined with aggressive management of obstruction and urine infection may help reduce morbidity and mortality.

Child↗

PubMed2004

Dementia in Qatar.

OBJECTIVE: Dementia is a major public health problem among the elderly in developed countries and a growing problem in the underdeveloped countries. There are no published data on dementia in any of the Arabic countries. The aim of this study was to determine the different sub-types of dementia among Qataris. METHODS: A retrospective and prospective ongoing hospital-based study in which all medical records of the patients with diagnosis of dementia seen at the Hamad General Hospital, Doha, Qatar, between June 1997 and June 2003, whether inpatient or outpatient were reviewed. Dementia was defined according to diagnostic and statistical manual (DSM) IV criteria. Those who had dementia were evaluated by a psychologist, psychiatrist, neurologist and a geriatrician. All had brain computerized tomography, magnetic resonance imaging or both and routine blood tests. Finally, they were classified into sub-types according to the cause of dementia. RESULTS: Out of 300 patients, 134 fulfilled the inclusion criteria, most of them were illiterate, married and non-smokers. Among those dementia sub-types were: Alzheimer disease (AD) 39 (29%), vascular dementia (VaD) 30 (22%), mixed AD and VaD 20 (15%) and Parkinson's disease with dementia 8 (6%) were noted. The rest of them had dementia due to other medical conditions. CONCLUSION: Our study showed that AD is more prevalent than VaD. It also showed that patients and their families seek medical help late due to the general belief among the public that forgetfulness and other associated cognitive impairment are part of the normal aging process. The emergence of new drugs and advancement in the prevention of cerebrovascular diseases makes early diagnosis of dementia sub-type important. A community based study, to show the real prevalence and incidence of sub-types of dementia, is highly indicated. These data are necessary for planning and setting up community services and health care programs for demented patients.

Age Distribution↗

PubMed2004

Management of idiopathic sudden sensorineural hearing loss: experience in newly developing Qatar.

Idiopathic sudden sensorineural hearing loss is a medical emergency that requires urgent diagnosis and treatment, and the adaptation of a proper protocol for management is a priority. In most cases, such treatment is rather controversial and depends on a variety of factors. The aim of this study was to determine and identify as early as possible those factors that play the important role in the prognosis of the condition, to describe the experience, and to suggest a treatment protocol that can be adopted in a tertiary hospital, such as Hamad General Hospital. Our study was retrospective and descriptive. It was conducted in the ear, nose, and throat outpatient clinics at Hamad General Hospital and the ear, nose, and throat wards at Rumailah Hospital. We enrolled a total of 21 patients with idiopathic sudden sensorineural hearing loss. The treatment protocol that was adopted--consisting of high-dose steroid therapy, full-dose antiviral drug (acyclovir), and a histamine analog, betahistine--resulted in hearing improvement in 57.4% of cases. Then the possible good and bad prognostic factors were discussed. The results of our study revealed that the steroid therapy protocol practiced in Qatar resulted in hearing improvement in patients with idiopathic sudden sensorineural hearing loss. Good prognostic factors include early diagnosis, marked reduction of symptoms, and improved shape of the audiometric curve.

Acyclovir↗

PubMed2005

Antibiotic prescribing pattern in a medical intensive care unit in Qatar.

OBJECTIVES: The primary objectives were to evaluate the current usage of anti-microbial agents in the Medical Intensive Care Unit (MICU) of Hamad Medical Corporation (HMC) in Doha, State of Qatar and to correlate this with: a) the infectious disease pattern, b) the isolated microorganisms and their sensitivity pattern, and, importantly, c) the patient's clinical outcome. A secondary objective was to evaluate the influence of the use of steroid therapy on the development of fungal infections. METHODS: A prospective study covering a 2-month period from February through April 2004, including all patients admitted to the MICU for a minimum of 48 hours, and receiving a systemic antibiotic. RESULTS: From the 71 eligible patients admitted, 54 (76%) were treated for presumed or proven infections and received antibiotics, corresponding with 280 (89%) of the 313 patient days. Respiratory infections accounted for 57%. A total of 159 antibiotics (134 intravenously and 25 orally) were administered to the 54 patients during their stay in the MICU, corresponding with an average of almost 3 antibiotics per patient. Ceftriaxone was prescribed in 31 patients (57%) as initial therapy. Throughout the study period, a total of 385 microbiology samples for culturing were taken, corresponding with almost one sample per patient per day. Fifty-two percent of patients had a microbiologically proven infection (MPI): 18% with community-acquired pneumonia (CAP), 18% ventilated-acquired pneumonia (VAP), and 11% with hospital-acquired pneumonia (HAP). In the group of bacterial MPI, sensitivity pattern resulted in change in empirical antibiotic therapy in 12 of 23 patients (52%). In the group of patients with non-MPI, antibiotherapy was changed in 5 of the 26 patients (19%). Yeast infections developed in 13 of 30 (43%) patients receiving steroids (with 3 out of 9 patients (33%) receiving steroids for severe sepsis, and septic shock) compared to 5 of 24 (21%) patients receiving no steroids. CONCLUSION: This study highlights the urgent need for updated empiric and treatment guidelines as well as the monitoring of the antibiotic usage.

Adolescent↗

PubMed2005

Clinical characteristics of Crohn s disease in Qatar.

OBJECTIVE: To assess the clinical characteristics of Crohn's disease (CD) in Qatar. METHODS: This is a retrospective descriptive study. We studied 50 CD patients admitted to Hamad General Hospital over a period of 8 years from January 1995 to December 2002. We retrospectively collected and analyzed the demographic and clinical data. We made the diagnostic classification of definite CD in accordance with the criteria based on the International Classification of Disease ninth revision [ICD-9]. We based the obtained information on the following parameters: the age at the time of admission, gender and Crohn's risk factor profiles. RESULTS: Of the studied population, 60% were males and 40% females. Sixty-two percent were Qataris and 38% expatriates. Most of the subjects were <40 years of age (80%). Fifty-two percent had ileo-colonic disease, 24% colonic and 24% ileal disease. The majority of the Crohn's patients had the symptom of abdominal pain (84%), followed by weight loss (80%) and diarrhea (70%). Pallor sign was most frequent in patients with inflammatory CD (76.9%) and obstructive CD (66.7%), whereas we found the anal signs in patients with fistulas (84.2%). CONCLUSION: The study showed a relatively high frequency of ileo-colonic Crohn's disease compared to colonic and ileal diseases. We observed that the most frequent symptom is abdominal pain.

Adolescent↗