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Imported epidemic non-A, non-B hepatitis in Qatar.

During one year, 198 patients were admitted to the Hamad General Hospital, Qatar, with acute viral hepatitis. Sera from 126 of these were tested for HBsAg, IgM anti-HBc, IgG anti-HAV, IgM anti-HAV, and delta antibody in those positive for HBsAg. Only 6% of the patients were Qatari nationals and the remainder were immigrants. Of the 126 patients tested, 7 had acute hepatitis A, 29 had acute hepatitis B (none were positive for delta antibody), and the remaining 91 were regarded as having had acute non-A, non-B hepatitis. Of this latter group, 75% were Indian immigrants of whom 59% presented within six weeks of arrival in Qatar and only 2 patients presented later than eight weeks. These patients were thought to have contracted the infection in transit camps in India before immigration to Qatar.

Adolescent

Leprosy in Qatar.

Clinical and histopathologic features of 104 cases of leprosy diagnosed between 1982 and 1989 in the State of Qatar were studied. There were 88 male (84.6%) and 16 (15.4%) female patients aged 18 to 64 years. Eighty-four of the cases were diagnosed during the initial mandatory medical screening on arrival to Qatar. Almost all (103) were expatriates and only one 50-year-old woman was a Qatari. Indians formed the largest group (60.6%), followed by Bangladeshi (6.7%), Pakistani (5.8%), and others. The majority of cases were classified as lepromatous (43.3%) or tuberculoid (43.3%). Although Qatar is a relatively leprosy-free country, the influx of a large number of workers from developing countries seeking employment forms a potential public health hazard.

Adolescent

Henoch-Schöenlein syndrome in Qatar: the effects of steroid therapy and paucity of renal involvement.

This is a retrospective study of 40 patients admitted to Hamad General Hospital in the state of Qatar between January 1983 and December 1987 with the diagnosis of Henoch-Schöenlein syndrome. Of the 40 patients, 25 were boys and 15 were girls, with a ratio of 1.6:1. Ages ranged from 2 years 3 months to 13 years, with a mean of 6 years. There were six episodes of recurrence in four patients. There was a clustering of cases in late summer and early winter. About half of the patients had a history of preceding upper respiratory infection. All of them had the typical skin rash. The percentages of joint, gastro-intestinal and renal manifestations were 80%, 65% and 17.39%, respectively. One patient had penile swelling which has not been reported before. Steroid therapy seemed to enhance early resolution of abdominal pain but did not affect the course of the syndrome. Sixty-seven per cent of the patients were followed up for from 4 weeks to 5 years, with a mean of 8 months. Only one patient with renal involvement continued to have proteinuria with microscopic haematuria and hypertension. The rest were normal within about 2 months. The remarkably low incidence of renal involvement in our study may be related to local variations in causative factors. Henoch-Schöenlein syndrome is a milder disease in Qatar than in other countries.

Adolescent

Survey of major blinding conditions in Qatar.

Qatar is one of the rapidly developing Gulf States. Its life style is rapidly changing from a seminomadic to a more settled urban one. This is the first study of the causes of economic blindness (6/60) in Qatar. It embraces 3,072 patients (70% males and 30% females). The most common causes in those under 40 years of age were trachoma, infectious diseases, retinal diseases, trauma and congenital malformations. After 40 years, cataract and glucoma occupy the second and third commonest causes after trachoma. Thus, a proper antitrachoma campaign will cut down the incidence of blidness by 50%. Control of individual behavior and antenatal caution in prescribing medicines can reduce the risk of trauma and congenital malformations. Cataract is not preventable, but early detection of glaucoma delays the damage of ocular tissues. This is the same with systemic disease.

Adolescent

Granuloma inguinale. Report of the first case in Qatar.

The first known case of granuloma inguinale in the State of Qatar was observed in an Indian expatriate who contracted the disease in India. The patient had the ulcero-vegetative clinical variant of the disease, which was suspected from the history, lack of spontaneous healing for five months, and the typical clinical picture. The diagnosis was confirmed by the finding of intracellular Donovan bodies in a crushed-tissue smear stained with Wright's stain. The patient was treated by tetracycline hydrochloride (2 g daily for 20 days). The ulcer was healed completely within ten days. The diagnosis of more cases of granuloma inguinale in Qatar is anticipated because of the recent improvement of health care, medical records, and attraction of medical attention to the disease.

Adult

Fatty acid composition of eleven algae from coastal zones of Qatar.

The fatty acid composition of eleven species of algae belonging to Rhodophyceae, collected from the coastal zones of Qatar, are reported. The major fatty acids identified were palmitic (16:0), myristic (14:0), oleic (18:1), eicosadienoic (20:2), linoleic (18:2), stearic (18:0) and hexadecaenoic acid (16:1). The fatty acids were characterized by the relatively high abundance of polyunsaturated acids, while the C18 unsaturated acids were appreciably more abundant than the C20 unsaturated acids.

Eukaryota

The emergence of antimicrobial resistant Salmonella typhi in Qatar: epidemiology and therapeutic implications.

Multiresistant Salmonella seems to be a growing problem in Qatar and its treatment remains problematic. Of 100 Salmonella bacteraemias that occurred between 1 October 1989 and 30 September 1990, 30 were caused by S. typhi resistant to one or more of the conventional antibiotics usually recommended for the treatment of typhoid fever (ampicillin, chloramphenicol, and trimethoprim-sulphamethoxazole). Of those, 25 (83%) were acquired by patients during visits to the Indian subcontinent. Two patients with isolates sensitive to ampicillin were successfully treated with amoxicillin, 6 paediatric patients were cured with cefotaxime, and 20 adult patients responded favourable to ciprofloxacin. A 9 year old boy failed initial therapy with cefuroxime but responded well to ciprofloxacin. One adult patient was treated successfully with a combination of ciprofloxacin and cefotaxime. We conclude that cefotaxime and ciprofloxacin can serve as first line therapy for typhoid fever in areas where multi-resistant Salmonella is prevalent.

Adolescent

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

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

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

Detection of African horsesickness (AHS) in recently vaccinated horses with inactivated vaccine in Qatar.

Two 7-year old Arabian racing horses were reported to show typical AHS symptoms in Qatar and died shortly after. The horses had been vaccinated with formol inactivated vaccine approximately 10 days before the onset of the disease. Blood samples from these horses were collected and AHS virus isolated from one sample after intracerebral (i.c.) inoculation into suckling mice. The virus identity was confirmed by complement fixation test (CFT) using the virus antigen and reference type 9 of AHS virus hyperimmune serum. The serotype of the isolated virus was identified by serum neutralization test (SNT) using reference types of AHS virus. Two possibilities of the original source of this infection were suggested. The infection might be due first to the natural endemic occurrence of the virus in the country and secondly, to the presence of residual infectious virus in the inactivated vaccine.

African Horse Sickness

Pre- and neonatal hydrocephalus in the Middle East: experience in Qatar.

In a retrospective study, all cases of hydrocephalus diagnosed antenatally or within the first 10 days of life during the period 1986-1989 were reviewed. Thirty-four cases were diagnosed antenatally and 31 after delivery. Among the last, 13 were hemorrhagic. In 17 cases a meningomyelocele was present. In 12 cases other malformations outside the nervous system were observed. This represents an incidence of 157/100,000 live births for hydrocephalus and 41/100,000 for meningomyelocele. All cases were compared against a control group that had normal antenatal ultrasound findings at the same time (35 cases), and against a second control group consisting of 53 women with five or more normal pregnancies at the time, and all normal babies. The differences are evaluated and their significance and implications for the future discussed.

Adult

Intussusception in children under 2 years of age in the State of Qatar : analysis of 67 cases.

Intussusception is one of the leading causes of bowel obstruction in early infancy and childhood. From 1984-1989, 67 patients under 2 years of age with intussusception were diagnosed and treated in our institution. There were 48 boys and 19 girls ranging in age from 2 months to 2 years with a mean of 7.4 months. Presenting symptoms and signs included abdominal pain (96%), vomiting (93%), rectal bleeding (60%) and a palpable mass (67%). Symptoms and signs were present for less than 24 hours in about 80% of cases. Most of the intussusceptions were of the ileocolic type (75%). The overall success rate of hydrostatic barium enema reduction was 49%. The highest rate of reduction by enema was among patients between 9 and 16 months of age (83%). The success rate of barium enema reduction was negligible after 24 hours of cardinal symptoms. Five children underwent surgical exploration without contrast studies because of delayed presentation and signs of an acute abdomen. A pathological lead point was found in only four cases, the commonest being Meckel's diverticulum. The average length of hospitalization was 2.57 days after barium enema reduction and 7.55 days after surgical reduction. There were no deaths. There was no case of perforation during enema reduction. Three children had recurrence within 3 months of initial presentation. The best outcome is associated with early diagnosis and barium enema reduction, or selected surgical intervention when indicated.

Barium Sulfate

Management of fracture of the penis in Qatar.

We present 21 patients with fracture of the penis treated between July 1982 and July 1990. Eighteen patients were treated surgically, with good functional and morphological recovery; 3 refused surgery, 1 of whom had penile deformity and pain on erection. The literature is reviewed with respect to the necessity of different diagnostic and therapeutic options.

Adult

Transcultural aspects of psychiatric patients in Qatar.

The illness behaviour of Qatari psychiatric patients is defined by the nature of their symptomatology. The importance of somatic symptoms in determining the patient role and patient-doctor relationship is discussed in the light of cultural characteristics of the Qatari community. Delusory cultural beliefs related to possession, sorcery and envy provide a conceptual framework for explanation of many disorders. Inter-generational conflict is an important factor in neurotic disorders. Failure to report symptoms in an abstract fashion is characteristic of qatari patients. The cultural and religious heritage absorbs many behaviours which would otherwise be considered symptomatic of psychiatric disorder.

Culture