Use of complementary and alternative medicine among midlife Arab women living in Qatar

The prevalence of use of complementary and alternative medicine [CAM] is widespread and is growing worldwide. This cross-sectional study in Qatar examined the use of CAM and its correlates among Arab women in their midlife years. Women aged 40-60 years [n = 814] were recruited at primary care centres in Qatar and completed a specially designed, pre-tested questionnaire. Overall, 38.2% of midlife women in Qatar had used CAM in the previous 12 months. Nutritional remedies and herbal remedies were the most commonly used CAM therapies, followed by physical methods. Qatari nationality and higher level of education were independently associated with CAM use. Menopause transition status was not independently associated with use of CAM. The prevalence of CAM use by women in Qatar was high, consistent with other reports worldwide. It is essential to educate and inform patients and health-care providers about the benefits and limitations associated with CAM

Have neonatal mortality rates in the state of Qatar become static? A PEARL study analysis

To ascertain the national neonatal mortality rate in Qatar during the first quarter of 2011 [1 January-31 March], we carried out a prospective pilot national epidemiologic study. Nationwide birth and neonatal mortality data were collected using predesigned, structured questionnaires. To analyse trends over the previous 4 years [2008-2011] we used neonatal mortality data for 2008-2010 from the database of the neonatal unit at the Women's Hospital, annual reports of Hamad Medical Corporation, and published neonatal mortality data for 2010 for comparative analysis. A total of 4909 live births and 21 neonatal deaths were recorded during the study period. The neonatal mortality rate was 4.28 /1000 live births [corrected neonatal mortality rate 2.85 /1000]. The early neonatal mortality rate was 1.84 /1000 and the late neonatal mortality rate was 2.44/1000 live births. Fifteen of the 21 neonatal deaths were in non-Qatari babies, reflecting the ethnic distribution in the population. Neonatal mortality rates in Qatar declined very little between 2008 and the first quarter of 2011

Prevalence, awareness and determinants of contraceptive use in Qatari women

We determined the knowledge of, attitude to and practice of contraception and the associated sociodemographic factors among a representative sample 1130 Qatari married women aged 18-49 years. Data were collected by questionnaire. The mean age of the women was 32.5 [SD 7.6] years. The vast majority [94.6%] knew about contraception but of these 1070, only 694 [64.9%] were in favour of contraception. Knowledge of contraception increased with increasing level of education [P < 0.001], but decreased the lower the household income [P = 0.002]. Only 511 [47.8%] women were currently using contraceptives, which was significantly associated with age, husband's age, years of marriage, education level, income level and attitude to family planning. The most commonly known and used contraceptives were intrauterine device and pills. Friends were the most common source of knowledge about family planning method [80.0%]

Outcome of occlusion treatment for strabismic amblyopia in children below 12 years old age

The aim of our study was to determine the related clinical factors affecting the outcome of occlusion treatment for Strabismic Amblyopia in Qatari children. This is a retrospective descriptive study. The study included 38 Qatari children with strabismic amblyopia who were treated with occlusion therapy. The survey was conducted among the Qatari children below 12 years of age during a 10 year period from 1 992-2002. During this study period, 23 girls and 15 boys were treated for strabismic amblyopia. A total of 38 Qatari children were treated during the 10 year period. Of these children, 39.5% were males and 60.5% females. After the treatment, it is found that their final visual acuity improved. 73.7% achieved 6/9 or more and 26.3% achieved less than 6/9. The initial visual acuity, the presence of anisometropia and compliance were found to be related to the outcome of amblyopia treatment. The age at the start of treatment was found unrelated to the outcome. It was further discovered that most vision loss from amblyopia can be reversed with the correct intervention. The results of the present study indicated that the main factors affecting the treatment of strabismic amblyopia are initial visual acuity, presence of anisometropia and compliance

Clinical and epidemiological characteristics of lung cancer cases in Qatar

This study documents for the first time the clinical and epidemiological characteristics of lung cancer cases in Qatar from 1998 to 2005. The age-standardized incidence rate was higher than that in many other Gulf countries: 8.95 per 100 000 [15.2 per 100 000 for males; 3.95 per 100 000 for females]. Mean age at diagnosis was 57.5 years. Most patients were current smokers or ex-smokers at the time of diagnosis [82.5%]. Unlike other Gulf countries, adenocarcinoma was the predominant type in both Qatari nationals and expatriates [43.9% of lung cancer types]. Many cases were in an advanced stage at diagnosis [64.2% at stage IV]. Incomplete information was available on mortality rate due to the migration of expatriates

Road traffic fatalities in Qatar, Jordan and the UAE: estimates using regression analysis and the relationship with economic growth

Smeed's equation is a widely used model for prediction of traffic fatalities but has been found inadequate for use in developing countries. We applied regression analysis to time-series data on vehicles, population and traffic fatalities in the United Arab Emirates [UAE], Jordan and Qatar. The data were fitted to exponential models for fatality prediction, producing an average absolute error of 20.9% for Qatar, 10.9% for Jordan and 5.5% for the UAE. We found a strong linear relationship between gross domestic product and fatality rate

outcome of severe traumatic brain injury in children in Qatar: six year study

Traumatic brain injuries [TBI] are important public health problem resulting in short-term or permanent disability and death. To determine the extent and outcome of severe TBI amongst children in Qatar medical records were reviewed retrospectively of all cases of severe TBI in children aged 1 4 years or less who attended the Children Rehabilitation Unit, Hamad General Hospital, Qatar, between January 2002 to December 2008. The severity of TBI was assessed by the Glasgow Coma Scale [GCS]. Of 65 children with severe TBI, most were male [73.8%] and 91% were older than five years of age. The leading causes of injury were road traffic accident [84.6%] and falls [10.8%]. Other causes included trauma by ceiling fan blades [4.6%], sports and recreation injuries. Early sequelae included spasticity [43.1%] and posttraumatic epilepsy [33.8%]; both were significantly associated with the increased severity and need for intracranial surgery. Almost a quarter of the children had communication disorders, 17 [26.2%] had poor cognition, 16 [24.6%] had hemiplegia and 12 [18.5%] had abnormal behaviour. Twelve [18.5%] children died within the first month of admission to hospital. It is clear that severe TBI results in significant morbidity and mortality among children in Qatar and special efforts are needed to reduce the causes especially motor vehicle crashes and injuries. Rehabilitation programs are also needed to limit the extent of long-term complications associated with TBI

Does delay in diagnosing acute appendicitis affect the outcome?

Acute appendicitis is the most common surgical case met in an emergency department. Immediate surgery results in the confirmation of diagnosis and control of sepsis. To determine whether the delay in operating upon patients with acute appendicitis will affect the outcome or the stage of the disease, and if the clinical parameters give an indication of the severity of the disease medical records were reviewed retrospectively of 373 appendectomized patients above 14 years of age who were diagnosed with appendicitis in the emergency department of Hamad General Hospital, State of Qatar, between June and September 2007; 341 were diagnosed as acute appendicitis. Patients were classified according to the pre-operative and histopathological findings into four grades; Al: inflamed appendix, A2: gangrenous appendix, A3: perforated appendix, A4: pus +/- mass formation. Complications increased with the duration of the pre-hospital delay. The length of stay in hospital correlated significantly with the grade of diagnosis. The presence of fever, no change in bowel habit, and rigidity correlated well with advanced pathology, the complications increasing with greater delay. We conclude that delayed appendectomy is unsafe since it is associated with an increase in pathological grading as well as increasing the morbidity and the length of stay in hospital

Hepatitis B and C viral infections in chronic liver disease: a population based study in Qatar

We investigated the incidence of hepatitis B [HBV] and C [HCV] virus infection among patients with liver disease in Qatar from 2000 to 2005. The grading and staging of HBV and HCV cases were obtained from pathology reports at the principal reference laboratory for Qatar. Of the 915 liver patients studied, 29.4% had HCV and 2.5% had HBV. The incidence of HBV and HCV infection was greater in non-Qataris than Qatari nationals and in males than females, especially for HCV. Most cases were uncomplicated [89.0%] and had no inflammation [76.4%]. The incidence of HCV has been increasing in liver patients in recent years up to a rate of 481 per 1000 patients with liver disease in 2005

Does morbid obesity increase morbidity in abdominoplasty?

To determine whether morbid obesity increased morbidity in abdominoplasty 200 mostly female patients [100 patients morbidly obese and 100 overweight and obese] were studied but showed no statistically significant difference in the complication rate between the two categories nor between them and the international rate of complication of dermolipectomy in non-obese patients although co-morbid diseases did increase the risk of complications. It is concluded that morbid obesity should not preclude abdominoplasty, that patients do benefit, especially obese patients who are unable to lose weight following dieting or even gastric banding. surgery

Emergency head CT scan ordering and yield: a Malaysian experience

The aims of this study were to determine the emergency brain CT scan ordering rate in our emergency department and its positive yield rate; identify significant clinical factors as predictors for scan yield; and evaluate the need for a CT scanner in the emergency department and implementation of guidelines for emergency brain CT scan. This was retrospective study. The study was carried out in UKM hospital, Malaysia from the 1st of January to the 31st of December 2003. The study included all emergency brain CT scans done to 1,687 patients who visited the emergency department of the hospital. Of these patients, 1,088 samples with complete and clear clinical data were studied. The medical records were reviewed retrospectively for selecting these samples. Samples were grouped into trauma and non-trauma. The ordering rate and positive yield rate were calculated and clinical predictors for positive yield were analyzed using Chi-square test. From the total 59,575 patients who visited the emergency department, head CT scan was likely to be helpful in 1,687 patients. A head CT study was requested for these patients. This resulted in an ordering rate of 2.83%. Of the 1,088 samples reviewed, 716 scans showed positive findings, giving the overall scan yield of 65.8%. Non-trauma vases had significant higher scan yield [70.5%]. Age >55 years was noted to have higher risk of positive scans in both groups, especially those presented with seizures. Other significant factors were dysarthria, limb weakness and facial asymmetry in non-trauma cases [all p< 0.05]. The 2.83% ordering rate with 65.8% scan yield signifies the fact that emergency physicians in the study do not order unnecessary CT scan of the head. These findings were noteworthy and might suggest that we revise the request criteria for head CT. however, validated and locally applied CT scan guidelines should be developed and used in order to further enhance its cost-effectiveness in developing countries where resources are limited but its benefits in current and future settings can well be foreseen

Streptococcus pneumonia serotypes in newly developed state of Qatar: consideration for conjugate vaccine

The objective of the study was to determine prevalent pneumococcal serotypes causing infections in different age groups, their susceptibility to beta-lactams and macrolides and whether these serotypes are covered by the conjugated pneumococcal vaccines. 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. Predominant serotypes in children <2 years were: 6A, 6B, 9V, 11A, 14, 19A, 19F and 23F, predominant serotypes in children between 2-7 years 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. 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

Frequency of peptic ulcer disease during and after Ramadan in a United Arab Emirates hospital

We aimed to study the effect of Ramadan fasting on the occurrence of peptic ulcer disease and its complications in patients presenting to the Accident and Emergency Department at Al-Ain hospital, United Arab Emirates [UAE]. We retrospectively reviewed patient records over the 10-year period, 1992 to 2002. Of 470 patients treated for peptic ulcer disease, 215 were seen during Ramadan and 255 in the month after Ramadan. The frequency of peptic ulcer disease was higher after Ramadan than during Ramadan but this was not statistically significant. Peptic ulcer disease occurred more frequently in the age group 30-49 years. Peptic ulcer perforation occurred more frequently after Ramadan but the difference was not significant. Regression analysis identified the following variables as predictors of peptic ulcer disease: anorexia, pain, hypertension, smoking, epigastric pain, diabetes and family history

Vitamin D deficiency in rheumatology clinic practice in Qatar

In order to assess the prevalence of vitamin-D deficiency in patients attending the rheumatology outpatient clinic at Hamad Medical Corporation, Qatar, 360 consecutive patients [97 percent female] were tested for fasting levels of 25-hydroxyvitamin D, parathyroid hormone, calcium,, phosphorus, albumin and alkaline phosphatase. Two hundred and three patients [56 percent] showed vitamin D levels below 20 ng/ml from the results obtained it is concluded that levels of serum calcium, phosphorus, and alkaline phosphatase are of limited value in predicting vitamin-D status. 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 supplementation would be beneficial

Racial variation in clinical characteristic and outcome in patients presenting with acute myocardial infarction: comparison between Qatari and South Asian patients in Qatar

South Asians [SA] from the Indian Subcontinent are known to have coronary artery disease [CAD] at a very young age and also to have a more diffuse disease when compared to indigenous patients in the Western world. The aim of the study was to compare clinical characteristics and outcome of South Asian patients to Qatari patients presenting with acute myocardial infarction [AMI] in Qatar. The majority of SA residing in Qatar are manual workers of lower socioeconomic status when compared to the Qatari population. We conducted a retrospective analysis of a prospectively collected data of all patients diagnosed with acute myocardial infarction [AMI] in the State of Qatar during ten years [1991 -2001]. Patients were divided into two groups: Qataris [1598 patients] and South Asians [2606 patients]. Diagnostic classification of definite AMI was made in accordance with criteria based on the International Classification of Disease ninth revision [ICD-9]. The obtained information was based on the following parameters: age at the time of admission, gender, cardiovascular risk factor profiles [smoking, hypercholesterolemia, diabetes, and pre-existing coronary heart disease], and ECG. Data analyses were performed using univariate and stepwise logistic regression analysis. When compared to Qatari patients, SA patients were younger [47 yrs vs 61 yrs; p < 0.0001]. SA were more likely to be smokers [50.5% vs 23.4%; p < 0.0001] and male [96.9% vs 71.8% p < 0.0001]. SA were less likely to have: diabetes mellitus [24.8% vs 54.0%; p < 0.0001]; hypertension [19.9% vs 37.6%; p < 0.0001]; previous MI [8.1% vs 15.8%; p < 0.0001]; CABG [2.2% vs 3.9%; p = 0.002]. The number of patients who received thrombolytic therapy was significantly higher among SA when compared to Qatari [54.6% vs 25.9%; p < 0.0001], and this was significantly associated with lower in-hospital mortality rate [6.7% vs 16.8%; p < 0.0001]. SA patients who had AMI in Qatar had better outcome than Qataris. This may be explained by the patients' favorable baseline clinical characteristics such as younger age and less prevalence of diabetes and hypertension

Visual impairment and motor vehicle accidents

To examine the association between visual impairment and sustaining an injurious Motor Vehicle Accident [MVA] among drivers seen at the Accident and Emergency Department of Al-Ain Hospital, United Arab Emirates, [UAE]. A cross-sectional hospital based study. Accident Emergency Department [AED], Al-Ain Hospital, UAE. Male and females aged 18 years and above interviewed during the period January 1996 to December 1997. A total of 1542 drivers were examined and treated, but only 1428 drivers gave consent for the study. Socio-demographic data, visual acuity, level of injury, data about driving behavior and data from police reports were collected and analyzed. Study subjects were classified into two groups based on visual acuity: normal vision and visually impaired. A total of 1428 drivers were included in our study. of these, 1221 patients [85.6%] had normal vision, 207 patients [14.5%] were visually impaired at the time of sustaining MVA. The majority of victims [77%] were males. Most of the drivers [55%] were young and under the age of 40 years; 39.7% were UAE nationas; 32% had a primary school education; 37.5% had less than 2 years driving experience and 17.2% always used seat belts. Most [59%] admitted to crossing red traffic lights, 61.3% excessive speeding; 32.6% smoking while driving; 29.8% to using telephones while driving; 32.1% to putting their child in the front seat. Significantly higher risk was observed for careless driving [RR=1.29; 95% CI=1.10-1.66, p=0.049], speeding violations [RR=1.32; 95% CI=1.01-l.73, 0.041], and property damage [RR=1.80; 95% CI=l.31-2.48; p=0.05] among drivers having vision impairment. Visual impairment is considered a risk factor for MVA. Further investigation is essential and will require close inter-sectoral collaboration between traffic police, health, law, and transport authorities

Some risk factors for hypertension in the United Arab Emirates

A case-control study evaluated the relationship between hypertension and socioeconomic and lifestyle factors in Al-Ain city.The survey included 426 hypertensive adults aged 20-65 years attending urban and semi-urban clinics and a randomly selected sample of 436 normotensive controls. Hypertension among cases was higher for men, age 40-49 years, non-UAE nationals, urban living, currently married, having children, illiterate, administrative/professional job, living in traditional house and low income. There were significant differences between cases and controls with regard to obesity, raised cholesterol level, low physical activity and family history of heart disease, kidney disease or diabetes. Multivariate logistic regression analysis revealed that obesity, medium/high income, history of diabetes, low physical activity and having 3+ children were significantly associated with hypertension

Study of HER2/neu status in Qatari women with breast carcinoma

The study is aimed at determining the prevalence of HER2/neu overexpression in Qatari women with breast cancer and to assess the survival in patients with HER2/neu positive tumors. This is a retrospective study of clinical data of 70 Qatari female patients diagnosed with breast cancer during the period 1991 through to 2001, at Hamad Medical Corporation, Doha, Qatar. We also performed a retrospective review of breast tissue sample for those patients using paraffin sections and applying immunohistochemistry staining-[Hercep test [DAKO Inc]] to determine the HER2/neu status. Eighteen patients [26%] were HER2/neu positive [2+ and 3+] with a mean age at diagnosis of 49.3years, and 52 [74%] were negative [0 and 1+] with mean age at diagnosis of 46.6 years. Of the patients with positive HER2/neu, 5 [28%] had a relapse of the disease and 4 [22%] died of the disease during follow up. Of the patients with HER2/neu, negative test 9 [17%] had a relapse of the disease and 10 [19%] died of the disease. The median survival function at mean of covariates for HER2/neu positive patients was 26 months, and for HER2/NEU negative patients was 28 months. The prevalence of HER2/neu over expression in Qatari female with breast cancer in this study is 26%, but due to a small sample size it may not reflect really the prevalence. Patient with HER2/neu positive were older at diagnosis than patients with HER2/neu negative, also they had higher relapse rate and mortality. Median survival function was better for HER2/neu negative patients