Global distribution of consanguinity and their impact on complex diseases: genetic disorders from an endogamous population

Background: Marriage between close relatives has been practised globally since the early existence of human society. The role of consanguinity and inbreeding affecting human health is a topic of great interest in medical genetics

Objective: The objective of the study was to investigate the extent of consanguinity and its effects on common non-communicable diseases, the related risk factors, its role in human health and susceptibility to various chronic and complex diseases in Qatari population

Subjects and methods: The study design was a cross-sectional and multi-stage sampling based on Hospitals and primary health care [PHC] centres. A representative sample of 1626 subjects were approached and 1228 subjects [75.5%] consented to participate in the study between January 2013 and May 2014. The questionnaire based on socio-demographic data and for responses, on the Premarital Screening and Genetic Counseling [PMSGC] program knowledge, attitude and practice statements. Additionally, questions were asked regarding services, activities, how to attract and motivate the genetics counseling and screening for the hereditary diseases programme

Results: The mean age +/- S.D of the 1228 women interviewed was 39.25 +/- 9.57 years. The rate of consanguinity in the present generation was 43.5% [95% CI = 47.7-54.4]. There were statistically significant differences between males and females with regards to age, educational status, occupation status, household income, consanguinity, BMI, cigarette smoking and sheesha [water pipe] smoking. The consanguinity rate and coefficient of inbreeding in the parental was significantly higher than the maternal rate [44.3% versus 41.4%; p < 0.001] [0.018738 versus 0.017571 maternal]. The current generation of consanguineous parents had a slightly higher risk for diseases such as diabetes mellitus, cancer, blood and mental disorders, heart diseases, asthma, gastro-intestinal disorders, hypertension, hearing deficit, G6PD and common eye diseases

Conclusion: The present study revealed a higher incidence of certain diseases in consanguineous population with a high significant increase in the prevalence of common adult diseases such as diabetes mellitus, cancer, blood disorders, mental disorders, heart diseases, asthma, gastro-intestinal disorders, hypertension, hearing deficit, G6PD and common eye diseases. This confirms the role of genetic factors across the full spectrum of disease and not only for Mendelian disorders

Factors Affecting the Surgical Outcome of Primary Exotropia in Children.

Objective: The objective of current study to evaluate the outcome results of the surgical correction and as well as the effects of some factors on the outcome and surgical response of primary exotropia. Study Design: Retrospective Clinical Study. Place and Duration of Study: Hamad Medical Corporation –Tertiary Hospital in Qatar, study done over six months. Methods: Medical records of patients who underwent surgical correction of primary exotropia procedures between the years 2008 and 2013 were retrospectively reviewed. Patients less than 15 years of age were included in the study and the following data were collected: onset age of squint, age at surgery, type of exotropia, visual acuity, presence of amblyopia, anisometropia, refractive error (spherical equivalent), preoperative deviation, AV pattern, stereopsis, type of surgery and analysis using descriptive statistics, unpaired t- and chi-square statistical tests. Results: Of 74 patients we studied, 30 Male (40.5%), 44 Female (59.5%), 46 patients (62.2%) had successful surgical outcome, and 28 patients (37.8%) had unsuccessful outcome (all under correction). The response to surgery correlated mainly to with the preoperative angle. A higher response resulted from larger preoperative deviation and it this was better with lateral plus medial rectus muscle recessions than with bilateral lateral rectus recession. Conclusions: Preoperative deviation was the most important factor in determining better response to surgical correction of primary exotropia, and accurate measurement of the angle of deviation can improve the outcome and response to surgery.

impact of vitamin D deficiency on asthma, allergic rhinitis and wheezing in children: an emerging public health problem

Vitamin D deficiency has been declared a public health problem for both adults and children worldwide. Asthma and related allergic diseases are the leading causes of morbidity in children. The objective of this study was to investigate the potential role of Vitamin D deficiency in childhood asthma and other allergic diseases such as allergic rhinitis and wheezing. This cross-sectional study was conducted in Primary Health Care Centers [PHCs], from March 2012 to October 2013. A total of 2350 Qatari children below the age of 16 were selected from PHCs, and 1833 agreed to participate in this study giving a response rate of [78%]. Face-to-face interviews with parents of all the children were based on a questionnaire that included variables such as socio-demographic information, assessment of nondietary covariates, Vitamin D intake, type of feeding, and laboratory investigations. Their health status was assessed by serum Vitamin D [25-hydoxyvitamin D], family history and body mass index. Most of the children who had asthma [38.5%], allergic rhinitis [34.8%] and wheezing [35.7%] were below 5 years. Consanguinity was significantly higher in parents of children with allergic rhinitis [48.6%], followed by those with asthma [46.4%] and wheezing [40.8%] than in healthy children [35.9%] [P < 0.001]. The proportion of severe Vitamin D deficiency was significantly higher in children with wheezing [23.4%], allergic rhinitis [18.5%], and asthma [17%] than in healthy children [10.5%]. Exposure to the sun was significantly less in Vitamin D deficient children with asthma [60.3%], allergic rhinitis [62.5%] and wheezing [64.4%] than in controls [47.1%] [P = 0.008]. It was found that Vitamin D deficiency was a significant correlate for asthma [odds ratio [OR] =2.31; P < 0.001], allergic rhinitis [OR = 1.59; P < 0.001] and wheezing [relative risk = 1.29; P = 0.05]. The study findings revealed a high prevalence of Vitamin D deficiency in children with asthma and allergic diseases. Vitamin D deficiency was a strong correlate for asthma, allergic rhinitis and wheezing

Evaluation of Hemifield Sector Analysis Protocol in Multifocal Visual Evoked Potential Objective Perimetry for the Diagnosis and Early Detection of Glaucomatous Field Defects

PURPOSE: Multifocal visual evoked potential (mfVEP) is a newly introduced method used for objective visual field assessment. Several analysis protocols have been tested to identify early visual field losses in glaucoma patients using the mfVEP technique, some were successful in detection of field defects, which were comparable to the standard automated perimetry (SAP) visual field assessment, and others were not very informative and needed more adjustment and research work. In this study we implemented a novel analysis approach and evaluated its validity and whether it could be used effectively for early detection of visual field defects in glaucoma. METHODS: Three groups were tested in this study; normal controls (38 eyes), glaucoma patients (36 eyes) and glaucoma suspect patients (38 eyes). All subjects had a two standard Humphrey field analyzer (HFA) test 24-2 and a single mfVEP test undertaken in one session. Analysis of the mfVEP results was done using the new analysis protocol; the hemifield sector analysis (HSA) protocol. Analysis of the HFA was done using the standard grading system. RESULTS: Analysis of mfVEP results showed that there was a statistically significant difference between the three groups in the mean signal to noise ratio (ANOVA test, p < 0.001 with a 95% confidence interval). The difference between superior and inferior hemispheres in all subjects were statistically significant in the glaucoma patient group in all 11 sectors (t-test, p < 0.001), partially significant in 5 / 11 (t-test, p < 0.01), and no statistical difference in most sectors of the normal group (1 / 11 sectors was significant, t-test, p < 0.9). Sensitivity and specificity of the HSA protocol in detecting glaucoma was 97% and 86%, respectively, and for glaucoma suspect patients the values were 89% and 79%, respectively. CONCLUSIONS: The new HSA protocol used in the mfVEP testing can be applied to detect glaucomatous visual field defects in both glaucoma and glaucoma suspect patients. Using this protocol can provide information about focal visual field differences across the horizontal midline, which can be utilized to differentiate between glaucoma and normal subjects. Sensitivity and specificity of the mfVEP test showed very promising results and correlated with other anatomical changes in glaucoma field loss.

Evaluation of Hemifield Sector Analysis Protocol in Multifocal Visual Evoked Potential Objective Perimetry for the Diagnosis and Early Detection of Glaucomatous Field Defects

PURPOSE: Multifocal visual evoked potential (mfVEP) is a newly introduced method used for objective visual field assessment. Several analysis protocols have been tested to identify early visual field losses in glaucoma patients using the mfVEP technique, some were successful in detection of field defects, which were comparable to the standard automated perimetry (SAP) visual field assessment, and others were not very informative and needed more adjustment and research work. In this study we implemented a novel analysis approach and evaluated its validity and whether it could be used effectively for early detection of visual field defects in glaucoma. METHODS: Three groups were tested in this study; normal controls (38 eyes), glaucoma patients (36 eyes) and glaucoma suspect patients (38 eyes). All subjects had a two standard Humphrey field analyzer (HFA) test 24-2 and a single mfVEP test undertaken in one session. Analysis of the mfVEP results was done using the new analysis protocol; the hemifield sector analysis (HSA) protocol. Analysis of the HFA was done using the standard grading system. RESULTS: Analysis of mfVEP results showed that there was a statistically significant difference between the three groups in the mean signal to noise ratio (ANOVA test, p < 0.001 with a 95% confidence interval). The difference between superior and inferior hemispheres in all subjects were statistically significant in the glaucoma patient group in all 11 sectors (t-test, p < 0.001), partially significant in 5 / 11 (t-test, p < 0.01), and no statistical difference in most sectors of the normal group (1 / 11 sectors was significant, t-test, p < 0.9). Sensitivity and specificity of the HSA protocol in detecting glaucoma was 97% and 86%, respectively, and for glaucoma suspect patients the values were 89% and 79%, respectively. CONCLUSIONS: The new HSA protocol used in the mfVEP testing can be applied to detect glaucomatous visual field defects in both glaucoma and glaucoma suspect patients. Using this protocol can provide information about focal visual field differences across the horizontal midline, which can be utilized to differentiate between glaucoma and normal subjects. Sensitivity and specificity of the mfVEP test showed very promising results and correlated with other anatomical changes in glaucoma field loss.

Prevalence and Correlates of Low Back Pain in Primary Care: What Are the Contributing Factors in a Rapidly Developing Country

STUDY DESIGN: Cross-sectional. PURPOSE: The purpose of the study was to determine the prevalence of low back pain (LBP) in the primary care setting with emphasis on the socio-demographic contributing factors and impact of LBP on lifestyle habits. OVERVIEW OF LITERATURE: LBP is one of the most common medical conditions seen in the Primary Health Care Clinic. METHODS: A representative sample of 2,600 patients were approached and 1,829 subjects agreed to participate in this study (70.0%). Data on socio-demographic characteristics, life style habits and type of treatment were collected through a questionnaire. RESULTS: The prevalence of LBP in the study sample was 56.5% (95% confidence interval, 54.2-58.8). LBP was more prevalent among women (53.9%) compared to men (46.1%). There was significant difference between male and female patients of LBP in terms of ethnicity (p<0.001), marital status (p=0.010), occupation (p<0.001), monthly household income (p=0.004), and cigarette/sheesha smokers (p<0.001). The percentages of different aspects of functional disabilities were statistically significantly higher among females compared to male patients with LBP. Almost a quarter of female patients with LBP (26%) and 18% male patients with LBP reported pain in the arms and legs (p=0.002). In addition, gastrointestinal complaints such as abdominal pain and food intolerance were significantly higher among female patients with LBP as compared to males (31% vs. 24.6%, p=0.018; and 25% vs. 18%, p=0.008, respectively). Complaints about headache and fainting were also significantly higher among female patients as compared to male LBP patients (43% vs. 36%, p=0.029; and 26% vs. 20%, p=0.016, respectively). The multivariate logistic regression revealed that being female, prolonged standing, prolonged sitting, heavy weight lifting, weakness in the legs, regular exercise, and cigarette/sheesh a smoking had a significant effect on the presence of LBP. CONCLUSIONS: LBP is highly prevalent among both genders and in older age. Also, weakness in the legs, smoking, prolonged standing and sitting had a significant effect on LBP. Furthermore, the current study findings support the fact that LBP continues to be an important clinical, social and economic, burden and a public health problem affecting the population of the entire world.

Maternal complications and neonatal outcome in Arab women of a fast developing country

The objective of the study was to examine maternal complications that occur during the third trimester and their neonatal outcome in Arab women residing in Qatar. This is a prospective hospital-based study. The survey was carried out in women's hospital. The study was based on the log book of the women's hospital, from which we recruited women in their third trimester of pregnancy between the first week of January 2010 and April 2011. Of the 1824 Arab women who were approached to participate in the study, 1432 [78.5%] consented. Face-to-face interviews were conducted with the pregnant women in the third trimester attending routine antenatal clinics at a women's hospital. The questionnaire covered variables related to sociodemographic factors, family history, medical history, maternal complications, and neonatal outcome. Medical records of the patients were referred to collect the clinical variables. Of the pregnant women studied, 39.8% were less than 30 years of age. The risk of maternal complications was higher in housewives [60.8%] and women with a low monthly household income [38.2%]. Most of the pregnant women [77.6%] had antenatal care. Normal delivery [69.7%] was more common in expatriate Arab women, whereas caesarean was more prevalent in Qatari women [22.2%]. Women aged 35 years or older had a significantly higher risk of maternal complications such as gestational diabetes [20.8% vs 13.4%; P < 0.01], gestational hypertension [21.6% vs 15.2%; P = 0.003], and ante-partum hemorrhage [17.9% vs 13.7%; P = 0.042] than younger women. Gestational diabetes increased the risk of caesarean delivery [25.1%] and macrosomia [42.3%]. The frequency of caesarean delivery [22.1%] was higher in women with gestational hypertension. Neonatal complications such as Apgar score [<7] 1 minute [33.1% vs 21.2%; P < 0.001], 5 minutes [13.1% vs 8.2%; P = 0.005], and congenital anomalies [2.9% vs 0.9%; P = 0.007] were significantly higher in newborns of older women. Low birth weight [11.1%] and Apgar 1[st] minute < 7 rate [28.2%] were higher in newborns of mothers with ante-partum hemorrhage. The study findings revealed that maternal complications such as gestational diabetes, gestational hypertension, ante-partum hemorrhage, and maternal anemia were significantly higher in older pregnant women. Similarly, neonatal complications were higher in the newborns of older women. Gestational hypertension was the leading maternal complication observed in Arab women

Trends and characteristics of head and neck injury from falls a hospital based study, Qatar

The aim of this retrospective descriptive hospital-based study was to determine the trend in the number, incidence and pattern of head and neck injuries involved with falls. A retrospective analysis was carried out of 1,952 patients who were treated at the Accident and Emergency and Trauma centers of Hamad Medical Corporation, Qatar, for head [n= 1,629], neck [n = 225] and both [n = 98] injuries during the period 2001-2006. Head and neck injuries were determined according to the International Classification of Disease, ICD- Emergency Medical Services [EMS], Hamad Medical Corporation. The majority of the victims were non-Qataris [78.6%], men [86.6%] and in the age group 20-29 years [26.8%]. There was a disproportionately higher incidence of head and neck injuries from falls during weekends [27.1%]. Nearly half of the head and neck injuries from falls occurred at work [49.4%]. Neck injuries [10.2%] were more severe than head injuries [7.3%]. The incidence rate of head and neck injuries per 10,000 population increased from 2.1 in the year 2001 to 5.5 in 2006, particularly among the elderly population above 60 years of age [13.1 in 2003 to 18.6 in the year 2006]. Superficial injury to the head [29.4%] was more common among trauma patients. The present study findings revealed that the incidence of head and neck injuries was higher among young adults and the elderly population

Gestational age specific neonatal survival in the state of qatar [2003-2008]-a comparative study with international benchmarks

To analyze and compare the current gestational age specific neonatal survival rates between Qatar and international benchmarks. An analytical comparative study. Women's Hospital, Hamad Medical Corporation, Doha, Qatar, from 2003-2008. Six year's [2003-2008] gestational age specific neonatal mortality data was stratified for each completed week of gestation at birth from 24 weeks till term. The data from World Health Statistics by WHO [2010], Vermont Oxford Network [VON, 2007] and National Statistics United Kingdom [2006] were used as international benchmarks for comparative analysis. A total of 82,002 babies were born during the study period. Qatar's neonatal mortality rate [NMR] dropped from 6/1000 in 2003 to 4.3/1000 in 2008 [p<0.05]. The overall and gestational age specific neonatal mortality rates of Qatar were comparable with international benchmarks. The survival of<27 weeks and term babies was better in Qatar [p=0.01 and p<0.001 respectively] as compared to VON. The survival of>32 weeks babies was better in UK [p=0.01] as compared to Qatar. The relative risk [RR] of death decreased with increasing gestational age [p<0.0001]. Preterm babies [45%] followed by lethal chromosomal and congenital anomalies [26.5%] were the two leading causes of neonatal deaths in Qatar. The current total and gestational age specific neonatal survival rates in the State of Qatar are comparable with international benchmarks. In Qatar, persistently high rates of low birth weight and lethal chromosomal and congenital anomalies significantly contribute towards neonatal mortality

Prevalence of somatisation and psychologisation among patients visiting primary health care centres in the state of Qatar

Medically unexplained somatic complaints are among the most common clinical presentations in primary care in developing countries and they are considerable burden for patients and health care system. The aim of this study was to determine the prevalence of somatisation in comparison to psychologisation among a sample of Qatari patients who were visiting primary health care [PHC] centres and to investigate the clinical and socio-demographic characteristics of somatisers [STs] and psychologisers [PGs]. Method: The survey was conducted among PHC Qatari patients during the period from January to July 2007. About 2,320 patients were approached, of whom 1,689 agreed to participate and responded to the questionnaire. Among the studied Qatari patients, 404 patients were identified for clinical interview. The first stage of the study was conducted with the help of general practitioners, using the 12-item General Health Questionnaire. The second stage was carried out by a consultant using the Clinical Interview Schedule. A specific operational criterion was used to identify STs and PGs. The prevalence rate of STs among the total studied sample was 12.4%, while the PGs were 11.5%. Among the identified psychiatric cases, the proportion of STs [52%] was higher than PGs [48%]. Most of the diagnostic categories were more prevalent among PGs. The dissatisfaction at work and stressful life events within 12 months before the onset of the presenting symptoms were the three postulated determinants which were significantly more among STs than PGs. The prevalence of somatised mental disorder was little higher than the psychologised mental disorder. The prevalence of somatisation and psychologisation is comparable with other reported studies from the Middle-East and Western countries. Dissatisfaction at work and stressful life events were significantly higher among STs than PGs

[Screening of health care workers in NICU, labour and delivery theater for MRSA and MSSA colonization and their antimicrobial susceptibility pattern]

Staphylococcus aureus plays a major role in nosocomial infections. The development of resistance to methicillin among Staph. aureus is recognized as one of the main challenges in hospital infection control. The aim of the study was to assess the nasal carriage rate of MSSA [methicillin-sensitive Staphylococcus aureus], MRSA [methicillin-resistant Staphylococcus aureus] and their antimicrobial pattern among health care workers [Nurses and Physicians] of Neonatal Intensive Care Unit [NICU], labour and delivery theatre. Prospective descriptive study. This study was conducted over an eight month in NICU, labour room and delivery theaters of the Women's hospital, Hamad Medical Corporation from September 2005 through May 2006. Of the 466 health care workers, the study screened 340 staff members [73% of physicians and nurses], who are in close contact with patients in NICU, labour and delivery theatres, for MSSA and MRSA. Antimicrobial susceptibility testing was performed on all samples, which showed Staph. aureus colonization using the disk diffusion method. Seventy samples [20.6%] showed Staph. aureus colonization, 68 [97.1%] of them were MSSA and 2 samples [2.9%] were MRSA. Out of the 340 samples, 70 [20.6%] grew S. aureus. 20% of the House Care Workers [HCW] were MSSA carriers and only 0.6% were MRSA carriers. 17.7% of the total physicians and 21.2% of total nurses grew S. aureus; among them, only one physician and one nurse working in NICU were MRSA carriers. All the MSSA isolates were resistant to pencillin, whereas they were sensitive to vancomycin, teicoplanin, gentamicin and oxacillin. Similarly, all MRSA strains were resistant to penicillin, oxacillin and cefoxtin, while they were sensitive to erythromycin, clindamicin, vancomycin and teicoplanin. The prevalence rate of MRSA and MSSA among HCWs in Qatar is comparable to the rates found in other gulf countries. More nurses were carriers of MSSA than physicians. The whole issue deserves continuous surveillance

Factors contributing to school failure among school children in very fast developing Arabian society

Education is one of the main foundations for the child's development and also for national human resource development. Failure at school and grade retention is a serious concern among children, and their parents. The characteristics of school failure in Qatar have not been studied earlier. The aim of this study is to assess the presence of social, psychological, health and school related factors that cause school failure. All students who had failed their grades and had to be retained and repeat the year from 35 randomly selected schools of all grades elementary, intermediate and high school were included in this study for academic years from 2003 to 2008. Each student was individually interviewed by a well-trained school social worker. The study was performed on a total 699 children who were classified as school failures. Social reasons include living with one parent 26.9%, parental divorce [27%] parents showing no interest in their child's education and school system [41.6%], low income [19.3%], and smoking [19.6%]. Frequent absence from school was a result in 33.3%; incomplete homework [45.9%] and teachers identified 63.7% of students to be hyperactive, inattentive and disruptive in classroom. Most frequent psychological disorders include examination phobia [68.8%], anxiety [49.4%], anger [32.5%], fear [43.2%] and learning disability [37.9%]. The most prevalent health disorders included visual disorders [23.5%], asthma [14.9%], anemia [15.2%], and hearing deficiency [8.2%]. Psychological and health related factors were found to be more prevalent in students who failed a grade in school. The primary care pediatrician can play a key role by identifying students at high risk and providing early intervention

Treatment outcome of acne vulgaris with oral isotretinoin

To determine the clinical efficacy of oral isotretinoin in the treatment of severe acne and assess its effect on total serum cholesterol, triglycerides, HDL-cholesterol and Low-Density Lipoprotein-cholesterol [LDL-cholesterol]. A cohort, descriptive, hospital-based study. Al-Ain Medical District, Tawam Hospital, United Arab Emirates, from 1994 to 2002. A total of 198 patients seen at Tawam Hospital, referred with acne vulgaris for a minimum of 6 weeks, were treated by isotretinoin for the first time, were included in the study. Variables studied were as per objectives apart from demographics and distribution. The study included 63 [32%] males and 135 [68%] females of mean age [ +/- SD] of 21.3 +/- 5.6 years. Majority [81%] of patients was under 25 years. Of them, 26 patients had family history of acne. The most common site of acne was on face [66.7%], followed by trunk [26.2%] and neck [9.1%]. Of 198 patients treated, 32.8% were cured, 19.1% markedly improved, 11.1% moderately improved and 24.2% of patients were advised for further treatment. There was no marked change in total and LDL-cholesterol, while LDL and triglycerides changed markedly. In acne patients, isotretinoin is effective in producing remission. In addition, it was safe and its effect on serum lipids was transient, especially in healthy and young patients with normal liver functions

Presence of admitting team in emergency department, does it make a difference?

The Emergency Department [ED] Admitting Team was established on the 1st of September 2005 to attend patients admitted to Hamad General Hospital [HGH]. The team followed 1,065 patients for 3 months [September, October and November 2005].The study reports the change noticed during the period, on admission-disposition duration. The majority of patients were males [75%] and non-Qatari [72%], with medical cases more common than surgical cases. For the medical cases, chest infection was the leading cause of admission followed by coronary artery disease, while orthopedic cases followed by acute appendicitis were the main surgical causes of admission. The admitting team was able to cancel 10% of cases as most of them improved while pending admission. In addition, the admitting team facilitated admission of many patients to Intensive Care Units or to Operation rooms. The results were reviewed and the presence of the admitting team in ED was found to be beneficial

prevalence of attention deficit hyperactivity symptoms in schoolchildren in a highly consanguineous community

The objective of the present study was to find the prevalence of attention deficit hyperactivity [ADH] symptoms in a sample of primary schoolchildren in Qatar and investigate the behaviour of the children with and without ADH symptoms in a highly consanguineous community. A total of 2,500 primary school students, aged 6-12 years, were randomly selected from the government primary schools, and 1,869 students [947 boys and 922 girls] gave consent to participate in this study. An Arabic questionnaire was used to collect the sociodemographic variables and a standardized Arabic version of the Conners' Teacher Rating Scale for ADH symptoms. Of the 947 boys, 158 [16.7%; 95% confidence interval, CI, 14.4-19.2] and of the 922 girls, 50 [5.4%; 95% CI 4.1-7.1] scored above the cut-off [>/= 15] for ADH symptoms, thus giving an overall prevalence of 11.1% [95% CI 9.7-12.6]. The children who had higher scores for ADH symptoms were in the age group of 6-9 years. Children who had higher scores for ADH symptoms had a poorer school performance than those with lower scores [p = 0.002]. Two hundred [96.2%] children with ADH were disobedient, 126 [60.6%] noisy and hyperactive, 76 [36.5%] very cranky, 78 [37.5%] troublesome and 79 [37.9%] nervous. The logistic regression identified socio-economic condition, number of children, school performance and poor relationship between parents as the main contributors to ADH. Although the univariate analysis showed a significant relationship [p = 0.010] between ADH symptoms and consanguineous parents, logistic regression did not support this association [p = 0.075]. This suggests that consanguinity has no impact on ADH children. The study revealed that ADH is a common problem among schoolchildren. The children with higher scores for ADH symptoms had a poorer school performance than those with lower scores. A significant difference exists between the behaviour of children with and without ADH

pattern of acute myocardial infarction in a rapidly developed country

Cardiovascular Disease [CVD] is the leading cause of morbidity and mortality in many of the affluent Arab nations. Myocardial infarction may lead to impairment in the systolic or diastolic functions, to a prolonged pre-disposition to arrhythmias and other long-term complications. The aim of this paper was to study the pattern of Acute Myocardial Infarction [AMI] according to its site [Anterior or Inferior] and determine its predictors. This is a retrospective cohort study of all Qatari and Non-Qatari patients who were hospitalized with AMI in the Hamad General Hospital, State of Qatar from 1991 to 2003. The diagnostic classification of definite AMI was made in accordance with the criteria of the International Classification of Disease ninth revision [ICD-9]. The obtained information was based on the following parameters: the patient's age at the time of admission, gender, cardiovascular risk factor profiles [smoking status, hypercholesterolemia, diabetes, and pre-existing coronary heart disease], and AMI location. Of the 3210 patients admitted with AMI, 55.6% of the patients were diagnosed with anterior AMI and 44.4% with inferior AMI. Anterior and inferior AMI was more prevalent in men in the age group [40-69] years old. 80.1% of the inferior AMI patients were in this age group which was higher than the anterior group [76.3%]. When compared with non-Qatari's; stroke and mortality rates were higher among Qataris in the anterior AMI group; whereas heart block and mortality rates were significantly higher in Inferior AMI group. Gender, hypertension and age [above 50 years] were predictors of both groups. Mortality rate was significantly higher in anterior AMI patients. The present study revealed that there is a strong association between age, risk factors and site of AMI. Patients with anterior AMI have twice the mortality rate of that of inferior AMI subjects

Consanguineous marriages and their effects on common adult diseases: studies from an endogamous population

The aim of the study was to determine the extent and nature of consanguinity in the Qatari population and its effects on common adult diseases. The study was conducted in urban and semi-urban areas of Qatar between October 2004 and May 2005. The total sample of 1,050 married Qatari females 15 years of age and over were approached for study. The degree of con-sanguinity between each female and her spouse and the degree of consanguinity between their parents were recorded. Of 1,050 married Qatari females who were approached, 876 agreed to participate in the study, giving an 83.4% response. The rate of consanguinity in the present generation was 51% [95% confidence interval=47.7-54.4] with a coefficient of inbreeding of 0.023724. The consanguinity rate and coefficient of inbreeding in the current generation were significantly higher than the maternal rate [51.0 vs. 40.3%; p<0.001; 0.023724 vs. 0.016410 maternal]. All types of consanguineous marriages were higher in this generation, particularly first cousins [26.7 vs. 21.4% paternal and 23.1% maternal] and double first cousins [4.3 vs. 2.9% paternal and 0.8% maternal]. The current generation of consanguineous parents had a slightly higher risk for most diseases: cancer, mental disorders, heart diseases, gastro-intestinal disorders, hypertension, hearing deficit and diabetes mellitus. All reported diseases were more frequent in consanguineous marriages. The study showed that in a population with a high rate of consanguinity, there is a significant increase in the prevalence of common adult diseases like cancer, mental disorders, heart diseases, gastro-intestinal disorders, hypertension and hearing deficit

pattern of hypertension in rapidly developing Arabian Qatari population: hospital based - study

Hypertension and its complications appear to be increasingly common in developing Arabian Gulf countries. The aim of the present study was to determine the pattern of hypertension among Qatari patients visiting the outpatient clinic of the Hamad General Hosptial. This is a cross-sectional descriptive hospital-based study. Hamad General Hospital. Qatari subjects were recruited by stratified 1-in-2 systematic sampling procedure during a period from 1 January to 31 December 2001. The study included 1789 hypertensive patients aged 20-65 years who were visiting the hypertension outpatient clinic of the Hamad General Hospital. Face-to-face interviews were based on a questionnaire that included questions about sociodemographic status, cigarette smoking habit, lifestyle habits, body mass index [BMI], associated diseases, etiological risk factors and complications, biochemistry laboratory investigation, and mode of medication. Hypertension was defined according to World Health Organization [WHO] criteria as [Systolic Blood Pressure] SBP >/= 140 mmHg and/or [Diastolic Blood Pressure] DBP >/= 90 mmHg. Out of 1789 patients enrolled in this study as hypertensive, 458 were males [25.6%] and 1331 were females [74.4%]. The prevalence of hypertension was higher in male patients above 60 years old [46.9%] than females [34.9%]. There were statistically significant differences between males and females in respect of obesity, BMI>30 [p<0.001], and smoking habits [p<0.001]. Also the serum creatine was significantly higher among males than females [p<0.001] while cholesterol level and Low density liprotein [LDL] -cholesterol level were higher among the females significantly [p=0.003] in each case. The present study support the hypothesis of a positive association between hypertension and sociodemographic factors and life-style habits. Furthermore, women are more at risk than men in rapidly developing society of Qatari population