Trauma research in Qatar: a literature review and discussion of progress after establishment of a trauma research centre

A structured research programme is one of the main pillars of a trauma care system. Despite the high rate of injury-related mortalities, especially road traffic accidents, in Qatar, little consideration has been given to research in trauma. This review aimed to analyse research publications on the subject of trauma published from Qatar and to discuss the progress of clinical research in Qatar and the Gulf Cooperation Council countries with special emphasis on trauma research. A literature search using PubMed and Google Scholar search engines located 757 English-language articles within the fields of internal medicine, surgery and trauma originating from Qatar between the years 1993 and 2013. A steep increase in the number of trauma publications since 2010 could be linked to the setting up of a trauma research centre in Qatar in 2011. We believe that establishing a research unit has made a major impact on research productivity, which ultimately benefits health care.

Change in the structures, dynamics and disease-related mortality rates of the population of Qatari nationals: 2007-2011

Developing effective public health policies and strategies for interventions necessitates an assessment of the structure, dynamics, disease rates and causes of death in a population. Lately, Qatar has undertaken development resurgence in health and economy that resulted in improving the standard of health services and health status of the entire Qatari population [i.e., Qatari nationals and non-Qatari residents]. No study has attempted to evaluate the population structure/dynamics and recent changes in disease-related mortality rates among Qatari nationals. The present study examines the population structure/dynamics and the related changes in the cause-specific mortality rates and disease prevalence in the Qatari nationals. This is a retrospective, analytic descriptive analysis covering a period of 5 years [2007-2011] and utilizes a range of data sources from the State of Qatar including the population structure, disease-related mortality rates, and the prevalence of a range of chronic and infectious diseases. Factors reflecting population dynamics such as crude death [CDR], crude birth [CBR], total fertility [TFR] and infant mortality [IMR] rates were also calculated. The Qatari nationals is an expansive population with an annual growth rate of -4% and a stable male: female ratio. The CDR declined by 15% within the study period, whereas the CBR was almost stable. The total disease-specific death rate, however, was decreased among the Qatari nationals by 23% due to the decline in mortality rates attributed to diseases of the blood and immune system [43%], nervous system [44%] and cardiovascular system [41%]. There was a high prevalence of a range of chronic diseases, whereas very low frequencies of the infectious diseases within the study population. Public health strategies, approaches and programs developed to reduce disease burden and the related death, should be tailored to target the population of Qatari nationals which exhibits characteristics that vary from the entire Qatari population

Population health genomics in member countries of the cooperation council for the Arab states of the Gulf

The member countries of the Cooperation Council for the Arab States of the Gulf, also known as the Gulf Cooperation Council [GCC], have a diverse population of 35.1 million people and an overall population growth rate of over half a million people a year. The GCC countries have fast-growing economies based mainly on revenues from petroleum and related industrial products. Health services are provided by the government and the private sector, and GCC citizens have no mandatory health insurance plan. Patients incur no cost for government-provided health services at the point of care. Among the distinctive socio-cultural characteristics of GCC countries are marriage at a young age [sometimes at less than 15 years of age], child-bearing until menopause, a high birth rate [16 - 43 births/1000 population], large family size resulting from a high fertility rate [2-7 children per woman], and a high rate of inbreeding or consanguineous marriage [up to 58% of marriages in some areas]. The prevalence of genetic diseases in the GCC countries is high in comparison with rates in Europe and North America. Hemoglobinopathies, G6PD deficiency, inborn errors of metabolism, congenital hypothyroidism, deafness, and Down's syndrome represent the most prevalent genetic diseases in the GCC countries and have been discussed frequently in the literature. Public health activities are resourced by government. Premarital medical counselling is obligatory in Bahrain and Saudi Arabia, while it is encouraged in the rest of the GCC countries. Prenatal screening is offered as part of routine clinical prenatal services. Newborn screening programs vary between GCC countries with respect to organization and the conditions screened for. The many gaps that remain in current screening programs reflect gaps in effective surveillance and a resulting lack of national incidence and prevalence data for certain genetic diseases. The GCC countries as a whole would benefit from the adoption of a comprehensive screening and surveillance framework for genetic diseases. Adequate stakeholder engagement and good communication between medical and public health disciplines is needed for such a framework to be effective. Regular evaluation, dissemination of information, and the application of evidence-based knowledge to the specific needs of the region will be essential to improvements in genetic services

Angiosarcoma arising at the site of an interposition saphenous vein graft in an immunosuppressed renal transplanted patient: case report and review of the literature

Angiosarcomas are very rare neoplasms of endothelial origin, especially in renal transplanted patients. Only 16 cases of angiosarcoma arising in immunosuppressed renal transplant recipients have been reported in the literature. This includes our case which is unique because it involving an interposition vein graft in a 45 year-old man with chronic renal failure, treated by allograft kidney transplantation, who developed aneurysm proximal to the site of a functioning arteriovenous fistula, underwent excision of aneurysm and interposition vein graft. No specimen was sent for histopathology. He had recurrent swelling at the site of the interposition vein graft in less than six month requiring re-excision and histopathology confirmed the present of epitheliod angiosarcoma. After three months he developed painful mass at the site of the operation. He refused any surgery intervention or change in the immunosuppressive medication. He died five months later from pulmonary metastases. Although angiosarcomas are very rare in immunosuppressed renal transplanted patient a histological examination is indicated at the time of surgical exploration in patient who develop an enlarging mass or aneurysm with unexplained pain at the site of arteriovenous fistula