Hospital In Qatar Research Articles

Pre-eclampsia: incidence, determinants, and pregnancy outcomes from maternity hospitals in Qatar: a population-based case-control study

Background We aimed to study the maternal characteristics and obstetric and neonatal outcomes in pregnant mothers with pre-eclampsia (PE) compared to normotensive. Methods This was a population-based retrospective data analysis. Data were obtained from the PEARL-Peristat Study perinatal registry (Perinatal Neonatal Outcomes Research Study in the Arabian Gulf) Qatar. The birth periods ranged from January to December 2017 in the main Women’s Hospital (now named Women’s Wellness Research Center) and March to December 2017 in other hospitals. This study examined 19762 singleton births at 24 weeks of gestation and above. This analysis included only 19,194 births with complete data in the registry database at the time of this analysis, divided into normotensive women (n = 18,735) and women with PE (n = 459) excluding women with gestational hypertension and chronic hypertension without superimposed PE(n = 568). We compared the maternal characteristics of mothers with PE with normotensive mothers and studied the obstetric and neonatal outcomes including cesarean section, stillbirths, prematurity, fetal growth restriction and postpartum hemorrhage (PPH). Results The prevalence of hypertensive disorders among the 19,762 singleton pregnancies was 1027/19,762 (5.1%). The incidence of pre-eclampsia was 459/19,762 (2.3%) while gestational (341/19,762 (1.7%) and chronic hypertension 219/19,762 (1.1%)). A history of PE or eclampsia in past pregnancies was reported in 12.9% vs 0.9% p < .001 of PE vs normotensive women, respectively. After adjusting for significant maternal risk factors using multivariate logistic regression anlaysis, it was noted that PE was significantly associated with a higher odds for cesarean section (odds ratio (OR), 2.67 (95% CI, 2.19–3.25); p < .001), acute maternal morbidity (OR, 16.42 (95% CI, 5.58–48.30); p < .001), still births (OR, 3.27 (95% CI, 1.56–6.83); p < .001), preterm births (OR, 8.67 (95% CI, 7.05–10.65); p < .001), NICU admissions (OR, 4.41 (95% CI, 3.61–5.38); p < .001) and low birth weight (OR, 7.93 (95% CI, 6.43–9.29); p < .001). Conclusion Women with pre-eclampsia when compared to the normotensive women, they are older, nulliparous, diabetic and obese with an increased risk of preterm birth and cesarean deliveries. It was noted that PE was significantly associated with acute maternal morbidity, still births, cesarean section and preterm births. By taking preventive measures, prompt delivery and appropriate care we can reduce the risks associated with it or prolong the pregnancy to a gestational period which is considered safe for the neonatal survival. Therefore it’s imperative to be aware of the population-based risk factors and its mode of presentation in order to give a timely appropriate care and to prevent severe maternal and fetal morbidities and mortalities.

COVID-19 related multisystem inflammatory syndrome in children (MIS-C): a case series from a tertiary care pediatric hospital in Qatar

BackgroundMultisystem Inflammatory Syndrome in Children (MIS-C) is a severe complication of coronavirus disease 2019 (COVID-19) in children, which is increasingly being reported worldwide. Here we report the first case series of 7 children diagnosed with MIS-C in Qatar.MethodsClinical features and outcomes of COVID-19 positive patients admitted to Sidra Medicine, Qatar from June to October 2020, who met the WHO case definition for MIS-C were reviewed.ResultsThe mean age in our case series was 5.6 years, of which 71.4% were males. All patients were previously healthy but had a history of COVID-19 infection. Fever, rash, vomiting and abdominal pain were the most common symptoms (70–100%). The average hospitalization was 12.9 days with no case fatalities. Laboratory findings included lymphopenia and thrombocytopenia in most patients, as well as evidence of coagulopathy and elevated inflammatory markers such as C-reactive protein, ferritin and procalcitonin. Many patients (71.4%) required inotropic support in intensive care, while only one required respiratory support. Although all patients had elevated cardiac biomarkers, cardiovascular involvement was observed in 42.9% of patients with one patient developing a giant coronary aneurysm. All patients received intravenous immunoglobulin (IVIG) and 86% of patients received corticosteroids, with two patients requiring treatment with IL-1 inhibitors.ConclusionsOur report is one of the first reports on MIS-C from Asia. Although clinical features and outcomes are not significantly different from those reported elsewhere, lack of case fatalities in our cohort may indicate that early recognition and prompt medical attention is necessary for a favorable outcome in MIS-C.

P.94 Post-dural puncture headache: four year review of a tertiary maternity hospital in Qatar

Introduction: Post-dural puncture headache (PDPH) following accidental dural puncture (ADP) with an epidural needle is a well-known complication for women receiving neuraxial analgesia (NA). Rates of ADP with an epidural needle are estimated to be 0.19–3.6%, with approximately 60% of these women developing PDPH.

Knowledge of Sleep Disorders Among Physicians at a Tertiary Care Hospital in Qatar: Cross-sectional Study.

BackgroundSleep disorders constitute a major health problem because of their relatively high and rising prevalence. Several studies worldwide have analyzed health care providers’ knowledge of sleep disorders.ObjectiveIn this study, we aimed to assess the knowledge of sleep disorders among physicians in Qatar.MethodsA total of 250 physicians were surveyed regarding their knowledge of sleep medicine by using the validated 30-item Assessment of Sleep Knowledge in Medical Education (ASKME) Survey. The participants included residents, fellows, and consultants in medicine and allied subspecialties. A high score was defined as ≥60% of correctly answered questions, implying the respondent has adequate knowledge of sleep disorders.ResultsResponses were received from 158 of the 250 physicians, with a response rate of 63.2%. This included responses from 34 residents, 74 clinical fellows, and 50 consultants. The overall mean score was 15.53 (SD 4.42), with the highest possible score of 30. Only 57 of 158 (36.1%) respondents were able to answer ≥60% of the questions correctly. No statistically significant difference was found in the scores of participants with regard to their ranks (ie, residents, fellows, or consultants) or years of medical training.ConclusionsThis study demonstrates that health care providers in Qatar have decreased awareness and knowledge about sleep medicine, which may reflect reduced emphasis on sleep disorders during medical school and training. Increasing awareness regarding sleep medicine among nonspecialist physicians will allow early detection and treatment of sleep disorders, thereby reducing the morbidity associated with these disorders.

Predicting End-User Satisfaction With Clinical Information Systems

Clinical services in hospitals are too diversified and include different kinds of care patient needs. Clinical services need to be supported by clinical information systems (CIS). In this paper, the satisfaction of three categories of clinicians was tested including nurses and physicians working in a governmental hospital in Qatar. The study investigated the key variables affecting CIS users' satisfaction and the levels of users' satisfaction in Al Wakra Hospital. The research model incorporated five independent variables measuring including information quality, system quality, service quality, professional maturity, and personal innovativeness. A questionnaire was distributed to targeted end-users with a total of 296 usable responses. The necessary analyses were conducted, where results supported four out of five hypotheses. The adjusted coefficient of determination R2 was 0.714. Findings provide valuable insights for decision-makers in the healthcare sector in Qatar, where they contribute toward a better understanding of the reasons impacting end-user satisfaction.

Investigating the impact of electronic health record on healthcare professionals

Although there is a significant influence of implementing the electronic health records (EHR) system in Qatar, there are very limited studies reviewed and analyzed the influence of implementing the EHR system on healthcare professionals in Qatar. This research aims to assess, summarize, and analyze the influence of the EHR system in healthcare settings in Qatar. The outcome of assessing the implementation of the EHR system may have advantages and disadvantages, which can impact healthcare professionals in healthcare settings in Qatar. The main objective is to evaluate EHR on healthcare professionals in healthcare. A total number of 210 participants were selected randomly from three private hospitals in Qatar. A validated survey distributed to physicians, pharmacists, nurses, and dietitians who work in these healthcare hospitals in Qatar. The purpose is to identify whether the outcome of using the EHR system improved healthcare professionals’ work after it has shifted from using files and hand-writing paperwork to the EHR system. By applying online survey, results indicate that most healthcare professionals positively perceive the use of the EHR system as a valuable system.

Prevalence and Epidemiological Features of Workplace Violence among Female Nurses at Governmental Hospitals in Qatar

Prevalence and Epidemiological Features of Workplace Violence among Female Nurses at Governmental Hospitals in Qatar

Parenting style in a rapidly developing country: A report from the state of Qatar.

Objective:To investigate the different styles of parenting in the State of Qatar, a country that is considered a cosmopolitan hub with rapid development.Materials and Methods:A cross-sectional study was conducted at Sidra Medicine, the only tertiary pediatric hospital in Qatar. Parents of children 3–14 years old were offered a questionnaire.Results:A total of 114 questionnaires were completed (response rate = 95%). Approximately 65% of parents were between 30 and 39 years of age. Almost 90% of parents state that they are confident of their parenting ability. More than 90% of the participating parents stated that they are responsive to their child's feeling and needs, give comfort and understanding when their child is upset, praise their child when well-behaved, give reasons why rules should be followed, help children understand the impact of their behavior, explain consequences of bad behavior, take into account their child's desire before asking him/her to do something, encourage their child to freely express him/herself when disagreeing with his/her parents, and show respect to their child's opinion. However, 60% of parents sometimes scold, yell, and criticize their child when he/she misbehaves but less than 50% of them use threats as a consequence with little or no justification. Furthermore, two-thirds of parents give consequences by putting their child off somewhere with little or no explanation. Moreover, one in four participants gives in to their child when he/she causes a commotion about something, threatens their child with consequences more often than actually giving them, and states consequences to their child and do not actually do them.Conclusion:Residents in Qatar have a mixed type of parental style (authoritative, authoritarian, and permissive). This study will guide us to raise the awareness about the types of parenting style in Qatar, in order to provide professional parenting counseling taking into consideration the cultural background.

Biological and radiological biomarkers in SARS-CoV-2 infected healthcare workers in governmental hospitals in Qatar

Biological and radiological biomarkers in SARS-CoV-2 infected healthcare workers in governmental hospitals in Qatar

Corneal Confocal Microscopy and Brain MRI: Surrogate Markers of Neuronal Pathology in Schizophrenia

Background: Both neurodevelopmental and neurodegenerative processes have been proposed to contribute to the development of schizophrenia. However, there is no validated surrogate marker of neuronal pathology for schizophrenia. To quantify neuronal pathology in subjects with schizophrenia using corneal confocal microscopy (CCM) and brain volumetric MRI. Methods: In this cross-sectional study, subjects with DSM-5 based criteria for schizophrenia enrolled from the Psychiatry Hospital in Qatar and healthy controls were recruited between August 26, 2019 and March 11, 2020. Subjects with schizophrenia were assessed for positive and negative symptoms, and with controls underwent assessment of cognitive function, CCM and brain volumetric MRI. Neuronal pathology was assessed by quantifying corneal nerve fibre density (CNFD), length (CNFL), branch density (CNBD) and CNBD:CNFD ratio, and MRI volume of whole brain, cortical gray matter, ventricle, cingulate gyrus, hippocampus, amygdala, thalamus and entorhinal cortex. Findings: Subjects with schizophrenia (n=36) and controls (n=26) with a comparable age and gender were studied. After adjusting for confounders, subjects with schizophrenia had lower cognitive function (P≤0.01), CNFD, CNFL, CNBD and CNBD:CNFD ratio (P<0.0001) compared to controls. Quantitative MRI demonstrated a significant reduction in the cingulate gyrus volume (P<0.05) with no difference in whole brain (P=0.61), cortical gray matter (P=0.99), ventricle (P=0.47), hippocampus (P=0.10), amygdala (P=0.68), thalamus (P=0.20) and entorhinal cortex (P=0.26) volumes compared to controls. Corneal nerve measures and cingulate gyrus volume did not significantly correlate with symptom severity (P=0.35) or cognitive function (P=0.051). Corneal nerve measures had no significant association with metabolic syndrome (P=0.61) or diabetes (P=0.057). The area under the ROC curve to distinguish subjects with schizophrenia from controls was 88% for CNFL (P<0.0001), 84% for CNBD and CNBD:CNFD ratio (P<0.0001), 79% for CNFD (P<0.0001), 73% for the cingulate gyrus volume (P<0.05) and 70% for cognitive function (P<0.01). Interpretation: This study demonstrates a reduction in corneal nerve fibres and cingulate gyrus volume with a high diagnostic accuracy of CCM for schizophrenia. Funding Statement: Qatar National Research Fund (BMRP-5726113101) and Hamad Medical Corporation (IRGC-04-SI-17-166). Declaration of Interests: The authors declare no competing interest. Ethics Approval Statement: The study was approved by the IRB of Weill Cornell Medicine in Qatar and Hamad Medical Corporation. All participants gave informed consent to take part in the study. The research adhered to the tenets of the declaration of Helsinki.

Assessment of antimicrobial stewardship programs within governmental hospitals in Qatar: a SWOC analysis.

Antimicrobial resistance is a worldwide public health issue that requires emergent action. Antimicrobial stewardship programs (ASPs) have been proposed as a strategy to minimise resistance. Although ASPs were implemented in governmental hospitals in Qatar since 2015, a formal evaluation of these programs has not been conducted. We aimed to assess the status of ASPs in Qatar and to identify strengths, weaknesses, opportunities and challenges (SWOC) to further enhance ASPs within Hamad Medical Corporation (HMC). Lead stakeholders of ASPs in HMC filled a questionnaire adapted from the 2019 Centers for Disease Control Prevention checklist for ASPs. Notes were taken by research team to assist in formulating a SWOC analysis. All hospitals (12/12) had an infectious diseases physician and pharmacist designated as an ASP leader (major strength identified). Almost all hospitals lack a financial statement and information technology resources to support ASPs (major weaknesses identified). Nine hospitals had an antibiotic pre-authorisation policy and adopted a prospective audit with feedback strategy. Among hospitals surveyed, 11 hospitals tracked antibiotic use by measuring the defined daily dose, and only four hospitals tracked rates of Clostridioides difficile infection. Qatar's rich economy supports the allocation of financial resources and budgeting to improve ASPs despite the increased emergence of resistant organisms and the limited resources currently available to expand ASPs across the country's healthcare settings. Although ASPs were implemented in all governmental hospitals in Qatar, national efforts and more resources are needed to further develop and improve these programs.

Sociodemographic and clinical characteristics of patients with recurrent psychiatric readmissions in Qatar.

ObjectiveTo examine the sociodemographic and clinical characteristics of psychiatric patients with recurrent psychiatric readmissions (RPR).MethodsA retrospective study was conducted at Hamad General Hospital in Qatar on psychiatric patients with recurrent readmissions from August 2018 to January 2019.ResultsOf 380 psychiatric patients admitted during the study period, 40 (10.5%) were readmitted within 30 days of discharge. Most of the patients who were readmitted were single, male and unemployed. Psychotic spectrum disorder was the most frequent psychiatric condition and was diagnosed in 18 (45%) patients. A total of 30% of the patients were receiving treatment with anti-psychotics, and a similar number received more than one medication. Most patients showed poor or no compliance. Only 12.5% of patients stayed in the hospital for more than 5 weeks in their last admission during the study period.ConclusionsPoor compliance, male sex and single status were the most common demographic and clinical features of patients with RPR. Post-discharge psychiatric care should be tailored to meet the requirements of patients prone to RPR.

Effectiveness of Sofosbuvir Combined with Direct Acting Antivirals in Hepatitis C Patients in a Tertiary Teaching Hospital in Qatar: A Retrospective Observational Study

Background: Hepatitis C virus (HCV) infection is associated with significant morbidity and mortality. The effectiveness of sofosbuvir, as a new direct-acting antiviral (DAA) for chronic HCV infection, needs to be assessed and evaluated among patients with or without cirrhosis with all HCV genotypes.&#x0D; Aims: This study was conducted to determine the effectiveness of chronic HCV treatment as part of a combination therapy for all HCV genotypes in patients with or without cirrhosis.&#x0D; Study Design: A retrospective observational study.&#x0D; Methodology: All patients who received sofosbuvir treatment from the Pharmacy Department of Hamad General Hospital during a 12-month period (between 2014 and 2015) were included. Patients were observed up to 12 weeks after treatment course completion. Data were analyzed descriptively and compared using a paired t-test (alpha=0.05).&#x0D; Results: A total of 95 patients received sofosbuvir. All of these patients received sofosbuvir in combination with other antiviral medications. All HCV genotypes were included; 1a and 4 were the most dominant genotypes (37% and 30.5%, respectively). Half of the patients were treatment naïve. All patients achieved undetectable virus ribonucleic acid (RNA) starting from week 4 of the treatment. A sustained virological response at 12 weeks (SVR12) after completion of the treatment period was maintained in 95% of patients. Relapse was mostly observed in patients with genotype 1a (40%); no patients with HCV genotype 3 exhibited relapse.&#x0D; Conclusion: The SVR12 after sofosbuvir treatment was maintained in most patients, regardless of genotype, HCV complications HCV or co-administered drugs.

Impact of discharge education by clinical pharmacists on patients' adherence to post‐percutaneous coronary intervention medications: A retrospective cohort study using real‐world data

AbstractBackgroundSecondary prevention post myocardial infarction by optimizing secondary prevention cardiovascular medications is important; however, adherence to these medications is essential to achieve benefits. Nevertheless, the impact of education provided by clinical pharmacists to patients post primary percutaneous coronary intervention (PCI) has not yet been evaluated in a real‐world context.MethodsThis retrospective observational cohort study aimed to assess the impact of education provided by clinical pharmacists compared with other health care providers on adherence to post‐PCI medications and clinical outcomes among patients with ST‐elevation myocardial infarction (STEMI). This study included all patients admitted with STEMI to Heart Hospital in Qatar between 1 January 2016 and 31 December 2018. Adherence was assessed by medication availability 80% of the time, which was monitored by the rate of prescription refill in the year after discharge.ResultsA total of 1334 patients were included. The majority of patients included were male (96%) and Asian (78%), with a mean age of 51 years. Only 26% of the study population were educated by clinical pharmacists, while the remaining were educated by other health care professionals upon discharge. Adherence to aspirin, P2Y12 inhibitors, statins, and beta‐blockers was significantly better among patients who were educated by clinical pharmacists (aspirin, 59% vs 47%; adjusted odds ratio [aOR], 1.5; 95% confidence interval [CI], 1.1‐1.9; P = .002; P2Y12 inhibitor, 58% vs 47%; aOR, 1.5; 95% CI, 1.1‐1.9; P = .004; statin, 55% vs 46%; aOR, 1.3; 95% CI, 1.0‐1.7; P = .038; beta‐blocker, 46% vs 37%; aOR, 1.4; 95% CI, 1.1‐1.8; P = .018). However, there was no difference in re‐hospitalization for acute coronary syndrome or all‐cause mortality among patients who were educated by clinical pharmacists upon discharge compared with those who were educated by other health care providers.ConclusionMedication counseling provided by clinical pharmacists significantly improved adherence to post‐PCI medications among patients with STEMI.

Abstract 15001: Radial Access Has No Impact on Medications Adherence Post Coronary Intervention: A Retrospective Observational Cohort Study Using Real-world Data

Introduction: The Transradial artery access for Primary Percutaneous Coronary Intervention (PCI) is the preferred access for coronary interventions in ST Elevation Myocardial Infarction STEMI due to less complications post intervention and it has been shown to improve quality of life of patients post intervention. This decrease in complications may give the patient sense of ease and underestimation of disease severity, and hence worsen the patient’s compliance with medications. This retrospective observation study aimed to assess the impact of radial versus femoral access coronary interventions on adherence to post-PCI medications. Methods: We conducted a retrospective analysis for all patients who presented with STEMI and underwent primary PCI in a tertiary cardiac hospital in Qatar between January 1, 2016 and December 31, 2018. Adherence was assessed by refilling the first prescription post discharge. Adherence rates were compared between the patients who underwent PCI with radial versus femoral access using the Chi square test. Results: A total of 1339 patients who presented with acute STEMI and underwent primary PCI were included in our retrospective analysis. The majority of patients included were male (96%) with mean age of 51 years. The majority of patients (1082; 81%) underwent radial access, while 257 (19%) underwent femoral access. The two groups were comparable in terms of age, nationality, the presence of full versus partial insurance, and using medications before admission. The patients adherence to medications post-PCI, including aspirin, P2Y12 inhibitor, statin, beta-blocker, angiotensin converting enzyme (ACE) inhibitor/ angiotensin II receptor blocker (ARB) was comparable between the radial versus femoral access ( aspirin: 78% vs. 74%; p-value= 0.16, P2Y12 inhibitor: 81% vs. 79%; p-value=0.45, statin: 80% vs. 76%; p-value= 0.15, beta-blocker: 72% vs. 70; p-value= 0.51, ACE inhibitor/ARB: 79% vs. 74%; p-value= 0.09). Conclusion: In comparison to femoral access in primary coronary intervention in STEMI, the radial access resulted in similar adherence to post-PCI medications assessed by refilling of first prescription post discharge. Therefore, the radial access is a safe approach in terms medications adherence.

Experience of treating Candida auris cases at a general hospital in the state of Qatar.

So far there have been no studies on Candida auris in Qatar. This study aimed to describe the clinical spectrum and outcome of C. auris infection in patients admitted to a general hospital in Qatar. We conducted this descriptive observational study in a general hospital in Qatar. We have involved all patients with C. auris infection and colonization admitted to a general hospital from December 2018 to August 2019. We identified 13 patients with confirmed C.auris infection/colonization, of which five cases represented an actual C. auris infection, while the remaining eight cases were considered as colonization. The mean age of the patients with infection was 76.6 ± 8.4 years, while the mean age of the patients with colonization was 66.4 ± 24.7 years. Among the individuals clinically infected with C. auris, two had urinary tract infections, one had candidemia, one acquired soft tissue infection, and one had a lower respiratory tract infection. All strains of C. auris were susceptible to echinocandins, flucytosine, and posaconazole while resistance to fluconazole and amphotericin B. Of the patients with C. auris infection who received systemic antifungal therapy, three (60%) died during antifungal therapy. Our study showed that C. auris can cause a wide variety of invasive infections, including bloodstream infection, urinary tract infection, skin infection, and lower respiratory tract infections, especially in critically ill patients. In addition, our isolates showed resistance to the most common antifungal agents such as fluconazole and amphotericin B.

Development of image quality related reference doses called acceptable quality doses (AQD) in paediatric CT exams in Qatar

ObjectivesTo describe first experience of integrating assessment of image quality in paediatric X-ray computed tomography (CT) with analysis of the radiation dose indices to develop reference doses called acceptable quality dose (AQD).MethodsImage quality was scored by the radiologists at a tertiary care hospital in Qatar on a scale of 0 to 4 using the recently published scoring criteria. The patients undergoing head, chest and abdomen CT were divided in different weight groups as follows: < 5 kg, 5–< 15 kg, 15–< 30 kg, 30–< 50 kg, 50–< 80 kg and > 80 kg. The images that were clinically acceptable (score of 3) were included for assessment of median values of CTDIvol and DLP to obtain AQDs in different weight groups.ResultsAfter initial training in image quality scoring of CT images of 49 patients by three radiologists, the study on 715 patients indicated 665 studies (93%) were clinically acceptable as per scoring criteria. The median CTDIvol values for the above weight groups were 16, 20, 22, 22, 27 and 27 mGy and the median DLP values for these weight groups were 271, 377, 463, 486, 568 and 570 mGy cm, respectively, for head CT. Similar values are presented for chest and abdomen CTs.ConclusionsThe first ever experience of starting with image quality assessment and integrating it with analysis of dose indices to obtain AQD values shall provide a workable model for others and values for comparison within the facility and in other facilities leading to optimisation.Key Points• The first study to integrate image quality assessment with analysis of patient dose indices shows feasibility for routine practice in other centres.• The values of acceptable quality dose (AQD) were provided for head, chest and abdomen CT of children divided into weight groups rather than age. They shall act as reference values for future studies.• Verification of our findings on proportional increase in exposure parameters (CTDIvol and DLP) with weight by other investigators shall be helpful.

Clinical profiles of patients within the Mental Health Service in Qatar

Aim: The aim of this study was to explore the clinical profile of patients referred to the only dedicated Psychiatry Hospital in Qatar over a one-year period in order to understand the clinical needs of these patients. Methods: We examined, retrospectively, the records of patients who presented to the Emergency Department in Hamad General Hopsital with psychiatric problems and needed psychiatric assessment in the period between 1st of June 2015 to 31st of May 2016. We reviewed the records of 870 patients within one year from both electronic records and paper records. Results: Patients from 48 different nationalities presented to the Emergency Department with a psychiatric presentation. Patients who presented spoke 22 different languages. Clinical presentations covered a wide spectrum of stress related disorders. The most common diagnosis was bipolar affective disorder, depressive disorder and schizophrenia. Conclusion: This study gives a window into the clinical profiles of those who present with acute mental illness and highlights some risk factors to be aware of in treating such patients. The variety of cultures and languages of patients is important to recognize and emphasizes the ongoing need for adequate language translation for appropriate psychiatric evaluation of these patients.

Clinical outcomes of high-intensity doses of atorvastatin in patients with acute coronary syndrome: A retrospective cohort study using real-world data.

To compare the effectiveness and safety of 2 high-intensity atorvastatin doses (40 mg vs 80 mg) among acute coronary syndrome (ACS) patients. This retrospective observational cohort study using real-world data included patients admitted with ACS to the Heart Hospital in Qatar between 1 January 2017 and 31 December 2018. The primary endpoint was a composite of cardiovascular disease-associated death, nonfatal ACS and nonfatal stroke. Cox proportional hazard regression analysis was used to determine the association between the 2 high-intensity atorvastatin dosing regimens and the primary outcome at 1 month and 12 months postdischarge. Of the 626 patients included in the analyses, 475 (75.9%) received atorvastatin 40 mg, while 151 (24.1%) received atorvastatin 80 mg following ACS. Most of the patients were Asian (73%), male (97%) with a mean age of 50 years and presented with ST-elevation myocardial infarction (60%). The incidence of the primary effectiveness outcome did not differ between the atorvastatin 40-and 80-mg groups at 1 month (0.8 vs 1.3%; adjusted hazard ratio = 0.59, 95% confidence interval 0.04-8.13, P = .690) and at 12 months (3.2 vs 4%; adjusted hazard ratio = 0.57, 95% confidence interval 0.18-1.80, P = .340). Similarly, the use of the 2 doses of atorvastatin resulted in comparable safety outcomes, including liver toxicity, myopathy and rhabdomyolysis with an event rate of <1% in both groups. The use of atorvastatin 40 mg in comparison to atorvastatin 80 mg in patients with ACS resulted in similar cardiovascular effectiveness and safety outcomes.

The prevalence, mortality rate and functional outcome of intracerebral hemorrhage according to age sex and ethnic group in the state of Qatar

ObjectiveTo investigate the prevalence of intracerebral hemorrhage (ICH) using stroke database from the main tertiary hospital in Qatar (Hamad General Hospital) over the period of Dec 2013 to Oct 2017. MethodsThe prevalence of ICH was calculated based on age groups and ethnicity (Qatari nationals, non-Qatari Arab, South east Indian (SI) and Far East Asians (FE)). Thirty-day case fatality rate, poor clinical outcome at discharge (modified Rankin scale (mRS):3−6) and poor long-term outcome (mRS at 90 days: 3−6) were calculated per each age group sex and ethnicity. ResultThere were 653/4039 (16 %) with ICH. The median age was 53 (IQ range: 45–64) with a male/female ratio: 557/96 (85.3/14.7 %). The 30-day mortality rate was 14.7 % (96/653), poor outcome at discharge (mRS 3−6): 66.8 % (436/653) and poor long-term outcome (mRS 90 days:3−6) 50.1 % (199/397). The prevalence of ICH in Qatar was 24.9 per 100 000. The highest mortality rate was seen in the elderly (≥ 70 years old) (16/67 (23.9 %)) and young group (48/291 (16.5 %)).The most common ethnic group among our ICH population are the following: FE (40.59 per 100 000), Qatari (25.26 per 100 000) and SI ethnic group (24.97 per 100 000). In multiple logistic regression analysis only, old age (≥ 70 years old) was associated with 30 days mortality (adj OR: 2.51, 95 % CI: 1.14–5.54, P = 0.023). Similar regression analysis was also observed that age ≥ 70 years old (adj. OR: 4.18, 95 % CI: 1.27–13.77, P = 0.019), sex (male) (adj. OR: 0.21, 95 % CI: 0.08−0.56, P = 0.002), and ethnicity (SI vs Qatari: adj. OR: 4.08, 95 % CI: 1.28–12.92, P = 0.017); (FE vs Qatari: adj. OR: 2.22, 95 % CI: 0.65–7.67, P = 0.203) are statistically associated with poor outcome. ConclusionThe prevalence of ICH was high in the elderly and in the FE, Qatari, and SI ethnic group. Further studies are needed to better understand the differences in ICH prognosis in multiethnic groups.