Patients In Qatar Research Articles

Exploring Mortality and Associated Risks Among Assisted Home Hemodialysis Patients in Qatar.

Home hemodialysis (HD) is a well-established modality that promotes patient independence but poses significant challenges, particularly in regions like the Gulf Cooperation Council (GCC) countries. Assisted home HD has gained momentum in the GCC over the past few years. Qatar's assisted home HD program has expanded substantially in the past 2 years. This study examines the demographics, mortality rates, and associated risk factors within Qatar's assisted home HD patient population. This was a retrospective cohort study to review national data for all assisted home HD patients in Qatar between July 2021 and December 2023. Patients had to be > 60 years old and have limited mobility to be eligible for the assisted home HD program and included in the study. We had 114 assisted home HD patients with a median age of 71.5; 54 (47.4%) were males. During the study period, 20 patients (17.5%) died, and 8 (7%) stopped receiving the service for traveling abroad, personal preference for in-center HD, or changing dialysis modality. Most deaths occurred due to infectious causes. The deceased patients had significantly less HD vintage, more severe immobility, and more hospitalizations compared to the alive participants. On multivariate analysis, patients with severe immobility had 3.8 (CI: 1.1-12.8, 95% p < 0.05) times higher odds of mortality than patients with mild to moderate immobility. Our study found that mortality in the assisted home HD program is significant and mostly related to mobility status. Patients with severely reduced mobility had almost four times the risk of mortality compared to more mobile patients. Further, larger studies are needed to confirm these findings.

The prevalence of depression and anxiety symptoms and their associated factors among patients with cancer in Qatar: A cross-sectional study.

Cancer is a significant global health challenge. One of the biggest health issues that cancer patients face is depression and anxiety. This has a significant impact on their quality of life and treatment outcomes. The aim of this study was to investigate the frequency of depression and anxiety among cancer patients in Qatar. This study was a cross-sectional design using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scales. A total of 500 cancer patients were surveyed from the National Center for Cancer Care and Research in Doha. The study found that a significant proportion of cancer patients suffered from depression, with an average PHQ-9 score indicating mild levels of severity. Depression was commonly categorized as mild, with a smaller percentage experiencing moderate, moderate-to-severe, or severe depression. Additionally, patients were predominantly anxious, as reflected by an average GAD-7 score, with most patients experiencing mild to moderate symptoms, while a few experienced moderate or severe anxiety. These findings highlight the significant prevalence of both depression and anxiety among cancer patients, pointing to the importance of comprehensive mental health support. Moreover, patients with advanced-stage cancer, those in their 40s and 60s, those undergoing radiotherapy or hormone therapy, and female patients were found to be more susceptible to depression and anxiety. Treatment of mental health issues is essential to enhancing the effectiveness of cancer treatment. Cancer patients can have a higher quality of life and better adherence to cancer treatments when mental illnesses such as depression and anxiety are identified and treated early. Furthermore, most patients reported having depression and anxiety, according to the study, which showed that these conditions were more common in Qatar than in other countries. Several demographic groups have been linked to higher rates of depression and anxiety, including women, middle-aged adults, people with stage IV cancer, and patients receiving therapies such as radiotherapy and chemotherapy.

Distal humerus fractures: epidemiology and surgical management trends in hospitalized patients in Qatar

Distal humerus fractures: epidemiology and surgical management trends in hospitalized patients in Qatar

Dihydropyrimidine Dehydrogenase Deficiency (DPYD) Genotyping-Guided Fluoropyrimidine-Based Adjuvant Chemotherapy for Breast Cancer. A Cost-Effectiveness Analysis.

While standard doses of adjuvant fluoropyrimidine-based chemotherapies are generally safe for most patients, the risk of severe adverse drug reactions (ADRs) is increased for those with dihydropyrimidine dehydrogenase deficiency (DPYD), a genetic variation that affects drug metabolism. The objective of this study was to examine the cost effectiveness of offering DPYD pharmacogenetic-guided care, where genetic testing informs personalized dosing versus the current standard of care (SoC), which involves administering fluoropyrimidine-based therapies without prior genetic screening, for local or metastatic breast cancer patients in Qatar. We developed a two-stage decision analysis, with an analytic tree model over a 6-month period, followed by a life-table Markov model over a lifetime horizon. We compared the current SoC with the alternate strategy of DPYD genetic screening in patients living in Qatar with local or metastatic breast cancer who were eligible for adjuvant fluoropyrimidine therapy. Clinical outcomes and utilities were obtained from published studies, while healthcare costs were estimated from Hamad Medical Corporation, Qatar. The short-term outcome included the incremental cost-effectiveness ratio (ICER), defined as cost per success (survival without grade III/IV ADRs) at 6 months. The long-term outcome was the ICER, defined as cost per quality-adjusted life year (QALY) gained, with a 3% annual discount rate. The study adopted a public healthcare perspective in Qatar. Sensitivity analyses were conducted to explore the impact of key input parameters on the robustness of the model. In the short-term model, at its base case, DPYD genomic screening was dominant over SoC with a mean cost-saving of QAR84,585 (95% confidence interval [CI], 45,270-151,657). This cost saving reflects the overall economic benefits associated with the implementation of DPYD genomic screening. In the long-term model, compared to the current SoC, DPYD genetic screening would result in an ICER of QAR21,107 (95% CI -59,382-145,664) per QALY gained. Based on our model, implementing DPYD genetic screening to detect DPYD mutations in breast cancer patients before therapy initiation seems to be a cost-saving and cost-effective strategy in Qatar.

Incidence of surgical site infection among appendectomy, herniorrhaphy and caesarean section patients in Qatar.

Surgical site infection is a frequently reported adverse outcome of surgical procedures worldwide, impacting the quality-of-care for patients. To describe the incidence of surgical site infection among appendectomy, herniorrhaphy and caesarean section patients in Qatar and compare the rates with external benchmarks. We conducted this retrospective observational study among all 5127 appendectomy, herniorrhaphy and caesarean section patients admitted at The Cuban Hospital, Qatar, from 2013 to 2023. We analysed the data using SPSS version 22 and MedCalc, we determined the relative risk ratios, 95% CI and P-values, and used Student's t-test for comparison. A 2-sided α < 0.05 was considered statistically significant. Of the 5127 surgeries, 2463 were appendectomies, 751 were herniorrhaphies and 1913 were caesarean sections. Surgical site infections were 2.19% for appendectomy, 2.53% for herniorrhaphy and 2.56% for caesarean section. Surgical site infection decreased over the study period for appendectomy and herniorrhaphy, while it varied with no definite trend for caesarean section. Infection was higher for herniorrhaphy and appendectomy than reported by the National Healthcare Safety Network and the International Nosocomial Infection Control Consortium. The higher incidence of surgical site infection in Qatar than the benchmark countries provides evidence for stricter hospital infection prevention and control programmes to improve patient safety in the country.

Hearing Loss in COVID-19 Patients: An Audiological Profile of Symptomatic and Asymptomatic COVID-19 Patients in Qatar.

Background and objective Viral infections caused bycytomegalovirus, lymphocytic choriomeningitis virus, varicella-zoster virus, herpes simplex type 1 and type 2, rubella, measles, rubeola, HIV, West Nile virus, Lassa virus, and mumps are known to be associated with hearing loss. There have been reports of inner ear involvement in coronavirus disease 2019 (COVID-19) patients but the extent and variations in cochlear involvement of symptomatic and asymptomatic patients has not been adequately described. This study aimed to evaluate thehearing status among symptomatic and asymptomatic COVID-19 patientsto address the prospects for routine screening for hearing lossin COVID-19 patients. Methods Patients testing positive for COVID-19between March 2020 and May 2020and August 2020 and October 2020 in Qatarwere screened. A total of 110 patients aged 15-50 years were enrolled and grouped into symptomatic and asymptomatic COVID-19 after telephonic screening. Of them, seven were excluded for various reasons. A questionnaire was administered in person to all included participants. Audiological testing results of symptomatic and asymptomatic patients were analyzed. Results Of the 103 patients included in the study,49 were symptomatic and 54 asymptomatic; 15 (14.6 %) had high-frequency sensorineural hearing loss (SNHL) in one or both ears.Mean thresholds in extended high frequencies 10K-20K were higher in symptomatic patients. Abnormal distortion product otoacoustic emissions (DPOAEs) were seen in 40 (38.8%) patients; 63.3% (31/49) were symptomatic and 16.7% (9/54) were asymptomaticin 3K-8K frequencies (p=0.0001). Conclusions Symptomatic COVID-19 patients had significant involvement of the inner ears with abnormal pure tone audiometry (PTA), extended high-frequency audiometry (EHFA), and DPOAEscompared to asymptomatic COVID-19 patients. The extent of inner-ear involvement suggests the severity of the infection. The lack of audiovestibular symptoms does not rule out normal hearing in such patients. Screening for hearing loss should beroutinelyconsidered in post-COVID-19 patients.

Undiagnosed major risk factors in acute ischaemic stroke patients in Qatar: analysis from the Qatar stroke registry

ObjectiveWe examined the presentation to hospital, subtypes of ischaemic stroke for patients admitted to stroke services in Qatar and their 90-day prognosis based on the modified Rankin Scale (mRS) for...

Diabetic Retinopathy in Qatar, The Burden, Challenges and Risk Factors: A Literature Review

Background: Diabetes mellitus is the most common noncommunicable disease worldwide with multiorgan involvement. The international diabetes federation diabetes atlas reports that 10.5% of the adult population (20-79 yrs) has diabetes with almost half unaware that they are living with the condition. By 2045,1in 8 adults, approximately 783 million will be living with diabetes, an increase of 46%. Qatar faces a significant burden with a projected increase in prevalence from 17.8% in 2023, 29.5% by 2050, age group 20-79 years. Diabetic retinopathy is a micro-angiopathy resulting from the chronic effects of diabetes. It affects 3 out of 4 people living with diabetes after 15 years of disease duration. This is a literature review about the status of diabetic retinopathy in the state of Qatar. Methods: An extensive review of studies published about the status of diabetic retinopathy was contacted with the use of PubMed and Google Scholar using the Key words diabetic retinopathy, Qatar. Results: The prevalence of diabetic retinopathy in Qatar was 23.5% (95% CI) as per study by Elshafei et al., in 2011. The longer duration of diabetes and poor glycemic control was significant risk factors in the development of diabetic retinopathy. A review by Amin SR et al., in 2023 pointed out the importance of standard methods like digital photography in screening most diabetic patients in Qatar. Conclusion: As the burden of diabetes and diabetic retinopathy are on the rise in Qatar, extensive and elaborate research studies are required, and the policy makers and stake holders should address this issue as an important public health concern.

Incidence and epidemiological features of urogenital tuberculosis among adult inhabitants in Qatar

Urogenital tuberculosis (UGTB) has not been extensively studied in the Gulf region, particularly in Qatar. This study aimed to describe the incidence, demography, presentation, diagnosis, and treatment outcomes of UGTB among adult patients in Qatar. This retrospective descriptive study was conducted from January 1, 2015, to December 31, 2020, in six centers of Hamad Medical Corporation in Qatar. All patients with UGTB admitted or treated at these centers were included in the study. During the study period, we recruited 106 patients with isolated or combined UGTB, representing 0.4 percent of all TB cases and an incidence of 0.7 new UGTB cases per 100,000 population in Qatar between 2015 and 2020. Most patients were males [79 (74.5%)] and non-Qataris [102 (96.2%)]. The mean age of the patients was 40.60 ± 11.39 years. The mean illness duration was 86.98±129.84 days, and the most frequent presenting symptom was abdominal pain [51(48.1%)]. UGTB was diagnosed by direct bacilli identification or culture growth in 34 (32.1%) patients; histopathology in 55 (51.9 %) patients; and a combination of strong clinical, laboratory, and radiographic evidence of UGTB without microbiological or histological confirmation in 17 (16.0%) patients. All patients received anti-tuberculosis therapy with various durations, while surgical interventions were reported in 73(68.9%) cases. Most patients, 85 (80.2%), completed their treatment in Qatar, while 21 (19.8%) left the country before completion, and no mortalities had been reported. The diagnosis of UGTB is generally delayed due to vague clinical features. Awareness of UGTB is essential for physicians to suspect this disease in patients with unexplained urogenital symptoms, especially in patients from TB-endemic areas or with a history of pulmonary tuberculosis.

Cost-Minimization Analysis for Subcutaneous Daratumumab in the Treatment of Newly Diagnosed Multiple Myeloma in Three Gulf Countries

Background: The second most common hematologic cancer worldwide is multiple myeloma (MM), with incidence and mortality rates that have more than doubled over the past 30 years. The safety and efficacy of daratumumab regimens in the treatment of newly diagnosed MM (NDMM) is demonstrated in clinical trials. Objective: To assess the financial effects of the adoption of subcutaneous daratumumab (dara-SC) rather than intravenous daratumumab (dara-IV) for the treatment of NDMM in three Gulf countries (Qatar, Oman and the United Arab Emirates; UAE), a cost-minimization model was constructed. Methods: We performed static cost minimization analyses from a societal perspective to evaluate the costs and possible reductions in resource utilization associated with a shift from dara-IV infusion to dara-SC injection for NDMM patients over a 5-year time horizon. The model included 2 scenarios: the current scenario in which 100% of patients with NDMM are treated with dara-IV infusion and a future scenario in which dara-SC injection is gradually adopted over the modeled time horizon. The model differentiated precisely between autologous stem cell transplantation (ASCT)–eligible and ASCT-ineligible NDMM patients in terms of their number in each group and the associated therapeutic regimens. One-way sensitivity analyses were also conducted. Results: The model showed that the use of dara-SC in NDMM patients who were eligible or ineligible for ASCT resulted in lower non-drug costs, including premedication drug costs, adverse-effect costs, administration costs, medical staff costs, and indirect costs. The resulting total savings over the 5-year time horizon of the model for Hamad Medical Corporation, Sultan Qaboos University Hospital/Royal Hospital, Sheikh Shakhbout Medical City (SSMC), and Tawam Hospital were QAR −2 522 686, OMR −143 214, AED −30 010 627, and AED −5 003 471, respectively. Conclusion: The introduction of dara-SC as a front-line treatment for NDMM patients in Qatar (Hamad Medical Corporation), Oman (Sultan Qaboos University Hospital, Royal Hospital-MOH), and the UAE (SSMC and Tawam Hospital) can help save resources and minimize constraints on the healthcare system.

Prediabetes in Children: A Single Center Experience from Qatar

Background: Prediabetes is a state of hyperglycemia before the onset of frank diabetes mellitus. The prevalence of prediabetes is on the increase due to the obesity epidemic. No previous studies have described the clinical, biochemical, and immunological features of children and adolescents with prediabetes from the State of Qatar. Aim: To describe our single-center experience of children with prediabetes. Method: From 2018 to 2022, we enrolled patients below 18 years of age diagnosed with prediabetes. Clinical parameters were meticulously collected, encompassing age of onset, familial history, anthropometric measurements including weight and body mass index (BMI), HbA1C levels, diabetes-associated autoantibodies (GAD65, IAA, IA2, and ZnT8), as well as Insulin and C-peptide concentrations. Prediabetes diagnosis was established using HbA1C, with a diagnostic threshold set at 5.8% Results: Our study examined the prevalence of prediabetes among 1325 diabetes patients in Qatar, revealing a 1.6% prevalence rate. Among the cohort, 60% were Qatari nationals, and a significant 95% were overweight or obese (BMI 25-40 kg/m²), emphasizing the connection between prediabetes and obesity. Obesity-related complications, such as obstructive sleep apnea and non-alcoholic fatty liver disease, were common. Approximately 22.7% of patients exhibited positive antibodies, with two later developing Type 1 Diabetes. These findings stress the need for tailored interventions and monitoring for high-risk individuals to curb diabetes progression and complications. Conclusions: The primary risk factors identified for the development of Prediabetes were obesity and a familial history of diabetes. The majority of patients had grandparents affected by Type 2 Diabetes Mellitus (T2DM), with fewer having affected parents. Notably, 70% of patients were categorized as obese. Promoting healthy lifestyle modifications to manage obesity emerges as a pivotal strategy to mitigate the progression of Prediabetes towards full-blown diabetes in the future.

Cardiovascular calcification in hemodialysis patients: A Qatar-based prevalence and risk factors study.

Patients with end-stage kidney disease on hemodialysis (HD) have an increased risk of death due to the high prevalence of cardiovascular disease. Vascular calcification (VC) is predictive of cardiovascular disease and mortality. We conducted a study to evaluate the prevalence and risk factors for VC in dialysis patients in Qatar. This is a retrospective nationwide study including all chronic ambulatory dialysis patients in Qatar from 2020 to 2022. We used our national electronic medical record to track demographics, clinical characteristics, comorbidities, laboratory values, and diagnostic data for each patient. Calcifications were assessed by echocardiography (routinely done for all our dialysis population per national protocol), computed tomography, X-ray, and ultrasound. The study protocol was approved by the local medical research ethics committee (MRC-01-20-377). 842 HD patients were included in this study. Vascular calcifications (VC) were prevalent in 52.6% of patients. The main site of VC was Mitral valve calcifications in 55.5% of patients. Patients with VC were significantly older and had more prevalence of diabetes mellitus (p = 0.001 and p = 0.006, respectively). There was no statistically significant difference between patients with calcifications and patients without calcifications regarding serum calcium, phosphorus, and PTH level. In multivariate analysis, age and diabetes significantly increased the risk factor for calcification (95% CI 1.033-1.065, p < 0.0001, and 95% CI 1.128-2.272, p < 0001, respectively). Moreover, higher vitamin D levels and higher doses of IV Alfacalcidol were significant risk factors for calcifications (95% CI 1.005-1.030, p < 0.007, and 95% CI 1.092-1.270, p < 0.0001, respectively). Our study found that vascular calcification was widespread among our dialysis population in Qatar. Implementing the practice of echocardiography in dialysis patients was extremely helpful and the most productive in detecting vascular calcification. Diabetes mellitus almost doubles the risk for vascular calcifications in dialysis patients. These results are beneficial in identifying risk factors for vascular calcification, which can help stratify dialysis patients' risk of cardiovascular disease and optimize prevention efforts.

Enhancing Patient Safety in Prehospital Environment: Analyzing Patient Perspectives on Non-Transport Decisions With Natural Language Processing and Machine Learning.

This research explored the experiences and perspectives of patients declining hospital transportation after receiving prehospital emergency care using advanced computational techniques. Between 15th June and 1st August 2023, 210 patients in Qatar, treated by Hamad Medical Corporation Ambulance Service (HMCAS) but refusing transportation to hospital, were interviewed. Key outcome variables stratified by demographics included "reasons for refusing transport," "satisfaction with HMCAS service," and "postrefusal actions." Responses underwent sentiment analysis and topic modeling using latent Dirichlet allocation. Machine learning models, such as Naïve Bayes, K-nearest neighboring, random forest, and support vector machine, were used to predict patients' subsequent actions. Participants had an average age of 38.61 ± 19.91 years. The chief complaints were primarily chest and abdominal pains (18.49%; n = 39). Sentiment Analysis revealed a generally favorable perception of HMCAS-provided service. Latent Dirichlet allocation identified two main topics pertaining to refusal reasons and service satisfaction. Naïve Bayes and support vector machine algorithms were most effective in predicting postrefusal actions with an accuracy rate of 81.58%. This study highlighted the utility of Natural Language Processing and ML in enhancing our understanding of patient behaviors and sentiments in prehospital settings. These advanced computational methodologies allowed for a nuanced exploration of patient demographics and sentiments, providing insights for Quality Improvement initiatives. The study also advocates for continuously integrating automated feedback mechanisms to improve patient-centered care in the prehospital context. Continuous integration of automated feedback systems is recommended to improve prehospital patient-centered care.

Early predictors of intensive care unit admission among COVID-19 patients in Qatar.

COVID-19 is associated with significant morbidity and mortality. This study aimed to explore the early predictors of intensive care unit (ICU) admission among patients with COVID-19. This was a case-control study of adult patients with confirmed COVID-19. Cases were defined as patients admitted to ICU during the period February 29-May 29, 2020. For each case enrolled, one control was matched by age and gender. A total of 1,560 patients with confirmed COVID-19 were included. Each group included 780 patients with a predominant male gender (89.7%) and a median age of 49 years (interquartile range = 18). Predictors independently associated with ICU admission were cardiovascular disease (adjusted odds ratio (aOR) = 1.64, 95% confidence interval (CI): 1.16-2.32, p = 0.005), diabetes (aOR = 1.52, 95% CI: 1.08-2.13, p = 0.016), obesity (aOR = 1.46, 95% CI: 1.03-2.08, p = 0.034), lymphopenia (aOR = 2.69, 95% CI: 1.80-4.02, p < 0.001), high AST (aOR = 2.59, 95% CI: 1.53-4.36, p < 0.001), high ferritin (aOR = 1.96, 95% CI: 1.40-2.74, p < 0.001), high CRP (aOR = 4.09, 95% CI: 2.81-5.96, p < 0.001), and dyspnea (aOR = 2.50, 95% CI: 1.77-3.54, p < 0.001). Having cardiovascular disease, diabetes, obesity, lymphopenia, dyspnea, and increased AST, ferritin, and CRP were independent predictors for ICU admission in patients with COVID-19.

Occupational hazard in urolithiasis patients in Qatar: a single-center cross-sectional study.

Urolithiasis is one of the most prevalent urological diseases and is associated with a substantial economic burden. Its prevalence varies according to geographical location. Qatar is a Middle Eastern country located in the Afro-Asian Stone Belt. It has a dry and hot climate, which may predispose individuals working in these environments to form kidney stones (KSs). A population sample of 4204 patients was categorized into five occupational classes. The frequencies and correlations of these occupations with KS formation were calculated. Among the total cases, 2000 presented with KSs, with the majority being of Asian descent (49%), followed by individuals of Middle Eastern descent (35.1%). Technicians accounted for 35.15% of KS cases followed by clerks (29.2%) and executives (14.6%). Among KS cases, 44% had a single stone, 30% had multiple stones, and 26% had two stones. In comparing both KS and non-KS groups, age, gender, occupation, and race were significantly associated with KS formation (p-value < 0.05), while BMI did not show any significant correlation (p-value > 0.05). Asian males aged 31-40, working as technicians, were significantly more prone to urolithiasis. In comparing age, BMI, and gender with stone characteristics, only age was found significantly associated with stone size (p-value < 0.05). Occupation showed an impact on all studied stone characteristics. Clerks and technicians presented more frequently with stones within the 11-15 mm range, while executives more frequently presented with smaller stones (p-value < 0.001). Stone density was more frequently < 500 HU in workers, technicians and housewives and > 500 HU in executives and clerks (p-value < 0.001). Our findings revealed an elevated risk of urolithiasis among certain occupational groups, particularly technicians, who frequently work outdoors in high-temperature environments. Alternatively, the sedentary nature of clerical and executive positions can also contribute to the risk of urolithiasis.

Determinants of vaccine adherence among non-dialysis chronic kidney disease patients in Qatar.

Chronic kidney disease (CKD) is a global health problem. Reduced innate and adaptive immunological responses predispose CKD patients to infections. Despite the clinical and epidemiological importance of CKD and the great value of vaccination as a prophylactic measure, the utilization of recommended vaccines in Qatar has not yet been evaluated. We conducted a cross-sectional study to estimate the level of influenza, pneumococcal, and hepatitis B vaccination and the predictors of adherence to these recommended vaccines among non-dialysis CKD patients receiving renal ambulatory care in Qatar from 1 September 2020 to 30 April 2021. Complete vaccination was defined as receiving the three vaccines, and partial vaccination was defined as receiving one or two vaccines. The full and partial vaccination predictors were assessed using multivariate logistic regression and reported as odds ratio (OR) with p<0.05 indicating statistical significance. 416 non-dialysis CKD patients were included in our analysis. 73% were males; the mean age was 56 ± 15 years. More than 50% of the patients were from the Middle East, followed by 36% from Asia. Most patients had concurrent hypertension, concurrent diabetes mellitus, and were stage V CKD. Only 12% of the patients were fully vaccinated, while 73% received partial vaccination. The predictors of vaccination included age, gender, Asian origin, employment, living conditions, concurrent medical conditions, CKD stage, allergy to medications, and use of injectable medications. Only stage V CKD positively predicted adherence to full and partial vaccinations in non-dialysis CKD patients. There is very low adherence to the recommended vaccines in CKD patients, with a prevalence of complete vaccination of 12% only. Increased public awareness about the importance of vaccination in CKD may improve the adherence rates among these patients in Qatar.

Real-World Data Presenting the Descriptive Analysis of the Use of Tyrosine Kinase Inhibitors (TKIs) Among Metastatic Non-Small-Cell Lung Cancer (mNSCLC) Patients in Qatar: A Nationwide Retrospective Cohort Study.

There has been significant improvement in treating metastatic non-small-cell lung cancer (mNSCLC) over the past 2 decades. The aim of this study is to describe the use of tyrosine kinase inhibitors (TKIs) in Qatar. This study focuses on the objective response rate (ORR) and reported adverse drug events (ADEs) of TKIs used for the management of patients with mNSCLC. This is a descriptive retrospective cohort study. All non-small-cell lung cancers (NSCLCs) with epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) mutations who received TKIs between 2015 and 2019 in Qatar were included. The TKIs used during this period include EGFR inhibitors such as afatinib, erlotinib, gefitinib, and osimertinib and ALK inhibitors such as alectinib and crizotinib. The response on each TKI was identified by reporting the ORR (as the sum of the complete response [CR] and the partial response [PR]), in addition stable disease (SD) and disease progression (DP) were reported. While ADEs were reported using the National Cancer Institute's Common Terminology Criteria for Adverse Events (NCI-CTCAE). A total of 63 patients were included, of which 36 cases (57.1%) expressed EGFR mutation, and 27 patients (42.9%) expressed ALK rearrangement. The ORR in EGFR inhibitors was as follows: osimertinib 40%, gefitinib 33%, afatinib 22%, and erlotinib 18%. However, the response to the ALK-targeted therapy was 43% with alectinib and 40% with crizotinib. A total of 112 ADEs were reported. They were distributed as 63.4% (71 of 112) with the anti-EGFR and 36.6% (41 of 112) ADEs with the ALK inhibitors. In the anti-EGFR group, the most common types of ADEs were dermatological toxicity 30%, whereas, in the anti-ALK group, gastrointestinal toxicity was the most common (29%). The EGFR-targeted and ALK-targeted therapies appear to have acceptable clinical response rate and safety profile in our population. Close and frequent monitoring of adverse events is advised to ensure a good quality of life and prevent serious complications.

Epidemiologic and Clinical Patterns of Malignant Lymphoma in Qatar 2013–2017: A Population-Based Cohort Study

Introduction: Lymphoma, encompassing common non-Hodgkin lymphoma (NHL) and less common Hodgkin lymphoma (HL), represents significant hematological malignancies. Advancements in treatment modalities have reshaped survival rates, particularly in NHL. This complexity results in varying outcomes, some requiring extended observation periods and multiple chemotherapy treatments. The primary objective was to explore and compare the overall survival (OS) of HL and NHL at 1, 3, and 5-year follow-ups among adult lymphoma patients in Qatar during January 2013–December 2017. Further objectives encompass comparing the most prevalent histological types, clinical and epidemiological traits of HL and NHL, as well as secondary aims of assessing clinical features, treatment, response, disease-free survival, and OS. Methods: A retrospective, descriptive study of consecutive cases was conducted at Qatar’s NCCCR between 2013 and 2017. Inclusion criteria involved patients ≥18 years old, of any gender and clinical stage at diagnosis, who received chemotherapy and had known outcomes. Descriptive statistics were applied, and survival analysis utilized Kaplan-Meier curves. STATA version 13.0 facilitated data analysis. Results: Between 2013 and 2017, 414 individuals in Qatar were diagnosed with lymphoma. The median age at diagnosis was 49 years (IQR 36–95 years; p < 0.001) across all patients. Males exhibited a higher likelihood of developing HL and NHL, comprising 74% and 70% of cases, respectively, though this difference was statistically insignificant (p = 0.45). Among NHL-B subtypes, mature B-cell neoplasms (60%) predominated, while lymphocyte-rich subtype (49%) was prominent in HL cases. With a median follow-up of 17.3 months, OS rates at 1, 3, and 5 years were 99%, 82%, and 64%, respectively for all lymphoma patients. Subtype stratification revealed trends in 3-year follow-up OS (94 vs. 82%) for HL and NHL, with 5-year OS of 67% and 60%, respectively. HL demonstrated higher OS throughout the study period compared to NHL (p < 0.001), though median OS remained unreached. Conclusions: Diffuse large B-cell lymphoma emerged as the most prevalent subtype among lymphomas in Qatar. Generally, HL exhibited superior survival rates, at 67% compared to 60% for NHL. Minor deflation in survival rates, particularly for HL, might be attributed to Qatar’s immigration patterns.

Descriptive Analysis of Thromboembolic Events in COVID-19 Patients in Qatar

Descriptive Analysis of Thromboembolic Events in COVID-19 Patients in Qatar

Perceptions and experiences of community-based healthcare professionals in the state of Qatar having do not attempt resuscitation discussions during the COVID-19 pandemic.

The values and attitudes of healthcare professionals influence their handling of "do-not-attempt-resuscitation" (DNAR) orders, as does that of the families they interact with. The aim of this study was to describe attitudes, perceptions, and practices among community-based medical practitioners towards discussing cardiopulmonary resuscitation and DNAR orders with patients and their relatives, and to investigate if the COVID-19 pandemic affected their practice in having these discussions. This is a researcher-developed online survey-based study which aimed to recruit a convenience sample of respondents from a total population of 106 healthcare professionals working for the Mobile Healthcare Service (MHS), Hamad Medical Corporation Ambulance Service in the State of Qatar. 33 family physicians, 38 nurses, and 20 paramedics (n = 91) responded to the questionnaire, of who around 40, 8, and 50%, respectively, had engaged in Do Not Attempt Resuscitation discussions during their work with MHS. 15% of physicians who had experience with Do Not Attempt Resuscitation discussions in Qatar felt that the family or patient were not open to having such discussions. 90% of paramedics thought that Do Not Attempt Resuscitation was a taboo topic for their patients in Qatar, and this view was shared by 75% of physicians and 50% of nurses. Per the responses, the COVID-19 pandemic had not affected the likelihood of most of the physicians or nurses (and 50% of the paramedics) identifying patients with whom having a Do Not Attempt Resuscitation discussion would be clinically appropriate. Overall, for all three groups, the COVID-19 pandemic did not affect the likelihood of identifying patients with whom a Do Not Attempt Resuscitation discussion would be clinically appropriate. We found that the greatest barriers in having Do Not Attempt Resuscitation discussions were perceived to be the religious or cultural beliefs of the patient and/or their family, along with the factor of feeling the staff member did not know the patient or their family well enough. All three groups said they would be more likely to have a conversation about Do Not Attempt Resuscitation if barriers were addressed.