Qatar Medical Journal最新文献

{"title":"Meleney's gangrene triggered by suprapubic catheter dislodgment and urine extravasation: A case report and review of management strategies.","authors":"Ahmed Mohammed Umar, Mohammed Mustapha Kura, Daniel Joshua Maina, Abdullahi Khalid, Ayodeji Olawale Afolayan","doi":"10.5339/qmj.2026.67","DOIUrl":"10.5339/qmj.2026.67","url":null,"abstract":"<p><strong>Background: </strong>Necrotizing soft tissue infection represents a spectrum of bacterial infections that result in rapidly progressive, life-threatening tissue necrosis. Early diagnosis remains a challenge due to the rarity of the condition and variable presentation. Herein, we present a case of Meleney's gangrene managed at a tertiary healthcare facility in Nigeria.</p><p><strong>Case presentation: </strong>The patient presented to the emergency department with a 13-hour history of inability to pass urine associated with pain. Physical examination revealed a tender urinary bladder consistent with a diagnosis of acute urinary retention. Following multiple failed attempts at urethral catheterisation, an ultrasound-guided percutaneous suprapubic cystostomy (SPC) was performed. Four days after being discharged home, he came back with a complaint of a dislodged suprapubic tube and leakage of urine through the SPC stoma. Physical examination revealed mild peristomal skin discolouration and tenderness. He underwent an open suprapubic cystostomy. However, the skin discoloration progressed to Meleney's gangrene. Surgical debridement was performed, and broad-spectrum antibiotic therapy was initiated. The wound was later skin grafted after satisfactory wound care. However, most of the graft was lost, and the patient had successful secondary wound healing.</p><p><strong>Discussion: </strong>We strongly believe that the dislodgement of the suprapubic tube and subsequent extravasation of urine into the tissue planes and the retropubic space were the likely precipitating events in our patient, especially given that the urine was infected. Chemicals in urine, such as urea and ammonia, can irritate tissue, leading to chemical cellulitis and inflammation. Additionally, the extravasated urine creates an ideal environment for microbial proliferation. Consequently, the combined chemical and bacterial assault potentiates the local inflammatory response, allowing infection to spread quickly along fascial planes. Successful treatment relies on surgical debridement, broad-spectrum antibiotic therapy, wound management, and supportive care.</p><p><strong>Conclusion: </strong>This case report underscores the importance of proper suprapubic catheter placement to avoid dislodgement and urinary leak into subcutaneous tissue planes, which can trigger Meleney's gangrene. It provides a clear lesson that any suprapubic tube dislodgement must be regarded as high risk, warranting vigilant monitoring for signs of deep soft tissue infection.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 3","pages":"67"},"PeriodicalIF":0.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13618074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timed and targeted transfusion in Rh isoimmunization: A case report on early detection and neonatal outcomes.","authors":"Sameena Haroon, Muskan Aggarwal, Haroon Hussain, Adarsh Sugathan, Shamathmika Rao, Nayanatara Arun Kumar","doi":"10.5339/qmj.2026.64","DOIUrl":"10.5339/qmj.2026.64","url":null,"abstract":"<p><strong>Background: </strong>Rhesus (Rh) alloimmunization remains an important cause of fetal anaemia and perinatal morbidity despite the widespread use of anti-D immunoglobulin, particularly in regions with inadequate antenatal surveillance. Early detection of fetal anaemia using middle cerebral artery (MCA) Doppler ultrasonography and timely intervention are essential for improving neonatal outcomes.</p><p><strong>Case presentation: </strong>We report the case of a 35-year-old multigravida (G3P2L1) with Rh-negative blood group, managed at a tertiary-care referral centre in India. She had a previous history of neonatal death attributed to complications of Rh-isoimmunisation. During her current pregnancy, high antibody titres were detected at 32 weeks of gestation. MCA Doppler revealed severe fetal anaemia, following which a single intrauterine transfusion was performed at 33 weeks. Delivery was performed by caesarean section at 35 weeks and 4 days of gestation. The neonate required two double-volume exchange transfusions and intensive phototherapy in the immediate postnatal period. At 45 days of life, the infant developed late-onset normocytic normochromic anaemia, which was successfully managed with packed red blood cell transfusion.</p><p><strong>Discussion: </strong>This case highlights the importance of late third-trimester detection of severe fetal anaemia using MCA-peak systolic velocity (PSV) Doppler assessment, enabling timely intrauterine correction with a single transfusion and reducing the need for repeated invasive procedures. Despite antenatal optimization, the neonate required intensive postnatal management, including double-volume exchange transfusions, intravenous immunoglobulin (IVIG), and phototherapy, highlighting the continued impact of circulating maternal antibodies. Long-term haematological follow-up remained necessary.</p><p><strong>Conclusion: </strong>Early Doppler-based diagnosis, timely single intrauterine transfusion, structured neonatal intensive care, and long-term hematologic follow-up resulted in favourable survival with normal developmental progression at 15 months of age.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 3","pages":"64"},"PeriodicalIF":0.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149065804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moyamoya disease masquerading as CNS vasculitis: Diagnostic challenges and imaging insights.","authors":"Areej M Saad, Ahmed Hatim Mohamed Ahmed, Hana Elamin, Abdelrahman Hamad, Gamal Alfitori, Vivian Zuzel Rodriguez Sanchez, Elhassan M Abdalla, Aiman E Aldhubaibi","doi":"10.5339/qmj.2026.68","DOIUrl":"10.5339/qmj.2026.68","url":null,"abstract":"<p><strong>Background: </strong>Moyamoya disease (MMD) is a rare, progressive cerebrovascular disorder that can mimic central nervous system (CNS) vasculitis on imaging, particularly when advanced imaging techniques, such as vessel wall imaging, are used; thereby creating significant diagnostic uncertainty.</p><p><strong>Case presentation: </strong>A 38-year-old woman presented with a one-week history of headache and binocular diplopia. Neuroimaging demonstrated a subacute right occipitoparietal infarct. Magnetic resonance angiography showed multifocal stenoses with extensive collateral vessels. High-resolution vessel wall imaging demonstrated circumferential enhancement, initially raising concern for CNS vasculitis; however, cerebrospinal fluid analysis was non-inflammatory, and autoimmune and infectious panels were negative. Digital subtraction angiography confirmed bilateral terminal internal carotid artery stenosis with lenticulostriate collaterals, consistent with MMD. The presence of a positive family history of MMD further supported the diagnosis. She improved clinically, was discharged on aspirin, and remained asymptomatic at neurosurgery follow-up.</p><p><strong>Discussion: </strong>This case highlights the diagnostic challenges in differentiating MMD from CNS vasculitis. The presence of circumferential vessel wall enhancement, which is not specific and may overlap with inflammatory vasculopathies, illustrates how reliance on vessel wall imaging alone can be misleading. This case emphasizes the importance of integrating clinical, laboratory, radiological, and familial data to distinguish non-inflammatory arteriopathies from true vasculitis accurately. Similar diagnostic dilemmas have been reported in the literature, emphasizing the need for careful evaluation to avoid unnecessary immunosuppressive treatment.</p><p><strong>Conclusion: </strong>Differentiating MMD from CNS vasculitis requires careful integration of clinical, radiological, and familial data to prevent misdiagnosis and unnecessary immunosuppression. A structured, multimodal diagnostic approach is essential, particularly when imaging findings are atypical or potentially misleading. Early recognition and appropriate management can lead to favorable outcomes, as illustrated by our patient, who showed complete recovery and remained symptom-free on medical therapy.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 3","pages":"68"},"PeriodicalIF":0.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13622694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging insights into Panton-Valentine leukocidin-producing methicillin-resistant <i>Staphylococcus aureus</i> in Gulf Cooperation Council countries: A scoping review.","authors":"Sreethish Sasi, Ali Senosi Omrani, Theresa Paul, P Chitrambika, Muna Al Maslamani","doi":"10.5339/qmj.2026.63","DOIUrl":"10.5339/qmj.2026.63","url":null,"abstract":"<p><strong>Background: </strong>Panton-Valentine leukocidin (PVL)-producing methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) is a growing public health concern in Gulf Cooperation Council (GCC) countries. PVL enhances MRSA virulence, contributing to severe skin and soft tissue infections and necrotizing pneumonia.</p><p><strong>Objectives: </strong>To review the prevalence, molecular characteristics, and antibiotic resistance patterns of PVL-positive MRSA strains in GCC countries, i.e., Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates (UAE).</p><p><strong>Methods: </strong>We conducted a scoping review of studies published between January 2020 and December 2025 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Searches were performed in PubMed, EMBASE, Scopus, Cochrane Library, and Google Scholar, targeting original research reporting PVL presence in clinical MRSA isolates from GCC countries. Data were extracted into standardized forms and organized in comparative tables.</p><p><strong>Results: </strong>Fourteen original studies were included, primarily from Saudi Arabia, Kuwait, UAE, Bahrain, and Qatar. Across included studies, PVL prevalence among MRSA isolates varied widely, ranging from 0% to 62% depending on country, setting, and study design. Community-associated (CA) MRSA clones, such as ST80-IV, ST30-IV, and ST6-IV, predominated among PVL-positive strains, though PVL acquisition by hospital-associated (HA) lineages like ST22-IV and ST239-III was increasingly reported. PVL-positive strains exhibited resistance to fusidic acid, fluoroquinolones, and macrolides, but remained susceptible to vancomycin and linezolid.</p><p><strong>Conclusion: </strong>PVL-producing MRSA is a significant contributor to staphylococcal disease in the GCC, with prevalence in both community and hospital settings. The convergence of virulence and multidrug resistance among PVL-MRSA strains presents challenges for infection control. Strengthened regional surveillance, standardized molecular typing, and one-health-informed monitoring are needed.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 3","pages":"63"},"PeriodicalIF":0.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149065822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of dextrose prolotherapy on pain and functional outcomes in chronic shoulder pain: A systematic review and meta-analysis of randomized controlled trials.","authors":"Rizki Darmawan, Yose Waluyo, Nuralam Sam, Ahmad Taufik Fadillah Zainal, Moh Anfasa Giffari Makkaraka, Rivaldo Go","doi":"10.5339/qmj.2026.62","DOIUrl":"10.5339/qmj.2026.62","url":null,"abstract":"<p><strong>Background: </strong>Shoulder pain is a common musculoskeletal condition that substantially affects daily activities and work and imposes a considerable socioeconomic burden. Dextrose prolotherapy has been proposed as a regenerative intervention for musculoskeletal disorders, but previous reviews have primarily focused on specific shoulder conditions rather than chronic shoulder pain across different etiologies. This study evaluated the effects of dextrose prolotherapy on pain and functional outcomes in adults with chronic shoulder pain compared with control interventions.</p><p><strong>Methods: </strong>PubMed, ScienceDirect, and the Cochrane Library were searched on January 20, 2025. Three reviewers independently screened studies according to predefined eligibility criteria. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool, and pooled effects were estimated using standardized mean differences (SMDs).</p><p><strong>Results: </strong>Among 585 identified records, 12 randomized controlled trials were included in the systematic review, and seven were eligible for each quantitative synthesis. The overall pooled effect on pain was not statistically significant (SMD -0.19; 95% confidence interval [CI], -0.84 to 0.46). The pooled effect on functional outcomes was also not statistically significant (SMD -0.72; 95% CI, -1.85 to 0.41). Exploratory subgroup analysis suggested lower pain scores after repeated injections (at least three sessions; SMD -0.80; 95% CI, -1.26 to -0.35), whereas a single injection was associated with higher pain scores than control (SMD 0.60; 95% CI, 0.04 to 1.16). These subgroup findings were accompanied by substantial heterogeneity and were not derived from direct head-to-head comparisons.</p><p><strong>Conclusion: </strong>Current evidence does not demonstrate a statistically significant overall benefit of dextrose prolotherapy for pain or functional outcomes in chronic shoulder pain. Repeated injections may be associated with greater pain reduction than a single injection, but this exploratory finding requires confirmation in adequately powered, diagnosis-specific randomized trials using standardized injection protocols.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 3","pages":"62"},"PeriodicalIF":0.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149065767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral neck of femur stress fractures in unilateral hip pain: Is magnetic resonance imaging (MRI) of the contralateral hip necessary?","authors":"Vernon Tan Sze Yuen, Faris Indra Prahasta Bin Didi Indra","doi":"10.5339/qmj.2026.65","DOIUrl":"10.5339/qmj.2026.65","url":null,"abstract":"<p><strong>Background: </strong>Stress fractures may occur in healthy individuals following repetitive physical loading. They account for up to 10% of all orthopaedic injuries but rarely involve the femoral neck.</p><p><strong>Case presentation: </strong>We are reporting a young adult presenting with unilateral hip pain who was ultimately diagnosed with bilateral femoral neck stress fractures. Magnetic Resonance Imaging (MRI) revealed an occult contralateral fracture not visible on plain radiographs. Bilateral screw fixation was performed, with an excellent outcome at two years.</p><p><strong>Discussion: </strong>In this patient, stress fractures occurred on the bilateral femoral neck secondary to his intensive training for fire brigade recruitment involving running and repetitive jumping jacks. Although the patient presented with unilateral hip pain, given the history and the nature of his job, it is important to screen the contralateral hip to prevent misdiagnosis.</p><p><strong>Conclusion: </strong>The patient underwent bilateral neck of femur screw fixation and demonstrated an excellent outcome at 2-year post-operative follow-up. This case emphasizes the need for high suspicion and routine MRI of both hips in similar presentations.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 3","pages":"65"},"PeriodicalIF":0.0,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149065774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of umbilical hernia in patients with liver cirrhosis: A retrospective comparative analysis of management strategies.","authors":"Esraa Arabi, Abdalrhman Qazli, Ali Alamri, Yazed Albogami, Fatmah Alsohaibani, Ibrahim Albabtain, Zeyad Alyousef","doi":"10.5339/qmj.2026.61","DOIUrl":"10.5339/qmj.2026.61","url":null,"abstract":"<p><strong>Background: </strong>Managing umbilical hernia in cirrhotic patients is complex. No prior national studies have examined the outcomes associated with treatment approaches for this demographic.</p><p><strong>Objectives: </strong>To evaluate the results of cirrhotic patients with umbilical hernia treated conservatively compared to those who underwent elective surgical hernia repair.</p><p><strong>Methodology: </strong>This is a retrospective cohort study conducted over 5 years period from January 2017 to December 2022 at King Abdulaziz Medical City and King Abdullah Specialized Children's Hospital in Riyadh, Saudi Arabia. A comparison was conducted between those who underwent elective umbilical hernia repair and those treated conservatively. A chi-square test was used for categorical variables, while t-test and analysis of variance were used for numerical and categorical variables.</p><p><strong>Results: </strong>The study included 70 patients, out of which 54 patients initially planned for conservative treatment, and 21 eventually underwent emergent umbilical hernia repair. In the elective surgery group, 11 (68.8%) had a Child A score, whereas the emergency group had 9 patients (42.9%) with a Child B score and 10 patients (47.6%) with a Child C score (<i>p</i> = 0.001). Post-operatively, 12 patients (57.1%) required intensive care unit (ICU) admissions in the emergency group compared to only 2 patients (12.5%) in the elective group (<i>p</i> = 0.006).</p><p><strong>Conclusion: </strong>Expectant management of cirrhotic patients with umbilical hernia and ascites often results in a higher complication rate, frequently leading to emergency surgery, which is associated with significant morbidity. In contrast, elective hernia repair typically results in fewer complications and is therefore recommended.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 3","pages":"61"},"PeriodicalIF":0.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13618072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Added value of serial troponin I and N-terminal pro B-type natriuretic peptide for early detection of cardiotoxicity in breast cancer: A three-year retrospective cohort study.","authors":"Benard Shehu, Klerida Shehu, Bledar Kraja, Fatjona Kraja","doi":"10.5339/qmj.2026.60","DOIUrl":"https://doi.org/10.5339/qmj.2026.60","url":null,"abstract":"<p><strong>Background: </strong>Cardiotoxicity remains a major limitation in breast cancer treatment, especially with anthracyclines and radiotherapy. Early biomarkers may improve risk stratification.</p><p><strong>Methods: </strong>This retrospective cohort study included breast cancer patients treated between 2020 and 2023 with chemotherapy and/or radiotherapy. Troponin I (TPI) and N-terminal pro B-type natriuretic peptide (NT-proBNP) were measured at baseline and at three, six, 12, 18, 24, 30, and 36 months. Cardiotoxicity was defined per European Society of Cardiology (ESC) guidelines as a ≥10% drop in left ventricular ejection fraction (LVEF) to <53% or >15% relative reduction in global longitudinal strain (GLS). Receiver operating characteristic (ROC) analysis, logistic regression, and mixed-effects models assessed associations.</p><p><strong>Results: </strong>A total of 190 patients were included; 141 patients (74.2%) developed cardiotoxicity within 12 months. At six months, NT-proBNP (median: 212.6 pg/mL) and TPI (0.038 ng/mL) were significantly higher in the cardiotoxic group (<i>p</i> < 0.01). ROC area under the curve (AUC) for NT-proBNP at six months was 0.83 (95% CI: 0.77-0.89); for TPI, AUC = 0.79 (95% CI: 0.73-0.86). Multivariable regression showed both biomarkers remained independent predictors of cardiotoxicity after adjustment for GLS and cumulative anthracycline dose (NT-proBNP: OR 1.78 [95% CI 1.22-2.61], <i>p</i> = 0.003).</p><p><strong>Conclusion: </strong>In this real-world breast cancer cohort, serial NT-proBNP and TPI monitoring, particularly at 3 and 6 months, provided meaningful early prognostic information for subsequent cardiotoxicity beyond baseline assessment alone. When integrated with echocardiographic surveillance, these biomarkers may support earlier identification of high-risk patients, more tailored cardio-oncology follow-up, and timely cardioprotective intervention, although prospective external validation is required before routine implementation.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 3","pages":"60"},"PeriodicalIF":0.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13580469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Massive uterine angiomyolipoma mimicking uterine leiomyoma in a 49-year-old woman.","authors":"Sheela Manikyam, Thendral Kalaimani, Ashmitaa Srianand, Femela Muniraj","doi":"10.5339/qmj.2026.66","DOIUrl":"10.5339/qmj.2026.66","url":null,"abstract":"<p><strong>Background: </strong>Angiomyolipoma (AML) is a rare benign mesenchymal tumor, originating from perivascular epithelioid cells (PECs), composed of smooth muscle, fat, and thick-walled blood vessels, most often found in the kidney. Uterine AML is exceptionally rare, with under 40 cases reported worldwide and 3 from India prior to the present case. Unlike renal AMLs, uterine lesions are typically sporadic and not linked to tuberous sclerosis (TS), which, combined with their resemblance to fibroids, makes preoperative diagnosis challenging.</p><p><strong>Case description: </strong>A 49-year-old woman presented with six months of progressive lower abdominal distension and three months of amenorrhea. She had no signs of TS. Physical examination revealed a firm, non-mobile pelvic mass extending to the xiphisternum. Contrast-enhanced Computed Tomography (CT) showed a 27 × 18 × 19 cm submucosal uterine mass with right hydroureteronephrosis; Cancer Antigen-125 (CA 125 ag) was normal. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed, revealing a 7 kg anterior wall tumor. Histopathology confirmed classic AML architecture-interlacing smooth muscle bundles, mature adipocytes, and hyalinized blood vessels-without atypia or mitotic activity. She recovered well.</p><p><strong>Discussion: </strong>Uterine AML is a \"diagnostic chameleon,\" often mistaken for leiomyomas, lipoleiomyomas, or degenerated fibroids on imaging. Definitive diagnosis relies on histopathological examination. Each reported case contributes vital insights into this rare gynecologic entity and highlights the need to include AML in the differential diagnosis of unusual uterine masses.</p><p><strong>Conclusion: </strong>This case underscores the importance of maintaining clinical suspicion for uterine AML when encountering large or atypical uterine lesions. Our patient underwent a hysterectomy and had an uneventful recovery. Histologic confirmation and complete surgical excision are key to optimal management and favorable outcomes, enriching our understanding of extrarenal AMLs in gynecologic practice.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 3","pages":"66"},"PeriodicalIF":0.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13618073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and epidemiological patterns of meningitis among children and adolescents in Qatar: A primary care-based study.","authors":"Hissa Mohamed Ghaith Al-Kuwari, Aisha Thani Al-Kuwari, Ahmad Haj Bakri, Mohamed Ghaith Al-Kuwari","doi":"10.5339/qmj.2026.59","DOIUrl":"https://doi.org/10.5339/qmj.2026.59","url":null,"abstract":"<p><strong>Background: </strong>Meningitis remains an important public health problem, particularly among children. In Qatar, despite recent improvements in surveillance systems, comprehensive national data on meningitis epidemiology among children and adolescents are still limited.</p><p><strong>Methods: </strong>A retrospective analysis was conducted using surveillance-confirmed meningitis data from the Primary Health Care Corporation (PHCC) electronic medical records and the Ministry of Public Health, Qatar surveillance system between January 2021 and December 2024. All confirmed meningitis cases among children and adolescents aged 0-19 years were included. Incidence rates were calculated by age group, year, and PHCC operational region using registered population denominators. Mean annual incidence rates were compared across regions using one-way analysis of variance.</p><p><strong>Results: </strong>A total of 228 meningitis cases were reported during the study period. Viral meningitis was the most common etiology (84.2%), while bacterial meningitis was less frequent, with Streptococcus pneumoniae (S. pneumoniae) being the main bacterial pathogen (11.0%). The overall incidence among children and adolescents was 9.31 per 100,000 population, with the highest burden observed among infants aged 0-1 year (50.44 per 100,000). Incidence decreased with increasing age. Regional variation was observed, with the Western region reporting the highest mean annual incidence (13.62 per 100,000), followed by the Northern and Central regions (<i>p</i> = 0.018). This variation was largely driven by viral meningitis.</p><p><strong>Conclusion: </strong>This study provides the first national overview of meningitis epidemiology among children and adolescents in Qatar. Viral meningitis predominated, with the highest burden among infants, while S. pneumoniae remained the leading bacterial cause. The findings highlight the need to strengthen surveillance, improve data integration, and sustain vaccination efforts in line with the World Health Organization (WHO) Defeating Meningitis by 2030 roadmap.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 3","pages":"59"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13580468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}