Qatar Medical Journal最新文献

{"title":"Characteristics and outcomes of pulmonary barotrauma in patients with COVID-19 ARDS: A retrospective observational study.","authors":"Varun Mahajan, Kamal Kajal, Amarjyoti Hazarika, Karan Singla, Naveen Naik B, Ananya Ray, Venkata Ganesh, Ajay Singh, Ashish Bhalla, Goverdhan Dutt Puri","doi":"10.5339/qmj.2024.64","DOIUrl":"10.5339/qmj.2024.64","url":null,"abstract":"<p><strong>Introduction: </strong>Pulmonary barotrauma in coronavirus disease-2019 (COVID-19) acute respiratory distress syndrome (ARDS) carries high risk of mortality. While various studies have reported increased mortality, few have assessed the contributing factors for the occurrence of this complication. This study aimed at exploring the contributing factors for barotrauma in COVID-19 ARDS.</p><p><strong>Methodology: </strong>In this retrospective study, patients aged ≥18 years with laboratory confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) by reverse transcriptase polymerase chain reaction (RT-PCR) from a nasopharyngeal swab and having severe or critical COVID-19 disease requiring Intensive Care Unit (ICU) admission according to the World Health Organisation (WHO) criteria for disease severity in COVID-19 disease admitted at forty-bedded ICUs at a tertiary care research hospital in North India from April 1, 2020, to March 31, 2022 were included.</p><p><strong>Results: </strong>Of 825 patients admitted to COVID ICU, 40 developed pulmonary barotrauma, with a mortality rate of 85%. The mean ± SD PaO₂/FiO₂ was 96.76 ± 27.78 mmHg. Thirty-nine patients received steroids, 37 developed secondary bacterial infection of the lower respiratory tract with one or more organisms. <i>Acinetobacter baumannii</i> (<i>n</i> = 15), <i>Klebsiella pneumoniae</i> (<i>n</i> = 10), and <i>Pseudomonas aeruginosa</i> (<i>n</i> = 8) were the commonest isolates. Ten patients developed pneumomediastinum, of which 6 patients had subcutaneous emphysema along with pneumomediastinum, and 2 patients developed isolated subcutaneous emphysema. The remaining 28 patients developed pneumothorax.The mean (±SD) for static respiratory system compliance (Crs) for patients on mechanical ventilation on the day of barotrauma was 19.3 (±10.5) mL/cmH₂O.</p><p><strong>Conclusion: </strong>Patients with COVID-19 ARDS developing pulmonary barotrauma have a high associated mortality, and secondary bacterial infection, lung fragility, patient-ventilator asynchrony, as well as low respiratory system compliance, may contribute to lung injury, predisposing to barotrauma.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2024 4","pages":"64"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11816791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411495","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":"A pilot study comparing the rehabilitation functional outcomes of post-COVID-19 stroke and non-COVID stroke patients: An occupational therapy perspective.","authors":"Thajus Asirvatham, Reetha Sukumaran, Premraj Issac Chandran, Ajay Boppana, Mohammed Nasser Awadh","doi":"10.5339/qmj.2024.70","DOIUrl":"10.5339/qmj.2024.70","url":null,"abstract":"<p><p><b>Background and purpose:</b> Recent studies have highlighted the clinical characteristics and incidence of post-COVID-19 stroke conditions. Comparing the function and overall prognosis of stroke patients and post-COVID-19 stroke patients is an intriguing idea. Therefore, the aim of this study was to examine and compare the functional outcomes between the two groups from an occupational therapy perspective. <b>Methods:</b> Forty patients admitted to a rehabilitation facility were included, 20 of whom were diagnosed with post-COVID-19 stroke and 20 with non-COVID-19 stroke (ischemic and hemorrhagic). The study was a mixed design consisting of both prospective and retrospective data collection. Existing data from electronic medical records were used for the retrospective dataset. The retrospective dataset only consisted of data from post-COVID-19 stroke patients. The prospective dataset consisted of data from non-COVID-19 stroke patients. Data were collected at the time of admission and at discharge. Outcome measures included the functional independence measure (FIM), the Action Research Arm Test (ARAT), the post-COVID-19 functional status (PCFS) scale, the Borg rating of perceived exertion, and the mini-mental state examination (MMSE). <b>Results:</b> Both the post-COVID-19 stroke and non-COVID stroke groups showed significant differences before and after rehabilitation (NIHSS (National Institutes of Health Stroke Scale): <i>p</i> = 0.014, 0.000, FIM: <i>p</i> = 0.000, 0.000, MMSE: <i>p</i> = 0.015, 0.000, ARAT: <i>p</i> = 0.000, 0.000, respectively). However, the mean difference in the non-COVID-19 stroke group was higher than that in the post-COVID-19 stroke group, particularly in MMSE, FIM, and NIHSS scores (NIHSS: 2.8 ± 0.4, 0.9 ± 0.04, FIM: 34.8 ± 5.03, 32.95 ± 0.81, MMSE: 5.05 ± 3.5, 0.7 ± 1.17, ARAT: 1 ± 0.062, 1.2 ± 0.47, respectively). It was also found that in the post-COVID-19 stroke group, age had a positive influence on NIHSS (<i>p</i> = 0.022) and FIM (<i>p</i> = 0.047), and impaired side affected the NIHSS scores (<i>p</i> = 0.007). In the non-COVID-19 stroke group, significant correlations were found between the NIHSS and FIM scores (<i>r</i> = -0.445, <i>p</i> = 0.050) and the NIHSS and ARAT scores (<i>r</i> = -0.529, <i>p</i> = 0.017). <b>Conclusion:</b> Higher mean differences in the non-COVID-19 stroke group than in the post-COVID-19 group could be due to additional COVID-19 complications in the stroke condition itself. Overall functional gain was observed in both groups due to the effective rehabilitation. Therefore, rehabilitation is critical for functional optimization in such vulnerable populations. There is an urgent need to consider post-pandemic rehabilitation aspects.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2024 4","pages":"70"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383923","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":"Short-term effects of COVID-19 vaccines on cardiac biomarkers: A comparative study between Pfizer/BioNTech and Sinopharm.","authors":"Yousaf Dawood, Saddam M Abed, Yousif H Khalaf","doi":"10.5339/qmj.2024.73","DOIUrl":"10.5339/qmj.2024.73","url":null,"abstract":"<p><p><b>Objectives:</b> The aim of this study was to investigate the potential cardiac side effects associated with Pfizer/BioNTech and Sinopharm vaccines. <b>Methods:</b> A total of 200 healthy volunteers were enrolled after receiving two doses of Pfizer/BioNTech or Sinopharm vaccine 21 days apart. In addition, 100 healthy, unvaccinated individuals were included as a control group. Cardiac biomarkers such as cardiac troponin-I (cTnI), creatinine kinase-myocardial band (CK-MB), and myoglobin (MYO) were measured 4 days after receiving the second dose of vaccine. In addition, the SARS-CoV-2 neutralizing antibody levels of all participants were also determined. <b>Results:</b> Post-vaccination findings in both vaccinated groups were comparable. There was no statistically significant difference in cTnI, MYO, and CK-MB levels between the Pfizer/BioNTech and Sinopharm vaccine groups. Furthermore, our results showed that the levels of SARS-CoV-2 neutralizing antibodies stimulated by the Pfizer-BioNTech vaccine were significantly higher (171.19, <i>p</i> < 0.001) compared to the Sinopharm vaccine (70.14). Owing to the successful efficacy of the vaccine and based on the available data, COVID-19 vaccines remain the best option to eliminate the pandemic and its complications. <b>Conclusion:</b> Our study shows that both Pfizer-BioNTech and Sinopharm vaccines are safe for the heart in the short term, with no significant changes in cardiac biomarkers observed four days after vaccination. The findings suggest that these vaccines are effective and do not pose an immediate risk to cardiovascular health within the observed time frame. However, further research is required to assess the long-term cardiac safety profiles of these vaccines.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2024 4","pages":"73"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383976","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":"Telepsychiatry implementation in Qatar: A three-year analysis of no-show rates and its impact on mental health service delivery.","authors":"Ovais Wadoo, Faisal Khan, Javed Latoo, Yasser Saeed Khan, Prem Chandra, Yousaf Iqbal, Raed Amro, Shuja Reagu, Majid Alabdulla","doi":"10.5339/qmj.2024.50","DOIUrl":"10.5339/qmj.2024.50","url":null,"abstract":"<p><p><b>Background:</b> The COVID-19 pandemic triggered a rapid shift to telehealth and reshaped healthcare delivery worldwide. In Qatar, telehealth has emerged as a critical tool for ensuring uninterrupted care while minimizing the spread of viruses. However, its long-term efficacy, particularly in mental health services, is still poorly understood. The aim of this study was to address this gap by evaluating the post-pandemic impact of telehealth on the accessibility of mental health services in Qatar. <b>Methods:</b> We conducted a comparative analysis of no-show rates over a four-month period before the initiation of telepsychiatry and telepsychology (March to June 2019) and corresponding periods in 2020, 2021, and 2022. The analysis considered visit types (new visit and follow-up visit) in various psychiatric (child and adolescent, adult, geriatric, forensic, and intellectual disability) and psychological outpatient clinics before and after the implementation of telehealth services. <b>Results:</b> Among both new and follow-up cases, there was a significant reduction (<i>p</i> < 0.0001) in the collective proportion of no-show rates following the introduction of telehealth compared to the rates recorded before the implementation. Exceptions to this trend were appointments in child and adolescent mental health service psychology and forensic psychiatric services. <b>Conclusion:</b> Telehealth has proven instrumental in improving access to mental health services in Qatar post-pandemic. Its integration shows the potential for reducing no-show rates and enhancing continuity of care. These findings are important for healthcare policy-making and practice in Qatar and provide valuable insights into the global discourse on the evolving role of telehealth.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2024 4","pages":"50"},"PeriodicalIF":0.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257210","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 health-promoting lifestyle behaviors of healthcare employees in Qatar - A cross-sectional comparative study.","authors":"Shamja Sofia Razzakh, Rajvir Singh, Bilal Uddin Khan, Nesiya Hassan","doi":"10.5339/qmj.2024.74","DOIUrl":"10.5339/qmj.2024.74","url":null,"abstract":"<p><p><b>Background:</b> The World Health Organization (WHO) considers health to be a fundamental human right. Health is a resource that enables people to lead productive lives on an individual, social, and economic level. In Qatar, there are a limited number of studies addressing the health-promoting lifestyle behaviors of healthcare employees. <b>Aim:</b> The aim of this study was to compare the health-promoting lifestyle of at-risk and non-risk groups of employees working in Hamad Medical Corporation (HMC), the largest secondary and tertiary healthcare provider in the State of Qatar. <b>Methods:</b> This was a cross-sectional comparative research study of all categories of healthcare employees working in HMC facilities. Participants with a body mass index (BMI) >30 kg/m², smokers, or those with pre-existing non-communicable diseases (NCDs) were classified as the at-risk group, and individuals without any of these factors were classified as the non-risk group. Data were collected through an online survey using an adopted scale, Adolescent Health Promotion Short Form (AHP-SF), after approval by the Institutional Review Board (IRB) of HMC. <b>Results:</b> The age of the participants ranged from 22 to 69 years and the majority of them were female (64.07%). Most of the respondents were overweight or obese, accounting for 42.99% and 26.68% of the sample, respectively. Interestingly, 87.64% of the participants were non-smokers and approximately 70% had no chronic diseases. The overall AHP-SF score was 60.01/84 ± 12.32, with the highest score from the \"life appreciation\" subscale (12.68/16 ± 2.84) and the lowest score from the \"exercise\" subdomain (7.05/12 ± 2.93). Five subdomains - nutrition, social support, health responsibility, exercise, and stress management - of the AHP-SF scale showed no significant statistical differences between at-risk and non-risk groups. However, the \"life appreciation\" scale showed significant statistical differences between the at-risk (12.91/16 ± 2.69, <i>p</i> = 0.04) and non-risk (12.42/16 ± 2.98) groups. The AHP-SF scores varied significantly across the participants' regions of origin, with Americans having the highest score (63.93/84 ± 10.67, <i>p</i> = 0.03) compared to other regions. <b>Conclusions:</b> Healthcare employees moderately practice health-promoting lifestyle behaviors. The lowest scores were in the exercise subdomain, suggesting that more interventions are required to improve these behaviors. Healthcare organizations are ideal settings to implement comprehensive workplace wellness programs and awareness campaigns that can motivate employees to take greater responsibility for their own health and influence the wider community to adopt health-promoting lifestyle behaviors.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2024 4","pages":"74"},"PeriodicalIF":0.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384066","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":"Epidemiology, clinical characteristics, and treatment outcomes of leishmaniasis in Qatar: A retrospective study.","authors":"Mohammed Abukhattab, Joanne Daghfal, Mohammed Adam, Samar A Hashim, Fathima Koolikkad Mohammed, Muna Al-Maslamani","doi":"10.5339/qmj.2024.51","DOIUrl":"10.5339/qmj.2024.51","url":null,"abstract":"<p><strong>Background: </strong>Leishmaniasis is an emerging tropical infectious disease in Qatar. It is caused by the protozoan parasite of the <i>Leishmania</i> genus, which is endemic in many regions of the world, including the Middle East. In Qatar, there is limited data about this disease, which is hindering the efficient planning and implementation of disease prevention and control measures. Therefore, to address this knowledge gap, we conducted a retrospective study to gather information on the prevalence, clinical characteristics, as well as outcomes of leishmaniasis treatment. The primary objective of this study is to provide a comprehensive analysis of leishmaniasis cases in Qatar over seven years (2016-2022). The findings of this study offer valuable insights that can guide the development of a national registry and treatment program for leishmaniasis in Qatar.</p><p><strong>Methods: </strong>Using a retrospective cross-sectional study design, clinical and epidemiological data of all documented cases of leishmaniasis in Qatar between 2016 and 2022 were collected from electronic medical records at Hamad Medical Corporation (HMC).</p><p><strong>Results: </strong>A total of sixty-eight cases of leishmaniasis were detected in Qatar between 2016 and 2022. Males were predominant (69.12%) with a median age of 33 years. Our study revealed a higher incidence of leishmaniasis among individuals of Syrian nationality, followed by Pakistani and Sudanese, thus promoting further investigation into the underlying factors contributing to this health disparity. Our findings revealed important epidemiological trends, highlighted key clinical characteristics, identified risk factors associated with susceptibility to leishmaniasis, and reported treatment outcomes.</p><p><strong>Conclusion: </strong>This retrospective study presents the first comprehensive analysis of leishmaniasis in Qatar, shedding light on the epidemiology, clinical characteristics, and treatment outcomes of the disease. The data generated from this study can serve as a guide for authorities in establishing a national registry and treatment program for leishmaniasis in Qatar. Implementing these measures will contribute to the effective management and control of leishmaniasis, ultimately improving patient outcomes and public health in the country.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2024 4","pages":"51"},"PeriodicalIF":0.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11814621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411496","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":"Analysis of desert traffic accidents: A retrospective study.","authors":"Haris Iftikhar, Suha Turkmen, Aftab Mohammad Azad, Zain Bhutta, Melih Imamoglu, Serdar Karakullukcu, Amr Mohammed Elmoheen, Jassim Mohammad, Hany Attia Zaki Mahmoud, Ahmed Ibrahim Sheashaa, Guillaume Alinier","doi":"10.5339/qmj.2024.65","DOIUrl":"10.5339/qmj.2024.65","url":null,"abstract":"<p><strong>Introduction: </strong>Motor vehicle accidents (MVAs) are a leading cause of mortality and morbidity worldwide. There is limited literature on the injuries resulting from desert off-road driving accidents. This study aims to delineate the attributes of desert MVA and associated injuries as observed in Qatar.</p><p><strong>Methods: </strong>This is a Qatar-based retrospective descriptive multicenter study from electronic medical records (EMRs) between 2016 and 2022. Patients were evaluated based on demographic characteristics, type of injury and vehicle involved, injury locations, injury severity, treatments applied, length of hospital stay, number and outcome of surgeries, disability on discharge, and mortality.</p><p><strong>Results: </strong>Findings reveal a rising trend in accidents from October to March, peaking between 4:00 p.m. and 8:00 p.m. The patients were predominantly male under 40 years of age, not adhering to personal protective measures, and accidents often involved all-terrain vehicles (ATVs) and sport utility vehicles (SUVs). Blunt trauma emerged as the primary injury type, with orthopedic injuries being the most frequent. Most patients did not undergo surgery and had an average hospital stay of 2.9 days. A 1.5% mortality rate and 6.7% disability rate were observed.</p><p><strong>Conclusion: </strong>This study fills a critical gap in understanding desert traffic accidents in a Gulf Cooperation Council country. This study underscores the need for targeted interventions and public awareness campaigns tailored to the unique challenges of desert driving.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2024 4","pages":"65"},"PeriodicalIF":0.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434385","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":"Erector spinae block reduces intraoperative and postoperative opioid consumption in patients undergoing laparoscopic sleeve gastrectomy: A randomized controlled trial.","authors":"Anwar Ul Huda, Amer Saeed Alshahrani, Mohammad Yasir, Abdulaziz Sawilah, Ahmed Abdulrahman N Alharthi","doi":"10.5339/qmj.2024.58","DOIUrl":"10.5339/qmj.2024.58","url":null,"abstract":"<p><strong>Background: </strong>Obese patients are at increased risk of postoperative respiratory complications because of sedatives and opioids. The erector spinae block is a novel regional block that has been used in different surgeries. It offers an easier approach and a better safety profile. This study aimed to assess the role of erector spinae plane block (ESPB) in reducing postoperative pain scores and opioid consumption in patients undergoing sleeve gastrostomies.</p><p><strong>Methods: </strong>Institutional committee approval was obtained for this randomized controlled trial. Inclusion criteria included patients aged between 18 and 65 years with American Society of Anesthesiologists (ASA) scores 1-3 who were scheduled to undergo laparoscopic sleeve gastrectomy under general anesthesia. Simple randomization using sealed opaque envelopes was used to allocate study patients to either of the two groups. The intervention group received erector spinae block using 0.2% ropivacaine just after induction of anesthesia while the control group did not receive a block. Primary outcome variables were pain scores during the first 24 hours after surgery.</p><p><strong>Results: </strong>A total of 60 patients were included in the study. There was no significant difference in the baseline characteristics between two groups. Numerical rating scale (NRS) pain scores in the postoperative period were lower in the ESPB group but there was no statistical significance. Intraoperative remifentanil consumption was statistically lower in the ESPB group compared to the control group (<i>P</i> < 0.01). ESPB also reduced 24-hour opioid consumption (<i>P</i> = 0.002). There was no statistical difference in the incidence of adverse events between the two groups.</p><p><strong>Conclusion: </strong>The use of ESPB in laparoscopic sleeve gastrectomy patients is associated with a significant reduction in intraoperative and 24-hour postoperative opioid consumption.</p><p><strong>Trial registration id: </strong>The trial was registered with Clinicaltrials.gov as trial ID-NCT04368195.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2024 4","pages":"58"},"PeriodicalIF":0.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11816789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411497","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":"Characteristics of achalasia and detection of pulmonary complications: A comparison of findings in younger and elderly patients.","authors":"Jelena Jankovic, Branislava Milenkovic, Aleksandar Simic, Nenad Ivanovic, Ognjan Skrobic","doi":"10.5339/qmj.2024.52","DOIUrl":"10.5339/qmj.2024.52","url":null,"abstract":"<p><strong>Background: </strong>Achalasia is a rare esophageal motility disorder of unknown etiology, which leads to changes in the pressure and relaxation of the lower esophageal sphincter (LES), affecting peristalsis and contraction of the esophageal body. Dysphagia can impact individuals of any age, it is frequent in the elderly. Non-specific gastrointestinal symptoms are delayed and can give false diagnoses. The aim of this study is to compare clinical presentation and pulmonary complications in younger (Group I) and elderly patients (Group II).</p><p><strong>Methods: </strong>108 patients with achalasia were separated into two groups-young and elderly patients. Demographic, clinical, radiological and manometric data, smoking status, and symptom score were compared between these groups.</p><p><strong>Results: </strong>There was no significant difference in gender, duration of symptoms, body mass index (BMI), or diameter of esophagus between the two patient groups. There was a statistically significant difference between frequencies of comorbidity between groups (<i>p</i> = 0.009). Even though there were no differences in chest tomography scan (CT) findings and diameter, there were statistical differences in diffusion capacity (<i>p</i> = 0.041). Respiratory symptoms occurred in 38 (48.7%) patients in Group I and in 20 (66.7%) in Group II (<i>p</i> = 0.011). Cough was dominant in the younger group, but fatigue and chest pain were statistically significant and frequent in elderly group patients with achalasia. There was no significant difference in Eskardt symptom score (ESS), but there was the difference in the frequency of individual symptoms. Vomitus and regurgitation were statistically higher frequent in Group I, but dysphagia and weight loss in Group II. Subtype 1 was dominant in the younger group, and subtype 2 in a group with older patients.</p><p><strong>Conclusion: </strong>The younger achalasia population group was found to be associated with decreased diffusion capacity, type 1 achalasia, cough, and gastrointestinal symptoms such as vomitus and regurgitation. Geriatric status was found to be associated with frequent comorbidities, subtype 2, frequent respiratory symptoms, dysphagia, and weight loss. Our findings demonstrated an association between esophageal motility abnormalities and characteristics of geriatric population.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2024 4","pages":"52"},"PeriodicalIF":0.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392230","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":"A case of a young man with secondary hypertension.","authors":"Rishabh Baskara Salian, Nidhi Raj, Basavaprabhu Achappa, Suraj Pai, Arfath Ahmed, Svetanshu Sajwan","doi":"10.5339/qmj.2024.53","DOIUrl":"10.5339/qmj.2024.53","url":null,"abstract":"<p><strong>Background: </strong>Secondary hypertension is characterized by an elevated blood pressure greater than 140/90 mmHg, which occurs as a consequence of other diseases. The common etiologies of secondary hypertension include renal parenchymal causes, endocrine disorders, and vascular pathologies like coarctation of the aorta (CoA).</p><p><strong>Case presentation: </strong>A 20-year-old patient was admitted to our hospital as he complained of headache and palpitations since one week. On examination, the blood pressure in his right upper limb was 180/100 mmHg. The volume of the femoral and the dorsalis pedis pulses was found to be reduced bilaterally. The patient was started on antihypertensive medication labetalol 10 mg injection intravenously immediately. After clinical suspicion and a series of investigations, the patient was diagnosed with severe CoA, distal to the origin of the left subclavian artery via computed tomography (CT) aortogram. The patient was managed by coarctoplasty with stenting.</p><p><strong>Discussion: </strong>The most striking examination findings indicative of CoA include decreased lower limb pulses and a blood pressure difference of >20 mmHg across both the lower and upper extremities. It is important to evaluate the blood pressure in both upper and lower limbs to diagnose obstructive vascular diseases.</p><p><strong>Conclusion: </strong>The presence of multiple well-developed collaterals can often mask symptoms and delay the detection of hypertension in patients with CoA. Patients with CoA require regular follow-up to monitor left ventricular outflow tract obstruction, and patients with severe CoA should be treated interventionally to prevent complications including aortic aneurysm and dissection.The patient was managed by coarctoplasty with stenting and recovered well post-surgery.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2024 4","pages":"53"},"PeriodicalIF":0.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11814626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411493","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}