Qatar Medical Journal最新文献

{"title":"Functional and radiological changes in ICU survivors with COVID-19 at 1-year follow-up from the OUTSTRIP COVID-19 study.","authors":"Merlin Thomas, Mousa Hussein, Amal Al Rashid, Maysa Mohamed, Aalaa Kambal, Rajendra Kumar, Mansoor Ali Hameed, Rajvir Singh, Mushtaq Ahmad, Saibu George, Jaweria Akram, Aisha Hussain O Al Adab, Rajalekshmi Maheswari Rajagopal, Rohit Sharma, Tasleem Raza","doi":"10.5339/qmj.2025.40","DOIUrl":"10.5339/qmj.2025.40","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to determine the radiological changes on computed tomography (CT) scans of the chest and pulmonary function abnormalities at a 1-year follow-up in intensive care unit (ICU) survivors with severe COVID-19.</p><p><strong>Design: </strong>A 2-year prospective cohort study with an enrollment of 204 patients within 3 months after their discharge from the ICU at Hamad General Hospital, the tertiary care center in Qatar.</p><p><strong>Main results: </strong>The mean age of our cohort was 48.7 ± 8.6 years. CT chest was performed on a total of 135 patients at a 1-year follow-up, out of which 43 patients had a CT chest during hospital admission with COVID-19. Abnormal CT chest findings were seen in 118 (87.4%) patients at 1 year. The mean CT severity score significantly improved at 1 year (8.1 ± 6.8 vs. 19.4 ± 3.6, <i>p</i> < 0.001). Those with an abnormal CT chest in 1 year had a significantly lower but normal predicted forced vital capacity (91.9% ± 15.4 vs. 81.1% ± 13.7, <i>p</i> = 0.01), predicted total lung capacity (82.5% ± 13.9 vs. 94.3% ± 12.7, <i>p</i> = 0.02) and oxygen saturation after 6-minute walk test (6MWT) (97.5 ± 1.2 vs. 98.3 ± 0.651, <i>p</i> = 0.033). 6MWT distance was significantly shorter than the predicted distance in those with an abnormal CT (63 (62.4%) vs. 7 (77.8%), <i>p</i> = 0.020).</p><p><strong>Conclusion: </strong>Patients recovering from severe COVID-19 have significant improvement but persistent radiological changes at a 1-year follow-up that correlate with several physiological parameters, but these findings are limited by the absence of pre-COVID-19 baseline imaging.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2025 2","pages":"40"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12332895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818229","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":"Rare head and neck myositis with reversible myelodysplastic syndrome: The first reported lupus manifestation as an initial symptom.","authors":"Ayu Paramaiswari, Muhammad Fakhrur Rozi, Gede Perdana Putera, Kartika Widayati","doi":"10.5339/qmj.2025.65","DOIUrl":"10.5339/qmj.2025.65","url":null,"abstract":"<p><strong>Introduction: </strong>Systemic lupus erythematosus (SLE) is a systemic autoimmune disease characterized by a dysregulated immune response against self-antigen, leading to multi-organ involvement. Myositis, as an initial manifestation of SLE, is a rare clinical entity, particularly in newly diagnosed patients.</p><p><strong>Case presentation: </strong>A 27-year-old male presented with massive head and neck swelling, initially suspected to be superior vena cava syndrome (SVCS). Other symptoms included non-scarring alopecia, prolonged fever, oral ulcers, a history of hyperpigmented skin lesions, and progressive lower extremity weakness with edema. Hematological findings revealed persistent pancytopenia (anemia, leukopenia, and thrombocytopenia). Laboratory investigations demonstrated elevated muscle injury markers, including aspartate aminotransferase predominance and elevated creatine kinase. Immunological analysis showed a negative antinuclear antibody by indirect immunofluorescence, high anti-dsDNA titers, and normal complement levels. Bone marrow biopsy revealed trilineage dysplasia with macrophage activation, suggesting underlying hematologic involvement. Contrast-enhanced head and neck computed tomography ruled out SVCS, showing only diffuse muscle and subcutaneous edema. Based on the constellation of clinical, hematological, and imaging findings, the patient was diagnosed with myositis-associated SLE. The therapeutic approach included total plasma exchange (TPE), high-dose corticosteroid pulse therapy, and immunosuppressive induction therapy. Within 1 month of hospitalization, the patient demonstrated significant clinical and laboratory improvement and was subsequently transitioned to maintenance therapy with hydroxychloroquine (200 mg once daily), methylprednisolone (8 mg daily in a tapering regimen), and mycophenolate mofetil (500 mg twice daily). The patient achieved a lupus low disease activity state at follow-up.</p><p><strong>Discussion: </strong>This case represents a unique presentation of head and neck myositis in a newly diagnosed SLE patient, a manifestation not previously described in the literature. While orbital myositis in SLE has been reported, extensive myositis involving the head and neck as an initial SLE manifestation remains undocumented. Combining TPE, high-dose corticosteroids, and immunosuppressants was critical in disease control. Early recognition and aggressive immunomodulatory therapy are essential in managing such rare and severe SLE presentations.</p><p><strong>Conclusion: </strong>This case highlights an uncommon initial manifestation of SLE, emphasizing the importance of early clinical suspicion, comprehensive immunological and hematological evaluation, and prompt intervention. A multimodal therapeutic approach, including steroid pulse therapy, induction immunosuppression, and TPE, can lead to favorable clinical outcomes in severe and atypical SLE presentations.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2025 2","pages":"65"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12332898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818231","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":"Impact of healthcare restrictions due to COVID-19 on early pregnancy complications: A cross-sectional study.","authors":"Idriss Gharbi, Yasser Abdelaal, Moayyad Younis, Fathima Minisha, Obe John Ame, Victor Olagundoye, Thomas Farrell","doi":"10.5339/qmj.2025.43","DOIUrl":"10.5339/qmj.2025.43","url":null,"abstract":"<p><strong>Background: </strong>In March 2020, the World Health Organization declared COVID-19 a global pandemic. Healthcare organizations across the world introduced various measures to restrict the spread of the disease, with an increasing reliance on telephonic consultations as a key measure to limit exposure to COVID-19 in hospital facilities. This study assesses the impact of restrictive measures on gynecological emergency services by comparing services before the COVID-19 pandemic with services during the first and second waves of the pandemic (COVID-19 Peak 1 and COVID-19 Peak 2).</p><p><strong>Method: </strong>This was a retrospective single-center cross-sectional study comparing the first 50 women attending the emergency department (ED) of the Women's Wellness and Research Center in Qatar with a gynecological complaint during three distinct periods. The peak of the first COVID-19 wave from June 2020 was considered COVID-19 Peak 1, and the peak of the second wave from April 2021 was COVID-19 Peak 2. The control group included 50 women who attended the ED during non-COVID-19 times. Early pregnancy complications (miscarriage and ectopic pregnancy) were compared between the three periods to determine the impact of the COVID-19 restrictions on the clinical presentation, subsequent management, and any patient safety issues arising out of this in terms of complications.</p><p><strong>Results: </strong>Data from 50 patients were analyzed during each study period (total = 150). There were no statistically significant differences in age, nationality, and parity between the three groups. The gestational age at diagnosis of ectopic pregnancy or miscarriage was significantly higher, 12.4 ± 4.0 weeks during COVID-19 Peak 1 compared to 10.9 ± 3.6 in pre-COVID-19 and 9.7 ± 3.9 in COVID-19 Peak 2 (<i>p</i> = 0.002). The length of hospital stays (median ± interquartile range) for women with the diagnosis of miscarriage was significantly shorter during COVID-19 Peak 1(1 ± 2 days) compared to pre-COVID-19 (2 ± 1.5) and COVID-19 Peak 2 (1 ± 2), with <i>p</i> < 0.001. There was no difference in patient demographics, symptoms at presentation, type of management, and timing of surgical management.</p><p><strong>Conclusion: </strong>The COVID-19 restrictions led to a major shift in the way healthcare was delivered, with increased use of telephone consultations and prompt early discharge from the hospital. Although we did not record safety issues or adverse outcomes, we found a delay in gestational age at presentation and diagnosis, which has the potential to lead to adverse outcomes. The COVID-19 pandemic has further highlighted the importance of telemedicine in healthcare practice.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2025 2","pages":"43"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12332896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818230","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":"Monkeypox: A comprehensive review with a focus on the Middle East and North Africa (MENA) region.","authors":"Aya A Al-Rubaye","doi":"10.5339/qmj.2025.52","DOIUrl":"10.5339/qmj.2025.52","url":null,"abstract":"<p><p><b>Background:</b> Monkeypox (Mpox) was identified as a virus endemic to Central and Western Africa. Since 2022, the virus has gained global attention due to increasing cases in non-endemic countries among patients having no link to travel to endemic areas. The virus is primarily transmitted through animal-to-human contact but has increasingly spread via human-to-human transmission. A comprehensive understanding of the epidemiology of Mpox in the Middle East and North Africa (MENA) region is essential for effective disease prevention, diagnosis, surveillance, and control. <b>Methods:</b> This review investigates historical data and recent global and regional epidemiological trends of Mpox. The review discusses the clinical features, public health challenges, and preventive measures relevant to the MENA region using updated data from World Health Organization (WHO) reports, national health statistics, and additional relevant resources. <b>Results:</b> Mpox cases significantly spread globally during the 2022-2024 period. The MENA region has a relatively low number of documented cases, with 857 confirmed cases by August 2024. Saudi Arabia and the United Arab Emirates (UAE) reported the highest case numbers, reflecting effective surveillance and case detection. However, new cases of Mpox were announced in September 2024 in Morocco and Jordan following the WHO's declaration of Mpox as a public health emergency of international concern. <b>Conclusion:</b> The current number of cases in the MENA region could be underestimated due to underreporting, stigmatization, limited resources, and ongoing conflicts in several countries. It is essential to prioritize the containment of the outbreak, exploring all possible strategies to protect vulnerable communities.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2025 2","pages":"52"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12338107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823190","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 association of COVID-19 with the development of acute avascular necrosis of the head of the femur, apart from steroid usage.","authors":"Saurabh Sharma, Akhil Bhansal, Rehan Khan, Suresh Uikey, Jonsi Tavethia, Anshul Bhadania, Shubh Mehta, Kinjal Solanki, Prahar Darji, Kavya Darji, Kamal Sharma","doi":"10.5339/qmj.2025.38","DOIUrl":"10.5339/qmj.2025.38","url":null,"abstract":"<p><p><b>Background:</b> The SARS-CoV-2 pandemic (COVID-19) has significantly impacted global health, with emerging evidence indicating potential long-term complications affecting various organ systems, including the musculoskeletal system, like avascular necrosis (AVN) of the femoral head. This retrospective study aims to investigate the incidence and risk factors of AVN in patients treated for COVID-19. <b>Methods:</b> We conducted a cross-sectional retrospective study in the department of orthopedics at a tertiary care teaching hospital in Central India from July 2022 to December 2023. Patients presenting with new-onset hip pain and low back pain who were asymptomatic before COVID-19 with a new radiological diagnosis of AVN hip were included in the study. Data on demographics, comorbidities, steroid use, and COVID-19 management were collected and analyzed using statistical tests to identify associations between these factors and AVN incidence. <b>Results:</b> A total of 86 patients met the inclusion criteria. The majority of participants were males (83.7%), predominantly within the 30-45 years (44.2%) and 15-30 years (30.2%) age groups. Bilateral AVN was observed in 62.8% of cases. A significant portion (25.6%) had a history of COVID-19, with steroid use prevalent among 30.2% of participants, with an odds ratio of 4.47 indicating strong association. Statistically significant associations were found between COVID-19 status and age distribution (<i>p</i> = 0.049), comorbidities (<i>p</i> = 0.014), symptom onset (p = 0.001), and steroid therapy history (<i>p</i> = 0.002). <b>Conclusions:</b> This study highlights a notable incidence of AVN among COVID-19 patients, with significant correlations to steroid use and specific comorbidities. The findings underscore the importance of vigilant monitoring for AVN in post-COVID-19 patients, particularly those with a history of steroid therapy. Further research is needed to elucidate the mechanisms linking COVID-19 and AVN and to develop targeted prevention strategies.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2025 2","pages":"38"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823194","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":"Complete heart block following anaphylactic reaction to computed tomography contrast agent: A case report.","authors":"Mustafa Mahmood Eid","doi":"10.5339/qmj.2025.63","DOIUrl":"10.5339/qmj.2025.63","url":null,"abstract":"<p><p><b>Background:</b> A complete heart block (CHB) entails the total loss of atrioventricular conduction and the failure to transmit any supraventricular impulses to the ventricles. To date, there have been no reports of CHB following the injection of intravenous contrast dye for computerized tomography. <b>Case Presentation:</b> This case study details a patient who experienced a CHB and a syncopal episode after receiving intravenous contrast for a chest computed tomography (CT) scan. The patient was treated successfully for the anaphylactic reaction with steroids and intravenous fluid, and the heart rate improved with atropine and transcutaneous pacing. <b>Discussion:</b> Contrast agents can affect cardiac conduction and endothelial integrity through their ionic strength, osmolality, and the release of histamine. These factors, combined with localized ischemia and adenosine release, may disrupt ion flow, potentially leading to transient or permanent atrioventricular block. <b>Conclusion:</b> Anaphylactic reactions to CT contrast agents can lead to life-threatening cardiovascular complications, as exemplified in this case. Timely recognition and management of anaphylaxis, along with close cardiac monitoring, are crucial in such situations. Clinicians should be vigilant regarding the potential for severe cardiac manifestations in susceptible patients experiencing contrast-induced anaphylactic reactions, and they should take appropriate measures to ensure optimal care and recovery.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2025 2","pages":"63"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12338106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823184","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":"Evaluation of prothymosin alpha, trimethylamine-N-oxide, and ischemia-modified albumin in type 2 diabetes mellitus patients with dysregulated lipid profile.","authors":"Karam Mazin Gharab, Mohammad Ahmad Bik, Safaa Ehssan Atta, Ghufran S Jawad, Eissa Almaghrebi, Isam Noori Salman, AIi Unlu","doi":"10.5339/qmj.2025.39","DOIUrl":"10.5339/qmj.2025.39","url":null,"abstract":"<p><p><b>Background:</b> Prothymosin alpha (PTMα) is a small acidic polypeptide from the thymosin family with immune activity and protective properties against oxidative stress induced by reactive oxygen species trimethylamine-N-oxide (TMAO), produced in the liver from gut bacterial metabolite trimethylamine and associated with increased cardiovascular disease risk and higher all-cause mortality. Ischemia-modified albumin (IMA) is a significant oxidative stress biomarker, particularly in ischemia-reperfusion conditions. This study investigates PTMα, TMAO, and IMA levels in type 2 diabetes mellitus (T2DM) patients, both with and without hyperlipidemia, to explore their relationships and their potential role as biomarkers or therapeutic targets. <b>Method:</b> The study received ethical approval from the Selcuk University Faculty of Medicine Hospital committee under approval number 2024/33. The study included male and female T2DM patients aged 30-60, with 30 having hyperlipidemia and the rest being non-lipemic. TMAO was performed using API 3200 LC-MSMS while PTMα was analyzed using an ELISA kit from BT LAB, serum IMA levels were evaluated by the spectrophotometric method. <b>Results:</b> Comparisons were made between those with T2DM and control groups. In the T2DM group, PTMα was significantly higher in females (<i>p</i> = 0.047), while TMAO and IMA showed no significant gender difference. The control group had no significant differences in PTMα, TMAO, and IMA levels. Comparisons among healthy controls, non-lipemic T2DM patients, and hyperlipidemic T2DM patients revealed significantly decreased PTMα levels with no change in IMA levels across groups. In contrast, TMAO was significantly higher in the patient group. <b>Conclusion:</b> The findings of this study have potential implications for the field, suggesting that PTMα might serve as a prognostic indicator for T2DM and that reduced TMAO levels might play a role in T2DM pathogenesis, opening up new avenues for research and treatment.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2025 2","pages":"39"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823187","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":"An analysis of unplanned postoperative admissions to the intensive care units at different hospitals across Hamad Medical Corporation in Qatar.","authors":"Hashaam Ghafoor, Yasser Hammad, Ali Bel Khair, Osman Ahmed, Ekambaram Karunakaran, Hamed Mohamed Elgendy, Wael Mohammad Khalaf, Shaikh Nissaruddin, Hossam Mohamed Algallie, Tarek Anwar Ahmed Tageldin, Ashok Kandasamy, Gulzar Hussain, Amber Naz, Mariam Ali Karrar El Obied, Sanjeev Dharamchand Jain, Lamia Mahmoud Mohamed Tawfik, Walaa Mohamed Sayed Hassan, Nazeer Ahmed, Mohammed Huzain K Bukhari","doi":"10.5339/qmj.2025.35","DOIUrl":"10.5339/qmj.2025.35","url":null,"abstract":"<p><strong>Background: </strong>An unplanned intensive care admission (UIA) after elective surgery is a clinical indicator of patient safety and outcomes. Furthermore, it reflects both surgery- and anesthesia-related complications. The overall rate of UIA ranges from 0.28% to 2.2%. UIA is linked with higher rates ofmorbidity and mortality in surgical patients. Thus, understanding the factors leading to UIAs could improve the quality of patient care. In this study, we aimed to determine the rate and reasons for UIA following elective surgeries in public facilities in Qatar.</p><p><strong>Methods: </strong>UIA was defined as an admission to the intensive care unit (ICU) within 72 hours of anesthesia that was not anticipated during the pre-anesthesia assessment phase. A multicenter audit was conducted from January 1, 2021, to December 31, 2021, across five public hospitals in Qatar. UIA was identified from the electronic preoperative and postoperative anesthetic assessment notes and intraoperative notes.</p><p><strong>Results: </strong>Among the 2,087 ICU admissions, 42 (2.0%) were UIAs. Among the 42 patients, 57.1% were males, and the mean age was 41.83 ± 12.95 years. Most patients (64.3%) were classified as American Society of Anesthesiologists status II. The mean length of ICU stay was 2.60 ± 2.45 days. Most of the UIAs were surgery-related (54.8%), followed by anesthesia-related (26.2%) and medical-related (16.6%).</p><p><strong>Conclusion: </strong>The rate of UIA in our study was 2%, corresponding to the wide range of incidence reported in the literature. The causes of UIA are multiple; however, our study showed that the rate of anesthesia-related UIAs was 26.2%, which is less than in most previous studies.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2025 2","pages":"35"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486983","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":"Portal vein thrombosis in a patient on semaglutide.","authors":"Mohammed F Farooqi, Maria Khan, Muhammad Arshad, Adnan Agha","doi":"10.5339/qmj.2025.57","DOIUrl":"10.5339/qmj.2025.57","url":null,"abstract":"<p><p><b>Background:</b> Obesity and type 2 diabetes mellitus (T2DM) are both modern-day pandemics, significantly impacting worldwide healthcare. The glucagon-like peptide-1 receptor agonist (GLP1-RA) semaglutide is a novel treatment for both T2DM and obesity; however, it can be associated with an increased risk of venous thromboembolism (VTE). <b>Case presentation:</b> This case report describes a 59-year-old woman with T2DM who received semaglutide for the management of glycemic levels and also experienced the additional advantage of weight reduction. Within 6 months of initiating GLP1-RA, the patient presented with lower back pain associated with nausea and poor oral intake. She had no known risk factors for VTE or thrombophilia or any history of significant illness in her family. Her physical examination revealed no significant findings; only mild leukocytosis and neutrophilia were detected. She underwent an abdominal computed tomography scan, which revealed intrahepatic portal vein thrombosis without evidence of liver cirrhosis or abdominal malignancy. Her symptoms improved with oral anticoagulation (rivaroxaban). The result of the thrombophilia examination was negative for inherited or acquired thrombophilia, with the exception of mutation of Janus kinase 2, which may increase the risk of thrombosis. <b>Conclusions:</b> The use of GLP1-RA is increasing due to the growing desire for weight loss medications; therefore, it is pertinent for physicians to have a better understanding of the possible risks for thrombosis before initiating GLP1-RA treatment.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2025 2","pages":"57"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12338108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823192","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":"Back to bedside: Renal point-of-care ultrasonography (POCUS) by internal medicine resident physicians for identification of hydronephrosis in patients with acute kidney injury.","authors":"Fateen Ata, Rohit Sharma, Jaweria Akram, Bashar Tanous, Abdulla Arshad, Mohammed Alamin, Abdulrahman Al-Mashdali, Zohaib Yousaf, Muhammad Zahid","doi":"10.5339/qmj.2025.36","DOIUrl":"10.5339/qmj.2025.36","url":null,"abstract":"<p><strong>Background: </strong>Point-of-care ultrasonography (POCUS) has rapidly emerged as a valuable diagnostic tool in various medical conditions, including acute kidney injury (AKI) in the Western healthcare system. Its utility in the Middle East and Asian healthcare setups remains under-explored. This study aimed to assess the effectiveness of POCUS, performed by internal medicine residents (IMRs), in diagnosing hydronephrosis in AKI patients at a tertiary care training hospital in Qatar.</p><p><strong>Methods: </strong>We conducted a pilot prospective cross-sectional study from June 2021 to September 2021, enrolling adult patients admitted with AKI in the acute medical assessment unit (AMAU) via convenience sampling. IMRs received mandatory POCUS training (including a 30-minute didactic teaching session and supervised performance of renal POCUS scans). The primary outcome was the detection of hydronephrosis, with findings compared to departmental renal ultrasound scans performed by the radiologists.</p><p><strong>Results: </strong>Fifty patients were included, with POCUS identifying hydronephrosis in five out of nine patients with confirmed hydronephrosis via official departmental renal ultrasound, demonstrating a sensitivity of 83.3% and specificity of 93% for POCUS performed by IMRs. Hydronephrosis via bedside POCUS scans had clinically reliable positive and negative predictive values (55.6% and 98%, respectively). Cohen's kappa was 0.7 (0.45-0.94), indicating substantial agreement. One patient whose renal POCUS was reported as normal by IMR was identified to have hydronephrosis on an official departmental renal ultrasound.</p><p><strong>Conclusion: </strong>This study demonstrated the effectiveness of adequate training in improving the diagnostic skills of residents using POCUS for bedside detection of hydronephrosis in patients with AKI in a residency program from the Middle East. Residency programs that include POCUS training have the potential to significantly increase bedside diagnostic capabilities with improved quality of training and patient care.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2025 2","pages":"36"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486985","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}