Qatar Medical Journal最新文献

{"title":"Impact of age at diagnosis of type 1 diabetes on the occurrence of celiac disease in children.","authors":"Dalal Aicha Chellali, Ben Mehel Benakriche, Reda Belbouab, Mustapha Noumi","doi":"10.5339/qmj.2026.27","DOIUrl":"10.5339/qmj.2026.27","url":null,"abstract":"<p><strong>Introduction: </strong>Type 1 diabetes mellitus (T1DM) and celiac disease (CD) represent two frequently recognized and interrelated autoimmune disorders. Despite the well-documented coexistence of T1DM and CD, the exact etiology behind this association remains unclear.</p><p><strong>Methods: </strong>A retrospective study analyzed handwritten medical files of 109 children and adolescents diagnosed with T1DM documented between the years 2004 and 2022 in the Pediatric Unit of Mustapha Bacha University Hospital, Algiers, Algeria. Data were collected, including age, sex, age at diagnosis of both T1DM and CD, the mean annual Glycated Hemoglobin ( HbA1c) levels, celiac serology, and histopathological results. Comparisons between the CD-negative and CD-positive groups were performed using the Mann-Whitney U test.</p><p><strong>Results: </strong>The mean age was 9.99 ± 4.05 years, and the age at diagnosis of T1DM was 6.33 ± 3.45 years. HbA1c was 8.47 ± 1.42%, equivalent to 69.1 ± 15.5 mmol/mol. Celiac serology was positive in 21 patients (19.3%), including 11 patients with a confirmed CD (57.89%), with a mean age at CD diagnosis of 5.82 ± 2.82 years. The Mann-Whitney U test revealed a significant difference in the age at diagnosis of T1DM (P = 0.027). Logistic regression analysis showed that age at T1DM diagnosis was significantly associated with the risk of developing CD, with a 21.4% decrease in risk per additional year of age (odds ratio = 0.786 [95% CI, 0.627-0.986]; P = 0.038).</p><p><strong>Conclusion: </strong>In this retrospective cohort, younger age at T1DM diagnosis was associated with a higher risk of CD, supporting intensified screening in children diagnosed at younger ages. Prospective studies are warranted to confirm these clinical implications.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 2","pages":"27"},"PeriodicalIF":0.0,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13421392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632801","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":"Building a world-class emergency medicine system: Qatar's strategic evolution and outcomes.","authors":"Shahzad Anjum, Alreem Alkuwari, Khalid Bashir","doi":"10.5339/qmj.2026.37","DOIUrl":"10.5339/qmj.2026.37","url":null,"abstract":"<p><p>This narrative review examines the evolution, organization, and performance of emergency medicine (EM) services in Qatar within a nationally coordinated healthcare system. Qatar operates a highly centralized public healthcare model serving approximately 2.9 million residents through a single national health region, which includes 31 primary healthcare centers and multiple secondary and tertiary hospitals, encompassing both teaching and non-teaching institutions. Emergency departments manage a wide spectrum of acute presentations, most commonly trauma, cardiovascular emergencies, respiratory illnesses, and undifferentiated medical conditions. The review explores key aspects of workforce development, including structured training pathways, residency programs, and interprofessional education initiatives, placing Qatar's experience within a broader global context. International literature indicates that challenges related to workforce sustainability, trainee well-being, retention, and standardization of education are widely shared across health systems, highlighting the universal relevance of these issues. Qatar's nationally coordinated approach to emergency care delivery, residency training, clinical governance, and quality improvement has strengthened workforce capacity, enhanced clinical performance, and improved system resilience. The transformation from a fragmented, generalist-driven service to a cohesive, specialty-led network demonstrates how coordinated planning, structured education, and infrastructure investment can achieve international standards of emergency care. By synthesizing these developments, this review provides insights and transferable lessons for other nations seeking to establish robust, high-quality EM services, illustrating the impact of systematic, evidence-based approaches on both patient care and health system performance.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 2","pages":"37"},"PeriodicalIF":0.0,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13439644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680978","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":"Bridging morphology and genomics: p53, mismatch repair proteins, and β-catenin as immunohistochemistry surrogates for risk stratification in endometrial carcinoma.","authors":"Mona Saeed, Zeinab El Shereef, Shahenda Saleh, Doaa Abdelhady","doi":"10.5339/qmj.2026.21","DOIUrl":"10.5339/qmj.2026.21","url":null,"abstract":"<p><strong>Background: </strong>Endometrial carcinoma (EC) is the most frequent gynecologic cancer in developed countries, with considerable biological heterogeneity. The Cancer Genome Atlas molecular classification provides important prognostic information, but genomic profiling is not always practical. Immunohistochemistry (IHC)-based surrogates using p53, mismatch repair (MMR) proteins, and β-catenin offer a practical alternative.</p><p><strong>Objective: </strong>This study aims to evaluate the prognostic value of an expanded IHC-based molecular panel (p53, MMR, β-catenin) for risk stratification, with a focus on identifying high-risk patients within the heterogeneous \"no specific molecular profile\" (NSMP) subgroup.</p><p><strong>Methods: </strong>This retrospective cohort study included 150 EC patients treated between 2018 and 2022. IHC classified cases as p53-abnormal (p53abn), MMR-deficient (MMRd), or p53-wild type (NSMP). Nuclear β-catenin (surrogate for CTNNB1 mutation) was assessed. Survival analysis used Kaplan-Meier and Cox regression.</p><p><strong>Results: </strong>Nuclear β-catenin positivity was found in 22.0% (33/150) of all cases and in 24.8% (26/105) of NSMP tumors. It was associated with lymphovascular space invasion (LVSI; 69.7% vs. 24.0%; <i>P</i> < 0.001) and nodal metastasis (24.2% vs. 8.5%; <i>P</i> = 0.02). Within the NSMP subgroup, β-catenin-positive patients had significantly worse 3-year disease-free survival (68% vs. 89%; <i>P</i> = 0.003). In multivariable analysis, β-catenin positivity was an independent predictor of recurrence (hazard ratio = 2.2 [95% CI, 1.1-4.5]; <i>P</i> = 0.02), alongside LVSI and non-endometrioid histology.</p><p><strong>Conclusion: </strong>An IHC panel incorporating p53, MMR, and β-catenin effectively stratifies EC risk. Nuclear β-catenin identifies a higher-risk subset within the prognostically heterogeneous NSMP group, supporting its integration into routine prognostic protocols to guide adjuvant therapy and surveillance, particularly in resource-limited settings.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 2","pages":"21"},"PeriodicalIF":0.0,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13273373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280023","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":"Referral patterns and findings of patients undergoing CT coronary angiography.","authors":"Omar K Al-Saaidi, Saleh Baawain, Malik Al Ghafri, Sunil K Nadar","doi":"10.5339/qmj.2026.22","DOIUrl":"10.5339/qmj.2026.22","url":null,"abstract":"<p><strong>Background: </strong>Computed tomography coronary angiography (CTCA) is widely used to rule out significant coronary artery disease in patients who present with chest pain, with many international guidelines recommending its use. However, there is a tendency for it to be used indiscriminately.</p><p><strong>Objectives: </strong>This study aimed to evaluate the requesting patterns of CTCA at our institution and the outcomes of these patients. We also aimed to study the prevalence of coronary anomalies observed in these patients.</p><p><strong>Methodology: </strong>This was a retrospective study of patients who had undergone a CTCA at Sultan Qaboos University Hospital, Muscat, over 5 years (2019-2023). Information was obtained from the electronic patient records. Data are presented as a number (percentage) or mean ± standard deviation as appropriate.</p><p><strong>Results: </strong>The CTCAs of 1000 patients (mean age, 51.1 + 13.5 years; 606 or 60.6% male) were analyzed. Chest pain was the main indication for requesting CTCA in 670 patients (67.2%), with breathlessness and palpitations as the other indications in 198 (19.8%) and 110 (11%) patients, respectively. Of the findings, 835 (83.5%) patients had right dominance, 92 (9.2%) had left dominance, and the remainder were co-dominant. Of the congenital abnormalities noted, 25 (2.5%) had abnormal origins (right coronary artery 9, circumflex 9), and 27 had aneurysmal or ectatic vessels. One hundred and fifty-two patients had evidence of >50% stenosis, of which 131 patients (13.1%) subsequently had an angiogram. Of these, 77 (7.7%) had evidence of significant disease and underwent intervention.</p><p><strong>Conclusion: </strong>CTCA is often requested for indications other than chest pain. The use of CTCA resulted in only a small proportion of patients proceeding for invasive coronary angiography, and helps in triaging patients better.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 2","pages":"22"},"PeriodicalIF":0.0,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13273374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280004","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":"Trauma observation unit-based pathway for treatment of injured patients: A retrospective study.","authors":"Ismail Mahmood, Bahaa Daoud, Mohammad Asim, Ismayil Chruveri, Muneer Poyil, Leni Udayan, Ahmad Ajaj, Zubaidah Alomar, Husham Abdelrahman, Ayman El-Menyar, Sandro Rizoli, Hassan Al-Thani","doi":"10.5339/qmj.2026.24","DOIUrl":"10.5339/qmj.2026.24","url":null,"abstract":"<p><strong>Background: </strong>Trauma remains a leading cause of hospital admissions and mortality worldwide. In the Emergency Department, Trauma Observation Units (TOUs) have emerged as an effective strategy to optimize care for patients who do not require inpatient admission.</p><p><strong>Objectives: </strong>To evaluate the outcome and safety of a TOU protocol on inpatient admission rates, length of stay, missed injuries, adverse outcomes, and 30-day emergency department (ED) readmissions among adult trauma patients.</p><p><strong>Methodology: </strong>We conducted a retrospective observational study of all adult patients admitted under the TOU protocol at Hamad Trauma Center, between 2023 and 2024. Data included demographics, trauma activation level, injury severity score (ISS), diagnostic test, missed injuries, length of stay, adverse outcomes, inpatient admission rates, and ED re-admission within 30 days. Descriptive statistics were used to summarize patient characteristics and outcomes, with data reported as proportions, means ± SD, or medians (range), as appropriate.</p><p><strong>Results: </strong>A total of 187 trauma patients were admitted to the TOU. The mean age was 37.6 ±14.9 years, with a predominance of males (154; 82.4%). The mean ISS was 5.5 ± 4.0. Frequent diagnoses included lacerations/soft tissue injuries (58; 31.0%), rib fractures (35; 18.7%), mild head injuries (29; 15.5%), and spinal transverse process fractures (19; 10.2%). The median duration of TOU stay was 10 hours (range 2-54). Repeated investigations were carried out in 36.4% of the total. Only one missed injury (1; 0.5%) occurred, without clinical consequence. Inpatient admission was required for 31 patients (16.6%), and 2 patients (1.1%) were readmitted within 30 days.</p><p><strong>Conclusion: </strong>TOU was safe and effective in selected trauma patients, with no adverse outcomes and minimal missed injuries. This model offers a patient-centered, resource-efficient alternative to routine admission. Future multicenter studies should validate outcomes, cost-effectiveness, and patient-reported measures.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 2","pages":"24"},"PeriodicalIF":0.0,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13273372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279997","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 of movement disorders in the adult population of Qatar: Prevalence, types, and demographics.","authors":"Ali Msheik, Alaaeldin Ahmed, Fatima Al-Sada, Zeinab Al Mokdad, Ibrahim Abdelhafez, Aisha Alkubaisi","doi":"10.5339/qmj.2026.25","DOIUrl":"10.5339/qmj.2026.25","url":null,"abstract":"<p><strong>Background: </strong>Movement disorders encompass a range of neurological conditions affecting speed, fluency, quality, and ease of movement and including Parkinson's disease, essential tremor, dystonia, and others. Understanding their epidemiology is crucial for effective public health planning and resource allocation. This study aims to provide a comprehensive analysis of the epidemiological trends of movement disorders in Qatar.</p><p><strong>Methods: </strong>This study is a retrospective descriptive epidemiological cross-sectional analysis based on available clinical data from individuals diagnosed with movement disorders at Hamad General Hospital from January 2014 until March 2025. Individuals of any nationality residing in Qatar, diagnosed with any type of movement disorder, and aged 18 years or older at the time of diagnosis were included. The key variables extracted from the medical records included the age at diagnosis, the gender, nationality, and the type of movement disorder of each patient.</p><p><strong>Results: </strong>A total of 3017 patients were evaluated, with tremors (54%) and Parkinson's disease (25.8%) being the most common diagnoses; Qataris made up 39% of the cohort. Tremor patients were predominantly male (62%) and under 60 years old, with Qataris and Indians being the largest groups. Parkinson's patients were mostly male (67%), diagnosed between the ages of 41 and 80 years. Dystonia and neuropathy were less common; dystonia showed a younger median age (45 years), while neuropathy cases, mostly Qataris, had a median age of 70 years.</p><p><strong>Conclusion: </strong>The findings underscore the influence of age, gender, and nationality on disease distribution. Despite its retrospective nature, the study lays important groundwork for future research. Prospective studies are needed to deepen understanding and support targeted healthcare strategies.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 2","pages":"25"},"PeriodicalIF":0.0,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13273376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280009","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":"Post-COVID-19 anxiety and its impact on adults' health in Qatar in 2022.","authors":"Nada Adli, Mohamed Bala, Nahlah AlMesbah, Mai Ajabein, Maysa Homaida, Musa Adli Abuhashem, Nada Mohamad, Tajala Fayyaz, Mishkat Awad, Vahe Kehyayan, Abdul Hameed Al-Khenji, Mohamed Ghaith Al-Kuwari, Iheb Bougmiza, Nagah Selim","doi":"10.5339/qmj.2026.23","DOIUrl":"10.5339/qmj.2026.23","url":null,"abstract":"<p><strong>Background: </strong>Post-COVID-19 syndrome (PCS) is an emerging public health issue characterized by persistent symptoms, including anxiety. Anxiety is the most frequent mental health persistent symptom among patients with PCS, with global prevalence ranging from 6.5% to 63%. It negatively impacts people's functioning, productivity, and daily routine beyond recovery. This study aimed to examine the prevalence, determinants, and health impact of anxiety symptoms among adults with post-COVID-19 in Qatar during 2022.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in Qatar between January and July 2022, utilizing data from the Primary Health Care Corporation's Business Intelligence Unit. Out of 368 eligible individuals, 159 adults with confirmed PCS lasting more than 12 weeks were randomly selected and interviewed by telephone after providing consent. Anxiety levels were assessed using the Generalized Anxiety Disorder-7 (GAD-7) scale.</p><p><strong>Results: </strong>Out of 159, the prevalence of anxiety symptoms was 50.3% (<i>n</i> = 80) based on GAD-7. Most of the participants were female, Qatari, married, and unemployed. Hospitalization and functional impairment were also higher in the anxiety group compared to those without anxiety. Depression, disability, and cognitive dysfunction were strongly associated with the post-COVID-19 anxiety group compared to the non-anxiety group, with P < 0.05.</p><p><strong>Conclusion: </strong>Post-COVID-19 anxiety is prevalent among PCS patients in Qatar and linked to worse mental and physical health outcomes. Routine screening and integrated care approaches are essential to support recovery.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 2","pages":"23"},"PeriodicalIF":0.0,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13273375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279940","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":"Diagnostic accuracy of the Fibrosis-4 (FIB-4) index for advanced liver fibrosis in Qatari patients with MASLD: Comparison with liver biopsy and FibroScan.","authors":"Moataz Derbala, Ibrahim M Obeidat, Raya Abualsuod, Mahmoud Draidi, Nagah Selim, Jihene Maatoug, Alaa Elkalamawi","doi":"10.5339/qmj.2026.32","DOIUrl":"10.5339/qmj.2026.32","url":null,"abstract":"<p><strong>Background: </strong>Metabolically-dysfunction-associated steatotic liver disease (MASLD) is highly prevalent in populations with metabolic risk factors, and the liver fibrosis stage is the main determinant of long-term outcomes. The Fibrosis-4 (FIB-4) index is widely recommended as a first-line noninvasive test for fibrosis risk stratification; however, its diagnostic performance may vary across populations.</p><p><strong>Objective: </strong>To evaluate the diagnostic performance of the FIB-4 index for detecting advanced liver fibrosis in Qatari residents with MASLD, using liver biopsy as the primary reference standard and FibroScan as a secondary comparator.</p><p><strong>Methodology: </strong>This retrospective, cross-sectional diagnostic accuracy study included adults with MASLD evaluated at Hamad Medical Corporation in Qatar between January 2023 and December 2024. FIB-4 was calculated from routine laboratory parameters, and fibrosis was staged using the METAVIR (Meta-Analysis of Histological Data in Viral Hepatitis) scoring system. It is a histological scoring system used to grade necroinflammatory activity (A0-A3) and stage liver fibrosis (F0-F4). Advanced fibrosis was defined as METAVIR stage ≥F3. Diagnostic performance metrics and the area under the receiver operating characteristic curve (AUROC) were calculated at established cut-offs.</p><p><strong>Results: </strong>A total of 117 patients were included; 74 patients (63.2%) underwent liver biopsy, and 91 patients (77.7%) underwent FibroScan assessment. Advanced fibrosis was present in 21 patients (17.9%) on biopsy. At a FIB-4 cut-off of 1.3, sensitivity and specificity for detecting advanced fibrosis were 66.7% and 67.9%, respectively, compared with liver biopsy, with an overall accuracy of 67.6% and a negative predictive value of 83.7%. The AUROC for FIB-4 was 0.76.</p><p><strong>Conclusion: </strong>FIB-4 can be used as a first-line, accountable screening tool, followed by another confirmatory tool in high-risk patients.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 2","pages":"32"},"PeriodicalIF":0.0,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13430814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671453","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":"Neurological fallout of hyperglycemia: A case report of a rare presentation of osmotic demyelination syndrome.","authors":"Rekha Gupta, Chandrika Sachar, Parul Kaktyan","doi":"10.5339/qmj.2026.19","DOIUrl":"10.5339/qmj.2026.19","url":null,"abstract":"<p><strong>Background: </strong>: Osmotic demyelination syndrome (ODS) is a rare but potentially life-threatening neurological disorder. It is characterized by non-inflammatory demyelination, usually triggered by sudden shifts in serum osmolality. However, emerging evidence suggests that abrupt osmotic shifts caused by severe hyperglycemia, even in the absence of sodium imbalance, can also precipitate ODS.</p><p><strong>Case presentation: </strong>: A 57-year-old male with poorly controlled type 2 diabetes mellitus and chronic alcohol use presented with recurrent seizures and altered sensorium. Initial blood work revealed severe hyperglycemia (390 mg/dL), an elevated HbA1c level (15.2%), and a normal corrected serum sodium level (135 mEq/L). During hospitalization, the patient developed progressive neurological deterioration, culminating in quadriplegia.</p><p><strong>Imaging findings: </strong>: Initial non-contrast computed tomography (NCCT) of the brain was unremarkable. Magnetic resonance imaging (MRI) on day 11 showed symmetric T2/FLAIR (Fluid-Attenuated Inversion Recovery) hyperintensities in the central pons extending into the middle cerebellar peduncles. These findings, in the absence of diffusion restriction or enhancement, were characteristic of central pontine myelinolysis (CPM). No extrapontine involvement was observed.</p><p><strong>Differential diagnosis: </strong>: Radiological differentials considered included acute disseminated encephalomyelitis (ADEM), multiple sclerosis (MS), ischemic infarction, vasculitis, and brainstem glioma. However, the symmetric pontine involvement without enhancement or mass effect, along with the clinical context of hyperosmolar hyperglycemia, favored a diagnosis of ODS.</p><p><strong>Management and outcome: </strong>: Supportive therapy involving careful glucose correction, intravenous hydration, and close monitoring of metabolic parameters was initiated. The patient showed gradual neurological recovery during the hospital course.</p><p><strong>Conclusion: </strong>: This case highlights a rare presentation of CPM secondary to hyperosmolar hyperglycemia in the absence of hyponatremia. It underscores the importance of early recognition, neuroimaging, and cautious metabolic correction in diabetic patients presenting with new-onset neurological deficits.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 1","pages":"19"},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640635","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":"Pleural mesothelioma in a patient with Familial Mediterranean Fever: A case report.","authors":"Asma Albtoosh, Omar Wael Alhasan, Mohammad Alakhras, Luma Taweel, Baraa Ayed Al Odat, Maram Abdaljaleel, Husam Abuawad, Oday Abu Ajamieh, Tareq Gharaibeh, Khalid Oweidat, Samer Al Sawalhi","doi":"10.5339/qmj.2026.20","DOIUrl":"10.5339/qmj.2026.20","url":null,"abstract":"<p><strong>Background: </strong>Malignant mesothelioma is a rare, lethal neoplasm of mesothelial surfaces, classically attributed to asbestos exposure. However, as regulations have reduced asbestos use, there is an increased focus on non-asbestos-related causes. Among these, the chronic serosal inflammation characteristic of Familial Mediterranean Fever (FMF) has been reported in a few cases. Although a direct causal relationship has not yet been established, such cases are critical for identifying the potential long-term risks of chronic serosal inflammation. Here, we present the fourth documented case of pleural mesothelioma associated with FMF.</p><p><strong>Case presentation: </strong>A 55-year-old male patient with known FMF was admitted to the hospital with progressive shortness of breath and cough for one month. Physical examination and chest X-ray revealed a large left-sided pleural effusion. Thoracocentesis analysis demonstrated an exudative effusion with predominant lymphocytosis. A contrast-enhanced computed tomography (CT) scan showed pleural thickening with enlarged mediastinal lymph nodes. Positron emission tomography (PET) scan revealed avid pleural uptake (SUVmax = 7.5). A pleural biopsy was therefore performed, revealing epithelioid pleural mesothelioma. The patient had no known history of asbestos exposure. However, he was poorly compliant with colchicine treatment and experienced frequent episodes of serositis, occurring on average twice monthly. The patient underwent surgical resection followed by chemotherapy and is doing well 10 months after the initial presentation.</p><p><strong>Discussion: </strong>Many cases of FMF have been reported in association with peritoneal mesothelioma, but few have been linked to pleural mesothelioma. In this case, we highlight that chronic serosal inflammation, characteristic of untreated FMF, may represent a potential risk factor for non-asbestos-related malignant pleural mesothelioma. Larger-scale registry studies may be required to establish a statistically significant association.</p><p><strong>Conclusion: </strong>This case reinforces the hypothesis that uncontrolled FMF may predispose patients to malignant mesothelioma. The presence of such an association would further stress the importance of early recognition and management of FMF.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 1","pages":"20"},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640601","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}