Qatar Medical Journal最新文献

{"title":"Brainstem tuberculoma mimicking brainstem stroke: Crossed syndrome in a young female.","authors":"Mohammad Saquib Alam, Khwaja Saifullah Zafar, Ruhi Khan","doi":"10.5339/qmj.2026.18","DOIUrl":"10.5339/qmj.2026.18","url":null,"abstract":"<p><strong>Introduction: </strong>Tuberculosis (TB) involving the central nervous system (CNS) can present as tuberculoma and may mimic neoplasms or vascular lesions, particularly when the brainstem is involved. Early recognition is critical in endemic settings such as India.</p><p><strong>Case presentation: </strong>A previously healthy female in late adolescence presented with a one-month history of headache followed by progressive left-sided weakness and multiple cranial nerve deficits, producing a crossed brainstem syndrome. Magnetic resonance imaging (MRI) of the brain revealed conglomerated ring-enhancing lesions in the midbrain and pons, accompanied by surrounding edema. Magnetic resonance spectroscopy (MRS) demonstrated a lipid-lactate peak. Cerebrospinal fluid (CSF) analysis and systemic laboratory investigations were within normal limits. Empirical anti-tubercular therapy (ATT) with adjunctive corticosteroids was initiated, with clinical improvement noted within two weeks and continued gains on follow-up.</p><p><strong>Discussion: </strong>Brainstem tuberculoma can closely mimic brainstem stroke and other mass lesions. In endemic regions, characteristic MRI/MRS findings should prompt consideration of tuberculoma even when CSF findings are normal. Early treatment may prevent the need for invasive diagnostic procedures and improve outcomes.</p><p><strong>Conclusion: </strong>Brainstem tuberculoma should be considered an important differential diagnosis in young patients presenting with crossed brainstem signs in TB-endemic regions. A combination of characteristic imaging findings and high clinical suspicion can support the early initiation of ATT with adjunctive corticosteroids, which, in this case, was associated with prompt and favorable neurological recovery.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 1","pages":"18"},"PeriodicalIF":0.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640578","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":"Severe hypocapnia-induced coma in an asthma patient: When oxygen therapy becomes a double-edged sword.","authors":"Waheeb Naser, Yavuz Yigit","doi":"10.5339/qmj.2026.17","DOIUrl":"10.5339/qmj.2026.17","url":null,"abstract":"<p><strong>Background: </strong>Acute asthma exacerbations commonly lead to hyperventilation-induced hypocapnia (low arterial CO₂ levels). While mild hypocapnia is frequent, extreme hypocapnia (PaCO₂ ≤10 mmHg) causing coma is rare. This case highlights a life-threatening instance of severe hypocapnia in an asthma patient, complicated by anxiety-related hyperventilation and management challenges related to oxygen therapy.</p><p><strong>Case presentation: </strong>A 43-year-old man with a history of bronchial asthma presented to the emergency department with flu-like symptoms and acute shortness of breath. On arrival, he was normoxic, but he subsequently developed marked hyperventilation accompanied by carpopedal spasm and a state of unresponsiveness. Arterial blood gas analysis, while on supplemental oxygen, revealed profound respiratory alkalosis, with a pH of 7.75, PaCO₂ of 10 mmHg, and PaO₂ of 237 mmHg. Management consisted of cautious oxygen titration, controlled rebreathing to gradually restore carbon dioxide levels, light sedation to alleviate hyperventilation, and correction of electrolyte imbalances. Neuroimaging excluded intracranial pathology. The patient's neurological status improved within hours, leading to complete recovery without the need for invasive mechanical ventilation.</p><p><strong>Discussion: </strong>Asthma exacerbations complicated by severe hypocapnia present a unique and often underrecognized therapeutic dilemma. Although oxygen is essential to prevent hypoxemia, excessive administration may further lower PaCO₂, exacerbate cerebral vasoconstriction, and impair perfusion. Anxiety-related hyperventilation can further amplify these effects, potentially leading to transient cerebral dysfunction. Prompt recognition of extreme hypocapnia, careful modulation of oxygen delivery, and physiologically guided ventilation are essential to restore cerebral and systemic homeostasis.</p><p><strong>Conclusion: </strong>This case emphasizes the need to recognize extreme hypocapnia as a potential cause of coma in asthma exacerbations, especially when anxiety-driven hyperventilation is involved. With timely supportive care and careful ventilatory management, balancing oxygen therapy and CO₂ control, full neurological recovery and clinical stability were achieved.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 1","pages":"17"},"PeriodicalIF":0.0,"publicationDate":"2026-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640664","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":"Unexpected course of urethroplasty in patient with penile prosthesis.","authors":"Ibrahim Alnadhari, Muammer Alshrani, Nabil Moohialdin, Abdelrahman Mohamed, Omar Ali, Osama Abdeljaleel, Ahmad Shamsodini","doi":"10.5339/qmj.2026.16","DOIUrl":"10.5339/qmj.2026.16","url":null,"abstract":"<p><strong>Introduction: </strong>Urethral stricture disease is a complex and debilitating condition that significantly impairs urinary function and quality of life. Urethroplasty remains the gold-standard treatment, especially for complex, long-segment, or recurrent strictures. However, performing urethroplasty in patients with penile prostheses presents unique surgical challenges due to the associated anatomical and vascular considerations.</p><p><strong>Case presentation: </strong>We report the case of a male patient with a history of penile prosthesis implantation nine years earlier who presented with a recurrent bulbar urethral stricture. The patient underwent excision and primary anastomosis (EPA) urethroplasty. Postoperatively, he developed significant urinary leakage at the anastomotic site, which was confirmed by pericatheter urethrogram, and urine culture grew extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli. The condition was managed conservatively with intravenous antibiotics and suprapubic catheter placement, resulting in resolution of the leakage and preservation of prosthesis function.</p><p><strong>Discussion: </strong>This case highlights the interplay between urethral vascular compromise and the presence of a penile prosthesis, both of which can increase the risk of complications following urethroplasty. Infection, impaired healing, and altered anatomy contribute to the complexity of surgical management. Although the urethral stricture was amenable to EPA, the healing process was likely adversely affected by local infection and compromised blood supply.</p><p><strong>Conclusion: </strong>Urethroplasty in patients with a penile prosthesis requires a tailored approach that accounts for altered anatomy and vascularity. In this case, the EPA was complicated by infection and urine leakage; however, conservative management resulted in successful healing, restoration of urinary flow, and preservation of prosthesis function. This case highlights the importance of careful surgical planning and flexible postoperative care.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 1","pages":"16"},"PeriodicalIF":0.0,"publicationDate":"2026-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13018920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640592","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":"Acral metastasis of colonic cancer: A case report.","authors":"Haya Alkuwari, Alyaa Al-Wuhaili, Noora Al-Sulaiti, Hisham Osman, Rafif Mahmood Al Saady","doi":"10.5339/qmj.2026.15","DOIUrl":"10.5339/qmj.2026.15","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) is the third most common malignancy worldwide and accounts for 9.4% of all cancer-related deaths, making it the second leading cause of cancer mortality. Approximately 70% of patients develop metastatic disease, most commonly to the liver and lungs. Acral metastasis, particularly to the digits, is extremely rare and usually indicates advanced disease with a poor prognosis.</p><p><strong>Case presentation: </strong>We report a rare case of digital acrometastasis from colorectal adenocarcinoma in a 55-year-old male. The patient presented with a painful lesion on his right index finger, characterized by discoloration, a wound cavity, and granulation tissue at the fingertip. The patient had a prior history of treated colon cancer and was receiving immunotherapy. He underwent wedge excision and nail avulsion of the affected finger. Histopathological examination confirmed metastatic adenocarcinoma with an immunohistochemical profile consistent with colorectal origin. The patient was referred to the National Center for Cancer Care and Research (NCCCR); however, no follow-up information was available, as he did not return for further evaluation.</p><p><strong>Discussion: </strong>Bone metastasis from CRC is uncommon, and acrometastasis to the digits occurs in only 0.007-0.2% of cases. The differential diagnosis of digital lesions can be challenging and should include both benign and malignant conditions. Immunohistochemical staining is crucial for diagnosis, and with metastatic CRC typically expressing cytokeratin 20 (CK20) and caudal type homeobox (CDX2), it helps distinguish it from primary digital adenocarcinomas. Clinicians should consider acrometastasis in patients with a history of CRC who present with unexplained digital lesions.</p><p><strong>Conclusion: </strong>This case underscores the rare potential of CRC to metastasize to acral regions, including the distal phalanges. Clinicians should maintain a high index of suspicion for metastatic disease when evaluating digital lesions in patients with a history of malignancy, as timely diagnosis and management are essential for optimizing patient outcomes.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 1","pages":"15"},"PeriodicalIF":0.0,"publicationDate":"2026-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640483","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":"Bypassing pleural aspiration for early tissue diagnosis in suspected pleural malignancy: Development and external validation of a predictive model using supervised machine learning.","authors":"Adhnan Omar, Artemio Gonzales, Alina Ionescu","doi":"10.5339/qmj.2026.14","DOIUrl":"10.5339/qmj.2026.14","url":null,"abstract":"<p><strong>Background and objective: </strong>The conventional diagnostic pathway for pleural malignancy involves pleural aspiration, often followed by tissue biopsy. However, pleural aspiration has limited sensitivity, which can potentially delay a definitive diagnosis. The objective of this study was to develop and externally validate a predictive model using clinical data to identify patients who could safely bypass pleural aspiration and proceed directly to tissue biopsy.</p><p><strong>Methods: </strong>This was a retrospective cohort study of patients presenting to an acute hospital in the UK with suspected pleural malignancy between 2016 and 2025 (n = 646). A Random Forest classifier was trained on this dataset, and its performance was evaluated using an independent external validation cohort from another acute hospital in the UK (<i>n</i> = 32). Model performance was assessed using standard metrics, including accuracy, precision, recall, F1-score, and the area under the receiver operating characteristic curve (ROC-AUC).</p><p><strong>Results: </strong>The model demonstrated robust performance in the internal dataset and maintained its predictive strength during external validation (AUC: 0.86 vs. 0.83; precision 87% vs. 85%; recall 79% vs. 75%). Among the variables, computed tomography findings were the most influential predictor, as quantified by Gini importance. A simplified scoring system was subsequently derived for potential bedside clinical application.</p><p><strong>Conclusion: </strong>This externally validated model provides a valuable decision-support tool for clinicians, facilitating earlier tissue diagnosis in patients with suspected pleural malignancy. By potentially avoiding non-diagnostic aspiration, the model can streamline the diagnostic pathway and expedite patient care. Successful external validation enhances confidence in the model's generalizability and supports its potential for implementation into routine clinical practice.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 1","pages":"14"},"PeriodicalIF":0.0,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640596","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":"Comparison of <i>N</i>-butylcyanoacrylate glue and sutures for closure of inguinal skin incision after hernioplasty.","authors":"Nandkishor D Shinde, Afia Kausar, Anup S Desai","doi":"10.5339/qmj.2026.12","DOIUrl":"10.5339/qmj.2026.12","url":null,"abstract":"<p><strong>Background: </strong>Skin closure techniques in inguinal hernia surgery significantly influence postoperative outcomes, including pain, healing, scar formation, and patient satisfaction. The aim of this study is to evaluate the efficacy of <i>N</i>-butyl-2-cyanoacrylate tissue adhesive as an alternative to conventional sutures for skin closure in inguinal hernia surgeries.</p><p><strong>Methods: </strong>A prospective cross-sectional study was conducted at a tertiary care center from November 2023 to October 2025. Seventy patients aged 18-60 years undergoing inguinal hernia repair were randomly assigned to two groups: Group 1 (sutures) and Group 2 (tissue adhesive). Exclusion criteria included recurrent or strangulated hernia, allergies to cyanoacrylate/formaldehyde, and immunocompromised states. Outcomes assessed included pain (VAS), wound healing (Hollander score), scar quality (Vancouver Scar Scale and Visual Analogue Scar Scale), complications, and satisfaction scores.</p><p><strong>Results: </strong>Group 2 showed significantly lower pain scores at early postoperative intervals (<i>p</i> < 0.05), shorter wound closure time (8.8 ± 1.4 min vs. 11.7 ± 2.6 min; <i>p</i> = 0.000), and reduced hospital stay (1.9 ± 0.8 days vs. 3.5 ± 1.6 days; <i>p</i> = 0.000). No infections were reported in either group. Chronic pain at 30 days was less frequent in Group 2 (<i>p</i> = 0.046). Wound healing and scar scores favored Group 2 on days 7 and 30 (<i>p</i> < 0.05). Patient satisfaction was higher in Group 2 across all follow-up visits, while surgeons preferred sutures (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong><i>N</i>-Butyl-2-cyanoacrylate tissue adhesive offers superior early postoperative outcomes and higher patient satisfaction compared to sutures, although surgeons reported greater satisfaction with traditional methods. Tissue adhesive is a viable alternative for skin closure in inguinal hernia surgeries.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 1","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640579","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 retrospective evaluation of clinical outcomes in the use of inhaled nitric oxide in acute respiratory distress syndrome caused by COVID-19: The NITRICOVID study.","authors":"Mohamed Zuhail Kizhakka Peediyakkal, Muna A Rahman Al Maslamani, Nevin Kannappilly, Saifil Sidhique, Mohamed Aboukamar, Sreekanth Komath Mohan, Jintu Iype, Virendra Pratap Chaudhary, Ashib Thurakkal, Karimulla Shakeer Shaik, Solaiman Allafi, Abdulqadir Nashwan, Nabeel F Suleiman Al LObaney","doi":"10.5339/qmj.2026.13","DOIUrl":"10.5339/qmj.2026.13","url":null,"abstract":"<p><strong>Background: </strong>Acute respiratory distress syndrome (ARDS) remains a leading cause of mortality among critically ill patients with COVID-19. Inhaled nitric oxide (iNO), a selective pulmonary vasodilator, is often used as rescue therapy to improve oxygenation; however, its impact on survival remains uncertain.</p><p><strong>Objective: </strong>To evaluate the clinical outcomes of iNO therapy in patients with COVID-19-related ARDS and to stratify patients into Early, Delayed, and Non-Responder groups based on the timing of their oxygenation response.</p><p><strong>Methods: </strong>A retrospective cohort study of 99 patients with COVID-19-related ARDS who received iNO was conducted. Patients were categorized as.</p><p><strong>Early responders: </strong>≥20% improvement in the PaO₂/FiO₂ ratio within 8 h.</p><p><strong>Delayed responders: </strong>≥20% improvement in the PaO₂/FiO₂ ratio between 8 and 24 h.</p><p><strong>Non-responders no improvement: </strong><20% improvement in the PaO₂/FiO₂ ratio within 24 h, including those who showed in their PaO₂/FiO₂ ratio within 24 h of iNO initiation.Baseline demographics, comorbidities, and outcomes, including duration of mechanical ventilation, ICU and hospital length of stay, and mortality, were compared.</p><p><strong>Results: </strong>Early and Delayed Responders showed significant improvement in oxygenation (mean PaO₂/FiO₂: 137.3 vs. 126.9 vs. 106.4; <i>p</i> = 0.004), with mean percentage increases of 65.3%, 56.6%, and 8.2%, respectively (<i>p</i> < 0.001). However, this did not translate into differences in ICU mortality (64.8%, 62.5%, and 71.4%, respectively; <i>p</i> = 0.81) or other hospital outcomes. Rates of acute kidney injury (AKI), methemoglobinemia, and other complications were comparable among the groups.</p><p><strong>Conclusion: </strong>iNO improved oxygenation in a subset of patients with COVID-19-related ARDS but did not reduce mortality. Stratification by timing of response highlights patient heterogeneity and supports response-guided, time-limited use of iNO in critical care.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 1","pages":"13"},"PeriodicalIF":0.0,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640488","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 influence of ABCB1 rs4148738 (C>T) polymorphism on rivaroxaban exposure and bleeding risk in Iraqi patients with non-valvular atrial fibrillation.","authors":"Haider Khudhair Jalel, Mazin Ouda Hamid, Mohammed Hamzah Ibadi","doi":"10.5339/qmj.2026.10","DOIUrl":"10.5339/qmj.2026.10","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is a common arrhythmia linked to thromboembolic risks. Rivaroxaban, a direct oral anticoagulant, prevents strokes in non-valvular AF (NVAF) patients. However, the role of genetics in its pharmacokinetics and outcomes remains unclear.</p><p><strong>Aim of study: </strong>To explore the link between the ABCB1 (rs4148738 C>T) polymorphism, rivaroxaban steady-state plasma levels, and the occurrence of bleeding events in AF patients.Patients and methods: This cross-sectional study examines patients with AF treated with rivaroxaban anticoagulation from September 2024 to March 2025. We gathered clinical data covering demographics, comorbidities, and treatment adherence. Biochemical tests assessed renal function (serum creatinine and urea), and the steady-state plasma concentrations of rivaroxaban were determined via high-performance liquid chromatography. Genotyping was conducted using allele-specific polymerase chain reaction.</p><p><strong>Results: </strong>The study enrolled 100 participants (45 males, 55 females), most aged >46 years, with an obesity prevalence of 52%. The genotype distribution was noted as 26% CC, 39% CT, and 35% TT. Plasma levels of rivaroxaban were significantly lower in homozygous mutants (TT) compared to wild-type genotypes (<i>P</i> = 0.001). The rs4148738 polymorphism was associated with bleeding events, all of which occurred in CT carriers. This observation should be considered preliminary due to the limited sample size.</p><p><strong>Conclusion: </strong>The ABCB1 rs4148738 polymorphism influences rivaroxaban plasma levels in NVAF patients and shows a potential link to bleeding risk.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 1","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640594","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":"Systemic lupus erythematosus: Auditing standard of care in Qatar.","authors":"Mohamad Safieh, Abdul-Wahab Al-Allaf","doi":"10.5339/qmj.2026.9","DOIUrl":"10.5339/qmj.2026.9","url":null,"abstract":"<p><strong>Background: </strong>Systemic lupus erythematosus (SLE) is a complex autoimmune disease with heterogeneous clinical presentations influenced by ethnicity, geography, and healthcare practices. This audit evaluated adherence to key quality indicators for SLE management at Hamad General Hospital (HGH), a major public tertiary care center in Doha, Qatar, in line with international standards.</p><p><strong>Methods: </strong>A retrospective cross-sectional audit was conducted between March and July 2024 involving 61 patients with SLE attending the rheumatology clinic at HGH. This audit assessed adherence to four selected key quality indicators: hydroxychloroquine (HCQ) use, annual proteinuria screening, annual ophthalmologic screening for HCQ-related retinopathy, and medication reconciliation documentation during the most recent clinic visit.</p><p><strong>Results: </strong>All patients were initiated on HCQ, with 11.5% discontinuing it due to adverse effects. Annual proteinuria screening was completed in 95% of patients. Ophthalmologic screening for HCQ-related retinopathy was documented in 65%, and medication reconciliation was completed in 72% of cases. The cohort represented a total of 21 nationalities, including Qataris who accounted for 31%-a proportion higher than their estimated 11.6% representation in Qatar's national population.</p><p><strong>Conclusion: </strong>While adherence to HCQ initiation and renal monitoring met international benchmarks, ophthalmologic screening and medication reconciliation rates were suboptimal and required improvement. Targeted system-level and educational interventions are planned to enhance adherence to these standards. Re-audit following implementation will be essential to assess progress and to sustain the quality of care.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 1","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640584","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":"Malignant mesothelioma in the State of Qatar: A clinico-epidemiological study.","authors":"Wanis H Ibrahim, Nuha Fituri, Nadin H Abouzeid, Saif Addeen Khasawneh, Mohamed Elgara, Musa Hussein, Issam A Bozom, Reyad Mohsen, Hafedh Ghazouani","doi":"10.5339/qmj.2026.7","DOIUrl":"10.5339/qmj.2026.7","url":null,"abstract":"<p><strong>Background: </strong>Malignant mesothelioma (MM) is a potentially fatal cancer that originates from the mesothelial surfaces, predominantly the pleura. Asbestos is the principal risk factor with a long latency period between exposure and disease development. The objective of this study was to investigate the clinical and epidemiological characteristics of MM in the State of Qatar.</p><p><strong>Methodology: </strong>This was a retrospective cohort study of all MM cases diagnosed in the State of Qatar during the period from January 1, 2015, to December 31, 2023. MM cases were identified from the Qatari National Cancer Registry Database and the Hamad Medical Corporation (HMC) Histopathology Database. Demographic, clinical, laboratory, radiologic, and survival data were collected from these two databases.</p><p><strong>Results: </strong>Among the total 22 MM cases diagnosed during the study period, migrant Egyptians constituted 15/22 (68.2%). The mean age for the study population was 57.9 ± 9.2 years with an age-standardized incidence rate of 24.1 cases per 1,000,000 individuals per year. The epithelioid histologic type was the predominant type (16/19; 84.2%), and most patients (13/14; 92.9%) were diagnosed at an advanced disease stage. The median overall survival (OS) was 16 months. The 1-year OS rate was 60.67%, dropping to 20.22% over 3 years. Though the differences were not statistically significant, patients with epithelioid histology and those with left-sided tumors experienced better OS outcomes.</p><p><strong>Conclusion: </strong>MM is predominantly a cancer of Egyptian migrants in the State of Qatar, with a comparable incidence to the international rates. Epithelioid histologic type is the most common type in the State of Qatar, and the majority of patients are diagnosed at an advanced disease stage. Despite a better OS rate compared to other countries, the prognosis of MM remains grave.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 1","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476169","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}