Qatar Medical Journal最新文献

{"title":"Clinical characteristics and outcomes of adult patients admitted to acute care settings for alcohol withdrawal syndrome.","authors":"Aram Salehi, Manish Barman, Memon Noor Illahi, Bassem Naif Altaleb Alhariri, Abdulqadir J Nashwan, Kalpana Singh","doi":"10.5339/qmj.2026.6","DOIUrl":"10.5339/qmj.2026.6","url":null,"abstract":"<p><strong>Background: </strong>Alcohol consumption is associated with significant morbidities such as liver disease, cardiovascular issues, and mental health disorders like depression and anxiety. Addressing acute alcohol withdrawal syndrome (AWS) effectively is essential to improving the health outcomes of individuals with alcohol use disorders. This study aims to evaluate AWS management practices and outcomes, with a focus on symptom severity, treatment protocols, and factors associated with prolonged or complicated hospital stays.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed medical records of patients admitted to Hazm Mebaireek General Hospital (HMGH) with AWS between November 1, 2018, and October 31, 2021. Parameters assessed included demographic details, symptom severity using scales like Cushman's and SOFA, benzodiazepine treatment protocols, and outcomes such as length of stay, ICU admissions, and mortality.</p><p><strong>Results: </strong>A total of 98 male patients were included, with a mean age of 39.9 ± 9.7 years. Among these, 51% were Indian nationals, followed by Nepalese (33%). Symptoms ranged from nausea (33%) to agitation (36%) and tremors (67%). Severity levels of AWS varied, with 59% experiencing mild symptoms, 34% moderate, and 7% severe. Fixed-dose and symptom-triggered benzodiazepine regimens were applied inconsistently, often deviating from recommended guidelines. Complications included seizures in 14% of cases and ICU admissions in 4%. The average hospital stay was 4.7 ± 5.1 days.</p><p><strong>Conclusion: </strong>AWS predominantly affects young males, with a significant burden on healthcare resources. Treatment strategies often diverged from international guidelines, emphasizing the need for standardized protocols to improve care quality and reduce variability in outcomes.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476197","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":"Potentially inappropriate medications and regimen complexity among elderly patients in the emergency department: Insights from a pharmacist-led medication reconciliation study.","authors":"Sarah Mousavi, Mohammad Hossein Jabbary Diziche","doi":"10.5339/qmj.2026.8","DOIUrl":"10.5339/qmj.2026.8","url":null,"abstract":"<p><strong>Background: </strong>Polypharmacy and potentially inappropriate medications (PIMs) exposure are common in older adults, especially in emergency departments (EDs) with rapid decisions and incomplete histories. Pharmacist-led medication reconciliation improves safety but is rarely implemented in Iran.</p><p><strong>Objective: </strong>This study aimed to evaluate the prevalence and patterns of PIM use, medication regimen complexity, and associated factors among elderly patients admitted to the ED.</p><p><strong>Methodology: </strong>This cross-sectional study of patients aged 65+ years at Alzahra Hospital (October 2023-March 2024) involved medication reconciliation by pharmacy students under supervision. PIMs were identified using the 2023 American Geriatrics Society (AGS) Beers Criteria. Medication complexity and comorbidities were assessed via Medication Regimen Complexity Index (MRCI) and Charlson Comorbidity Index (CCI), with results analyzed through regression.</p><p><strong>Results: </strong>A total of 200 patients were included (mean age 78.1 ± 7.8 years; males: 109, 54.5%). Polypharmacy was observed in 104 patients (52%). The mean MRCI was 23.8 ± 13.5, and the mean CCI was 2.3 ± 1.6. PIM exposure was identified in 75 patients (37.5%), with 221 PIM prescriptions. The most frequent PIM classes were benzodiazepines (49/221, 22.2%), atypical antipsychotics (28/221, 12.7%), opioids (24/221, 10.9%), and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs: 18/221, 8.1%). Clinically significant drug-drug interactions occurred in 30 patients (15%). Female sex, mild comorbidity (CCI, 1-2), and higher MRCI independently predicted PIM use.</p><p><strong>Conclusions: </strong>PIM exposure was frequent among elderly ED patients. Pharmacist-led medication reconciliation effectively identified inappropriate prescribing and complex regimens, supporting the integration of clinical pharmacists into emergency care to improve geriatric medication safety.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 1","pages":"8"},"PeriodicalIF":0.0,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476219","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 perceived competency and attitude of emergency nurses towards the patients boarding in ED with psychiatric illness: A cross-sectional study in Qatar.","authors":"Nesiya Hassan, Hashem A R Mestarihi, Ameneh Ahmad Zadeh, Bejoy Chacko, Grethel Dela Paz, Rajvir Singh","doi":"10.5339/qmj.2026.1","DOIUrl":"10.5339/qmj.2026.1","url":null,"abstract":"<p><strong>Introduction: </strong>The boarding of patients with psychiatric illnesses in the Emergency Department (ED) has become a prevalent issue across the world, posing significant challenges for healthcare providers.</p><p><strong>Objectives: </strong>This study aimed to assess the perceived competency and attitude of emergency nurses toward the care of patients boarding with psychiatric illnesses.</p><p><strong>Methodology: </strong>This was a prospective cross-sectional research study used to recruit emergency nurses working in four selected facilities under the organization. The study utilized a validated questionnaire, the Opening Minds Scale for Health Care Providers (OMS-HC-15) and Behavioral Health Care Competency (BHCC) to collect the information from the participants through an online survey using a total enumerative sampling method. Frequency and percentage were used to find the demographic characteristics of the participants. ANOVA and t-tests were used to find out the association between the attitudes, competencies, and demographic profile of the participants.</p><p><strong>Results: </strong>Three hundred and ten completed responses from the participants were used for analysis. Most participants were in the 31 to 40 years age group (72.26%; <i>n</i> = 224), with a mean age of 42 years, which ranged from 26 to 56 years. Males (<i>n</i> = 183) participated more compared to females (<i>n</i> = 127), and 85.16% (<i>n</i> = 264) of them have Bachelor's degrees in nursing. 40% (<i>n</i> = 124) of the participants have more than 10 years of experience in ED. The mean percentage scores of attitude and competency domains were -14.16 ± 36.26 and 35.07 ± 25.73, respectively. The competency domain showed a statistically significant correlation with the participants' age (P = 0.038) and their facility (P = 0.014). In contrast, attitude did not exhibit statistical significance with any demographic variables.</p><p><strong>Conclusion: </strong>The emerging data from the current study stated that the attitudes of ED nurses were predominantly positive; however, their perceived competency was falling below average. This highlights the need to improve their competency to strengthen the current practice, the quality of care, and the overall experiences of psychiatric patients in the ED.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476329","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":"Geographic and age-specific trends in vaccine-preventable diseases in Qatar: A primary health care-based study (2021-2024).","authors":"Ahmad Omar Haj Bakri, Mohamed Ghaith Al-Kuwari, Aiman Ali Mohamed Elbourdiny, Maha Hammam M A Al-Shamali, Hamad Eid H R Al-Romaihi","doi":"10.5339/qmj.2026.4","DOIUrl":"10.5339/qmj.2026.4","url":null,"abstract":"<p><strong>Background: </strong>Vaccine-preventable diseases (VPDs) remain a public-health concern in Qatar despite high immunization coverage. Frequent population movement and incomplete vaccination records may lead to susceptibility clusters and under-reporting. These dynamics underline the need for sustained surveillance and targeted immunization strategies. This study aims to assess the influence of geographical variation and age-specific demographics on VPD incidence among the Primary Health Care Corporation (PHCC)-registered population in Qatar to inform immunization planning and address emerging gaps.</p><p><strong>Methods: </strong>A retrospective analysis of Qatar's Ministry of Public Health surveillance data (2021-2024), supplemented by PHCC medical records, examined annual incidence rates of VPDs by age group and region. Cases included acute flaccid paralysis, chickenpox, mumps, measles, pertussis, rotavirus, and meningitis due to viral, <i>Haemophilus influenzae</i>, <i>Streptococcus pneumoniae</i>, <i>Neisseria meningitidis</i>, and bacterial non-meningococcal pathogens.</p><p><strong>Results: </strong>Between 2021 and 2024, 5136 confirmed VPD cases were reported among PHCC-registered individuals. Chickenpox was most frequent, peaking in 2023 (1398 cases). Incidence was highest in children under 5 years old, particularly infants, for chickenpox (145.75/100,000), measles (66.35), pertussis (59.95), and rotavirus (47.61). Viral meningitis was concentrated in infants, with the Western region recording the highest rate (70.02). Regionally, chickenpox burden was greatest in the Central region, while pertussis, rotavirus, and measles rates were highest in the Western region. No statistically significant differences were observed between regions or across study years (P > 0.05 for all comparisons).</p><p><strong>Conclusion: </strong>Age-specific disparities in VPD incidence were noted in Qatar, with the highest burden among children under 5 years and in the Western region. Chickenpox was the most reported disease, followed by pertussis, rotavirus, and viral meningitis. No statistically significant differences were observed between regions, suggesting equitable immunization delivery across PHCC. These findings highlight the need to sustain high vaccination coverage, enhance parent-focused health education, strengthen surveillance to detect immunity gaps, and improve data linkage across PHCC, private providers, and national surveillance systems.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 1","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476175","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":"Correlation of mRENAL score with clinical outcomes after CT-guided renal cell carcinoma cryoablation: A retrospective observational study.","authors":"Mohammad Elhissi, Eiman Musa, Yaman M Alahmad, Aminah Alaani, Ahmed Omar, Ayman Elmajdoub, Khalid Al-Rumaihi, Husain Alturkistani, Mohamad Alhoda Mohamad Alahmad, Ali Barah","doi":"10.5339/qmj.2026.2","DOIUrl":"10.5339/qmj.2026.2","url":null,"abstract":"<p><strong>Background and objective: </strong>CT-guided cryoablation (CRA) has emerged as a safe and effective minimally invasive treatment for renal cell carcinoma (RCC), though outcomes can vary. The mRENAL score may help to predict clinical outcomes. The main objective of this study was to evaluate the correlation between mRENAL score and clinical outcomes in RCC cases treated by CT-CRA.</p><p><strong>Methodology: </strong>This was an observational, retrospective, single-center study that included CT-CRA procedures performed on RCCs between 2017 and 2023. Tumors were classified into three categories based on the mRENAL score: low, intermediate, and high risk. We employed the Firth logistic regression for multivariate analysis due to the small sample size and rare outcome events.</p><p><strong>Results: </strong>Our data included 53 cases, with a mean age of 53 ± 12 years. Technical success was achieved in all cases. Four cases had disease recurrence at the site of previously treated RCC (4/42, 9.5%), as 11 cases lost follow-up imaging. The Firth logistic regression analysis revealed that increasing mRENAL score was associated with a higher risk of recurrence (adjusted odds ratio = 0.42 [95% CI, 0.19-0.95]; <i>P</i> = 0.038). This trend towards statistical significance implies that for every 1-point increase in mRENAL score, the odds of clinical success decrease by at least 5% with over 95% confidence. No procedure-related mortality was observed.</p><p><strong>Conclusion: </strong>Our analysis demonstrates that the mRENAL score may help predict clinical outcomes, with lower mRENAL scores associated with higher clinical success rates following CT-CRA of RCC.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 1","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476257","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 impact of neoadjuvant chemotherapy on immunohistochemistry and molecular subtype in breast cancer: A retrospective analysis from Oman.","authors":"Mustafa Talib Al-Ani, Asila Rashid Al Ismaili, Nahad Al-Mahrouqi, Hasan Al-Sayegh, Khalid Al Baimani, Hind Saif Ali Alshahi, Arti Trehan, Zaid Al-Ishaq, Marwa Youssef, Asma Naaz Nadaf, Adil Aljarrah Alajmi","doi":"10.5339/qmj.2026.3","DOIUrl":"10.5339/qmj.2026.3","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant chemotherapy (NACT) is used in breast cancer (BC) to downsize and downstage the tumor before surgery. Different studies were conducted looking into the alterations in the immunohistochemistry after NACT, which may alter the adjuvant treatment. Our study aimed to assess the changes in immunohistochemistry biomarker status (estrogen receptor [ER], progesterone receptor [PR], and human epidermal growth factor receptor 2 [HER2]) in BC cells after administration of NACT at a single institution in Oman.</p><p><strong>Methods: </strong>We conducted a retrospective cross-sectional study on patients with BC with residual disease post-NACT in a single institution and studied immunohistochemistry status changes before and after NACT. We used the McNemar test to evaluate the receptor changes, and logistic regression to assess the effect of risk factors on receptor status change.</p><p><strong>Results: </strong>All biomarkers changed after NACT, with a tendency for BC cells to lose PR and HER2 expression and gain ER expression. The immunohistochemistry changes were 36/114 (31.6%) in PR, 7/114 (6.1%) in ER, and 11/114 (9.6%) in HER2. BC subtypes changed in 4/114 (3.5%) of HER2+ve, 10/114 (8.8%) of hormone positive (ER or PR) with HER2 overexpression (HER2+ve/HR+ve), 3/114 (2.6%) in hormone positive with HER2 negative (HR+ve), and 3/114 (2.6%) triple-negative BCs. These changes resulted in adjuvant treatment adjustments in 9/110 (8.18%) patients with residual disease.</p><p><strong>Conclusion: </strong>Changes in the expression of all immunohistochemistry biomarkers and BC subtypes occurred after NACT, which led to changes in adjuvant treatment in specific cases.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 1","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476311","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 prospective, randomised trial comparing the quality of recovery between full inhalation anaesthesia and total intravenous anaesthesia post gynaecological surgery.","authors":"Purtishil Junghare, Bisman Jeet Kaur Khurana, Hazarika Amarjyoti, Meena Shyam Charan, Naik Naveen, Arora Ashima, Bora Girdhar","doi":"10.5339/qmj.2026.5","DOIUrl":"10.5339/qmj.2026.5","url":null,"abstract":"<p><strong>Background: </strong>Assessing the quality of recovery (QOR) after open gynaecological surgery done under general anaesthesia (GA) is one of the methods to evaluate anaesthesia outcomes effectively. GA can be administered as full inhalation anaesthesia (FIA) and/or total intravenous anaesthesia (TIVA). Studies have not compared QOR between TIVA and FIA in this cohort. Our study aims to compare the effect of TIVA and FIA on postoperative recovery of patients assessed by the Quality of Recovery-40 (QOR-40) questionnaire.</p><p><strong>Methods: </strong>One hundred and eight consenting adult patients posted for open gynaecological surgeries under GA were randomly allocated to Sevoflurane-based full inhalation anaesthesia (Group FIA) or propofol-based TIVA (Group TIVA). The primary outcome was comparing the QOR-40 score on the first postoperative day (POD1). Comparing QOR-40 on POD2, extubation time, and Modified Observer's Assessment of Alertness/Sedation Scale (MOAA/S) score after extubation were the secondary outcomes. Epidural analgesia was provided throughout the study period in both groups.</p><p><strong>Results: </strong>The mean QOR-40 score in group FIA was not significantly different from that in group TIVA (171.44 ± 7.43 vs. 171.37 ± 7.48; <i>P</i> = 0.951). However, within the group, there was a significant reduction in scores in POD1 (<i>P</i> < 0.001) and POD2 (<i>P</i> < 0.001) from pre-operative values. There was no significant difference in extubation time (<i>P</i> = 0.207) and MOAA/S score (<i>P</i> = 0.548) between the groups.</p><p><strong>Conclusion: </strong>Our study found no significant difference in QOR-40 score, extubation time, and MOAA/S score between group FIA and TIVA.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2026 1","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476189","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":"Challenging case of bacterial meningitis due to <i>Moraxella</i> osloensis diagnosed by 16s rRNA sequencing.","authors":"Sreethish Sasi, Manal Hamed, Faiha Eltayeb, Andrez Perez-Lopez, Muna Al-Maslamani, Mohamed Abukhattab","doi":"10.5339/qmj.2025.122","DOIUrl":"10.5339/qmj.2025.122","url":null,"abstract":"<p><strong>Introduction: </strong><i>Moraxella</i> osloensis is a rare, Gram-negative, oxidase-positive coccobacillus that is infrequently identified as a pathogen in clinical diseases. It is usually opportunistic and associated with an immunocompromised host or the presence of invasive medical devices. Central nervous system infections caused by <i>M. osloensis</i> are extremely uncommon, with only a few cases documented in the literature.</p><p><strong>Case presentation: </strong>We report the case of a 49-year-old female from Cameroon with a history of diabetes mellitus and osteoarthritis who presented in Qatar with a 10-day history of headache, fever, and vomiting. Her condition progressed to confusion and persistent fever. Cerebrospinal fluid (CSF) analysis revealed purulent leukocytosis with elevated protein and glucose levels, but cultures and Gram stain were negative-findings atypical for bacterial meningitis. Empirical treatment with ceftriaxone and acyclovir was initiated. Definitive identification of <i>M. osloensis</i> was achieved via 16S rRNA sequencing of the CSF. The patient received two weeks of targeted ceftriaxone therapy, resulting in clinical improvement and full recovery by Day 17 of hospitalization.</p><p><strong>Discussion: </strong>This case highlights the diagnostic challenges associated with atypical presentations of meningitis and underscores the limitations of conventional microbiological methods in detecting rare pathogens. <i>M. osloensis</i> may not be isolated by routine culture and is frequently misidentified. Molecular diagnostic techniques, such as 16S rRNA sequencing, play a crucial role in achieving accurate identification. Given the organism's potential for resistance and its association with invasive infections, prompt recognition and appropriate therapy are essential.</p><p><strong>Conclusion: </strong><i>M. osloensis</i> is a rare yet potentially serious cause of bacterial meningitis, particularly in immunocompromised patients. Molecular diagnostic techniques are indispensable for confirming the pathogen in culture-negative cases. Timely diagnosis and appropriate treatment can lead to favorable outcomes, as demonstrated in this report.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2025 4","pages":"122"},"PeriodicalIF":0.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13014855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640383","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":"Renal recovery after acute kidney injury requiring dialysis: Predictors and long-term outcomes.","authors":"Mostafa Elshirbeny, Mohamed Amin, Rasha Abdulrahman, Tarek Ghonimi, Iman Khater, Ayman Al-Dahshan, Abdullah Hamad, Fadwa Al-Ali, Hassan Almalki, Mohamad Alkadi","doi":"10.5339/qmj.2025.124","DOIUrl":"10.5339/qmj.2025.124","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury requiring dialysis (AKI-D) is a severe medical condition that is common and associated with a high rate of morbidity and mortality. Identifying predictors of kidney recovery in patients with AKI-D might lead to better care and improved kidney and patient survival. This study aims to assess the long-term clinical outcomes of patients who had AKI-D during their hospitalization and remained on dialysis at discharge and identify predictors of renal recovery after discharge.</p><p><strong>Methods: </strong>We retrospectively studied adult patients hospitalized between January 2016 and December 2022 who had AKI-D during their hospitalization and continued receiving dialysis after discharge. Patients who had less than three months of follow-up, underwent kidney transplantation, or died within three months of dialysis initiation were excluded from the study.</p><p><strong>Results: </strong>Of the 64 patients in the study, 20 (31%) achieved renal recovery, while 44 (69%) remained dialysis dependent. The average time to renal recovery was 93 ± 61 days. Recovered AKI-D patients had significantly lower baseline and average weekly predialysis serum creatinine after discharge and significantly higher intensive care unit admission, length of hospital stay, vasopressor use, and number of dialysis sessions than non-recovered patients. Using multivariate analysis, we identified vasopressor use as the only independent predictor of renal recovery after discharge in patients with AKI-D (odds ratio, 16.244 [95% CI, 1.22-217.17]; <i>P</i> = 0.035).</p><p><strong>Conclusion: </strong>Renal recovery after discharge can be seen in up to one-third of patients with AKI-D, even if they have advanced chronic kidney disease at baseline or require dialysis for more than three months. The chance of renal recovery is higher in patients who require vasopressor use during hospitalization. Thus, patients with AKI-D should be closely monitored after discharge, and guidelines on managing such patients need to be created.</p>","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2025 4","pages":"125"},"PeriodicalIF":0.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13014857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640398","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":"Schimke immunoosseous dysplasia (SIOD): Delayed onset of rare disease and novel variant.","authors":"Mostafa Elshirbeny, Awais Nauman, Essa Abuhelaiqa, Hassan Almalki","doi":"10.5339/qmj.2025.121","DOIUrl":"10.5339/qmj.2025.121","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Schimke immunoosseous dysplasia (SIOD) is a condition marked by spondyloepiphyseal dysplasia (SED), leading to short stature, nephropathy, and T-cell immunodeficiency.&lt;b&gt;Case presentation:&lt;/b&gt; A 15-year-old male was referred to the nephrology clinic with a gradual onset of lower-limb swelling. Clinical examination revealed short stature. Laboratory studies revealed renal impairment and nephrotic-range proteinuria. Kidney biopsy showed global sclerosis in 3 of 28 glomeruli, segmental sclerosis in 16 of 28 glomeruli, and 90% foot-process effacement on electron microscopy. A skeletal survey showed flattened thoracolumbar vertebral bodies, a characteristic feature of SIOD. Flow cytometry revealed a low CD4 count. Whole-exome sequencing confirmed that the proband was homozygous for the p.(R611C) variant in the &lt;i&gt;SMARCAL1&lt;/i&gt; gene. The patient was treated with a calcineurin inhibitor (CNI), angiotensin receptor blockers (ARBs), and prophylactic anticoagulation. Initially, he experienced improvement in serum albumin levels and proteinuria. However, his urine protein and creatinine levels subsequently increased, prompting discontinuation of CNI. The patient progressed to end-stage kidney disease (ESKD) and required hemodialysis 18 months after the initial presentation.&lt;b&gt;Discussion:&lt;/b&gt; This report describes a case of SIOD, a rare multisystem disorder characterized by short stature due to SED and nephrotic syndrome, distinguishing it from other hereditary nephrotic syndromes. The patient presented unusually in adolescence with nephrotic-range proteinuria and skeletal abnormalities, representing a rarely reported juvenile variant. Genetic testing revealed a novel homozygous &lt;i&gt;SMARCAL1&lt;/i&gt; mutation, p.(R611C), which was confirmed in his younger sibling. However, the phenotypic expression differed, reflecting the weak genotype-phenotype correlation in SIOD. Unlike many SIOD cases, our patient did not experience recurrent infections despite abnormal immune parameters, suggesting a milder immunodeficiency and making kidney transplantation with cautious immunosuppression a feasible option. Current therapeutic challenges include the lack of effective disease-specific treatments, limited success with conventional transplantation due to infection and malignancy risks, and emerging but logistically complex approaches such as combined stem-cell and kidney transplantation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;SIOD is a rare genetic disorder with variable presentation and outcomes. Our patient, carrying a novel &lt;i&gt;SMARCAL1&lt;/i&gt; mutation and presenting with juvenile-onset disease, progressed to ESKD but had only mild immune dysfunction, making kidney transplantation a potential treatment option. Early recognition is essential to avoid unnecessary treatments, guide supportive care, and enable timely referral for advanced therapies. Clinicians should consider SIOD in patients presenting with short stature and nephrotic syndrome to optimize","PeriodicalId":53667,"journal":{"name":"Qatar Medical Journal","volume":"2025 4","pages":"121"},"PeriodicalIF":0.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13014858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640520","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}