Qatar Medical Journal - Volume 2025, Issue 3

Qatar, a small yet wealthy state on the Arabian Peninsula, has witnessed significant changes in its healthcare system over the years. This article examines the development of healthcare in Qatar, with a focus on plastic surgery services, starting from traditional medicine to becoming one of the most advanced systems in the region. Key milestones include the establishment of Hamad Medical Corporation and the Ministry of Public Health, which have played important roles in organizing and improving healthcare services, in line with Qatar National Vision 2030.

The article also highlights the growth of plastic surgery services, which began in the 1970s with limited resources and visiting specialists. Over time, these services have expanded with the recruitment of skilled surgeons and the introduction of advanced facilities. The integration of burn care, the growth of reconstructive and aesthetic procedures, and the launch of a plastic surgery residency program demonstrate Qatar’s efforts to enhance this field.

The private sector has also contributed to this progress, offering a range of services that complement the public healthcare system. These developments reflect Qatar’s commitment to providing quality healthcare and supporting the well-being of its people. This article traces the key steps in the history of healthcare and plastic surgery in Qatar, showing how they have evolved to meet the needs of the population.

Background: Biliary atresia (BA) is a lfe-threatening neonatal liver disease characterized by inflammation and obstruction of bile ducts. Identifying the most reliable and valid ultraaound (US) parameter or combination of parameters can enhance noninvasive diagnosis accuracy, potentially reducing unnecessary surgeries and treatment delays. We aimed to detect the mosi reliable and valid US parameter or combination of parameters to diagnose BA, thereby minimizing unnecessary surgical exploration or treatment delays.

Methods: We conducted a prospective cohort study on cholestatic pediatric patients. Data were nollected between January 2013 and July 2019 from the Fattouma Bourguiba University Hospital Monastir, Tun isia, in callaboration with the pediatric surgical and radiological departments. After full clinical and laboratory evaluation, abdominal ultrasonography was performed to assess the biliary structure, with three possible outcomes: BA ruled out, confirmed, or inconclusive. Accordingly, the patients were divided into group 1 (diagnosed with BA) and group 2 (diagnosed with other biliary conditions).

Results: The participants, 61 cholestatic neonates and infants,were aged 6 to 160 postnatal days (mean, 58.28 ± 34.24 days); 60.7% were male (n = 37). The gallbladder (GB) was not detected usig, US in 20 patients. BA diagnosis correlated with cord sign [X² (1, n = 61) = 53.52], GB evacuation alteration [X² (1, n = 61) = 18.41%], and hepatic artery/portal vein ratio [X² (1, n = 61) = 30.25; normal value <0.49]. A positive cord sign or the presence of alteration of evacuation indicates the possibility of BA with a 100% sensitivity and 86.2% specificity. Similarly, with the presence of evacuation alteration or porta hepatic thickness (≥2.4), the sensitivity reached 100%; however, a specificity of 86.2% was observed.

Conclusions: US parameters can detect patients with BA with approximately 100% sensitivity. However, additional research is needed to confirm negative cases. Multicenter studies are needed to verify our findings.

Background: Osteoarticular infections (OAIs) in Qatar’s pediatric population represent a significant source of morbidity, highlighting the need for a comprehensive evaluation of their clinical, microbiological, and treatment characteristics. Understanding the presentation and management of these infections is essential for optimizing patient outcomes and guiding future therapeutic approaches.

Methods: Retrospective cohort study of 62 hospitalized children with OAIs treated at Hamad Medical Corporation from 2016 to 2018.

Results: Over 2 years, 62 patients were diagnosed and treated for OAIs. Osteomyelitis emerged as the most prevalent infection type, comprising 48.4% of cases, followed by septic arthritis at 20.9% and concurrent infections at 17.7%. The cohort demonstrated a male predominance of 66.1%. The common clinical manifestations included fever (77.4%), functional limitations (82.3%), and pain (88.7%). Staphylococcus aureus was the most frequently isolated pathogen, present in 24.1% (15/62) of cases, with approximately 50% of these being methicillin-resistant Staphylococcus aureus. Among the radiological studies conducted, 75% revealed abnormal ultrasound findings, while all patients exhibited abnormal magnetic resonance imaging results (n = 53). The antibiotic regimen most frequently prescribed was clindamycin (79%), followed by the cephalosporin ceftriaxone (67.7%). The group with concurrent infections showed the longest duration of both parenteral and oral antibiotic therapy, the highest complication rates, and the longest median hospital stay of 21 days.

Conclusions: OAIs present substantial clinical challenges, marked by complex presentations and diagnostic difficulties. Staphylococcus aureus remains the predominant pathogen, with methicillin-resistant Staphylococcus aureus accounting for nearly half of the cases. Concurrent infections are linked with more severe complications and prolonged hospitalizations, though they also exhibit the highest rates of positive microbiological results.

Background: Sickness absenteeism is a significant global health concern, and understanding its causes is crucial for developing effective prevention strategies. This study aimed to identify the medical causes of sickness absenteeism among adults in Qatar, using a standardized classification scheme.

Methods: A cross-sectional analysis was conducted using data from Electronic Health Records of individuals aged 18 years or older during 2019. The study included all clinical encounters resulting in sick leave. Data were restructured to analyze individuals with sick leaves as the primary unit. A standardized classification scheme for sick leave causes was used. The study reported the relative frequency of reasons for seeking sickness leave and calculated the age and gender specific sick leave incidence rates and the reason-specific rates

Results: During the study period, 387,496 clinical encounters resulting in sick leave were identified, involving 87,738 unique individuals having at least one sick leave. A higher prevalence of sick leave was among younger adults (<25 years) and females, with females being 5.4× more likely to have at least one sick leave per year compared to males. The leading causes of sick leave included cold, cough, flu—influenza (159.9/10,000), and gastrointestinal problems (93.8/10,000). Gender differences were noted, with males experiencing more injuries and infectious diseases, while females reported more genitourinary disorders, headaches, cardiac-related problems, and blood disorders.

Conclusions: This study provides valuable insights into sickness absenteeism in Qatar, highlighting theprimary medical causes. The findings can inform the development of targeted interventions and support systems for a healthier workforce.

Background: Stillbirths (SBs) remain the largest contributor to perinatal mortality, with nearly two-thirds of SBs consistently reported as unexplained. Studies have consistently shown fetal growth restriction (FGR) as a major contributor to SB. Early detection and appropriate management are vital to reducing SB, and the Relevant Condition at Death (ReCoDe) classification utilizes customized birthweight (CBW) centiles to diagnose FGR, decreasing the proportion of SB remaining unclassified.

Methods: This was a retrospective cohort study to classify SBs using the ReCoDe classification system. A random sample of SBs above 24 weeks’ gestational age was included, and relevant clinical, laboratory, and histopathological diagnoses were extracted from medical records. The birthweights were customized according to maternal height, weight, ethnicity, parity, fetal biological sex, andgestational age at diagnosis of SB to obtain CBW centiles. FGR was defined as CBW centiles <10 percentile.

Results: The mean age of the 254 women included was 30.5 (standard deviation = 6.2) years, with 17% being <25 years and 9.1% being ≥40 years. The majority were multiparous, 12% grand multiparous. The mean body mass index at booking was 28.6 ± 5.6 kg/m2, with 31% being in the obese category (?30 kg/m2). FGR was the most common diagnosis (52%), followed by maternal diabetes (24.0%), placental abruption (16.5%), other major placental insufficiency (15.4%), lethal congenital anomalies (13.8%), and chorioamnionitis (13.8%). The most common primary diagnosis was FGR (37.0%), followed by congenital anomalies (13.8%), placental abruption (9.1%), and maternal diabetes (6.7%). FGR remained the leading primary diagnosis in non-anomalous babies (43%), with >63% with a secondary diagnosis. The most common secondary diagnosis associated with FGR was other placental insufficiency (23.4%), followed by abruption and maternal conditions. After applying the classification system, only 18 cases remained unclassified (7.1%).

Conclusions: Applying the ReCoDe classification with CBW centiles, we were able to classify most of our SBs, with only 7.1% remaining unclassified. Appropriate classification of SB is vital for understanding what went wrong, counselling bereaved families, planning future pregnancies, and improving perinatal care. Early identification of FGR will allow appropriate monitoring and timely delivery.

Background: Herpes zoster (HZ) is a secondary viral infection that results from the reactivation of latent varicella zoster virus, characterized by dermatological manifestations and neurological sequelae. The incidence of HZ increases with age and is higher among immunocompromised individuals. While the global literature extensively documents HZ disease and its impact, there is a paucity of data in regional studies. Despite the availability of vaccines, HZ poses a public health challenge, especially in regions with limited healthcare access, underscoring the need for better surveillance and management strategies globally, regionally, and nationally.

The study aims to estimate the incidence of HZ among attendees of primary healthcare facilities in the Kingdom of Bahrain, analyze the demographic distribution of patients based on age, sex, and risk factors, and gain insights into the clinical presentation and the most common complications within the local society.

Methods: This study used a retrospective cross-sectional design, targeting all patients who visited governmental healthcare facilities and were reported to have been diagnosed with HZ in 2021, according to electronic medical records. Patients were contacted via phone to collect specific information related to the episodes they experienced, while additional information was retrieved from electronic health records (EHR). Informed consent was obtained from all participants. During the calls, five patients declined to provide details about the episodes; their decision was respected, and only the information available in their EHR was used. All collected data were systematically recorded in an Excel spreadsheet for analysis.

Results: The total incidence of HZ was 59.09 per 100,000 population. The median age was 42.8 ±19 years, with a higher prevalence observed in males (53.4%). Of the study participants 79.1% were Bahrainis, 22.3% had diabetes, and 3% had other comorbidities. The most frequently reported clinical manifestations were rash (79.9%) and pain (15.8%). The trunk (30.5%), back (19.5%), and abdomen (13.9%) were the most commonly reported locations affected by HZ. Antiviral treatment was administered to 65.2% of the patients. The most commonly reported complications included post-herpetic neuralgia (6.7%) and cellulitis (4.4%).

Conclusion: Individuals in older age groups exhibit a significantly higher likelihood of developing HZ infection along with the associated post-infection complications. This finding aligns with those from other studies. It is recommended to implement interventions aimed at reducing both the incidence and morbidity of HZ, particularly targeting those at higher risk.

Background: Dysfunctions in thyroid hormones induce various effects on hematopoiesis such as anemia, changes in red blood cells (RBC) and platelet counts, as well as changes in hematological indices. The aim of the present study was to assess the association between thyroid hormone levels and hematological indices among women with thyroid dysfunction who were attending an outpatient clinic in Mosul, Iraq.

Methods: This case–control study was conducted at Al-Wafa Specialist Centre for Diabetes and Endocrine Diseases from April to July 2024. A total of 300 women participated in this study (100 with hypothyroidism, 100 with hyperthyroidism, and 100 with normal thyroid function serving as controls). The hematological indices of the three groups were analyzed and compared. Blood indices were analyzed using the Mythic-18 hematology analyzer. Ethical approval was obtained before data collection, and written consent was obtained from all participants.

Results: All RBC indices [hemoglobin (Hb), RBC count, hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC)] were significantly lower in patients with hypothyroidism compared to those in the control group (p ≤ 0.05), except for red blood cell distribution width (RDW), which was significantly higher in patients with hypothyroidism (p = 0.000).

White blood cell count was significantly lower in patient with hypothyroidism compared to those in the control group (p = 0.000). In contrast, no statistically significant differences were observed in any blood indices in patients with hyperthyroidism compared to the control group. A statistically significant negative correlation was identified between thyroid-stimulating hormone and Hb, RBC count, HCT, MCV, MCH, alongside a statistically significant positive correlation with RDW.

Conclusion: The dysfunction of thyroid hormones has an impact on blood indices. Anemia is frequently observed in patients with thyroid dysfunction, especially in cases of hypothyroidism. Variations in blood indices may indicate underlying thyroid disorders. Therefore, it is imperative not to disregard the assessment of thyroid hormones in cases of unexplained anemia or unaccounted changes in blood indices.

Objective: This study aims to evaluate the outcomes of surgical treatment in adult and pediatric patients with post-corrosive gastric outlet obstruction (GOO) in Yemen.

Patients and methods: A prospective observational study was conducted at Al-Thawra Modern General Hospital (TMGH), from January 1, 2019 to January 31, 2023. The study involved 77 patients, comprising both adults and children, who were admitted for surgical treatment of post-corrosive GOO. Data were collected from medical records, patient interviews, and follow-up visits.

Results: Among the 77 patients, 77% (n = 59) were pediatric patients and 23% (n = 18) were adults. The mean age of the cohort was 10.6 years, with an average age of 4.12 years for pediatric patients and 30.8 years for adults. The primary cause of post-corrosive GOO was the accidental ingestion of acidic substances, accounting for 97% of cases. Common symptoms at presentation included vomiting, early satiety, and weight loss. Definitive surgery was performed in one stage in 95% of patients, with Heineke–Mikulicz pyloroplasty being the most common procedure (82%) in pediatric cases, whereas gastrojejunostomy was mainly used in adults (67%). Postoperative complications occurred in 22% of patients, with vomiting, wound infection, and aspiration pneumonia being the most common. Anastomotic restriction was observed in two pediatric patients who required reoperation. The overall mortality rate was 1.3%, with one pediatric patient having succumbed. Notably, improvements in GOO symptoms were observed in 96% of patients. Pediatric patients had a longer median hospital stay (6.5 days) than adult patients (6 days).

Conclusion: Corrosive injuries, particularly in the pediatric population, pose a significant issue in Yemen due to the unsafe storage of sulfuric acid. It is recommended to conduct early surgical interventions within 4 weeks after ingestion to prevent weight loss and to reduce prolonged hospitalization. Further research and interventions are needed to prevent such injuries, improve public awareness, and regulate the sale and storage of corrosive substances.

Background: Ambulance collisions pose a significant occupational risk to personnel, patients, and the public. Despite ongoing efforts to improve safety measures, the complex nature of emergency response operations continues to pose challenges in reducing collision risks.

Objective: This study investigates the role of the dedicated Vehicle Collisions Review Panel at Hamad Medical Corporation Ambulance Service (HMCAS) in identifying, understanding, and managing risks associated with ambulance collisions.

Methods: A retrospective quantitative analysis of HMCAS ambulance collision records from 2023 was conducted using descriptive and bivariate analyses, along with supervised and unsupervised machine learning (ML) techniques – including multinomial logistic regression (MLR), decision tree (DT) analysis, association rule mining (ARM), and time series forecasting – to uncover hidden patterns, predictive insights, and future projections.

Results: A total of 131 ambulance collisions were analyzed. The majority of incidents involved emergency urban ambulances. MLR and DT achieved prediction accuracies of 41% and 35%, respectively. ARM revealed significant association between daytime incidents, normal road conditions, and the absence of patient involvement. Time series forecasting predicted a gradual increase followed by stabilization in collision incidents.

Conclusion: This study highlights the crucial role of a dedicated collision review panel in managing and mitigating ambulance collision risks. ML techniques provided evidence-based support for decision-making. Future research is needed to evaluate the long-term impacts of targeted training programs and safety protocols.

Background: The physiological changes during Ramadan in people with type 2 diabetes (T2D) are not well described in the literature. However, advances in technology have created new frontiers to understand these changes. This study aims to understand the impact of Ramadan fasting on blood glucose excursion, vital signs, and physical activities in people with T2D who are on three or more antidiabetic medications.

Methods: This prospective observational study was conducted at Hamad General Hospital, National Diabetes Centre, between February 1, 2020 and May 30, 2020 (covering three months before and including the month of Ramadan). We included people with T2D who were on three or more antidiabetic medications. Medications were adjusted during Ramadan based on international guidelines. Flash glucose monitoring and Fitbit devices were used to monitor glucose levels and physical activity. The primary outcomes were changes in time in range (TIR), time above range (TAR), and time below range (TBR) before and during Ramadan.

Results: We included 18 patients with T2D, of whom 13 were males (72.2%). The mean age was 51.2 years (SD 7.4), the mean HBA1c was 7.8% (SD 1.0), and the mean duration of T2D was 12.5 years (SD 3.1). There were no significant changes in TIR, TAR, and TBR before and after Ramadan. There was no statistically significant difference in the TIR, TAR, and TBR during fasting hours and after iftar. However, the ambulatory glucose profile shows a reduction in glucose levels during fasting hours, reaching a nadir just before iftar, followed by a prolonged period of hyperglycemia post iftar. Physical activity levels decreased during fasting hours but increased approximately one hour before iftar. Multilinear regression analysis showed a positive correlation between engaging in vigorous physical activity and the TBR during fasting hours [β-coefficient (95% CI): 0.26 (0.07–0.45), p < 0.05].

Conclusion: Our findings show no significant changes in the overall glucose profile, except for prolonged post-iftar hyperglycemia. Intensive physical activity during fasting hours can increase the risk of hypoglycemia. This studyhighlights the need for further in-depth research to better understand the impact of lifestyle changes on blood glucose excursion during Ramadan.

Background: Vitamin D deficiency is a widespread global public health concern. Although it is prevalent in the Middle East, available data remain limited. This gap in research leaves important questions unanswered regarding the exact prevalence of vitamin D deficiency and its potential impact on the population health. This study aims to determine the prevalence of vitamin D status among individuals in Qatar during the SARS-COV-2 pandemic (2020), using a fully automated chemiluminescent immunoassay.

Methods: This epidemiological study included 1,000 participants selected from the Primary Health Care Corporation electronic medical record system. Random sampling was used to select the study sample, and data analysis was performed to determine prevalence by gender, age group, and patient’s continent of origin. Serum levels of 25-hydroxyvitamin D [25(OH)D] were interpreted according to the guidelines of The Endocrine Society. Levels were classified as follows: vitamin D deficiency (serum 25(OH)D<20 ng/mL), vitamin D insufficiency (20–29 ng/mL), optimal levels (30–50 ng/mL), and potential toxicity (>50 ng/mL).

Results: The overall prevalence of vitamin D deficiency in Qatar was 49.8%. While there was no significant variation by gender, the prevalence varied significantly across age groups (p <0.0001) and by patients’ continent of origin (p <0.0001). Deficiency rates were highest in the 10–17 years age group (63%) and lowest among individuals aged >60 years (24.7%). Additionally, the deficiency rates were highest among individuals from Asian countries (51.6%) and the Middle East and North Africa (MENA) region (49.8%), and lowest among those from America and Europe.

Conclusion: This study reveals a high prevalence of vitamin D deficiency in Qatar, affecting nearly half of the population and showing significant variations across age groups and geographical backgrounds. Individuals from Asian and MENA regions were more affected than those from America and Europe, highlighting possible lifestyle or genetic influences. These findings are intended to guide public health interventions and support global efforts to address vitamin D deficiencies.

Background:Cryptosporidium is a common pathogenic parasite known to cause diarrhea in humans and animals, particularly in young children living in poor conditions. Although diarrheal disease is usually mild in immunocompetent individuals, it may progress into a life-threatening complication among the immunocompromised. Due to insensitive conventional diagnostic methods, the identification of Cryptosporidium can be inaccurate and challenging. The present study aimed to investigate the prevalence of cryptosporidiosis infection in Qatar by comparing four different diagnostic methods for detecting Cryptosporidium in human stool samples.

Methods: From January 2018 to December 2019, stool samples from patients with various gastrointestinal symptoms were collected at the microbiology laboratory at Hamad General Hospital in Qatar for parasitic detection. The stool samples were tested using four diagnostic methods: routine microscopy, immunochromatography (ICT), multiplex polymerase chain reaction (PCR), and modified Kinyoun’s acid-fast stain (MKS).

Results: In the evaluation of the four different detection methods, 36 (18%) out of 205 stool samples tested positive for Cryptosporidium, with detection rates of 18%, 15%, 7%, and 6% using PCR, ICT, MKS, and routine microscopy, respectively.

Conclusion: The superior sensitivity of PCR and ICT supports their integration into routine diagnostics to improve the detection and public health surveillance of cryptosporidiosis in Qatar.

Background: Children with cerebral palsy (CP) are at high risk of malnutrition due to feeding difficulties and motor impairments, which can further exacerbate their condition. Nutritional status plays a critical role in the growth and health outcomes of these children, yet limited data are available on this issue in Qatar. This study aimed to assess the nutritional status and growth patterns in children with CP attending a pediatric rehabilitation clinic in Qatar.

Methods: A retrospective observational study was conducted on 150 children with CP, aged 3 to 14 years, who were followed regularly at the Pediatric Rehabilitation Department, Qatar Rehabilitation Institute. Nutritional status was evaluated using anthropometric measurements (height, weight, and body mass index [BMI]) based on World Health Organization growth charts. χ² tests were performed to assess associations between BMI and demographic variables, including gender, nationality, motor type, weight, and height.

Results: The prevalence of underweight children was 48.7% and 35.3% had an underweight BMI. Significant associations were found between BMI and nationality (p = 0.05), weight status (p < 0.001), and height status (p = 0.00(6). However, no significant associations were observed between BMI and gender (p = 0.21) or motor type (p = 0.2). Short stature and low weight were identified as strong indicators of undernutrition.

Conclusions: Undernutrition remains a major concern among children with CP in Qatar, particularly among those with short stature and low weight. Tailored nutritional interventions and regular monitoring are essential to improve growth outcomes and prevent malnutrition-related complications in this vulnerable population.

Background: Celiac disease (CD) is a chronic immune-mediated disorder of the digestive system triggered by gluten ingestion among genetically predisposed individuals. It is a chronic disease that causes malnutrition, but it is a non-fatal condition. A significant proportion of cases remain undiagnosed due to asymptomatic or nonspecific presentations, contributing to delayed diagnosis and long-term complications. CD is not a contraindication for blood donation. This study aims to determine the seroprevalence of CD antibodies and the prevalence of biopsy-proven CD among blood donors.

Methods: A cross-sectional study was conducted on 1,497 blood donors (≥18 years) at Hamad Medical Corporation, Doha, Qatar, between 2018 and 2022. Serum anti-tissue transglutaminase IgA (anti-tTG IgA) and anti-endomysial IgA (anti-EM IgA) antibodies were measured in enrolled blood donors. Individuals with positive results for either antibody underwent esophagogastroduodenoscopy (EGD) with duodenal biopsies to confirm the diagnosis.

Results: Serological testing revealed a seroprevalence of 0.8% (95% CI, 0.4%–1.4%) for anti-tTG IgA, with 83.3% of these individuals also being positive for anti-EM IgA. All seropositive individuals were male. Of 12 seropositive individuals, 4 (33%) consented to EGD and duodenal biopsy. Histological findings confirmed CD in two cases (50% of seropositive individuals who consented to biopsy). Both confirmed cases exhibited Marsh grade 2 changes.

Conclusion: The seroprevalence of CD antibodies among healthy blood donors was 0.8%, and biopsy-proven CD was 50% among seropositive individuals who consented to EGD. These findings highlight the presence of undiagnosed CD in this population, predominantly in males, and underscore the need for further community-based studies to assess the true prevalence and clinical implications of CD.

Background: Intravenous lidocaine is used to treat acute postoperative pain by reducing discomfort, accelerating mobilization, and shortening hospitalization. This study evaluated the effects of intravenous bolus and continuous lidocaine infusion on pain intensity, fentanyl requirements, and plasma norepinephrine levels in hysterectomy surgery under spinal anesthesia.

Methods: A double-blinded randomized clinical trial was conducted on 46 patients undergoing hysterectomy with spinal anesthesia. The lidocaine group (n = 23) received a 2% lidocaine bolus (1.5 mg/kg) followed by a continuous infusion (1 mg/kg/hour) for 24 hours. The control group (n = 23) received 0.9% NaCl. Resting and moving numeric rating scale (NRS) pain scores, total fentanyl requirements, and norepinephrine levels were recorded at 4, 6, 12, and 24 hours postoperatively.

Results: Statistically significant differences in resting pain NRS were observed at the 4th, 6th, 12th, and 24th hours (0.52 ± 0.51 vs. 1.52 ± 0.51, 0.61 ± 0.58 vs. 1.52 ± 0.51, 0.52 ± 0.51 vs. 1.74 ± 0.81, and 0.52 ± 0.51 vs. 1.52 ± 0.51, respectively; p < 0.001). The reduction in pain score on the moving NRS in the lidocaine group was significantly greater at 6 hours (2.22 ± 0.79 vs. 2.91 ± 1.04; p = 0.001) and 12 hours (2.26 ± 0.75 vs. 2.57 ± 1.12; p < 0.001) postoperatively compared to the control group. Total fentanyl requirements were significantly lower in the lidocaine group (103.04 ± 33.63 mcg vs. 421.74 ± 74.32 mcg; p < 0.001). Plasma norepinephrine changes differed significantly at T6–T0 (−0.66 ± 1.81 pg/mL vs. 1.98 ± 1.69 pg/mL; p < 0.001) and T24–T0 (−1.74 ± 1.94 pg/mL vs. 1.53 ± 1.12 pg/mL; p < 0.001). No side effects were observed.

Conclusion: Intravenous bolus and continuous lidocaine infusion reduced postoperative pain intensity, fentanyl requirements, and norepinephrine levels without significant side effects.

Background: Thyroglobulin has been identified as a marker for thyroid cancer monitoring. However, researchers have proposed and employed it as a biomarker to assess iodine-dependent thyroid dysfunction during pregnancy. Pregnancy is a hyperdynamic state that significantly strains the mother’s iodine stores due to the demands of the foetus. This study combined thyroglobulin and thyroid function tests to see their impact on identifying more patients who are at risk for thyroid disorders in pregnancy. The aim of the study was to determine thyroglobulin as an adjunct biomarker in thyroid function assessment in pregnancy.

Methods: Participants were across five centers, and the study was conducted over a period of 9 months (June 2019–February 2020). The study comprised a cohort of 250 pregnant women who were attending their antenatal clinic visits. These participants were selected randomly using a table of random numbers. Blood samples were taken and analyzed using immunoassay techniques. The data were analyzed using Statistical Package for Social Sciences (SPSS), version 21 (IBM, Chicago, IL).

Results: Thyroid-stimulating hormone (TSH) assay only identified 35 (14%) participants, whereas the combination of the TSH and Tg assays identified 50 (20%) participants. Thyroglobulin and free thyroxine measurements revealed the presence of hyperthyroidism in 15 (9.6%) and hypothyroidism in 8 (3.2%). Using both TSH and thyroglobulin, we identified 54 (21.6%) participants as having thyroid dysfunction, with a higher prevalence of 40 (16%) hypothyroid participants compared to 14 (5.6%) hyperthyroid participants.

Conclusion: Thyroglobulin is valuable during pregnancy, with the ability to reflect iodine status as a sensitive marker in identifying early thyroid dysfunction.

Background: Infertility is a rising global and regional concern, yet its associated factors remain underexplored in Qatar. This study investigated demographic, lifestyle, and medical factors linked to infertility, aiming to provide insights that can enhance reproductive healthcare strategies and patient outcomes in the region.

Methods: A total of 998,328 eligible individuals from 27 Primary Health Care Centers in Qatar were identified for this case-control study. Data were collected between January 2016 and December 2022. Eligible individuals were aged 18 to 49 years with a documented fertility status. After 1:1 matching by age, gender, and nationality, the final sample included 51,542 participants (25,771 cases, 25,771 controls). Analyses were stratified by gender and nationality.

Results: A total of 16,158 female cases and 9,613 male cases with infertility were identified and matched to fertile individuals. After multivariable logistic regression, in Qatari and non-Qatari females, polycystic ovarian syndrome was associated with higher odds of infertility (odds ratio [OR], 4.34 [95% CI, 3.36–5.61]; p < 0.001) and (OR, 5.54 [95% CI, 4.74–6.47]; p < 0.001), respectively. Uterine polyps showed a strong association in both groups (OR, 3.18 [95% CI, 2.21–4.59]; p < 0.001) and (OR, 6.05 [95% CI, 4.57–8.01]; p < 0.001), respectively. In both male groups, varicocele was associated with higher odds of infertility (OR, 39.46 [95% CI, 22.60–68.90]; p < 0.001) and (OR, 37.75 [95% CI, 26.32–54.16]; p < 0.001), respectively. Similarly, in erectile dysfunction (OR, 4.54 [95% CI, 3.32–6.21]; p < 0.001) and (OR, 6.59 [95% CI, 4.74–9.17]; p < 0.001), respectively.

Conclusion: In females and males, reproductive diseases and other comorbidities were associated with higher odds of infertility in both Qatari and non-Qatari individuals. Future studies should investigate temporal associations and include additional risk factors to guide effective infertility prevention strategies.

Background: Invasive candidiasis has risen alarmingly over the last decades, with diagnosis often complicated by colonization at multiple body sites. The Candida score offers a simplified tool to help identify patients at risk of invasive candidiasis, particularly in intensive care unit (ICU) settings; however, its applicability in patients with broader characteristics remains uncertain. Moreover, research on Candida colonization and the utility of such tools in Indonesia is still limited. This study aimed to evaluate the association between clinical and laboratory characteristics and patient outcomes, while also assessing the predictive value of the Candida score in both ICU and non-ICU patients at a tertiary academic hospital in Yogyakarta, Indonesia.

Materials and Methods: This is an observational retrospective cohort study. During the period of January 2019 to December 2021, recorded laboratory data and clinical characteristics of patients (ICU and non-ICU patients) whose specimens yielded Candida spp. were collected through electronic health records. The correlation of laboratory profile and clinical characteristics with the outcome was analyzed comparatively using bivariate and multivariate analysis.

Results: Ward status, length of stay, number of comorbid, history of steroids, Candida score of ≥3, and mechanical ventilation were significantly correlated with the non-survivor group. Multivariate analysis showed that intensive care status and a Candida score ≥3 were found to have the strongest and independent correlation with the non-survivor group (p ≤ 0.001; OR 11.8 [95% CI, 4.368–31.962] and p = 0.004; OR, 3.9 [95% CI, 1.562–9.065], respectively).

Conclusion: Being in the ICU and having a Candida score of ≥3 was independently correlated with poorer clinical outcomes in hospitalized patients with Candida spp. colonization.

Objective: The study was conducted to determine the impact of the COVID-19 pandemic on the incidence and stage of breast cancer in different age groups.

Methods: This retrospective study analyzed changes in the epidemiological and clinical structure of the cohort of patients treated in the radiotherapy department of the Bydgoszcz Oncology Centre in Poland from 2016 to 2023.

Results: The results of the study showed that in the group of patients under 39 years of age, an increase in the incidence rate was recorded in 2020, and a decrease in 2021 to 2023. A decrease in the incidence rate was also observed in the group of patients aged 40 to 49 years in the period 2021 to 2022 and in the groups 50 to 59, 60 to 69, and >80, from 2020 to 2023. An increase in the incidence rate was recorded in the group of patients aged 70 to 79 years in 2020, 2022, and 2023, and a decrease was observed in 2021. In the group of patients under 40 years of age, the impact of the pandemic on reducing the number of cases of stage I cancer was recorded in 2020, 2022, 2023, stage IIa—in 2020, stage IIIa—from 2020 to 2023, stage IIIb—in 2020. Instead, in 2020, the number of cases of stage IIb and stage IIIc breast cancer increased, and the rate of stage IV cancer detection increased significantly, which remained high throughout the pandemic. In the group of patients over 40 years of age, a decrease in the detection rate of stage I cancer was observed from 2020 to 2023, and stage IIa in 2020. An increase in stage IIIa cancer detection was recorded in 2020, stage IIIb in 2021 to 2023, and a significant increase in stage IV detection from 2020 to 2023.

Conclusion: The results demonstrated that the COVID-19 pandemic has become one of the important factors in the delayed diagnosis of breast cancer.