Lifestyle factors and internet addiction among school children

Aim

The aim was to determine the association between internet addition [IA] and fatigue, sleep disturbance, depression, and life style factors among school children.

Subjects and methods

A cross-sectional survey based on multistage stratified random sampling and 1188 students (73.3%) gave consent during October 2011 to December 2012. Data including socio-demographic details, lifestyle and dietary habits Internet Addiction Test (IAT), Fatigue Scale, Epworth Sleepiness Scale [ESS] and Beck Depression Inventory (BDI) test. Univariate and multiple logistic regression analysis were performed.

Results

The overall prevalence of IA among school children was 19.8%. The proportion of IA was significantly more among males (56.4%) as compare to females (43.6%; P = 0.035), school performance (P < 0.001) and family income (P = 0.032). Those with IA had significantly less number of sleep hours (6.16 ± 0.80 vs. 6.58 ± 1.29; P < 0.001) as compared to normal. Those with IA had significantly high number of hours internet use (3.82 ± 1.64 vs. 3.03 ± 1.64; P < 0.001) as compared to normal. A significantly larger proportion of IA than normal subjects reported having headaches (P = 0.010), double vision (P = 0.037), eye hurt (P = 0.021), eye tired (P = 0.005), dizziness (34.4% vs. 27.3%; P = 0.002), fatigue, and hearing problem (P = 0.048). A significantly larger proportion of students with IA most frequently gratifying site (19.9% vs. 11.6%; P < 0.001), browsed games (38.6% vs. 29.9%; P = 0.010), chat sites (29.7% vs. 22%; P = 0.013), email (54.2% vs. 63.1%; P = 0.36), and research (61.0% vs. 69.2%; P = 0.017).

Conclusion

The current study confirmed the of evidence linking problematic internet use with negative fatigue, greater numbers of symptoms, anxiety, sleeping disturbances, depressive and lifestyle risk factors, among vulnerable young children.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Does consanguinity increase the risk of mental illnesses? A population based study

The aim of this study was to assess the impact of consanguinity on risk for mental disorders especially in primary health care-PHC settings. It was decided to ascertain prevalence of common mental disorders and consanguinity. We set out to study the burden of commonest psychiatric disorders among consanguineous marriages at PHC using the WHO Composite International Diagnostic Interview (WHO-CIDI) and examine their symptom patterns and co-morbidity in Qatar. A prospective cross sectional study was carried out over a year between November 2011 to October 2012. A total of 2.000 Qatari subjects aged 18 to 65 years were approached; 1.475 (73.3%) gave consent and participated in this study. Prevalence of psychiatric disorders using the WHO Composite International Diagnostic Interview (CIDI, version 3.0) showed that six most common disorders were major depression disorders (18.3%), any impulse control condition (18.3%), any anxiety disorders (17.2%), any mood disorders (16.9%), followed by separation anxiety disorders (15.2%), personality disorder (14.1%). The mean age ± SD of the 1.475 subjects interviewed was 39.3 ± 9.8 years. The rate of consanguinity in the present generation was 31.5% [95% CI = 29.1–33.7]. There were statistically significant differences between consanguineous and non-consanguineous with regards to age, educational status, occupation status, household income as well as BMI, cigarette smoking and sheesha smoking. One-fifth of all adults who attended the PHC center 20% had at least one psychiatric diagnosis. The prevalence of the generalized anxiety disorders; social phobia, specific phobia, major depression, and personality disorders were significantly higher in consanguineous marriages than in non-consanguineous.

Disclosure of interest

The author has not supplied his declaration of competing interest.

Depression, anxiety and stress [DASS21] symptoms in menopausal Arab women: Shedding more light on a complex relationship

Aim

The objectıve was to determine correlation between depression, anxiety and stress in menopausal and post-menopausal women and shedding more light on a complex relationship.

Methods

A cross-sectional based on Arabian women at the Primary Health Care (PHC) Centers in Qatar during July 2012 and May 2014 and 1101 women agreed to participate and responded to the study. Depression, anxiety and stress were measured using the Depression Anxiety Stress Scales (DASS-21). Data on body mass index (BMI), clinical and other parameters were used.

Results

The mean age and SD of the menopausal age was 49.55 ± 3.12, and postmenopausal age was 58.08 ± 3.26 (P < 0.001). There were statistically significant differences between menopausal stages with regards to age, ethnicity, educational status, occupation status, and place of living. Also, there were statistically significant differences between menopausal stages with regards to BMI, systolic and diastolic blood pressure, vitamin D deficiency, and diseases. Depression and anxiety were more common among postmenopause women. The multivariate regression analyses revealed that age in years, diastolic BP, consanguinity, regular exercise were predictor for depression. Meanwhile, diastolic BP, occupation and physical activity considered the main risk factors for anxiety. Furthermore, age in years, occupation and sheesha smoking habits were considered as the main risk factors associated with stress.

Conclusion

A large number of factors were associated with experiencing menopausal and psychosocial problems and which had negative effects on the quality of life among Arabian women. Depression, anxiety and stress should be considered as an important risk factors for osteoporosis.

Disclosure of interest

The author ha not supplied his/her declaration of competing interest.

Study of shift work and risk of coronary events

Background: The effects of shift work on coronary heart diseases (CHD) are well described. Most of the studies on coronary events in shift workers are supportive of the hypothesis that they are at increased risk.

Objective: The objective of this study was to investigate the relation shift work has to risk of CHD in a cohort of men from different Asian races working in a fertilizer plant in the Middle East. Design: This is a case series of cohort study.

Subjects: The medical records for 2562 staff employed at the plant, from the start of the company in 1972 till 2003, were surveyed. Of these, 648 were shift workers and 1914 were daytime workers. A total of 223 employees had cardiovascular event.

Methods: For each case we recorded the date and age at start of employment, and the age at the time of diagnosis. Data from their last medical examination in the company were used to calculate their BMI, and to register whether they were smokers, had diabetes, or were senior or intermediate staff. Univariate and multivariate statistical analyses were performed.

Results: The incidence of CHD is significantly higher in shift workers (13.5%) compared with the daytime workers (7.1%). Also, there was a statistically significant difference between shift workers and daytime workers concerning hypertension and cerebrovascular incidents.

Conclusion: Our results suggest the possibility of an overall relationship between shift work and cardiovascular diseases.

Modified carpal box technique in the diagnosis of suspected scaphoid fractures

Purpose: To establish and test the clinical efficacy of a new diagnostic algorithm with the extensive utilization of modified carpal box radiography (mX-CB) in the detection of scaphoid fractures.

Material and Methods: Initial and early follow-up radiographic evaluation of 146 suspected scaphoid fractures were carried out by mX-CB. Patients with unconfirmed diagnosis were referred to CT. Patients were followed for 1 year after injury. Sensitivity, specificity and interobserver agreement of reading mX-CB images were determined statistically.

Results: No non-union or avascular necrosis was seen at 1 year after the injury. 90% of the fractures were diagnosed by mX-CB, only 6.8% of the patients needed referral to CT. Sensitivity of mX-CB at initial presentation was 81.6%. Interobserver agreement was very high among evaluators of mX-CB images.

Conclusion: Extensive utilization of mX-CB as primary and early follow-up investigation resulted in high initial diagnostic accuracy and low referral rate to a more expensive diagnostic modality.

Prevalence and determinants of common fears in children and their socio-demographic characteristic

Objective

Most children experience some degree of fear during their development. Excessive fears can create serious obstacles to children. The aim of this study was to identify the most common fears in a sample of children and adolescents and examine the socio-demographic correlates of fears.

Subjects and methods

This cross-sectional study was conducted during the period July 2010 to February 2012 at Public and Private Schools of the Ministry of Education and Higher Education, in Qatar. Out of 2188 students approached, 1703 students agreed to participate in this study, with a response rate of 77.8%. The questionnaire includes socio-demographic information, academic performance, behaviour at home and various fears.

Results

More than half of the children experienced fears (56.7%). Most of them were in the intermediate level, 12–15 years old (46.1%). Overall, reported fears were significantly more frequent in girls (62.6%) than boys (37.4%) (P < 0.001). A significant difference was observed between girls and boys who experienced fears in their age group (P < 0.001), education of mother (P = 0.04), household income (P = 0.008) and academic performance (P < 0.001). The most frequent reported fears were fear of someone dying in the family (85.2%), parents getting divorced (84.5%), breaking religious law (82%), being kidnapped (78.2%), family members ill (78%) and dying (76.7%).

Conclusions

The study findings revealed that fears were highly prevalent in Arab children and adolescents in Qatar. Girls reported more fears than boys. There was a significant difference observed between girls and boys in their age group and academic performance for the reported fears.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.

Depression, anxiety and stress [DASS21] symptoms in menopausal Arab women: Shedding more light on a complex relationship

Objective

To determine correlation between depression, anxiety and stress in menopausal and post-menopausal women and shedding more light on a complex relationship.

Methods

A cross-sectional descriptive study was used and 1468 women aged 45–65 years were included and 1101 women agreed to participate (75.0%). Depression, anxiety and stress were measured using the Depression Anxiety Stress Scales (DASS-21). Data on body mass index (BMI), clinical and other parameters was used.

Results

A total of 1101 women agreed to participate after informed consent was obtained. The mean age and SD of the menopausal age was 49.55 ± 3.12, the mean and SD of postmenopausal age was 58.08 ± 3.26 (P < 0.001). There were statistically significant differences between menopausal stages with regards to age, ethnicity, educational status, occupation status, and place of living. Also, there were statistically significant differences between menopausal stages with regards to BMI, systolic and diastolic blood pressure, vitamin D deficiency, and diseases. Depression and anxiety were more common among post-menopause women. Also, there were no differences between the groups regarding the frequency of certain levels of stress among menopause and post-menopause. Multivariate regression analyses revealed that age in years, diastolic BP, consanguinity, regular exercise were predictor for depression. Meanwhile, diastolic BP, occupation and physical activity considered the main risk factors for anxiety. Furthermore, age in years, occupation and sheesha smoking habits were considered as the main risk factors associated with stress.

Conclusion

A large number of factors were associated with experiencing menopausal and psychosocial problems which had negative effects on the quality of life among Arabian women.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.

Low vitamin D, and bone mineral density with depressive symptoms burden in menopausal and post-menopause women

Objective

The objective of current study was conducted to determine whether low vitamin D level and BMD are associated with depressive symptoms as burden in Arab women during the menopausal and post-menopausal period.

Design and setting

A cross-sectional descriptive study.

Subjects

A multi-stage sampling design was used and a representative sample of 1436 women aged 45–65 years were included.

Methods

Bone mineral densitometry measurements [BMD] (g/m2) was assessed at the BMD unit using. Data on body mass index (BMI), clinical biochemistry variables including serum 25-hydroxyvitamin D were collected. The Beck Depression Inventory (BDI) was administered for depression purposes.

Results

Of the 1436 women living in urban and rural areas, 1106 women agreed to participate (77.0%). There were statistically significance differences between menopausal stages with regards to ethnicity, education level, systolic and diastolic blood pressure, parity, sheesha smoking and depressive symptoms. Overall, 30.4% of women were affected with osteopenia/osteoporosis in menopause and postmenopausal (24.4% vs. 35.7%; P = 0.0442). Osteopenia in menopause and postmenopausal (18.7% vs. 29.3%; P = 0.030) and osteoporosis (9.9% vs. 15.9%; P = 0.049) were significantly higher in post-menopausal women than in pre-menopausal women (P = 0.046). Similarly, vitamin D deficiency was more prevalent among postmenopausal women than menopausal women. The study revealed that vitamin D level, hemoglobin level, serum iron fasting plasma glucose, calcium, triglycerides, HDL cholesterol, LDL cholesterol, alkaline phosphate and magnesium were considerably lower in postmenopausal compared to menopause women (P < 0.001).

Conclusion

The study confirmed strong association between vitamin D level and BMD in Arab women during the menopausal and post-menopausal period.

Disclosure of interest

The author has not supplied his declaration of competing interest.

Depression, Anxiety, and Stress Symptoms in Menopausal Arab Women: Shedding More Light on a Complex Relationship

Background:

The association between depression, anxiety, and stress among Arab menopause and postmenopausal women have been explored in detailed.

Aim:

The objective of this study was to determine the correlation between depression, anxiety, and stress in menopausal and postmenopausal women and shedding more light on a complex relationship.

Subjects and Methods:

A cross-sectional descriptive study was used to generate menopause symptoms experienced by Arabian women at the primary health care centers in Qatar. A representative sample of 1468 women aged 45–65 years were approached during July 2012 and May 2014 and 1101 women agreed to participate (75.0%) and responded to the study. Depression, anxiety, and stress were measured using the Depression Anxiety Stress Scales 21. Data on body mass index (BMI), clinical and other parameters were used. Univariate, multivariate, and matrix correlation analysis were performed for statistical analysis.

Results:

A total of 1101 women agreed to participate after informed consent was obtained. The mean age and standard deviation (SD) of the menopausal age were 49.55 (3.12), the mean and SD of postmenopausal age was 58.08 (3.26) (P < 0.001). There were statistically significant differences between menopausal stages with regards to age, ethnicity, educational status, occupation status, and place of living. Furthermore, there were statistically significant differences between menopausal stages with regards to BMI, systolic and diastolic blood pressure (BP), Vitamin D deficiency, and diseases. Depression and anxiety were more common among postmenopause women. Furthermore, there were no differences between the groups regarding the frequency of certain levels of stress among menopause and postmenopause. The multivariate regression analyses revealed that age in years, diastolic BP, consanguinity, regular exercise were a predictor for depression. Meanwhile, diastolic BP, occupation, and physical activity considered the main risk factors for anxiety. Furthermore, age in years, occupation, and sheesha smoking habits were considered as the main risk factors associated with stress.

Conclusion:

A large number of factors were associated with experiencing menopausal and psycho-social problems and which had negative effects on the quality of life among Arabian women. Depression, anxiety, and stress should be considered as important risk factors for osteoporosis.

Higher prevalence of iron deficiency as strong predictor of attention deficit hyperactivity disorder in children

Background:

It has been reported that ferritin and iron deficiency may be related to the path physiology of attention deficit hyperactivity disorder (ADHD).

Aim:

The aim of this study was to determine the association between iron deficiency and ADHD and the impact and role of iron deficiency on the development of ADHD in children.

Subjects and Methods:

The study based on the case-control study age- and sex-matched control and conducted at the School Health and Primary Healthcare Clinics, Qatar. A total of 630 children with ADHD aged 5-18 and 630 controls aged 5-18 years old. Sociodemographic and clinical data were collected, including physician diagnosis. The health status of the subjects was assessed by ascertaining clinical presentations and symptoms, family history, body mass index (BMI), iron deficiency, ferritin, serum 25-hydroxyvitamin D, calcium, magnesium, and phosphorus levels. Descriptive, univariate, and multivariate statistical analysis were performed.

Results:

Mean age (standard deviation [SD] in years) for ADHD and control children were 11.54 (3.83) versus 11.50 (3.62). There were statistically significant differences between ADHD versus control children for vitamin D [16.81 (7.84) vs. 22.18 (9.00) ng/ml], serum iron [82.11 (13.61) vs. 85.60 (12.47) ng/ml], ferritin [36.26 (5.93) vs. 38.19 (5.61) ng/ml], hemoglobin [12.02 (2.13) vs. 12.89 (2.02) g/dL], magnesium [0.82 (0.08) vs. 0.88 (0.06) mmol/L], serum calcium level [2.35 (0.12) vs. 2.39 (0.14) mmol/L], and phosphorous [1.47 (0.30) vs. 1.54 (0.26) mmol/L]. Of total 630 of ADHD children, 116 (18.4%) had severe vitamin D deficiency (<10 ng/ml). Multivariate logistic regression analysis revealed that serum vitamin D level, serum iron, ferritin, serum calcium level, physical activity, nervous behavior, consanguinity, BMI, and child order were considered as the main factors associated with the ADHD after adjusting for age, gender, and other variables.

Conclusion:

The study indicates that low serum iron, ferritin levels, and vitamin D deficiency may be associated with ADHD.

Bone mineral density in midlife women: the Study of Women's Health in Qatar

OBJECTIVES

The aim of this study is to investigate bone mineral density (BMD) for a large cross-section of midlife Arab women living in Qatar and to evaluate the association of body mass index (BMI), menopause status, and nationality, on BMD of the spine and femur.

STUDY DESIGN

A cross-sectional study was conducted among women aged 40-60 years recruited from nine primary-care health centers in Qatar. BMD (g/m(2)) was assessed at the lumbar spine and the femur.

RESULTS

The combined prevalence of osteopenia and osteoporosis was 4% at the femur and 16.2% at the spine. BMI and menstrual status were both independently associated with BMD at the spine and at the femur (all p values < 0.001). As BMI increased, BMD increased at both the spine and femur. Women who menstruated in the past 12 months had 0.82 g/cm(2) and 0.61 g/cm(2) greater BMD at the spine and femur, respectively, compared with women who had not menstruated in 12 months. Nationality was not associated with mean BMD of the spine or the femur.

CONCLUSIONS

No significant differences were observed between Qatari and non-Qatari women in terms of mean BMD values at the spine and the femur except for the femur in the age group 55-60, where values were lower among non-Qataris (p = 0.04). Multivariable analyses showed that BMI and menstrual status were found to be strongly associated with BMD levels at the spine and femur. The high prevalence of obesity observed in this sample may explain the low levels of osteopenia and osteoporosis observed.

Use of complementary and alternative medicine among midlife Arab women living in Qatar

The prevalence of use of complementary and alternative medicine (CAM) is widespread and is growing worldwide. This cross-sectional study in Qatar examined the use of CAM and its correlates among Arab women in their midlife years. Women aged 40-60 years (n = 814) were recruited at primary care centres in Qatar and completed a specially designed, pre-tested questionnaire. Overall, 38.2% of midlife women in Qatar had used CAM in the previous 12 months. Nutritional remedies and herbal remedies were the most commonly used CAM therapies, followed by physical methods. Qatari nationality and higher level of education were independently associated with CAM use. Menopause transition status was not independently associated with use of CAM. The prevalence of CAM use by women in Qatar was high, consistent with other reports worldwide. It is essential to educate and inform patients and health-care providers about the benefits and limitations associated with CAM.

Relationship between patient satisfactions with diabetes care and treatment

BACKGROUND

Measurement of treatment satisfaction in diabetes is important as it has been shown to be associated with positive outcomes, reduced disease cost and better health.

AIM

The aim of this study was to assess the relationship between treatment satisfaction of diabetes patients and socioeconomic, clinical, medication adherence and health-related factors in Qatar.

DESIGN

This is a cross-sectional study.

SETTING

The survey was carried out in primary health care centers and hospitals from April 2010 to May 2011.

SUBJECTS

Of a total of 3000 diabetic patients, 2582 patients gave their consent to take part in the study, with a response rate of 86.1%.

MATERIALS AND METHODS

The Diabetes Treatment Satisfaction Questionnaire was used to measure the patient satisfaction. The modified Morisky Medication Adherence was used to measure medication taking behavior. A multivariate stepwise linear regression model was performed to identify factors independently associated with patients' satisfaction instrument.

RESULTS

Of the studied patients, majority of the diabetes patients were Qataris (61.2%), married (86.1%), above secondary education (46.9%) and unemployed (28.6%). Diabetes patients who had professional jobs (3.97 ± 0.65; P = 0.009) and those who were staying alone had a significantly higher treatment satisfaction score (4.01 ± 0.64; P = 0.001) compared with the other patients. Patients who were taking tablets were significantly more satisfied with treatment (4.08 ± 0.60; P < 0.001). Diabetes patients of primary health care centers (3.96 vs. 3.80; P < 0.001) were more satisfied with treatment than patients visiting hospitals. Multivariate regression analysis revealed that age of the patient (P < 0.001), expatriates (P = 0.023), patients visiting hospitals (P < 0.001), treatment with insulin (P < 0.001) and any diabetes complications (P < 0.001) were significantly less satisfied with the treatment.

CONCLUSION

The study findings revealed that patient satisfaction was positively associated with sociodemographic variables like high income, employment, married individuals and those with higher levels of education. We found a lower treatment satisfaction in patients with diabetes-related complications and insulin treatment.

The hopeless age? A qualitative exploration of the experience of menopause in Arab women in Qatar

OBJECTIVE

The aim of this study was qualitatively to describe and examine the expectations and experiences of the midlife transition in Arab women living in Qatar.

METHOD

Six focus groups were conducted with Arab women living in Qatar: three groups of local Qatari women, and three groups of non-Qatari Arab women originating from neighboring countries. A purposive sample of 41 pre-, peri-, and postmenopausal women aged 40-60 years participated. The semi-structured group format encouraged discussion around knowledge about menopause; physical, emotional and social experiences related to menopause; and cultural differences that may exist related to menopause.

RESULTS

The majority of women considered menopause as a maturing experience, although the term 'menopause' was considered to have negative connotations. Postmenopausal women described menopausal symptoms consistent with general knowledge, but many premenopausal women were unaware of symptoms, even if they knew someone who had experienced menopause. Postmenopausal women were more socially active than before and were able to participate in religious activities that they previously could not attend during menses. How a woman experienced menopause depended on the husband's level of support, and some women believed that Western women did not have the appropriate support from husbands and families that Arab women have; they felt this lack of support could lead to negative outcomes such as being at an increased risk for suicide caused by depression during menopause.

CONCLUSION

Qatari and non-Qatari women had many similarities in how they perceived and experienced menopause, although they collectively believed that the experiences of Western women are different.

Prevalence of common phobias and their socio-demographic correlates in children and adolescents in a traditional developing society

OBJECTIVE

The aim of this study was to identify the most common phobias in children and adolescents and to determine the prevalence, age distribution, and socio-demographic correlates of phobias.

METHOD

This was a prospective cross-sectional study conducted at public and private schools from July 2009 to February 2009. The questionnaire included socio-demographic information, extra-curricular activities and hobbies, behaviour at home and various phobic fears and it was distributed among children aged 6 to 18 years. Psychiatrists determined the definitive diagnosis for various phobias by checking and screening their symptoms.

RESULTS

Of the studied subjects, 44% were males and 56% were females. The overall prevalence of phobia in children and adolescents was 19.7%. Among children with phobia, females had higher rates of phobias (62.4% vs 37.6%) than males. Nearly half of total sufferers were in the 12-15 year age group (46.3%). Social phobia (12.7%) was the commonest phobia found followed by agoraphobia (8.6%). Secondary school children were highly afflicted with social phobia (14.9%), agoraphobia (11.7%) and specific phobia (9.6%), while preparatory students (8.3%) were more likely to have 'medical' phobia (fear of physical illness, medical tests and procedures). A significant difference was observed between the age groups in children with agoraphobia (p=0.002).

CONCLUSION

The overall prevalence of phobia in children and adolescents in Qatar was higher than rates found in other epidemiologic studies, with the most common phobias observed being social phobia, agoraphobia and specific phobia.

The impact of socio-economic, lifestyle habits, and obesity in developing of pregnancy-induced hypertension in fast-growing country: global comparisons

OBJECTIVE

The aim of the study was to determine the prevalence and associated risk factors of pregnancy-induced hypertension (PIH) in the third trimester of Arab women and their neonatal outcome.

DESIGN

A prospective study.

SETTING

Women's Hospital and Maternity Clinics.

SUBJECTS AND METHODS

The study was based on pregnant women in third trimester from the first week of January 2010 to April 2011. A total of 2,056 pregnant women, who had any kind of maternal complications, were approached and 1,608 women (78.2%) expressed their consent to participate in the study. A questionnaire covered variables related to socio-demographic factors, family history, medical history, maternal complications, and neonatal outcome. Multiple logistic regressions were used to describe the relationship between socio-demographic factors and PIH.

RESULTS

Pregnant women with Qatari nationality were 30% more likely to have PIH (Adj. OR 0.7; 95% CI 0.5-0.9, p = 0.03). Those living in villas were 50% more likely than those living in apartments (Adj. OR 0.5; 95% CI 0.3-0.9) and 40% more likely than those living in traditional houses (Adj. OR 0.6; 95% CI 0.4-0.8) to have PIH. The odds of PIH linearly increases with each decrease of 5,000 QAR in monthly income from > 20,000 to 10-15,000 (Adj. OR 1.2; 95% CI 0.7-2.1, Adj. OR 1.9; 95% CI 1.1-3.2, respectively) and then it starts decreasing from 10,000 to < 5,000 monthly income (Adj. OR 1.8;95% CI 1.1-3.1 and Adj. OR 1.3; 95% CI 0.7-2.7 respectively). The odds of PIH linearly increase with each five years increase in age among pregnant women from 30 to 45 years of age. A 10-fold increase in PIH odds was observed when body mass index (BMI) increased above > or = 30 (obese) (Adj. OR 10.0; 95% CI 6.4-15.6). Pregnant women who had no history of previous abortion were 60% less likely than those who had positive history of previous abortion (Adj. OR 1.6; 95% CI 1.1-1.2; p = 0.007) to have PIH. The odds of PIH increases by 50% when women do not receive antenatal care (Adj. OR 1.5; 95% CI 1.1-2.1; p = 0.040).

CONCLUSION

Qatar has a high prevalence of PIH compared to both regional and global rates. Maternal age > 30, increased BMI, previous abortion, lack of antenatal care, and physical activity were found to be significantly associated with increased risk of PIH in Arab women and could be potentially modifiable risk factors.

Have neonatal mortality rates in the state of Qatar become static? A PEARL study analysis

To ascertain the national neonatal mortality rate in Qatar during the first quarter of 2011 (1 January-31 March), we carried out a prospective pilot national epidemiologic study. Nationwide birth and neonatal mortality data were collected using predesigned, structured questionnaires. To analyse trends over the previous 4 years (2008-2011) we used neonatal mortality data for 2008-2010 from the database of the neonatal unit at the Women's Hospital, annual reports of Hamad Medical Corporation, and published neonatal mortality data for 2010 for comparative analysis. A total of 4909 live births and 21 neonatal deaths were recorded during the study period. The neonatal mortality rate was 4.28/1000 live births (corrected neonatal mortality rate 2.85/1000). The early neonatal mortality rate was 1.84/1000 and the late neonatal mortality rate was 2.44/1000 live births. Fifteen of the 21 neonatal deaths were in non-Qatari babies, reflecting the ethnic distribution in the population. Neonatal mortality rates in Qatar declined very little between 2008 and the first quarter of 2011.

Prevalence and associated risk factors of ante-partum hemorrhage among Arab women in an economically fast growing society

OBJECTIVE

The aim of this study was to determine the prevalence and associated risk factors of antepartum hemorrhage (APH) in the third trimester of Arab women residing in Qatar and their neonatal outcome.

DESIGN AND SETTING

A prospective hospital-based study was conducted in the Women's Hospital and Maternity Clinics.

MATERIALS AND METHODS

The study was based on pregnant women in the third trimester from the first week of January 2010 to April 2011. A total of 2,056 pregnant women, who had any kind of maternal complications, were approached and 1,608 women (78.2%) expressed their consent to participate in the study. The questionnaire covered variables related to socio-demographic factors, family history, medical history, maternal complications and neonatal outcome. Multiple logistic regressions were used to describe the association between socio-demographic factors and APH.

RESULTS

The overall prevalence of APH among Arab women residing in Qatar was 15.3% with 6.7% among Qatari's and 8.6% among non-Qatari Arab women; the difference in ethnicities was not significant. Among maternal socio-demographic characteristics, lower education (primary or below AOR 1.72; 95%CI 1.22-2.43, and intermediate education AOR 1.41; 95%CI 0.88-2.26; P=0.005) compared to university education was significantly associated with APH. As for maternal biological characteristics, family history of G6PD (AOR 1.87; 95% CI 1.18-2.95; P=0.007) and family history of Down's Syndrome (AOR 1.88; 95%CI 1.35-2.62; P=<0.001) were significantly associated with APH at the multivariable level; family history of hypertension (OR 1.78; 95%CI 1.30-2.44; P<0.001) was significant at the univariate level. Neonatal outcomes as a result of APH included increased risk of Apgar score at 1 minutes <7 (AOR 1.44; 95%CI 1.12-2.02; P=0.04) and minor congenital anomaly (AOR 2.82; 95%CI 1.39-5.71; P=0.004).

CONCLUSION

Qatar has a high prevalence of APH. Poor education, family history of hypertension, G6PD and Down's syndrome were found to be significantly associated with increased risk of APH in Qatar. Neonates of APH are at significantly increased risk of adverse outcome. Thus it is essential that obstetricians are alerted to these risk factors for early detection and to decrease the negative effects of APH.

Outcome of Occlusion Treatment for Strabismic Amblyopia in Children Below 12 Years Old Age

AbstractObjective:The aim of our study was to determine the related clinical factors affecting the outcome of occlusion treatment for Strabismic Amblyopia in Qatari children.

Design:This is a retrospective descriptive study.

Subjects and Methods: The study included 38 Qatari children with strabismic amblyopia who were treated with occlusion therapy. The survey was conducted among the Qatari children below 12 years of age during a 10 year period from 1992-2002. During this study period, 23 girls and 15 boys were treated for strabismic amblyopia.

Results:A total of 38 Qatari children were treated during the 10 year period. Of these children, 39.5% were males and 60.5% females. After the treatment, it is found that their final visual acuity improved. 73.7% achieved 6/9 or more and 26.3% achieved less than 6/9. The initial visual acuity, the presence of anisometropia and compliance were found to be related to the outcome of amblyopia treatment. The age at the start of treatment was found unrelated to the outcome. It was further discovered that most vision loss from amblyopia can be reversed with the correct intervention.

Conclusion:The results of the present study indicated that the main factors affecting the treatment of strabismic amblyopia are initial visual acuity, presence of anisometropia and compliance.

Is high prevalence of vitamin D deficiency evidence for asthma and allergy risks?

BACKGROUND

Studies suggest a link between vitamin D deficiency and development of asthma and allergic diseases.

AIM

To determine a) the association between vitamin D and asthma among children, b) difference in level of vitamin D in asthmatic children and control, and c) effect of vitamin D on atopy markers.

SETTING

Case-control study done, between October 2009 to July 2010, on asthmatics and controls (< 15 years) at Pediatric Allergy-Immunology Clinics and Primary Health care Clinics (PHC), Qatar. METHODS & SUBJECTS: A total of 483 cases and 483 controls matched by age, gender and ethnicity. Sociodemographic & clinical data was collected through physician diagnosis and questionnaire. Their health status was assessed by past or present clinical manifestations, family history, physical examination, BMI, and serum 25(OH) vitamin D, calcium, and phosphorus.

RESULTS

44.8% of asthmatic and 50.0% of controls were males, and 55.2% of asthmatic and 50% of controls were females. The mean age (+/- SD, in years)for asthmatic versus controls was 7.0 +/- 3.8 vs. 8.4 +/- 3.6. Vitamin D deficiency was more prevalent in asthmatics than controls. The mean value of Vitamin D in asthmatics was much lower than the normal value, and there was a significant difference found in the mean values of vitamin D between asthmatics (17.5 +/- 11.0) and the controls (20.8 +/- 10.0). Furthermore, there were statistically significant differences between asthmatic subjects and controls with respect to serum level of vitamin D (p < 0.001). Lower Vitamin D levels were associated with more allergic disease and elevated serum IgE.

CONCLUSION

Serum vitamin D levels were lower in asthmatic than control. Vitamin D deficiency was higher among children with asthma, allergic rhinitis, atopic dermatitis, acute urticaria, and food allergy. In addition, vitamin D deficiency was associated with IgE atopy markers in asthmatic children more than controls.

Prevalence, awareness and determinants of contraceptive use in Qatari women

We determined the knowledge of, attitude to and practice of contraception and the associated sociodemographic factors among a representative sample 1130 Qatari married women aged 18-49 years. Data were collected by questionnaire. The mean age of the women was 32.5 (SD 7.6) years. The vast majority (94.6%) knew about contraception but of these 1070, only 694 (64.9%) were in favour of contraception. Knowledge of contraception increased with increasing level of education (P < 0.001), but decreased the lower the household income (P = 0.002). Only 511 (47.8%) women were currently using contraceptives, which was significantly associated with age, husband's age, years of marriage, education level, income level and attitude to family planning. The most commonly known and used contraceptives were intrauterine device and pills. Friends were the most common source of knowledge about family planning method (80.0%).

The Outcome of Severe Traumatic Brain Injury in Children in Qatar: Six year study

Traumatic brain injuries (TBI) are important public health problem resulting in short-term or permanent disability and death. To determine the extent and outcome of severe TBI amongst children in Qatar medical records were reviewed retrospectively of all cases of severe TBI in children aged 14 years or less who attended the Children Rehabilitation Unit, Hamad General Hospital, Qatar, between January 2002 to December 2008. The severity of TBI was assessed by the Glasgow Coma Scale (GCS). Of 65 children with severe TBI, most were male (73.8 %) and 91 % were older than five years of age. The leading causes of injury were road traffic accident (84.6%) and falls (10.8%). Other causes included trauma by ceiling fan blades (4.6%), sports and recreation injuries. Early sequelae included spasticity (43.1 %) and posttraumatic epilepsy (33.8%); both were significantly associated with the increased severity and need for intracranial surgery. Almost a quarter of the children had communication disorders, 17 (26.2 %) had poor cognition, 16 (24.6%) had hemiplegia and 12 (18.5 %) had abnormal behaviour. Twelve (18.5%) children died within the first month of admission to hospital. It is clear that severe TBI results in significant morbidity and mortality among children in Qatar and special efforts are needed to reduce the causes especially motor vehicle crashes and injuries. Rehabilitation programs are also needed to limit the extent of long-term complications associated with TBI.

Does Delay in Diagnosing Acute Appendicitis Affect the Outcome?

Acute appendicitis is the most common surgical case met in an emergency department. Immediate surgery results in the confirmation of diagnosis and control of sepsis. To determine whether the delay in operating upon patients with acute appendicitis will affect the outcome or the stage of the disease, and if the clinical parameters give an indication of the severity of the disease medical records were reviewed retrospectively of 373 appendectomized patients above 14 years of age who were diagnosed with appendicitis in the emergency department of Hamad General Hospital, State of Qatar, between June and September 2007; 341 were diagnosed as acute appendicitis. Patients were classified according to the pre-operative and histopathological findings into four grades; A1: inflamed appendix, A2: gangrenous appendix, A3: perforated appendix, A4: pus +/- mass formation. Complications increased with the duration of the pre-hospital delay. The length of stay in hospital correlated significantly with the grade of diagnosis. The presence of fever, no change in bowel habit, and rigidity correlated well with advanced pathology, the complications increasing with greater delay. We conclude that delayed appendectomy is unsafe since it is associated with an increase in pathological grading as well as increasing the morbidity and the length of stay in hospital.

Road traffic fatalities in Qatar, Jordan and the UAE: estimates using regression analysis and the relationship with economic growth

Smeed's equation is a widely used model for prediction of traffic fatalities but has been inadequate for use in developing countries. We applied regression analysis to time-series data on vehicles, exponential models for fatality prediction, producing an average absolute error of 20.9% for Qatar, 10.9% for population and traffic fatalities in the United Arab Emirates (UAE), Jordan and Qatar. The data were fitted to Jordan and 5.5% for the UAE. We found a strong linear relationship between gross domestic product and fatality rate.

Clinical and epidemiological characteristics of lung cancer cases in Qatar

This study documents for the first time the clinical and epidemiological characteristics of lung cancer cases in Qatar from 1998 to 2005. The age-standardized incidence rate was higher than that in many other Gulf countries: 8.95 per 100,000 (15.2 per 100,000 for males; 3.95 per 100,000 for females). Mean age at diagnosis was 57.5 years. Most patients were current smokers or ex-smokers at the time of diagnosis (82.5%). Unlike other Gulf countries, adenocarcinoma was the predominant type in both Qatari nationals and expatriates (43.9% of lung cancer types). Many cases were in an advanced stage at diagnosis (64.2% at stage IV). Incomplete information was available on mortality rate due to the migration of expatriates.