Risk factors of zinc deficiency in children with atopic dermatitis.

Summary: Background and objectives. Zinc deficiency increases risk of infections, allergies and autoimmunity. We wished to determine risk factors in severe atopic dermatitis (AD) and identify of hypozincemia rate. Materials and methods. Retrospective study done on AD children (≤ 14 years) with serum zinc test. Data included demographic and laboratory tests (serum zinc level, IgE, food-specific IgE), and skin tests. Results. 168 AD children, aged 38.9 months with concomitant allergies in 47 (28%), family history of allergies in 131 (80%), and parental consanguinity in 134 (79.9%). AD was mild in 12 (7.2%, SCORAD 15.8) children, moderate in 41 (24.5%, SCORAD 30.4), and severe in 115 (68.3%, SCORAD 69.4). Hypozincemia was observed in 42 (25%, zinc 8.6 ± 1.1 µmoI/L) children and associated only with severe AD (p = 0.0418) and elevated IgE (p = 0.001). Conclusions. Hypozincemia is rather prevalent in AD, and severe AD and high IgE increase its risk. An adjunct oral zinc may help reducing severe poorly responsive AD.

Relationship between intraoperative non-technical performance and technical events in bariatric surgery.

BACKGROUND: The operating theatre is a unique environment with complex team interactions, where technical and non-technical performance affect patient outcomes. The correlation between technical and non-technical performance, however, remains underinvestigated. The purpose of this study was to explore these interactions in the operating theatre. METHODS: A prospective single-centre observational study was conducted at a tertiary academic medical centre. One surgeon and three fellows participated as main operators. All patients who underwent a laparoscopic Roux-en-Y gastric bypass and had the procedures captured using the Operating Room Black Box® platform were included. Technical assessment was performed using the Objective Structured Assessment of Technical Skills and Generic Error Rating Tool instruments. For non-technical assessment, the Non-Technical Skills for Surgeons (NOTSS) and Scrub Practitioners' List of Intraoperative Non-Technical Skills (SPLINTS) tools were used. Spearman rank-order correlation and N-gram statistics were conducted. RESULTS: Fifty-six patients were included in the study and 90 procedural steps (gastrojejunostomy and jejunojejunostomy) were analysed. There was a moderate to strong correlation between technical adverse events (rs = 0·417-0·687), rectifications (rs = 0·380-0·768) and non-technical performance of the surgical and nursing teams (NOTSS and SPLINTS). N-gram statistics showed that after technical errors, events and prior rectifications, the staff surgeon and the scrub nurse exhibited the most positive non-technical behaviours, irrespective of operator (staff surgeon or fellow). CONCLUSION: This study demonstrated that technical and non-technical performances are related, on both an individual and a team level. Valuable data can be obtained around intraoperative errors, events and rectifications.

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.

The distribution of the ABO blood groups among diabetes mellitus patients in Qatar.

BACKGROUND: There is strong evidence in the literature that there is an association between ABO blood group and certain diseases. AIM: The aim of this study was to investigate any association between the ABO blood groups and diabetes mellitus (DM) in Qatar. DESIGN: This was a sex-matched case-control study. SETTING: This study was carried out in the diabetic outpatient clinics and blood bank of the Hamad Medical Corporation (HMC) from April 2011 to December 2012. SUBJECTS AND METHODS: The study included 1633 diabetic patients and 1650 nondiabetic apparently healthy controls. A total of 2148 adult patients above 18 years of age were selected consecutively from the diabetic clinics of the hospitals and 1633 patients gave consent to take part in this study, thus giving a response rate of 76%. A total of 2150 nondiabetic healthy adults above 18 years of age were recruited from the blood bank and 1650 individuals agreed to take part in this study, giving a response rate of 76.7%. Blood group of the recruited subjects was taken from the database of the Blood Bank, Central laboratory, HMC. RESULTS: The data revealed that the blood group B was significantly more common in diabetic patients as compared with healthy population (25.7% vs. 20.4%; P < 0.001). Blood group O was significantly less common in diabetic patients compared with nondiabetics (38.5% vs. 45.4%; P < 0.001). Among diabetic men, the frequency of only blood group B was significantly higher, while on the contrary among diabetic women the frequency of both A and B (29.7% vs. 24.8%; P = 0.03 and 25.5% vs. 20%; P < 0.009, respectively) were significantly higher as compared with nondiabetic healthy population. CONCLUSION: The findings in this study suggest that ABO antigens are associated with DM. DM is more common in individuals with blood group B.

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.

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.

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%).

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.

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.

The impact of air pollution on hospital admission for respiratory and cardiovascular diseases in an oil and gas-rich country.

OBJECTIVES: Aim of this study was to evaluate the impact of air pollution on hospital admissions for respiratory and cardiovascular diseases in an oil rich developing country, State of Qatar. METHODS: A prospective cohort population based study was conducted at different stations of Qatar during the period (2002-2005) for recording the concentration of air pollutants daily for sulphur dioxide (SO2), nitric oxide (NO), nitrogen dioxide (NO2), carbon monoxide (CO), ozone (O3) and particulate matter (PM10). Hospital admission data were collected from the inpatient discharge database of the Medical Records Department, Hamad General Hospital. RESULTS: An average of 5.36 admissions from ischemic heart diseases was counted daily in all the population which was even higher than the respiratory diseases (3.4/day). Minimum temperature was inversely correlated with all pollutants except for O3 and SO2. CONCLUSION: There was an association between increasing air pollutant levels and patients admitted for respiratory and cardiovascular diseases.

Hepatitis B and C viral infections in chronic liver disease: a population based study in Qatar.

We investigated the incidence of hepatitis B (HBV) and C (HCV) virus infection among patients with liver disease in Qatar from 2000 to 2005. The grading and staging of HBV and HCV cases were obtained from pathology reports at the principal reference laboratory for Qatar. Of the 915 liver patients studied, 29.4% had HCV and 2.5% had HBV. The incidence of HBV and HCV infection was greater in non-Qataris than Qatari nationals and in males than females, especially for HCV. Most cases were uncomplicated (89.0%) and had no inflammation (76.4%). The incidence of HCV has been increasing in liver patients in recent years up to a rate of 481 per 1000 patients with liver disease in 2005.

Viral kinetic of HCV genotype-4 during pegylated interferon alpha 2a: ribavirin therapy.

Kinetics of hepatitis C virus (HCV) during pegylated interferon (PEG-IFN) and early monitoring of viral decline were recently described to predict treatment outcomes and in turn reduce the course of treatment, adverse effects and cost. However, there is limited (if any) information on the viral dynamics of HCV-4. Our aim is to follow the HCV-RNA kinetics during PEG-IFN alpha 2a and ribavirin therapy and the best time for predicting sustained viral response (SVR) in genotype-4 patients. Serum HCV-RNA levels before initial dosing (baseline level) and at 24 h, week 1, week 4, week 12, week 24, week 48 and week 72 were assessed in 84 HCV genotype-4 patients treated weekly by PEG-IFN alpha 2a and daily ribavirin. At the end of treatment, out of the 84 treated patients, 19 (22.6%) were non-responders while 65 (77%) showed end-of-treatment response (ETR). However, 8 patients relapsed (9.5%), thus the SVR was observed in 57 patients (67.9%). Younger patients were more likely to attain SVR, where the odds of SVR increased by a factor of 0.94 for each year increase in age (95% CI: 0.90-0.99, P = 0.019). Although a significant negative correlation between stage of fibrosis and rate of viral decline at weeks 1 and 4 (P < 0.005 and 0.001, respectively) was seen, neither fibrosis stage (χ(2) = 3.4882, P > 0.1) nor grade of inflammation (χ(2) = 0.0057, P > 0.1) significantly predicted response to treatment. Non-responders had no or only a limited decline at week 1 and week 4, whereas sustained virological responders had a significant decline at both week 1 and week 4. Area under the (receiver operating characteristic) curve (AUC) revealed that week 12 is better than any other time point in predicting the SVR (AUC = 0.97; 95% CI: 0.94-1.01), (sensitivity 98.3%; 95% CI: 90.7-99.9), (specificity 88.5%; 95% CI: 71.0-96.0), positive predictive value of 94.9% and negative predictive value of 95.8%. A drop of more than 1.17 log viral load at week 1 and viral clearance or decline >3 log were considered as the earliest predictors of SVR. In genotype-4 patients, while failure to achieve an EVR at week 12 predicts non-response, an RVR at week 1 and week 4 98% guaranteed SVR. These findings further re-enforce the value of week 12 in the course of IFN treatment. Genotype-4 patients who show significant viral clearance (>1.17 log viral load) by the first week of treatment and viral clearance >3 log by week 4 are expected to show SVR and should therefore be assigned to a shorter drug regimen lasting for 24 weeks. Those unfortunate cases who do not achieve viral clearance by week 1 or week 4 should not be deprived from the treatment but rather given more time till week 12 before being classified as non-responders.

Prevalence and determinants of fecal incontinence in premenopausal women in an Arabian community.

OBJECTIVES: The aim of this study was to determine the prevalence, awareness and determinants of fecal incontinence among Qatari women. METHOD: In the cross-sectional community-based study in primary health-care centers, using a multistage sampling design, a representative sample of randomly selected 776 Qatari women aged from 40 to 48 years were approached from January to August 2007; only 596 women, with a response rate of 76.8%, gave consent and were included in the analysis. Participants completed a questionnaire assessing fecal incontinence in the previous 12 months and health care-seeking behavior for fecal symptoms. Fecal incontinence, determined by self-report, was categorized by frequency. Females reported the level of bother of fecal incontinence and their general quality of life. Potential risk factors were assessed by self-report, interview, physical examination, and record review. RESULTS: Of the studied Qatari women, 62 (10.4%) were found to have fecal incontinence. There was a significant difference between fecal incontinent and continent groups with regard to menopause (p < 0.0001), surgical repair of genital prolapse (p < 0.0001) and constipation (p < 0.0001). Only 31 incontinent patients (50%) had sought medical advice. Of the fecal incontinent women, 77.4% felt embarrassment in consulting a doctor and 77.4% believed their condition was worth reporting to a doctor. Aging (51.6%) was the major cause of fecal incontinence in women, followed by childbirth (40.3%), then menopause (25.8%) and lastly paralysis (14.5%). Most of the sufferers were troubled by their inability to pray (64.5%). Their relationship with their husband (41.9%) was the significant consequence for fecal incontinent Qatari women (p = 0.02); 37.1% isolated themselves from social activities and going out to shop. CONCLUSIONS: The study findings revealed that fecal incontinence is a common symptom among women in the community. There was a correlation between fecal incontinence and menopause. Overall, most of the fecal incontinent women reported that fecal incontinence significantly affected quality of life and only half of the studied women had consulted a physician for the symptom.

Size at birth in a rapidly developing economy: intrauterine growth pattern of UAE infants.

BACKGROUND: Despite rapid economic growth and the recognition of intrauterine growth pattern as an important indicator of neonatal morbidity and mortality, the size at birth relative to gestation for UAE (United Arab Emirates) live births has not been investigated. AIM: The present study evaluated the intrauterine growth pattern of UAE infants and compared the data with the currently used reference standard. SUBJECTS AND METHODS: A total of 2497 singleton hospital live births to UAE mothers without pregnancy complications were studied. Anthropometric measurements and gestational age assessment of each infant were carried out according to standard procedures. The LMS computer program was used to construct perentile curves. RESULTS: The mean birth weight, length and head circumference of 1113 male term infants were 3298 g, 50.6 cm and 34.5 cm, respectively, and the same parameters for 1118 female term infants were 3201 g, 49.9 cm and 34.0 cm, respectively. These growth parameters were higher in males than females. Mean birth weight data were similar to those reported previously from a study from an economically developed community. The 10th percentile values were higher than in the currently used reference chart. CONCLUSION: Data on size at birth for UAE infants indicate that continuing use of the current reference chart may underestimate the prevalence of fetal growth failure in the population. Data from larger numbers of very preterm infants are needed to generate percentiles charts for very preterm infants.

The level of awareness of stroke risk factors and symptoms in the Gulf Cooperation Council countries: Gulf Cooperation Council stroke awareness study.

OBJECTIVE: To assess the knowledge of stroke in the general public in the Gulf Cooperation Council (GCC) countries. BACKGROUND: The Arabian Gulf is a rapidly developing part of the world with major changes in the lifestyle that can increase the risk of stroke. To design effective stroke treatment and prevention strategies, an assessment of the public knowledge of stroke is required. METHODS: A cross-sectional community-based survey was conducted at primary health care centers (PHCs), in urban and semi-urban areas, of the GCC countries (Qatar, Saudi Arabia, Kuwait, Bahrain, the United Arab Emirates, Oman) on the level of stroke awareness in the general public. Health care workers completed 3,750 face-to-face interviews. RESULTS: 1,089 (29.0%) were familiar with the term 'stroke', and 29.3% considered the age group 30-50 at the highest risk for stroke. The commonest risk factors identified were hypertension (23.1%) and smoking (27.3%). People who did not know the term stroke had a higher incidence of diabetes, hypertension, and had more than one risk factor (p < 0.05). The most frequently identified stroke symptoms were weakness (23%) and speech problems (21.7%). Of those who recognized stroke, blockage of blood vessels was identified as the commonest cause of stroke (22%) followed by tension/worrying (20%). Doctors and nurses were regarded as the best source of stroke information (70%). In the univariate comparison, younger age (p < 0.001), higher level of education (p < 0.001), and female gender (p = 0.008) better predicted stroke recognition. In a multivariate logistic regression analysis, the level of education, monthly income and smoking were independent variables predicting stroke knowledge. CONCLUSION: The majority of the patients had not even heard the term stroke. Stroke knowledge was poorest among the groups that were at the highest risk for stroke. Stroke education has to focus on the high-risk groups, particularly the younger population. The health care workers at the PHCs and hospitals will need instructions on providing stroke information to the public. The level of knowledge of stroke risk factors and symptoms emphasizes the need for stroke education efforts in the community.