Avicenna - Volume 2014, Issue 1

This manuscript is developed from the findings of the Qatar Unified Imaging Project (QUIP), a research project documenting the cultural heritage of Qatar and the bordering Gulf regions through primary sources. Through the critical evaluation of published works and primary sources we explore the culture of traditional medicine in the Arab world beginning with historical texts of the 11th century to the most current study of Qatar in the 21st century. Traditions contain and reflect the cultural beliefs of the people who created and preserved what they believed most valuable.

Medical heritage figures prominently into the historical documentation of Qatar in the 20th century, and reflects the historical contributions of the Arabs to the development of chemistry and pharmacology, as well as the transnational influences that have affected Qatar's health care systems over time. Western-based medicine in the Gulf was introduced by Christian missionaries. These “modern” practices were grounded in a very different belief system, one foreign to the established healing culture. Despite ongoing developments in modern medicine many traditional practices maintain their popularity today. There is a viable place for tradition and heritage in healing. Medical anthropology helps us to identify cultural representations within traditional treatment practices that positively inform evolving healthcare procedures. We hypothesize that health care professionals can serve their clients' needs more effectively through the integration of traditional techniques into patient care.

Childhood obesity and overweight have reached epidemic proportions in both developed as well as some developing countries including Qatar. This paper is a literature review of studies published in the last 10 years in the area of childhood overweight and obesity in the state of Qatar. A high gross domestic product in Qatar has led to a high socio economic status among the Qatari population and the adoption western lifestyles that promote childhood overweight and obesity. Risk factors for overweight and obesity include poor dietary habits, lack of physical activity, sedentary lifestyles and socio-cultural practices. The prevalence of childhood overweight and obesity in Qatar was found to be comparable to other GCC countries. The state of Qatar is called upon to prioritize this public health issue and implement interventions to combat the problem.

Diabetes mellitus (DM) and gestational diabetes (GDM) are often diagnosed and their long-term progression monitored either by a fasting blood glucose test (FGT) or an oral blood glucose tolerance test (OGTT). These tests are well-standardized and are conveniently carried out via blood samples drawn from the patient's arm, which are later analyzed to measure blood glucose concentration.

Pre-analytical guidelines for laboratory analysis of blood samples intended for the measurement of plasma glucose maintain that the two principal factors which contribute to poor reproducibility of the OGTT are (i) the variable effects of administration of a hyperosmolar glucose solution on gastric emptying, and (ii) the ambient temperature while the blood sample is being captured. Although viewing ambient temperature as a purely random effect may be acceptable for routine diagnostic tests carried out in “the West”, the substantially higher regular temperatures experienced throughout the year by many African, Asian and Middle-Eastern countries suggest that in some locations and circumstances, ambient temperature might be better regarded as a systematic influence on the OGTT.

The principal purpose of this short literature review is to highlight the potentially significant influence of ambient temperature (during the blood-draw) on the results of OGTT blood glucose measurements. Physicians and healthworkers should be aware of this phenomenon which not only can affect the diagnoses for particular patients but is also capable of producing a significant impact on subsequent prevalence estimates for both diabetes and gestational diabetes. Further studies should be conducted throughout the Arabian Gulf to elucidate the magnitude of this effect on local populations by making use of well-characterized patients under standardized conditions where temperature and humidity can be strictly controlled.

Current clinical recommendations for patients with stable coronary artery disease (CAD) and those post-acute coronary syndromes (ACS) suggest initiation of patients on dual antiplatelet therapy, an angiotensin-converting enzyme (ACE) inhibitor, a beta-blocker and an HMG-CoA reductase inhibitor prior to hospital discharge. Commonly, this drug regimen is continued indefinitely. More recently, however, emerging evidence suggests that long-term therapy with beta-blockers may in fact be of no benefit to patients with stable CAD. This evidence-based review will summarize the current practice recommendations, as well as provide a critical analysis of available literature regarding beta-blockers in stable CAD. Both efficacy and safety will be considered and implications for current clinical practice will be discussed.

Objectives: To explore the prevailing attitudes and knowledge of evidence-based practice (EBP), and to compare the relationship between EBP attitudes and knowledge, amongst nurses in Qatar's public health system.

Study design: A quantitative cross-sectional survey evaluating EBP-related attitudes and knowledge amongst a sample of 400 registered nurses at Hamad General Hospital (HGH), Qatar's largest public hospital.

Methods: Data was collected via a questionnaire, distributed to participants who were randomly selected using a hospital nursing staff directory. Descriptive analysis, Shapiro-Wilk Test for normality, Spearman's Rank Correlation Coefficient analysis (to evaluate significance of correlation exhibited between demographic and professional variables), Mann-Whitney U tests and Kruskal-Wallis tests were used to analyse the data.

Results: Significant, positive correlation was found between EBP attitude and knowledge scores, indicating a complementary pattern in which EBP perceptions develop. Age was also found to have a significant, positive correlation with EBP attitude, though no other experience indictors provided significant outcomes. Application of EBP knowledge was found to increase with level of education and varied by clinical specialty, suggesting that both academic background and current professional practice exert influence on perceptions and familiarity with EBP.

Conclusion: The results offer valuable insight on EBP attitudes and knowledge in HGH's nursing workforce, indicating where EBP perceptions and preparedness may differ within. This study is a pivotal first step in understanding the status quo in Qatar's health system as it pertains to EBP, from which future research can help develop tailored development strategies for EBP implementation, leading to quality improvement in health outcomes.