Journal of Emergency Medicine, Trauma and Acute Care - 1 - Qatar Health 2022 Conference abstracts, January 2022

Welcome to this special issue of JEMTAC dedicated to the selection of 74 abstracts submitted to the Qatar Health 2022 online conference. The years are passing and the COVID-19 pandemic situation has not changed much globally. Although new vaccines have been developed and several restrictive measures have been rolled out in most countries to protect people, thousands are still succumbing to the effects of COVID-191,2. Similar to t Read More

Background: Hosting 2022 FIFA World Cup (WC2022) in Qatar is a mega event that can shape a country's development1. Partnerships as preparedness efforts for mass gatherings within the health system can ensure a safe and efficient practice in hosting countries2,3. This work aims to provide an analysis of the existing literature around partnership frameworks to inform the development of an innovative partnership framework for Prim Read More

Background: International sporting events such as the World Athletics (WA) competition require proper medical coverage to ensure the wellbeing of athletes, support teams, and spectators1. Several factors may have an impact on people's requirements for medical attention such as the climate, altitude, and intensity of the sporting competition on the athletes2,3. The International Association of Athletics Federations (IAAF) held its 201 Read More

Background: Sudden Cardiac Arrest (SCA) is defined as the abrupt loss of heart function as an occurrence without physical contact (absent commotio cordis). SCA's morbidity ratio is 1:50,000 of all deaths. The published estimates on SCA suggest that 11% of all victims have a normal heart. Current screening investigations include electrocardiography (ECG), echography, 24-hour ECG monitoring, eliciting stress history, and cardiac Magnet Read More

Background: Regular physical activity (PA) is an effective preventative measure for diverse health risks among all age groups 1. Global PA guidelines provide recommendations on the required levels for active lifestyle based on evidence-based behavioral benchmarks to increase awareness and reduce overall morbidity and mortality rates 2. The Qatar National Physical Activity Guidelines (QNPAG) were first developed in 2014. The recently rel Read More

Background: Inter-professional education (IPE) highlights collaborative practices aimed at promoting the working relationship between two or more healthcare professions1. IPE achieves together more than what individuals can achieve to improve healthcare practices at an organizational level1. In order to reduce the risk of injury during positioning and transfers of children admitted in the Almaha units, nursing, physical therapy, and occ Read More

Background: Complementary medicine therapies are used globally. Around 88% of the countries that are members of the World Health Organization (WHO) reported using such practices while there is no information reported from the remaining 12% of countries 1. Cupping therapy is an ancient therapy trending to be used among athletes 2. Other complementary medicine therapies such as chiropractic are also used in sports medicin Read More

Background: The ongoing coronavirus disease 2019 (COVID-19) pandemic has resulted in a global health emergency. With incomplete vaccination and incomplete protection of the vaccinated population, there remains an urgent need to develop drugs to treat COVID-19. Our previou in silico analysis suggested vulnerability of SARS-CoV-2 to inactivation by the endogenous reactive metabolite, methylglyoxal (MG), by modification of arginine Read More

Background: Coronavirus Disease 2019 (COVID-19) was first discovered in China and resulted in a pandemic crisis.1,2 Many agents were investigated with inconclusive outcomes.3 This study was conducted to compare the efficacy and safety outcomes of darunavir-cobicistat versus lopinavir-ritonavir in the treatment of patients with COVID-19. Methods: This retrospective, multicenter, observational study was conducted on adult patients hospi Read More

Background: COVID-19 infection is caused by a novel coronavirus. It was identified initially in late 2019 as the cause of a cluster of pneumonia cases in Wuhan, China. It spread worldwide causing a pandemic. Since the start of the COVID-19 pandemic, multiple complications have been linked to COVID-19 infections, one of them being pleural effusion. To the best of our knowledge, only a few case reports have discussed the incidence of candida Read More

Background: Paramedics are subjected to high levels of stress, which increase their risk of depression, burnout, quitting the profession, or even committing suicide.1 Some recent studies have focused on the coping strategies used by nurses in response to the COVID-19 pandemic2, but little is known regarding paramedics. This study explored the potential coping strategies used by Hamad Medical Corporation Ambulance Service (H Read More

Background: People respond to stressful situations differently based on their ethnicity.1 This study explored the impact of ethnicity on coping strategies used to deal with work-related stress among Hamad Medical Corporation Ambulance Service (HMCAS) paramedics in Qatar before and during the COVID-19 pandemic. It is based on the associated work conducted by the same team.2,3Methods: An online survey combining validated tools Read More

Background: Paramedics are at risk of burnout which represents a concern for the healthcare system and public health1. In Italy, about 20% of health practitioners were infected, and some died during their work fighting against the COVID-19 pandemic2, but little is known regarding paramedics. This study assessed the level of stress associated with the work of Hamad Medical Corporation Ambulance Service (HMCAS) paramedics in Qatar Read More

Background: Internationally, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, causing corona virus disease (COVID-19), has increased the demand on healthcare services and resources1. The proper use of personal protective equipment (PPE) by paramedics has recently become apparent2. The risk of COVID-19 transmission has increased during prehospital life-saving procedures generating aerosols such as n Read More

Introduction: The COVID-19 pandemic had a significant impact on medical and maternity services across the world. The reported increase in maternal and neonatal morbidity and mortality is not only attributable to the disease itself but also the disruptions in the health services during lockdowns1,2. Qatar maintained continuity of maternity services during the peak of the pandemic by telephone consultations3. It played a vital role in mini Read More

Background: In response to the declaration of COVID-19 reaching pandemic status, Mesaieed General Hospital (MGH) was commissioned in record time1. A multidisciplinary team of healthcare professionals effectively worked together to confront the challenges and changing demands that arose due to the crisis2. This work aims to describe the systematic approach used in our newly opened hospital in preparation for the national surges of Read More

Background: Due to the COVID-19 pandemic, all out-patients clinics shifted to telehealth visits1. However some patients still needed to be seen as face to face visit2, mostly through the new urgent referrals which were overbooked in the clinics due to the limited availability of slots3. The aim of this quality improvement project was to decrease the percentage of re-booked urgent referrals for in-person visits in the general paediatric clinic Read More

Background: The COVID-19 pandemic changed the way we deliver primary health care services for good. The need to protect staff and patients from the spread of infection while still providing essential healthcare services to the public was challenging but ignited innovations to facilitate healthcare delivery. International research supports the action of containing the spread of a virus by limiting the number of people co-located, if possible Read More

Background: Since the 2020 COVID-19 Pandemic struck the healthcare industry, there has been a rapidly evolving and escalating situation across the globe that lead healthcare organizations to embrace changes at an accelerated rate1. Hamad Medical Corporation (HMC) had to cope with an overwhelming number of patients being admitted to Acute Care areas during early 2021. When four HMC tertiary and secondary care hospit Read More

Background: As the number of coronavirus disease (COVID-19) patients has rapidly increased around the world, the World Health Organization (WHO) declared the COVID-19 outbreak as a global pandemic in March 2020.1 The pandemic created a global crisis affecting all countries, business sectors, and citizens around the world in their everyday lives.2 Qatar's national policies and strategies focus on protecting the lives and the recovery Read More

Background: There is a paucity of robust, theory-based research investigating vaccination behavior.1 Using Theoretical Domains Framework (TDF), the study aimed to explore the key behavioral determinants influencing vaccine behavior among pharmacy professionals in Qatar. Methods: A cross-sectional online survey of pharmacy professionals was conducted in April 2021. Survey items included questions related to demographics, va Read More

Background: Pharmacists are front-line healthcare workers who contributed to fighting the coronavirus disease 2019 (COVID-19) pandemic. Knowledge and attitude of both community and hospital pharmacists about COVID-19 were reviewed at different practice settings1. This work aims to evaluate the knowledge and attitude of hospital pharmacists in Qatar about COVID-19. Methods: A descriptive cross-sectional web-based survey was distri Read More

Background: COVID-19 has brought several patient challenges related to anxiety disorders impacting their wellbeing 1. According to Vaartio-Rajalin et al., 2, expressive art therapy (AT) has many advantages including mental health, physical, and social wellbeing. AT was introduced to COVID-19 patients on the 29th of May, 2021 as part of our Patient Wellbeing Programme launched at Umm Salal Isolation Facility (USIF) in Qatar. USIF provided Read More

Background: Home Health Care Services is a non-residential long-term care facility, part of Hamad Medical Corporation. It serves around 2,700 patients, the majority of which are elderly, with multiple co-morbidities and polypharmacy, and subsequently, an increased risk of drug-related problems and inappropriate medication use.1 The clinical pharmacists’ ultimate focus is to provide effective pharmaceutical care to improve health outcom Read More

Background: In the data collected in the Hamad General Hospital (HGH), general pediatric in-patient unit, it was found that only 58% of medication orders were correctly prescribed by the resident physicians. This leads to patient care delays in a critical context and affects the discharge process1,2. By placing the correct order of medications, medication errors can be reduced. It prevents unnecessary calls being made to physicians by nu Read More

Background: Asthma is a leading chronic disease in children worldwide, which if left untreated or poorly controlled, can lead to altered lung function and poor quality of life.1 Early detection and improved control of asthma are recommended to decrease utilization of emergency services and hospitalizations. Respiratory diseases are the most common conditions seen in Pediatric Emergency Centers (PECs) in Qatar.2 The five PECs a Read More

Background: Understanding the epidemiology of traumatic head injuries (THI) is essential to shape public health (PH) policies, implement prevention strategies, and justify the allocation of resources towards public safety, education, and research 1. The World Health Organization (WHO) has recognized a gap in data and the high financial cost of THI's. Falls from shopping carts (SCs) are the most common cause of such injuries. This study aim Read More

Background: The Level 1 Trauma Center at Hamad General Hospital (HGH) offers world-class trauma services for Qatar, which also boasts the coveted Trauma Distinction Accreditation1 award by Accreditation Canada. Consequently, HGH is expected to meet the Level 1 service specifications, which requires that an anesthetist should respond to Trauma 1 (T1) call within 15 minutes. Unfortunately, it was reported that this was not achieved Read More

Background: The evaluation of the pregnant trauma patient presents unique challenges. There are two patients potentially at risk; the mother and the fetus who both require evaluation and management.1 Physiological changes like ligaments laxity, weight gain, and changes in the center of gravity make pregnant women at increased risk for trauma.2 Knowing the other physiological changes is crucial for the adapted trauma management in p Read More

Background: The diaphragm is a musculotendinous structure providing a significant drive for respiration and lung expansion during inspiration. The other muscles aiding in ventilation are intercostal, abdominal, and accessory muscles, including sternocleidomastoid and scalene.1 Direct neck trauma, either blunt or penetrating, potentially can contribute to diaphragmatic paralysis related to phrenic nerve palsy.2 The use of ultrasound to confirm d Read More

Background: Benign Prostatic Hyperplasia (BPH) is one of the most frequent diseases in men. The laser treatment for BPH has challenged TURP due to advances in laser technology, a better understanding of tissue-laser interactions, and rowing clinical experience.1 The objective of this work is to evaluate the safety and efficacy of Holmium Laser Enucleation of Prostate (HoLEP) and compare it to Bipolar Transurethral resection of the p Read More

Background: Mesaieed Hospital (MSH) was a COVID-19 center from the 7th of February till the 28th of June, 2021 with a high capacity and turnover. Therefore, timely discharge was crucial.1 Before implementing the clinical pharmacy service, MSH discharge pharmacy was receiving discharge prescriptions from noon. Since clinical pharmacists did not review discharge prescriptions, errors identified by the discharge pharmacy result Read More

Background: Overactive bladder (OAB), as described by the International Continence Society (ICS), is characterized by complex symptoms, which include urinary urgency (strong, sudden need to urinate that is difficult to delay) with or without urge incontinence that is usually associated with frequency (abnormally frequent urination) and nocturia (excessive urination at night).1 The objective of this study is to assess the efficacy of Read More

Background: Antimicrobial resistance (AMR) determinants such as mobile colistin resistance (MCR-1) that encodes colistin resistance are increasingly spreading in healthcare-associated and community-acquired infections.1 Colistin, a cationic peptide antibiotic, resistance is encoded by the MCR-1 gene that functions as phosphoethanolamine (PEA) transferase which adds a PEA moiety to lipid A head group rendering it resistant to host antimic Read More

Background: Group B Streptococci (GBS) or Streptococcus agalactiae colonize humans genitourinary and gastrointestinal tracts particularly in females1. The pathogen is capable of causing invasive disease primarily in infants, pregnant and postpartum women as well as the elderly and patients with comorbidities2. There is a paucity of studies on the disease with regional differences in prevalence and presentation of invasive bloodstream Read More

Background: Antimicrobial resistance (AMR) is a global threat to public health. There is a dire need for new antibiotics as AMR threatens our last-resort antibiotics efficacy.1,2 Myrtle plants have been used in folk medicine for centuries. Essential oils from these plants demonstrated therapeutics effects. This study aims to examine the antibacterial activity of essential oils extracted from Myrtus communis L and Melaleuca leucadendron against Read More

Background: The rise in antibiotic resistance requires prompt action to reduce the burden of untreatable bacterial diseases1. Staphylococcus aureus is a human commensal and opportunistic pathogen that causes a broad range of diseases, from mild skin infections to infective endocarditis. The World Health Organization has placed S. aureus on the high-priority pathogen list due to its multidrug-resisting nature2. The study aims to identify Read More

Background: Non-statin therapies (NSTs) have been shown to provide additional benefits for cardiovascular risk reduction among patients with type 2 diabetes mellitus (T2DM), but their economic merits have not been confirmed. The objective of this systematic review is to evaluate the cost-effectiveness of NSTs for primary and secondary prevention of cardiovascular disease (CVD) in T2DM patients.1Methods: A literature search Read More

Background: Subclinical hypothyroidism (SCH) remains one of the most common biochemical manifestations of thyroid dysfunction.1 Similarly, type 2 diabetes mellitus (T2DM) is considered the most common metabolic disorder in clinical practice.2Methods: This is a systematic review to ascertain the prevalence and optimum management approach for thyroid dysfunction in patients with T2DM. We conducted a search on PubMed and Goog Read More

Background: Insulin therapy is commonly used to control hyperglycemia in hospitalized diabetic patients. There are different delivery devices of Aspart and Glargine insulin which are available in 1000 IU vial and 300 IU Flexpen. As per the manufacturer's recommendations, insulin pre-filled pens are designed for single patient use only, whereas the vial form is intended for multidose administration for different patients, therefore, the selec Read More

Background: One of the most prevalent viruses among dialysis patients is Hepatitis C as it affects 8.4% of the dialysis patients in Qatar1. It causes serious complications including end-stage liver disease. There is no available vaccine to protect against the transmission of the Hepatitis C virus (HCV). However, antiviral drugs lead to precious benefits including reducing the risk of morbidity/mortality, increasing life expectancy, and eventuall Read More

Background: Hamad General Hospital (HGH) Nephrology Department is the main provider for dialysis services in Qatar, serving almost 900 patients. The introduction of the COVID-19 vaccination is a crucial step in protecting End Stage Renal Disease (ESRD) patients who are vulnerable and prone to infections due to their immunocompromised status.1 They are at high risk because they are unable to practice adequate safe physical distan Read More

Background: Patient-centered care is a concept focussing on meeting the specific health needs of patients as expressed by them. Patients Reported Experience Measures (PREM) is another concept associated with patient-centered care. PREM surveys capture information about the healthcare experience as perceived by patients.1 Its importance lies in the incorporation of patient feedback into the clinical decisions and service evolut Read More

Background: The D-dimer test has a diagnostic role in pulmonary embolism (PE) and deep vein thrombosis (DVT). In a low-risk patient with negative D-dimer, PE or DVT can safely be ruled out. This work aims at investigating whether the D-dimer has a similar role in cerebral vein thrombosis (CVT) diagnosis. Methods: A literature review was performed in PubMed, Google scholar, and BestBETs electronic resources to identify studies publi Read More

Background: Clinical Pharmacists (CPs) have a vital role in the patient transition of care (TOC), including medication reconciliation and counseling upon admission, transfer, and discharge.1 The Clinical Pharmacy Department at Al Wakra Hospital, Qatar, Hamad Medical Corporation (HMC), established a collaborative practice agreement with the Internal Medicine Department.2 The post-discharge phone follow-up (PDPF) telehealth service aim Read More

Background: For some time, paramedics and nurses of the National Ambulance Service in Qatar provided outpatient parenteral antimicrobial therapy (OPAT) to patients with the support of Family Physicians. Like in many other countries of the Middle East, there is a high prevalence of antimicrobial resistance which makes treating infectious conditions challenging. Methods: This is a retrospective cohort study of patients referred to the A Read More

Background: Labour analgesia blocks the aggravated sympathetic overactivity due to labor pains in preeclampsia.1 Performing regional anesthesia in obese parturients with severe scoliosis poses challenges due to technical difficulties and alterations in epidural space.2Case presentation: A 24-year-old primigravida (40 weeks, weight 111kg, Body Mass Index 41) presented to our emergency department with mild contractions and hypertensio Read More

Introduction: Nearly 98% of women in developed nations benefit from antenatal services.1,2 In Qatar, all pregnant women are provided with antenatal care services at primary and secondary care facilities. If indicated, they are referred or transferred to tertiary care hospitals.3 However, it was noted that a significant number of women opted not to avail of these services. This study is conducted to assess the prevalence of women with no/p Read More

Background: Poor knowledge and attitude of postpartum complication (KAPC) among women delays their management and increases Maternal Mortality Ratio (MMR).1 MMR in Lebanon increased from 24 deaths per 100,000 live births in 2005 to 29 in 2017.2 This study aims to assess the perceived KAPC of Lebanese women and how it differs according to their level of education and age groups, in different regions in Lebanon. Methods: This com Read More

Background: Early ambulation is considered as one of the post-operative interventions in Enhanced Recovery After Surgery protocol and women could be ambulated anytime from 6-8 hours post-surgery.1 Early ambulation benefits patients by reducing the risk of deep vein thrombosis, improving breastfeeding rate, promoting better diet and nutrition, and improving their satisfaction.2 A retrospective baseline data collection from Dece Read More