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- Volume 2019, Issue 2
Qatar Medical Journal - 2 - Qatar Critical Care Conference Proceedings, February 2020
2 - Qatar Critical Care Conference Proceedings, February 2020
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Social media and critical care
By Mamoon YusafSocial media has transformed the way we communicate with each other in the last decade or so. Out of 4 billion internet users, more than 3 billion are on social media. The medical community has also been transformed in terms of how we approach this vast medium of information. Microblogging sites like Twitter are beneficial in the way we share and disseminate professional knowledge. The critical care community has recently gained a lot Read More
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How to do clinical trials in the ICU
More LessSite-initiated clinical trials are challenging, particularly with vulnerable populations like ICU patients. But they can be useful if you can answer “Yes” to these questions: (1) Could the answer change practice? (2) Does my ICU see enough of these patients to answer the question? (3) Can I treat both the investigational and control group patients in a fair manner? Other approaches to ICU clinical research, such as joining another multicenter cli Read More
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Burnout signals are alarming worldwide: the active role of leadership
Authors: Amr S Omar, Yasser Shouman and Suraj SudarsananIntroduction: The burnout phenomenon first came to clinical science 50 years ago. It is exponentially rising worldwide which prompted its discoverers to develop the most popular tool for its assessment, known as the Maslach burnout inventory (MBI)1. Common symptoms of burnout include depression, irritability, and insomnia. It is known to hit professional areas where higher levels of stress are common. Intensive care unit (ICU) practitioner Read More
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Weird and wonderful ICU cases: Unusual causes of shock
More LessDuring their practice, intensivists are ought to face challenging cases that are rare. Intensivists need to be aware of the rare causes of shock beyond common presentations. In each category of shock, there are rare causes that require prompt identification and management. Certain clues in the patient's presentation might point to those rare causes. Classically shock is classified into: distributive, hypovolemic, cardiogenic, and obstruc Read More
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Factors contributing to patients’ presentation to the emergency department of an academic hospital in Oman after leaving other hospitals against medical advice
More LessBackground: One of the reasons to leave against medical advice (LAMA) from a hospital is to seek treatment in another hospital1. Those patients are at high risk of readmission and mortality compared to patients with planned discharge2. The aim of this study was to identify the factors for patients' presentations to an academic tertiary hospital Emergency Department (ED) specifically after LAMA from another hospital and to investigate t Read More
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Nutritional management of critically ill patients: outcomes associated with the implementation of a clinical dietetic service within a high-volume intensive care unit
More LessBackground: The provision of nutritional support among critically ill patients is complex and multifactorial.1 There is a gap in the literature around the optimal amount of energy and protein critically ill patients require.2 There has been a direct association with malnutrition and morbidity and mortality among critically ill patients.3,4 The benefit of early nutritional support is becoming increasingly understood within the literature, albeit there h Read More
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Hyponatremia induced compartment syndrome of all extremities: Case report and review
Authors: Nissar Sheikh, Gulzar Hussain, Arshad Chanda and Shakeel RaizBackground: Compartment syndrome is a well-recognised complication from trauma, burns, orthopaedic, vascular, or other surgery of the limbs. Hyponatremia related rhabdomyolysis leading to compartment syndrome of all four extremities with renal and hepatic impairment is rare.1,2,3 Although the rhabdomyolysis can occur without hyponatremia. Young men have the highest incidence of compartment syndrome, particularl Read More
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Analgesic sparing effects of Dexmedetomidine in surgical intensive care patients
Authors: Nissar Sheikh, Arshad Chanda, Saher Thaseen, Zia Mahmood, Adel Ganaw and Nabil ShallikBackground: Dexmedetomidine (Dex) is a sedative agent with analgesic property.1,2 A recent review of the literature has shown clear advantages over the traditional sedation namely lesser respiratory depression, less delirium, better sedation, analgesia, organ protection and anti-shivering effect.3,4 Optimal sedation in critically ill patients is of vital importance, under sedation will raise work of breathing and causes adverse hemodynamic Read More
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A rare case of propofol related infusion syndrome in a neurosurgical patient
Authors: Ranjan M. Mathias, Nissar Shaikh, Arshad Chanda, Qazi Zeeshan and Shakhsanam MirishovaBackground: For the last three decades propofol has been used in anaesthesia and as a sedation technique. Several reports have warned about its use in higher doses for prolonged durations as it can have severe side effects such as propofol related infusion syndrome (PRIS), which can be fatal.1,2,3 PRIS is a rare and complex clinical condition characterized by severe metabolic acidosis, rhabdomyolysis, cardiac, liver and kidney dysfunctio Read More
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Safety of prone positioning in critically ill patients
Background: During the past two years, 5% of patients admitted to the Medical Intensive Care Unit (MICU) of Hamad General Hospital (HGH) had severe acute respiratory distress syndrome (ARDS) with a PaO2/FiO2 ratio less than 100 mmHg. The risks associated with this condition include ventilator associated lung injury, over distension of lungs, and poor gas exchange which results in increased morbidity and mortality. With quality impro Read More
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Towards next generation cannulation simulators
Background: Cannulation, in extracorporeal membrane oxygenation (ECMO), is the act of inserting a cannula through the body1. For femoral veins, femoral arteries, and the jugular vein, the cannula stops at the inferior vena cava (IVC) beside the hepatic vein and at the beginning of the distal aorta, and the superior vena cava at the right atrium, respectively. Cannulation is considered a critical operation and requires intensive training. Sim Read More
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Incidence, risk factors and outcome of delirium in a surgical intensive care unit of a tertiary care hospital
Authors: Asghar Ashraf, Madiha Hashmi, Amir Raza, Bushra Salim and Muhammad Faisal KhanBackground and Objective: Delirium in critically ill patients is common and distressing.1 The incidence of delirium in intensive care units (ICU) has been reported to range from 45-87%.2,3 Arguably, delirium is a well-recognized cause of morbidity and mortality among ICU patients. It can lead to longer hospital stays, lower six-month survival, and cognitive impairment persisting even years after discharge.3 It has therefore been recommende Read More
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Risk factors for severe bronchiolitis among children in the emergency department at Sultan Qaboos University Hospital
Authors: Maitha S. Al Asmi and Abdullah Al ReesiBackground and Aim: Bronchiolitis is an acute viral lower respiratory tract infection. It is a common disease among children below 2 years old, resulting in frequent presentation to the emergency department and occasionally admission1. For proper management of such patients, studying the disease spectrum and the risk factors is important2. The aim of this study was to investigate the demographics and risk factors for severe bronchioliti Read More
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Reflective learning conversations as an approach for clinical learning and teaching in critical care
Authors: Emad Almomani, Tawfiq Alraoush, Omar Saadah, Ahmed Al Nsour, Megha Kamble, Jisha Samuel, Karim Atallah and Emad MustafaBackground: Reflective practice has become an integral element in healthcare and education.1,2 Hamad Medical Corporation (HMC) is the largest healthcare organization in Qatar and it aims to: develop highly competent healthcare practitioners, promote nurses’ critical thinking, enhance the implementation of evidence-based practice, encourage deep learning approaches, create positive learning environments, maintain patient s Read More
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Qatar National Paediatric Sepsis Program: Where are we?
Authors: Ahmed Labib and Rasha AshourBackground: Sepsis and septic shock are medical emergencies and necessitate early and timely recognition and intervention. Failure of early recognition can lead to significant deterioration and may unfortunately culminate in death.1,2 Young people are considered at high risk of sepsis.3,4 Despite hundreds of trials and a multitude of approaches, an effective and efficient sepsis-cure agent does not exist. Most research into sepsis mana Read More
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Mortality of ischemic stroke patients admitted to the intensive care unit in Sultan Qaboos University Hospital
More LessBackground: Haemorrhagic and ischemic stroke is the second most common cause of death worldwide, with more than 10 million cases each year1. Hypertension, diabetes mellitus, smoking, hyperlipidemia, and aging are the most common risk factors of this cerebrovascular disease2. Mortality and disability increase with the complications experienced during the early phase of stroke, such as infection, seizures, and thromboembolism3. T Read More
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Pre-hospital use of capnography during emergency sedation analgesia
Background: Providing optimal patient care in the challenging, uncontrolled, and sometimes hostile pre-hospital environment may require the use of potent analgesics and sedatives. During pre-hospital emergencies, narcotics or sedatives administered for sedation, anxiolysis, or analgesia to allow the patient to tolerate unpleasant procedures, such as traction splint application, can result in cardiovascular and respiratory adverse events.1 E Read More
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Scoline apnoea and pregnancy: SICU experiences
Authors: Nissar Shaikh, Mohammed A. Imran, Muhammad Zubair, Moad Ehfeda and Firdous UmmunnisaBackground: Suxamethonium chloride (scoline) is a short acting depolarizing muscle relaxant; it was discovered early in the nineteenth century but not used in clinical practice until 1951.1 Scoline became a popular muscle relaxant due to its rapid onset of action, quick metabolism and hence shorter duration of action. It is metabolized by cholinesterase. Scoline apnoea was described within a few years of clinical use of Suxamethonium du Read More
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Life threatening perioperative arrhythmias and hypokalemia
Authors: Ranjan M. Mathias, Nissar Shaikh, Shakeel Riaz and Arif VallianiBackground: Perioperative arrhythmia is a common general anesthesia complication of cardiothoracic surgeries. Sudden or acute onset of life threatening perioperative arrhythmias are rare clinical events in non-cardiac surgical patients.1,2 Electrolytes imbalance, particularly hypokalemia and dyskalemia, is one of the main possible underlining cause for the occurrence of these arrhythmias.3,4,5 We present two cases of severe hyp Read More
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Post renal transplant acute myocardial infarction
Authors: Arshad H. Chanda, Nissar Shaikh, Aref Villani, Mohammad Aturahman and Marcus LanceBackground: Renal transplant recipients (RTR) have a comparatively lower risk of acute myocardial infarction (AMI) than wait-list patients. Cardiovascular diseases especially AMI are the leading cause of morbidity and mortality in post-renal transplant patients.1,4 They account for up to 50% of the deaths in RTR. The incidence of AMI in RTR is about 0.2% but it is on the rise. Meticulous pre-operative assessment of cardiac status, a Read More
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