Qatar Medical Journal - Volume 2024, Issue 4

Background and purpose: Recent studies have highlighted the clinical characteristics and incidence of post-COVID-19 stroke conditions. Comparing the function and overall prognosis of stroke patients and post-COVID-19 stroke patients is an intriguing idea. Therefore, the aim of this study was to examine and compare the functional outcomes between the two groups from an occupational therapy perspective.

Methods: Forty patients admitted to a rehabilitation facility were included, 20 of whom were diagnosed with post-COVID-19 stroke and 20 with non-COVID-19 stroke (ischemic and hemorrhagic). The study was a mixed design consisting of both prospective and retrospective data collection. Existing data from electronic medical records were used for the retrospective dataset. The retrospective dataset only consisted of data from post-COVID-19 stroke patients. The prospective dataset consisted of data from non-COVID-19 stroke patients. Data were collected at the time of admission and at discharge. Outcome measures included the functional independence measure (FIM), the Action Research Arm Test (ARAT), the post-COVID-19 functional status (PCFS) scale, the Borg rating of perceived exertion, and the mini-mental state examination (MMSE).

Results: Both the post-COVID-19 stroke and non-COVID stroke groups showed significant differences before and after rehabilitation (NIHSS (National Institutes of Health Stroke Scale): p = 0.014, 0.000, FIM: p = 0.000, 0.000, MMSE: p = 0.015, 0.000, ARAT: p = 0.000, 0.000, respectively). However, the mean difference in the non-COVID-19 stroke group was higher than that in the post-COVID-19 stroke group, particularly in MMSE, FIM, and NIHSS scores (NIHSS: 2.8 ± 0.4, 0.9 ± 0.04, FIM: 34.8 ± 5.03, 32.95 ± 0.81, MMSE: 5.05 ± 3.5, 0.7 ± 1.17, ARAT: 1 ± 0.062, 1.2 ± 0.47, respectively). It was also found that in the post-COVID-19 stroke group, age had a positive influence on NIHSS (p = 0.022) and FIM (p = 0.047), and impaired side affected the NIHSS scores (p = 0.007). In the non-COVID-19 stroke group, significant correlations were found between the NIHSS and FIM scores (r = -0.445, p = 0.050) and the NIHSS and ARAT scores (r = -0.529, p = 0.017).

Conclusion: Higher mean differences in the non-COVID-19 stroke group than in the post-COVID-19 group could be due to additional COVID-19 complications in the stroke condition itself. Overall functional gain was observed in both groups due to the effective rehabilitation. Therefore, rehabilitation is critical for functional optimization in such vulnerable populations. There is an urgent need to consider post-pandemic rehabilitation aspects.

Purpose: The aim of this study was to investigate the possibility of including miRNA-371 and miRNA-143 in the early detection and diagnosis of the extent of the metabolic syndrome (MetS) in obese patients by measuring the expression of miRNA-143 and miRNA-371 in metabolically and pre-metabolically obese individuals and comparing the results with metabolically healthy obese controls. In addition, the study aimed to assess the correlation between the two types of miRNA and the criteria of MetS.

Methods: The expression levels of miRNA-143 and miRNA-371 were determined using quantitative real-time polymerase chain reaction (PCR) for 135 obese patients who were divided into the following three different categories based on metabolic criteria: 1) metabolic syndrome obese (MetS) group, 2) pre-metabolic syndrome obese (PreMetS) group, and 3) metabolically healthy obese (MHO) group.

Results: The results indicated a significant association of miRNA-143 and miRNA-371 with the MetS group compared with the PreMetS and MHO groups. As a result, the correlation analysis for these miRNAs revealed a large association with the results of the analysis for various factors, especially with regard to fasting glucose and lipid profiles in the MetS group.

Conclusion: There was an association between obesity and MetS. This study was able to establish the role of miRNA-371 and miRNA-143 molecules in metabolically obese individuals. Therefore, by tracking the regulatory pathway of these molecules and expanding the understanding of the process of regulation and interference with the various metabolic pathways, this study could provide a deeper analysis and understanding of the MetS in obesity and the molecular causes leading to it.

Background: Hirsutism is a common endocrine problem with high prevalence in Iraqi women. Polycystic ovarian syndrome and idiopathic hirsutism (IH) are the most common etiology of this disorder. There is a clear association between insulin resistance and polycystic ovarian syndrome. However, there is insufficient data on the relationship between insulin resistance and IH.

Aim: The aim of this study was to determine whether Iraqi women with IH have insulin resistance.

Methods: The study included two groups: 60 Iraqi women with IH and 60 women without hirsutism as a control group. A physical examination, a medical history, and the patient's age and BMI were collected. Blood samples were collected for hormone analysis, including insulin, follicle-stimulating hormone, luteinizing hormone, prolactin, dehydroepiandrosterone sulfate, 17-hydroxyprogesterone, and free testosterone. To evaluate insulin resistance in both groups, the homeostasis model assessment-insulin resistance (HOMA-IR) and the quantitative insulin sensitivity check index (QUICKI) were used in addition to the Matsuda index.

Results: Basal insulin was higher in the IH group (9.5 ± 0.2 mIU/L) than in the control group (4.8 ± 3.7 mIU/L), with a p value of < 0.0001. HOMA-IR was higher in the IH group (2.3 ± 4.1 μU mg), while in the control group, it was (0.8 ± 1.2 μU mg), with a p value of 0.007. There was a significant difference in the QUICKI, which was lower in the IH group (0.31 ± 0.2 μU^-1/mg) than in the control group (0.45 ± 0.1 μU^-1/mg), with a p value of < 0.0001. The insulin sensitivity index (Matsuda) was significantly lower in the IH group (3.1 ± 0.4) than in the control group (7.8 ± 1.3), with a p value of < 0.0001.

Conclusion: According to the results of this study, Iraqi women with IH have insulin resistance and higher basal insulin levels.

Objectives: The aim of this study was to investigate the potential cardiac side effects associated with Pfizer/BioNTech and Sinopharm vaccines.

Methods: A total of 200 healthy volunteers were enrolled after receiving two doses of Pfizer/BioNTech or Sinopharm vaccine 21 days apart. In addition, 100 healthy, unvaccinated individuals were included as a control group. Cardiac biomarkers such as cardiac troponin-I (cTnI), creatinine kinase–myocardial band (CK-MB), and myoglobin (MYO) were measured 4 days after receiving the second dose of vaccine. In addition, the SARS-CoV-2 neutralizing antibody levels of all participants were also determined.

Results: Post-vaccination findings in both vaccinated groups were comparable. There was no statistically significant difference in cTnI, MYO, and CK-MB levels between the Pfizer/BioNTech and Sinopharm vaccine groups. Furthermore, our results showed that the levels of SARS-CoV-2 neutralizing antibodies stimulated by the Pfizer–BioNTech vaccine were significantly higher (171.19, p < 0.001) compared to the Sinopharm vaccine (70.14). Owing to the successful efficacy of the vaccine and based on the available data, COVID-19 vaccines remain the best option to eliminate the pandemic and its complications.

Conclusion: Our study shows that both Pfizer–BioNTech and Sinopharm vaccines are safe for the heart in the short term, with no significant changes in cardiac biomarkers observed four days after vaccination. The findings suggest that these vaccines are effective and do not pose an immediate risk to cardiovascular health within the observed time frame. However, further research is required to assess the long-term cardiac safety profiles of these vaccines.

Background: The World Health Organization (WHO) considers health to be a fundamental human right. Health is a resource that enables people to lead productive lives on an individual, social, and economic level. In Qatar, there are a limited number of studies addressing the health-promoting lifestyle behaviors of healthcare employees.

Aim: The aim of this study was to compare the health-promoting lifestyle of at-risk and non-risk groups of employees working in Hamad Medical Corporation (HMC), the largest secondary and tertiary healthcare provider in the State of Qatar.

Methods: This was a cross-sectional comparative research study of all categories of healthcare employees working in HMC facilities. Participants with a body mass index (BMI) >30 kg/m², smokers, or those with pre-existing non-communicable diseases (NCDs) were classified as the at-risk group, and individuals without any of these factors were classified as the non-risk group. Data were collected through an online survey using an adopted scale, Adolescent Health Promotion Short Form (AHP-SF), after approval by the Institutional Review Board (IRB) of HMC.

Results: The age of the participants ranged from 22 to 69 years and the majority of them were female (64.07%). Most of the respondents were overweight or obese, accounting for 42.99% and 26.68% of the sample, respectively. Interestingly, 87.64% of the participants were non-smokers and approximately 70% had no chronic diseases. The overall AHP-SF score was 60.01/84 ± 12.32, with the highest score from the “life appreciation” subscale (12.68/16 ± 2.84) and the lowest score from the “exercise” subdomain (7.05/12 ± 2.93). Five subdomains – nutrition, social support, health responsibility, exercise, and stress management – of the AHP-SF scale showed no significant statistical differences between at-risk and non-risk groups. However, the “life appreciation” scale showed significant statistical differences between the at-risk (12.91/16 ± 2.69, p = 0.04) and non-risk (12.42/16 ± 2.98) groups. The AHP-SF scores varied significantly across the participants’ regions of origin, with Americans having the highest score (63.93/84 ± 10.67, p = 0.03) compared to other regions.

Conclusions: Healthcare employees moderately practice health-promoting lifestyle behaviors. The lowest scores were in the exercise subdomain, suggesting that more interventions are required to improve these behaviors. Healthcare organizations are ideal settings to implement comprehensive workplace wellness programs and awareness campaigns that can motivate employees to take greater responsibility for their own health and influence the wider community to adopt health-promoting lifestyle behaviors.

Background: Obesity and type 2 diabetes mellitus (T2DM) are modern-day pandemics that have a significant impact on global healthcare. The glucagon-like peptide-1 receptor agonist (GLP1-RA) semaglutide is a novel treatment for both T2DM and obesity, but can be associated with an increased risk of venous thromboembolism.

Case presentation: This case report describes a 59-year-old woman with T2DM who received semaglutide to manage glycemic levels, and also experienced the additional benefit of weight reduction. Within six months of initiating GLP1-RA, the patient experienced low back pain associated with nausea and poor oral intake. She had no known risk factors for venous thromboembolism or thrombophilia and had no history of significant illness in her family. Her physical examination revealed no significant findings. Only mild leukocytosis and neutrophilia were noted. She underwent an abdominal computed tomography scan, which revealed intrahepatic portal vein thrombosis without evidence of liver cirrhosis or abdominal malignancy. Her symptoms improved with oral anticoagulation (rivaroxaban). The result of thrombophilia examination was negative for inherited or acquired thrombophilia, except for a Janus kinase 2 mutation, which may increase the risk of thrombosis.

Conclusions: The use of GLP1-RA is increasing due to the growing desire for weight loss medications. Therefore, it is important that physicians better understand the possible risks of thrombosis before initiating GLP1-RA treatment.