Avicenna - الأعداد السابقة

Healthcare policies in Qatar place a high value on the concept of patient and family-centered care (PFCC) in primary care. The Institute of Medicine raised the concern of patient care in 2001 and Davis et al. advocates of PFCC, promoted the concept. The Primary Health Care Corporation (PHCC) and Hamad Medical Corporation (HMC) in Qatar provide all the government health services of the country at this time. They have sought to integrate PFCC into its systems, while preserving the traditional Qatari way of life. Families in times past were excluded from healthcare involvement as medical specialization progressed, but the undervalued importance of families contributing to healthcare was later realized. Twenty-one established health centers in 2013, are to be augmented by thirty more within five years. By 2011, all Qatar's major hospitals and its Ambulance Service had achieved JCI accreditation. Entitlement to government healthcare is free for Qatari nationals, or at a small charge for expatriates who maintain a valid health card. Patients have access to a physician at health centers, but have to be referred for hospital consultant appointments. A range of services is available, including a pharmacy, at every health center. A Charter of Patient, Family, and Children's Rights is in place for HMC supporting family participation in care. The Center for Health Care Improvement (CHCI) was launched in 2008 and focuses on PFCC. Eight core objectives of the CHCI are outlined. Effective patient education with the adoption of sound healthcare policies and fiscal responsibility should help Qatar attain the goals it requires.

Background The philosophy and practice of pharmaceutical care (PC) has challenged Middle Eastern pharmacists to embrace a new paradigm that focuses on outcomes of care rather than products or tasks. Although the application of PC was found to be associated with a reduction in adverse drug reactions, length of hospital stay and cost of care in the developed world, the status and application of the practice remains less clear in the Arabic-speaking Middle East (ME). The aim of this project was to describe the current status of PC services in a number of Arabic-speaking ME countries. Methods We conducted literature search to identify what had been published on the status of PC in the ME. We also invited individuals who have good understanding of the pharmacy environment in the respective country. The individuals identified were asked to respond to a set of standardized questions relating to PC services in their countries. Results The literature search generated 12 publications in total. Ten country informants agreed to provide information on PC practice and pharmacy practice in general in their respective countries and they ultimately provided information related to these areas. Conclusions The PC concept is still often confused with clinical pharmacy, which remains to be a priority in several countries in the region. Pharmacy education is rapidly changing change in many of the ME. These changes are hoped to reflect a wider recognition and application of PC services in the hospital and community settings.

Background: The ethnic profile of Qatar is a combination of its indigenous peoples (Qataris) and non-resident foreigners (non-Qataris). Its population has increased dramatically during the last 30 years to around 1.9 m (although only 15% are Qataris) leading to an increase in the number of local births. A recent unexpected surge in births has lead to a need to re-evaluate the trends in birth numbers and develop more reliable predictions for both near- (2015) and far-term (2025) annual numbers of births to support the many healthcare planning initiatives which are currently underway. Methods: There is considerable information already available in Qatar which can facilitate such a study. This paper collates these various data, charts and investigates their visible trends and develops a simple mathematical model which projects the annual number of births which might reasonably be expected to emerge later in this decade and beyond. Results: The Qatari sub-population has maintained a reliable linear increase in birth numbers since data first began to be collected. The births among the non-GCC and Asian sub-populations are the primary cause of the recent nonlinear increase which can be well-described in the near-term by a simple quadratic curve. Far-term projections require a non-linear mathematical model which combines the regular linear increase among the Qataris with an exponentially decreasing demand for “in-Qatar” births from the non-Qataris. The trend for multiple births in Qatar (i.e. the annual number of live-born twins, triplets etc.) has shown significant increases during the last 20 years but may be reaching a plateau. Among Qataris the numbers have been higher but – at least for triplets and higher-order births – this gap has decreased in the last few years. It appears that the increase in multiple births has been associated with the current expansion of IVF programs and other forms of assisted conception in Qatar. Conclusions: The annual number of births in Qatar has recently shown a significant departure from its previous trend, requiring a radical reassessment of future projections. There has also been a concomitant increase in multiple births which has been associated with the expansion of IVF programs and other forms of assisted conception. A simple quadratic model predicts that there will be ∼22,500 births in 2015, of which ∼8,000 will be Qatari. A far-term projection for 2025 suggests that this number is likely to rise to ∼27,000 but with some small additional increase yet to come.

Preeclampsia is a pregnancy specific condition characterized by hypertension and proteinuria. It complicates about 10% of all pregnancies. It is a major cause of maternal and fetal morbidity and mortality. Interestingly, preeclampsia may have an impact on the health of the mother or infant, beyond the pregnancy. It is believed that several ligands and receptors of different families of growth factors have been involved in the development of preeclampsia. We performed a systematic search of PubMed including combination of terms such as preeclampsia, growth factors, treatment, vascular endothelial growth factor A, activin A, inhibin A, placental growth factor, transforming growth factor β-1, Nodal, placenta, trophoblast cells, biomarkers and detection. In this review we have summarized current knowledge on the role of growth factors in early detection and treatment of preeclampsia. Although these growth factors have significant roles in normal and complicated pregnancies, the current value of these growth factors as biomarkers, for the precise prediction of preeclampsia, has its limitation. Therefore, future studies need to be done to support some of the very promising and interesting data to develop affordable and widely available tests for early detection and treatment of preeclampsia.

Background: Prostaglandins, in particular prostaglandin E2 (PGE2), are elevated in adenomas and colorectal cancers (CRC). Experimental and epidemiological studies have demonstrated reduced incidence of adenomas and CRC by inhibitors of prostanoid synthesis (NSAIDs). This study aimed to characterize the expression and localization of key enzymes/receptors for PGE2 synthesis in adenomas and CRC in comparison to normal colon. Methods: Immunoblotting and immunohistochemistry were used for semi-quantitative and qualitative analysis of COX-1, COX-2, mPGES-1 and the EP2 receptor in biopsies from patients undergoing resection of adenomas or surgery for CRC (Dukes' A-C). Normal colon served as control for the corresponding tumor in each of the CRC patients. Results: COX-1 was decreased significantly in all groups of CRC (Dukes' A-C) compared to normal colon. In contrast, COX-2 was increased, but only in the combined group of CRC. Microsomal PGES-1 was increased in CRC (Duke's B), and EP2 was augmented in adenomas and CRC. The localization was predominantly epithelial in normal colon and in adenomas, while in CRC both epithelial- and stromal expression was demonstrated. Conclusions: The results support the PGE2- pathway, with epithelial- stromal interactions, in the evolvement of adenomas and in the progression of CRC. Co-expression of COX-1 and COX-2 is in line with the preventive effects of non-specific NSAIDs on adenoma formation. The decrease of COX-1, in combination with an increase of COX-2, favors the potential use of selective COX-2 inhibitors as an adjunct therapy in CRC.

Background: Teenage pregnancy comprises 24.2 percent of the total pregnancies of Bangladesh, which is a great threat to the overall health of the country. In Bangladesh, a large number of young women migrate to urban areas for work and most of them live in slum areas. This study aims at shedding light on the factors that contribute to the incidence of pregnancy among the women before reaching the age 18 in slum areas. Methods: This study is based on primary data, and a total of 522 samples were sorted out from the total 609 interviewed ever married women. These 609 respondents were interviewed using purposive sampling technique. Both bivariate and multivariate analytical techniques have been applied to analyze the data. Results: Result shows that as much as about 83.7 percent respondents were found to be married before reaching age 18, and 79 percent conceived before age 18. Incidence of early conception decreases with the increase in the education of respondents and in the education of their husbands. Respondents—with higher family income, and who have ever used family planning are less likely to experience early conception compared to their counterparts. Conclusions: The situation indicates that the overall health of the community is at stake. For the traction of the situation, priority should be given to enhance education and income level of slum people, especially women. Family planning programmes should be strengthened and improved with a special focus to the coverage of the slum areas.

Physical inactivity is a global health concern. Evidence suggests low levels of physical activity among Arabic adults living in Middle Eastern countries. To help ensure the success of strategies to promote physical activity, a better understanding of the barriers and facilitators to physical activity is needed. The objective of this article is to present a review of the literature that focuses on the barriers and facilitators to physical activity among Arabic adults. A socio-ecological framework was used to guide this review. Following a database search (2002–2013), a total of 15 studies were included in this review. The findings revealed that barriers (i.e., factors that impede physical activity), occurred at the individual level (e.g., lack of time, health status), social/cultural/policy level (e.g., traditional roles for women, lack of social support, use of housemaids), and the environmental level (e.g., hot weather, lack of exercise facilities). Some of the facilitators (i.e., factors that enable/promote physical activity) were: Muslim religion, desire to have slimmer bodies, and having good social support systems. Future intervention studies aimed at promoting physical activity among Arabic adults need to address these multiple influencing factors.

Little information exists concerning (i) source contributions to airborne particulate pollution in Qatar, (ii) the potential impact that deteriorating air quality may have on the respiratory health of residents, and (iii) how climate change may affect respiratory health through its impact on air quality. Air quality in Qatar may be negatively affected by naturally occurring contributions including dust/sand originating from adjacent desert regions, microbial communities that may be associated with these particulates, and volatile organic compounds (VOCs) released by blooms of phytoplankton in coastal waters. Of increasing concern are anthropogenic contributions, including emissions from the rapidly growing number of vehicles, from ships travelling in the Persian Gulf, and from industrial and construction activities. We examine the relative importance of these contributions and discuss some of the expected impacts on respiratory health. We conclude by speculating on the impact that climate change may have on air quality and respiratory health around Qatar.