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  • 1.
    El Ansari, Walid
    et al.
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Department of Surgery, Hamad General Hospital, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar / Faculty of Applied Sciences, University of Gloucestershire, Gloucester, United Kingdom.
    Berg-Beckhoff, Gabriele
    Unit for Health Promotion Research, Institute of Public Health, University of Southern Denmark, Esbjerg, Denmark.
    Country and Gender-Specific Achievement of Healthy Nutrition and Physical Activity Guidelines: Latent Class Analysis of 6266 University Students in Egypt, Libya, and Palestine2017Ingår i: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 9, nr 7, s. 1-12, artikel-id 738Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Research on healthy behaviour such as physical activity and healthy nutrition and their combination is lacking among university students in Arab countries. The current survey assessed healthy nutrition, and moderate/vigorous physical activity (PA) of 6266 students in Egypt, Libya, and Palestine. We computed a nutrition guideline achievement index using WHO recommendation, as well as the achievement of PA recommendations using guidelines for adults of the American Heart Association guidelines. Latent class regression analysis identified homogenous groups of male and female students, based on their achievements of both guidelines. We examined associations between group membership and achievement of guidelines. A three-class solution model best fitted the data, generating three student Groups: "Healthy Eaters" (7.7% of females, 10.8% of males), "Physically Active" (21.7% of females, 25.8% of males), and "Low Healthy Behaviour" (70.6% of females, 63.4% of males). We did not observe a latent class that exhibited combined healthy behaviours (physically active and healthy eaters), and there were no major differences between countries. We observed a very low rate of healthy nutrition (approximate to 10% of students achieved greater than four of the eight nutrition guidelines), with little gender differences across the countries. About 18-47% of students achieved the PA guidelines, depending on country and gender, more often among males. Few females achieved the PA guidelines, particularly in Libya and Palestine. Culturally adapted multi-behavioural interventions need to encourage healthy lifestyles, nutrition and PA behaviours. National policies need to promote active living while addressing cultural, geographic, and other barriers to young adults' engagement in PA.

  • 2.
    El Ansari, Walid
    et al.
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, State of Qatar / College of Medicine, Qatar University, Doha, State of Qatar / Faculty of Applied Sciences, University of Gloucestershire, Gloucester, United Kingdom.
    Khalil, Khalid A.
    Faculty of Medical Technology, Misrata, Libya.
    Ssewanyana, Derrick
    Utrecht Centre for Child and Adolescent Studies, Utrecht University, Netherlands.
    Stock, Christiane
    Unit for Health Promotion Research, Institute of Public Health, University of Southern Denmark, Esbjerg, Denmark.
    Behavioral risk factor clusters among university students at nine universities in Libya2018Ingår i: AIMS Public Health, ISSN 2327-8994, Vol. 5, nr 3, s. 296-311Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: This study identifies and describes the clustering of 5 behavioral risk factors (BRFs) among university students. We also investigated whether cluster membership is associated with the students' self-rated academic performance and self-rated health. Material and methods: A sample of 1300 undergraduates at 6 universities and 3 colleges in Libya completed a self-administered questionnaire that assessed BRFs (nutrition, physical activity, alcohol consumption, smoking, illicit drug use, inadequate sleep). A two-step cluster analysis generated student clusters with similar lifestyles. Results: Two contrasting clusters of almost even size emerged (after exclusion of alcohol and illicit drug use due to very low prevalence). Cluster 1 comprised students with higher engagement in all forms of physical activity, higher levels of health consciousness, greater daily fruit/vegetable intake and better sleep patterns than students in cluster 2. Only as regards the consumption of sweets, cluster 1 students had less favorable practices than cluster 2 students. The prevalence of smoking was equally low in both clusters. Students in cluster 2, depicting a less healthy lifestyle, were characterized by a higher proportion of women, of students with less income and of higher years of study. Belonging to cluster 2 was associated with lower self-rated health (OR: 0.46, p < 0.001) and with lower self-rated academic performance (OR: 0.66, p < 0.001). Conclusion: Preventive programs should not address BRFs in isolation and should particularly target students with clustering of BRFs using specifically tailored approaches.

  • 3.
    El Ansari, Walid
    et al.
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Department of Surgery, Hamad General Hospital, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar / School of Sports and Exercise, Faculty of Applied Sciences, University of Gloucestershire, Gloucester, England, United Kingdom.
    Samara, Anastasia
    Unit for Health Promotion, Institute of Public Health, University of Southern Denmark, Odense, Denmark.
    Adherence to Recommended Dietary Guidelines and the Relationships with the Importance of Eating Healthy in Egyptian University Students2018Ingår i: International Journal of Preventive Medicine, ISSN 2008-7802, E-ISSN 2008-8213, Vol. 9, nr 1, artikel-id 73Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Little is known on the food consumption habits and adherence to dietary guidelines among young adults. We examined students' adherence to recommended guidelines, and the associations between importance of eating healthy and guidelines adherence. Methods: A total of 3271 undergraduates at 11 faculties, Assiut University, Egypt (2009-2010), completed a questionnaire reporting their consumption of 12 food groups; number of servings of fruits/vegetables/day; and how important it is for them to eat healthy. We employed the WHO guidelines for the Eastern Mediterranean region (WHO 2012) to compute students' adherence to dietary guidelines for the different food groups. Chi-square tested the differences for adherence to guidelines by gender, and the associations between the importance of healthy eating and guidelines adherence for the whole sample and by gender. Results: Except for cereal products, no food group had an adherence level >45%. Gender differences were observed (men had better adherence for sweets, cake/cookies, snacks, and raw vegetables but not for fast food/canned food or cooked vegetables, P < 0.001 for each). There was a significant positive trend between the increase of subjective importance of eating healthy and adherence to guidelines (P = 0.012-<0.001). However, this association was only for some food groups and gender dependent. Conclusions: Across the majority of food groups we examined, this sample exhibited low adherence levels to International Nutrition Guidelines. Healthier eating educational/intervention efforts should target foods exhibiting low adherence (most food groups, particularly salad/raw vegetables, fresh fruits, dairy/dairy products, meat/sausage products); consider gender differences (females reported lower adherence across most food groups); and note the relation between adherence and subjective importance of eating healthy by food groups and gender.

  • 4.
    El Ansari, Walid
    et al.
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / University of Gloucestershire, Gloucester, United Kingdom / Qatar University, Doha, Qatar.
    Ssewanyana, Derrick
    Utrecht University, Netherlands.
    Stock, Christiane
    University of Southern Denmark, Esbjerg, Denmark.
    Behavioral Health Risk Profiles of Undergraduate University Students in England, Wales, and Northern Ireland: A Cluster Analysis2018Ingår i: Frontiers In Public Health, ISSN 2296-2565, Vol. 6, artikel-id 120Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Limited research has explored clustering of lifestyle behavioral risk factors (BRFs) among university students. This study aimed to explore clustering of BRFs, composition of clusters, and the association of the clusters with self-rated health and perceived academic performance. Method: We assessed (BRFs), namely tobacco smoking, physical inactivity, alcohol consumption, illicit drug use, unhealthy nutrition, and inadequate sleep, using a self-administered general Student Health Survey among 3,706 undergraduates at seven UK universities. Results: A two-step cluster analysis generated: Cluster 1 (the high physically active and health conscious) with very high health awareness/consciousness, good nutrition, and physical activity (PA), and relatively low alcohol, tobacco, and other drug (ATOD) use. Cluster 2 (the abstinent) had very low ATOD use, high health awareness, good nutrition, and medium high PA. Cluster 3 (the moderately health conscious) included the highest regard for healthy eating, second highest fruit/vegetable consumption, and moderately high ATOD use. Cluster 4 (the risk taking) showed the highest ATOD use, were the least health conscious, least fruit consuming, and attached the least importance on eating healthy. Compared to the healthy cluster (Cluster 1), students in other clusters had lower self-rated health, and particularly, students in the risk taking cluster (Cluster 4) reported lower academic performance. These associations were stronger for men than for women. Of the four clusters, Cluster 4 had the youngest students. Conclusion: Our results suggested that prevention among university students should address multiple BRFs simultaneously, with particular focus on the younger students.

  • 5.
    El Ansari, Walid
    et al.
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Department of Surgery, Hamad General Hospital, Doha, Qatar / College of Medicine, Doha, Qatar / Faculty of Applied Sciences, University of Gloucestershire, Gloucester, United Kingdom.
    Suominen, Sakari
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. University of Turku, Department of Public Health, Turku, Finland.
    Draper, Steve
    University Centre Hartpury, Gloucester, United Kingdom.
    Correlates of achieving the guidelines of four forms of physical activity, and the relationship between guidelines achievement and academic performance: Undergraduate students in Finland2017Ingår i: Central European Journal of Public Health, ISSN 1210-7778, E-ISSN 1803-1048, Vol. 25, nr 2, s. 87-95Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: We surveyed and compared, by gender, the levels and correlates of achieving the international guidelines of four forms of physical activity (PA): moderate PA (MPA), vigorous PA (VPA), moderate or vigorous PA (MVPA), and muscle strengthening PA (MSPA). The study assessed the associations between achieving the guidelines of the four PA forms and a range of socio-demographic, health and academic performance variables. Methods: Data was collected across the seven faculties of the University of Turku (2013-2014 from a representative sample of 1,189 undergraduates). An English language online self-administered questionnaire assessed frequency and duration of PA/week for each form of PA. We employed cut-offs for the guidelines in accordance with the American Heart Association. Chi-square statistic tested the differences in PA, socio-demographic variables and academic performance between males and females. Binary logistic regression examined the factors associated with achieving the four PA guidelines and linear regression examined the association between the frequency of PA and academic performance. Results: Achievement of PA guidelines was relatively low across the sample. Female students were less likely to achieve the VPA or MSPA guidelines, but were more health conscious and in generally exhibited better academic performace than males. High health awareness and excellent/very good self-rated health were the strongest predictors of achieving all forms of PA. Parents' education level was positively related to likelihood of achieving the VPA, MVPA and MSPA guidelines. Achieving the MPA guidelines (but not VPA or MSPA) was positively associated with subjective perceptions of better academic performance. Conclusions: Achievement of PA guidelines was generally low for this sample of Finnish students, and was associated with positive health status and high health awareness. Universities need a holistic approach to improve awareness of health and promote PA in students' lifestyles.

  • 6.
    Elbardisi, Haitham
    et al.
    Hamad Medical Corporation, Doha, Qatar.
    Majzoub, Ahmad
    Hamad Medical Corporation, Doha, Qatar.
    Al Said, Sami
    Hamad Medical Corporation, Doha, Qatar.
    Al Rumaihi, Khalid
    Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Hamad General Hospital, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Alattar, Alia
    Hamad Medical Corporation, Qatar.
    Arafa, Mohamed
    Hamad Medical Corporation, Doha, Qatar / Cairo University, Cairo, Egypt.
    Geographical differences in semen characteristics of 13 892 infertile men2018Ingår i: Arab Journal of Urology, ISSN 2090-598X, Vol. 16, nr 1, s. 3-9Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To assess the relationship between geographical differences and all semen parameters, across 13,892 infertile men of 84 diverse nationalities, recruited at a specialised tertiary hospital that represents the main healthcare provider in Qatar. Male infertility is an important and global public health problem. Despite this, there is a significant scarcity of epidemiological male infertility and semen analysis research in the Middle East and North Africa (MENA) region, as well as geographical comparisons with other parts of the world. Patients and methods: Retrospective study of semen findings of 13 892 infertile men assessed at the Male Infertility Unit at Hamad Medical Corporation, in Qatar between January 2012 and August 2015. Based on country of origin, patients were categorised into those from the MENA region (n = 8799) and non-MENA patients (n = 5093). The two groups were compared across demographic features and semen characteristics: age, sperm volume, sperm total motility, sperm progressive motility (PMot), abnormal sperm forms (ABF), and sperm DNA fragmentation (SDF). Results: The whole sample's mean (SD) age was 35.7 (0.7) years, sperm concentration was 32.3 (0.25) × 106 sperm/mL, total motility was 45.4 (0.2)%, sperm PMot was 25.1 (0.2)%, and ABF was 79.9 (0.2)%. Overall, 841 patients had azoospermia (6.05%), 3231 had oligospermia (23.3%), 4239 had asthenospermia (30.5%) and 6772 had teratospermia (48.7%). SDF (1050 patients) was abnormal in 333 patients (31.7%). MENA patients were significantly younger than their non-MENA counterparts and had a greater semen volume. Non-MENA patients had significantly higher sperm counts, total motility and PMot, and lower ABF. SDF showed no statistical difference between the two groups. MENA patients had significantly higher prevalence of oligospermia, asthenospermia, and teratospermia; and lower prevalence of normal sperm concentration, normal motility, and normal morphology. Throughout the 4 years of the study, MENA patients constantly had significantly lower sperm counts; generally lower sperm total motility percentage and generally lower quality sperm morphology. We compared patients by age (≤40 and &gt;40 years): in the patients aged ≤40 years, the same results as for the overall study were reproduced; in the &gt;40-years group, the same results were reproduced with the exception of morphology, which was not significantly different between the MENA and non-MENA patients. Conclusion: Semen quality is generally lower in male infertility patients from the MENA region compared to non-MENA regions. © 2018 Arab Association of Urology

  • 7.
    Elhag, Wahiba
    et al.
    Department of Bariatric Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, State of Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, State of Qatar / College of Medicine, Qatar University, Doha, State of Qatar.
    Abdulrazzaq, Sama
    Department of Bariatric Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, State of Qatar.
    Abdullah, Ali
    Department of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, State of Qatar.
    Elsherif, Mohamed
    Department of Bariatric Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, State of Qatar.
    Elgenaied, Israa
    Department of Bariatric Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, State of Qatar.
    Evolution of 29 Anthropometric, Nutritional, and Cardiometabolic Parameters Among Morbidly Obese Adolescents 2 Years Post Sleeve Gastrectomy2018Ingår i: Obesity Surgery, ISSN 0960-8923, E-ISSN 1708-0428, Vol. 28, nr 2, s. 474-482Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Laparoscopic sleeve gastrectomy (LSG) is a popular treatment for adolescent morbid obesity. Research on LSG outcomes among adolescents assessed a narrow range of anthropometric, nutritional, or cardiometabolic parameters, leading to an incomplete picture of these changes. We examined a wide variety of anthropometric, nutritional, and cardiometabolic parameters among adolescents before and after LSG. Methods We retrospectively reviewed medical charts of all obese adolescents who underwent LSG at Hamad Medical Corporation, Qatar, between January 2011 and June 2015 (N = 102). We assessed preoperative levels and postoperative changes in 4 anthropometric, 15 nutritional, and 10 cardiometabolic parameters. Results The study sample comprised 79 patients with complete information (36 males, mean age 15.99 +/- 1.1 years). At a mean of 24.2 months post-LSG, we observed (1) significantly reduced mean weight and body mass index by 51.82 +/- 28.1 kg and 17 +/- 6.24 kg/m(2), respectively; (2) the highest prevalence of post-LSG deficiencies pertained to vitamin D, albumin, and ferritin (89.3, 38, and 33.3%, respectively); (3) low hemoglobin levels (29.3%) only in females; (4) trace elements were not deficient; (4) significant reductions in percentage of adolescents with elevated low-density lipoprotein (from 66.1 to 38.9%), alanine aminotransferase (from 45.3 to 10.9%), and aspartate aminotransferase (from 24.1 to 8.6%) levels; (5) 100% remission of prediabetes cases; and (6) 80% remission of type 2 diabetes cases. Conclusions LSG achieved significant weight loss and improvement of cardiometabolic risk factors among adolescents. However, the slight worsening of preexisting nutritional deficiencies warrants careful preoperative surveillance and appropriate postoperative nutritional supplementation.

  • 8.
    Elhag, Wahiba
    et al.
    Department of Bariatric Surgery/Bariatric Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Razaq, Sama
    Department of Bariatric Surgery/Bariatric Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    Elsherif, Mohamed
    Department of Bariatric Surgery/Bariatric Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qata.
    Mustafa, Isra
    Department of Bariatric Surgery/Bariatric Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qata.
    Lorcaserin vs. Phentermine among non-surgical and surgical obese patients: Anthropometric, glycemic, lipid, safety and cost outcomes2019Ingår i: Annals of Medicine and Surgery, ISSN 2049-0801, Vol. 45, s. 75-81Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: To evaluate effectiveness, safety, and costs of Lorcaserin vs. phentermine among obese non–surgical and surgical patients (post bariatric surgery). Methods: This retrospective study retrieved charts of all patients (January 2013–June 2016) who received Lorcaserin or phentermine for 3 months. The study assessed anthropometric, glycemic, and lipid changes, as well as side effects and cost of medications among overweight and obese non-surgical (n = 83) and surgical patients (n = 46). These two patient groups were compared using Chi-square (χ2) and unpaired‘t’ test for qualitative and quantitative variables respectively. Results: At 3 months, among the non-surgical group, Phentermine patients had greater percentage of total weight loss (TWL%) (7.65 ± 8.26 vs. 2.99 ± 3.72%, P = 0.003), and greater BMI reduction (−3.16 ± 3.63 vs. −1.15 ± 1.53 kg/m2, P = 0.003) than Lorcaserin. Within the surgical group, Lorcaserin patients had significantly smaller TWL% (1.86 ± 5.06 vs. 7.62 ± 9.80%, P = 0.012), and smaller BMI reduction (−0.74 ± 1.80 vs. −3.06 ± 4.08 kg/m2, P = 0.012) than Phentermine. Lorcaserin exhibited significant total cholesterol and LDL improvements only among surgical patients with significant weight reduction (≥5% TW). Both medications were not associated with glycemic improvements among non-surgical and surgical groups. Phentermine had slightly more side effects but was less expensive. Conclusions: Among both patient groups, phentermine was more effective in achieving weight loss. Lorcaserin showed dyslipidemia improvements only among surgical patients who achieved significant weight reduction. Anti-obesity medications as part of weight management programs can result in weight loss among non-surgical and surgical patients, or halt weight regain among surgical patients. This is the first study to evaluate the effectiveness and safety of two anti-obesity medications (lorcaserin vs. phentermine) among two distinct obese patient groups, non-surgical and surgical patients. 

  • 9.
    Elmoghazy, Walid
    et al.
    Department of Surgery, Hamad Medical Corporation, Doha, Qatar / Department of Surgery, Sohag University, Sohag, Egypt.
    Ahmed, Khalid
    Department of Surgery, Hamad Medical Corporation, Doha, Qatar.
    Vijay, Adarsh
    Department of Surgery, Hamad Medical Corporation, Doha, Qatar.
    Kamel, Yasser
    Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar.
    Elaffandi, Ahmed
    Department of Surgery, Hamad Medical Corporation, Doha, Qatar / Department of Surgical Oncology, National Cancer Institute, Cairo University, Egypt.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Department of Surgery, Hamad Medical Corporation, Doha, Qatar .
    Kakil, Rasul
    National Center for Cancer Care and Research, Doha, Qatar.
    Khalaf, Hatem
    Department of Surgery, Hamad Medical Corporation, Doha, Qatar.
    Hepatocellular carcinoma in a rapidly growing community: Epidemiology, clinico-pathology and predictors of extrahepatic metastasis2019Ingår i: Arab Journal of Gastroenterology, ISSN 1687-1979, Vol. 20, nr 1, s. 38-43Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background and study aims: Hepatocellular carcinoma (HCC) with extrahepatic metastasis has been studied, however, data from the Middle East remain scarce. In this study, we assess epidemiology of HCC in Qatar, and identify predictors of the metastatic behaviour. Patients and methods: All newly-diagnosed HCC patients on top of liver cirrhosis between 2011 and 2015 were included in the study. Results: A total of 180 patients met our inclusion criteria. The mean age was 58.8 ± 10.5 years with a mean follow-up of 1.0 ± 1.1 years. There were 150 male patients and HCV was the most common cause of liver cirrhosis 108 (60%), and 22 (12.2%) patients were classified as Child-Pugh class C. The overall survival of 51.1%, and 47 (26%) had at least one extrahepatic metastasis at the time of diagnosis. Single site metastasis was diagnosed in 10 patients, whereas 37 patients had multiple sites metastases. We compared patients who had metastases with patients who did not have metastasis at the time of diagnosis of HCC regarding several variables, and analysis revealed that tumour diameter larger than 5 cm (OR = 6.10, 95% CI = 1.85–20.12) (p = 0.003), and bilobar liver involvement (OR = 5.49, 95% CI = 1.10–27.30) (p = 0.037) were independent predictors of metastatic behaviour of HCC. Conclusion: The incidence of HCC is rising in our population, extrahepatic metastasis is no longer rare and tumours larger than 5 cm and bilobar involvement are determinants of the extrahepatic metastasis. © 2019 Pan-Arab Association of Gastroenterology

  • 10.
    Hammad, Yasser A.
    et al.
    Department of Anesthesia, ICU and Perioperative Medicine, Hamad Medical Corporation, Doha, Qatar / Weill Cornell Medicine Qatar, Doha, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Department of Surgery, Hamad General Hospital, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Shallik, Nabil A.
    Department of Anesthesia, ICU and Perioperative Medicine, Hamad Medical Corporation, Doha, Qatar / Weill Cornell Medicine Qatar, Doha, Qatar / Department of Anesthesia and SICU, Tanta University, Egypt.
    Sadek, Monzer H.
    Sidra Medicine, Doha, Qatar.
    Feki, Abdellatif M.
    Department of Anesthesia, ICU and Perioperative Medicine, Hamad Medical Corporation, Doha, Qatar.
    Bedhiaf, Kaouther
    Department of Anesthesia, ICU and Perioperative Medicine, Hamad Medical Corporation, Doha, Qatar.
    Khecharem, Fekria
    Department of Anesthesia, ICU and Perioperative Medicine, Hamad Medical Corporation, Doha, Qatar.
    Shehata, Walid M.
    Department of Transplant Surgery, Hamad General Hospital, Doha, Qatar.
    Bali, Souad
    Department of Anesthesia, ICU and Perioperative Medicine, Hamad Medical Corporation, Doha, Qatar.
    Muhammed, Abdulkader
    Department of Anesthesia, ICU and Perioperative Medicine, Hamad Medical Corporation, Doha, Qatar.
    Quality improvement can decrease blood delivery turnaround time: Evidence from a single tertiary-care academic medical center2018Ingår i: Middle East Journal of Anesthesiology, ISSN 0544-0440, Vol. 25, nr 3, s. 273-281Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Context: Blood transfusion services are critical to any hospitals’ functioning, and timely blood/ component therapy resuscitation is lifesaving. Yet, few blood delivery turnaround time (TAT) studies have been undertaken. Aims: We assessed blood delivery TAT at our institution before and after implementing an intervention. Settings and Design: This before-after study assessed blood delivery TAT at our institution at baseline (first audit, December 2015 - February 2016); analyzed the causes of any delays and implemented a multipronged organizational, educational and operational remedial actions for risk mitigation for 3 months, aiming to shorten the blood delivery TAT; and then 9 months later assessed the blood delivery TAT again (second audit, November 2017 - December 2017). Methods and Material: For each of the two audits, we assessed three indices that comprise TAT: Response time (time from doctor’s request until blood is ready for collection, T1); processing time (time from the arrival of technician to blood bank and start of paperwork processing at the blood bank’s front desk until actual collection of the blood, T2); and, Transport time (time from blood bank to arrival to operating theatre, T3). Statistical analysis used: The observed proportions for categorical variables were reported as percentage and compared using Chi square test. Results: After implementing the remedial actions, the second audit confirmed considerable improvements across all three components that comprise the blood TAT. The transport time significantly decreased from an initial majority of > 15 mins duration, to a majority of < 15 mins transport time after the second audit; there was a 50% improvement in 30 mins response time; and the percentage of requests processed in < 10 mins were significantly higher after the second audit. Conclusions: Our program and its findings in terms of much improved blood delivery TAT after implementing this quality improvement approach represent an appropriate and effective solution to the challenge of making blood available fast enough to meet true hemorrhagic emergencies.

  • 11.
    Khidir, N.
    et al.
    Department of Metabolic & Bariatric Surgery, Hamad General Hospital, Doha, Qatar.
    Al Dhaheri, M.
    Department of Metabolic & Bariatric Surgery, Hamad General Hospital, Doha, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Department of Surgery, Hamad General Hospital, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Al Kuwari, M.
    Department of Metabolic & Bariatric Surgery, Hamad General Hospital, Doha, Qatar.
    Sargsyan, D.
    Department of Metabolic & Bariatric Surgery, Hamad General Hospital, Doha, Qatar.
    Bashah, M.
    Department of Metabolic & Bariatric Surgery, Hamad General Hospital, Doha, Qatar / Weill Cornell Medicine-Qatar, Doha, Qatar / Qatar Metabolic Institute, Doha, Qatar.
    Outcomes of Laparoscopic Gastric Greater Curvature Plication in Morbidly Obese Patients2017Ingår i: Journal of Obesity, ISSN 2090-0708, E-ISSN 2090-0716, Vol. 2017, artikel-id 7989714Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Laparoscopic gastric greater curvature plication (LGGCP) is a restrictive bariatric procedure without gastrectomy. However, limited literature on effectiveness of gastric plication exists.

    OBJECTIVES: We assessed LGGCP's efficacy, effects on associated comorbidities, safety and the rate of complications, and patient satisfaction with LGGCP's outcomes among morbidly obese patients.

    METHOD: Analysis of retrospectively data collected from medical records of 26 patients who had undergone LGGCP at Hamad General Hospital, Qatar, during 2011-2012.

    RESULTS: Most patients (92%) were Qatari nationals. The sample's mean age was 35.1 years. Mean duration of hospital stay was 3.9 ± 1.2 days. Mean preoperative BMI was 40.7 kg/m(2) that decreased at 2 years to 34.6 kg/m(2). LGGCP's effects on comorbidities were such that 7.6% of patients experienced resolutions of their comorbidities. There were no mortality or postoperative complications that required reoperation. Six patients (23%) were satisfied with the LGGCP's outcomes while 10 patients (38.5%) underwent sleeve gastrectomy subsequently.

    CONCLUSION: LGGCP had acceptable short term weight loss results, exhibited almost no postoperative complications, and improved patients' comorbidities. Despite the durability of the gastric fold, some patients regained weight. Future research may assess the possibility of an increase in the gastric pouch size postplication associated with weight regain.

  • 12.
    Majzoub, Ahmad
    et al.
    Hamad Medical Corporation, Doha, Qatar.
    Arafa, Mohamad
    Hamad Medical Corporation, Doha, Qatar.
    Mahdi, Mohamed
    Hamad Medical Corporation, Doha, Qatar.
    Agarwal, Ashok
    Cleveland Clinic Foundation, Cleveland, United States.
    Al Said, Sami
    Hamad Medical Corporation, Doha, Qatar.
    Al-Emadi, Ibrahim
    Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / Qatar University, Doha, Qatar.
    Alattar, Alia
    Women's Hospital, Hamad Medical Corporation, Doha, Qatar.
    Al Rumaihi, Khalid
    Hamad Medical Corporation, Doha, Qatar.
    Elbardisi, Haitham
    Hamad Medical Corporation, Doha, Qatar.
    Oxidation–reduction potential and sperm DNA fragmentation, and their associations with sperm morphological anomalies amongst fertile and infertile men2018Ingår i: Arab Journal of Urology, ISSN 2090-598X, Vol. 16, nr 1, s. 87-95Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To assess seminal oxidation–reduction potential (ORP) and sperm DNA fragmentation (SDF) in male infertility and their relationships with sperm morphology in fertile and infertile men. Patients and methods: Prospective case-control study comparing the findings of infertile men (n = 1168) to those of men with confirmed fertility (n = 100) regarding demographics and semen characteristics (conventional and advanced semen tests). Spearman rank correlation assessed the correlation between ORP, SDF, and different morphological indices. Means of ORP and SDF were assessed in variable levels of normal sperm morphology amongst all participants. Results: Infertile patients had a significantly lower mean sperm count (32.7 vs 58.7 × 106 sperm/mL), total motility (50.1% vs 60.4%), and normal morphology (5.7% vs 9.9%). Conversely, infertile patients had significantly higher mean head defects (54% vs 48%), and higher ORP and SDF values than fertile controls. ORP and SDF showed significant positive correlations and significant negative correlations with sperm head defects and normal morphology in infertile patients, respectively. ORP and SDF were significantly inversely associated with the level of normal sperm morphology. Using receiver operating characteristic curve analysis, ORP and SDF threshold values of 1.73 mV/106 sperm/mL and 25.5%, respectively, were associated with 76% and 56% sensitivity and 72% and 72.2% specificity, respectively, in differentiating &lt;4% from ≥4% normal morphology. Conclusion: A direct inverse relationship exists between seminal ORP and SDF with various levels of normal sperm morphology. Using ORP and SDF measures in conjunction with standard semen morphology analysis could validate the result of the fertility status of patients. © 2017 Arab Association of Urology

  • 13.
    Saafan, Tamer
    et al.
    Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    Bashah, Moataz
    Department of Bariatric Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / College of Medicine, Doha, Qatar.
    Karam, Mohsen
    Department of Bariatric Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    Histopathological Changes in Laparoscopic Sleeve Gastrectomy Specimens: Prevalence, Risk Factors, and Value of Routine Histopathologic Examination2017Ingår i: Obesity Surgery, ISSN 0960-8923, E-ISSN 1708-0428, Vol. 27, nr 7, s. 1741-1749Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Laparoscopic sleeve gastrectomy (LSG) is a common surgical therapeutic option for obese patients, with debate about the value of routine histopathologic examination of LSG specimens. We assessed the following: prevalence of different histopathologic changes in LSG specimens, risk factors associated with premalignant and with frequent histopathologic changes, and whether routine histopathologic examination is warranted for LSG patients with nonsignificant clinical history. Retrospective review of records of all LSG patients operated upon at Hamad General Hospital, Qatar (February 2011-July 2014, n = 1555), was conducted. Risk factors (age, BMI, gender, and Helicobacter pylori) were assessed in relation to specific abnormal histopathologic changes. Mean age and BMI of our sample were 35.5 years and 46.8, respectively. Females comprised 69.7% of the sample. Normal histopathologic specimens comprised 52% of the sample. The most common histopathologic changes were chronic inactive gastritis (33%), chronic active gastritis (6.8%), follicular gastritis (2.7%), and lymphoid aggregates (2.2%). We observed rare histopathology in 3.3% of the sample [e.g., intestinal metaplasia and gastrointestinal stromal tumor (GIST)]. Older age was associated with GIST and intestinal metaplasia (P = 0.001 for both). Females were associated with chronic active gastritis (P = 0.003). H. pylori infection was associated with follicular gastritis, lymphoid aggregates, GIST, intestinal metaplasia, and chronic active gastritis (P < 0.001 for each). Older age, H. pylori, and female gender are risk factors for several abnormal histopathologic changes. Histopathologic examination of LSG specimens might harbor significant findings; however, routine histopathologic examination of all LSG specimens, particularly in the absence of suggestive clinical symptoms, is questionable. The association between female gender and chronic active gastritis; and the association between H. pylori infection and GIST are both novel findings that have not been previously reported in the published literature.

  • 14.
    Saafan, Tamer
    et al.
    Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, 3050, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, 3050, Qatar ; College of Medicine, Qatar University, Doha, 2713, Qatar.
    Al-Yahri, Omer
    Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, 3050, Qatar.
    Eleter, Ammar
    Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, 3050, Qatar.
    Eljohary, Hisham
    Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, 3050, Qatar.
    Alfkey, Rashad
    Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, 3050, Qatar.
    Hajjar, Mustafa
    Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, 3050, Qatar.
    Toffaha, Ali
    Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, 3050, Qatar.
    El Osta, Abdelrahman
    Department of Surgery, AlWakra Hospital, AlWakra, Qatar.
    Assessment of PULP score in predicting 30-day perforated duodenal ulcer morbidity, and comparison of its performance with Boey and ASA, a retrospective study2019Ingår i: Annals of Medicine and Surgery, ISSN 2049-0801, Vol. 42, s. 23-28Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: /aim: Scores commonly employed to risk stratify perforated peptic ulcer patients include ASA (American Society of Anesthesiologists), Boey and peptic ulcer perforation score (PULP). However, few studies assessed and compared the accuracy indices of these three scores in predicting post PPU repair 30-day morbidity. We assessed accuracy indices of PULP, and compared them to Boey and ASA in predicting post perforated duodenal (PDU) ulcer repair 30-day morbidity. Methods: Retrospective chart review of all PDU patients (perforated duodenal ulcers only) at the largest two hospitals in Qatar (N = 152). Data included demographic, clinical, laboratory, operative, and post repair 30-day morbidity. Area under the Curve (AUC), sensitivity and specificity were computed for each of the 3 scores. Multivariate logistic regression assessed the accuracy indices of each score. Results: All patients were males (M age 37.41 years). Post PDU repair 30-day morbidity was 10.5% (16 morbidities). Older age, higher ASA (≥3), Boey (≥1) or PULP (≥8) scores, shock on admission and preoperative comorbidities; and conversely, lower hemoglobin and albumin were all positively significantly associated with higher post PDU 30-day morbidity. PULP displayed the largest AUC (72%), and was the only score to significantly predict 30-day morbidity. The current study is the first to report the sensitivity and specificity of these three scores for post PDU repair 30-day morbidity; and first to assess accuracy indices for PULP in predicting post PDU repair 30-day morbidity. Conclusion: PULP score had the largest AUC and was the only score to significantly predict post PDU repair 30-day morbidity. © 2019 The Author(s)

  • 15.
    Saafan, Tamer
    et al.
    Department of Bariatric Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Bashah, Moataz
    Department of Bariatric Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / Weill Cornell Medicine, Doha, Qatar.
    Compared to What? Is BMI Associated with Histopathological Changes in Laparoscopic Sleeve Gastrectomy Specimens?2019Ingår i: Obesity Surgery, ISSN 0960-8923, E-ISSN 1708-0428, Vol. 29, nr 7, s. 2166-2173Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Obesity is a risk for many different cancers. Laparoscopic sleeve gastrectomy (LSG) is common, and benign or pre-malignant histopathology types are reported in the removed gastric specimens. We assessed whether higher BMI was associated with certain benign or pre-malignant histopathological changes. Method Retrospective chart review of all primary LSG patients (N = 1555). Demographic, clinical, and LSG histopathology data were retrieved. BMI of patients with specific benign or pre-malignant conditions in their gastric specimens was compared with the BMI of the rest of the patients with abnormal histopathology specimens and also compared with the BMI of patients with normal control specimens. Results Females comprised 70% of the patients. Mean BMI were 46.3 (females) and 48 (males). Normal LSG specimens comprised 52%. Most common abnormal histopathologies were chronic inactive gastritis (33%), chronic active gastritis (6.8%), follicular gastritis (2.7%), lymphoid aggregates (2.2%), intestinal metaplasia (1.4%) and GIST (0.7%). After controlling for confounders (age, gender, H. pylori, diabetes mellitus type 2, hypertension), no significant association was observed between the BMI of patients with specific benign or pre-malignant histopathology compared with the BMI of the rest of the patients with abnormal histopathologies and compared to the BMI of patients with normal histopathologies. Conclusion When confounders were taken into account, there appeared no significant associations between the BMI of patients with specific benign or pre-malignant histopathology compared with the BMI of the rest of the patients with abnormal histopathologies and compared to the BMI of patients with normal histopathologies of their gastric specimens. There was a very weak correlation between BMI and other covariates.

  • 16.
    Sulieman, Ibnouf
    et al.
    Department of Surgery, Division of Organ Transplant, Hamad General Hospital, Doha, Qatar.
    Elmoghazy, Walid
    Department of Surgery, Division of Organ Transplant, Hamad General Hospital, Doha, Qatar / Department of Surgery, Sohag University, Sohag, Egypt.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Elaffandi, Ahmed
    Department of Surgery, Division of Organ Transplant, Hamad General Hospital, Doha, Qatar / Department of Surgical Oncology, National Cancer Institute, Cairo University, Egypt.
    Khalaf, Hatem
    Department of Surgery, Division of Organ Transplant, Hamad General Hospital, Doha, Qatar.
    Gallbladder cancer: 7-Year experience from Qatar2019Ingår i: Annals of Medicine and Surgery, ISSN 2049-0801, Vol. 44, s. 33-38Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Gallbladder cancer (GC) is a relatively rare disease. To date, there are no studies describing the epidemiology of this disease in Qatar. Objective: To study the epidemiology of Gallbladder Cancer in Qatar. Methods: A retrospective analysis of the cases of GC in Hamad General Hospital in Qatar from 2009 to 2016. Results: Thirty-five patients presented with GC during the study period, 10 females (28.6%) and 25 males (71.4%). Fourteen patients (40%) were diagnosed incidentally after laparoscopic cholecystectomy, 16 (48.6%) were diagnosed pathologically, and 4 (11.4%) were diagnosed radiologically. The median age at diagnosis was 54 years (31–78). 74.3% of the disease occurred in patients less than 60 years old. Metastatic disease was discovered in 25 patients (71.4%) versus no metastasis in 10 patients (28.6%). The most common sites for metastasis were the liver (42.9%), peritoneum (25.7%), and lymph nodes (25.7%). Curative central hepatic resection was done in 8 patients (22.9%). Pathology showed adenocarcinoma in 27 patients (77.1%), neuroendocrine tumor in 3 patients (8.6%) and high-grade dysplasia in 1 patient (2.9%). No histopathology was available for 4 patients (11.4%). Twenty-eight patients (80.0%) had regular follow up, with 22 (62.9%) still alive. Six patients (17.1%) died during follow up with survival after diagnosis ranging from 42 days to 6.8 years. Conclusions: In Qatar, due to the unique demographics, GC is more common in males and younger age groups. Most of the patients present late with metastasis, but curative resection is associated with long-term survival.

  • 17.
    Toffaha, Ali
    et al.
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Elaiwy, Orwa
    Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar.
    Obaid, Munzir
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    Al-Yahri, Omer
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    Abdelazim, Sherif
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    First sliding Amyand hernia harbouring appendicular schistosomiasis: Case report2019Ingår i: International journal of surgery case reports, ISSN 2210-2612, E-ISSN 2210-2612, Vol. 63, s. 143-146Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Amyand's hernia (AH) is rare, schistosomiasis of the appendix is very uncommon, and both conditions coexisting together is an extremely rare event. Pre-operative diagnosis of each of the two conditions is usually difficult. To the best of our knowledge, the current paper is first to report both these two conditions in coexistence. Presentation of case: A 31-year old man who had no comorbidities was admitted electively as a day case of non-complicated right indirect inguinal hernia. Further history and physical examination were unremarkable. Intraoperatively the patient was found to have right sliding AH with appendicular schistosomiasis (AS). The patient underwent Lichtenstein repair of the hernia with appendectomy. On follow up he was referred to infectious disease clinic, and the post-operative course was uneventful. Conclusions: Intraoperative identification of non-typical hernia sac before its opening should alert the surgeon to the possibility of sliding hernia and the presence of an organ as a part of the sac. Rare causes of appendicular masses like schistosomiasis granuloma should be considered in endemic areas or immigrants from these areas, despite the difficulty of preoperative diagnosis. Management should follow general guidelines of appendectomy, hernia repair and dealing with the associated pathology if present. 

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