Background and objectives. Zinc deficiency increases risk of infections, allergies and autoimmunity. We wished to determine risk factors in severe atopic dermatitis (AD) and identifi ofhypozincemia rate. Materials and methods. Retrospective study done on AD children (<= 14 years) with serum zinc test. Data included demographic and laboratory tests (serum zinc level IgE, food-specific IgE), and skin tests. Results. 168 AD children, aged 38.9 months with concomitant allergies in 47 (28%), family history ofallergies in 131 (80%), and parental consanguinity in 134 (79.9%). AD was mild in 12 (72%, SCORAD 15.8) children, moderate in 41(24.5%, SCORAD 30.4), and severe in 115 (68.3%, SCORAD 69.4). Hypozincemia was observed in 42 (25%, zinc 8.6 +/- 1.1 mu moI/L) children and associated only with severe AD (p = 0.0418) and elevated IgE (p = 0.001). Conclusions. Hypozincemia is rather prevalent in AD, and severe AD and high IgE increase its risk. An adjunct oral zinc may help reducing severe poorly responsive AD.

AimThe aim was to determine the association between internet addition [IA] and fatigue, sleep disturbance, depression, and life style factors among school children.Subjects and methodsA cross-sectional survey based on multistage stratified random sampling and 1188 students (73.3%) gave consent during October 2011 to December 2012. Data including socio-demographic details, lifestyle and dietary habits Internet Addiction Test (IAT), Fatigue Scale, Epworth Sleepiness Scale [ESS] and Beck Depression Inventory (BDI) test. Univariate and multiple logistic regression analysis were performed.ResultsThe overall prevalence of IA among school children was 19.8%. The proportion of IA was significantly more among males (56.4%) as compare to females (43.6%; P = 0.035), school performance (P < 0.001) and family income (P = 0.032). Those with IA had significantly less number of sleep hours (6.16 ± 0.80 vs. 6.58 ± 1.29; P < 0.001) as compared to normal. Those with IA had significantly high number of hours internet use (3.82 ± 1.64 vs. 3.03 ± 1.64; P < 0.001) as compared to normal. A significantly larger proportion of IA than normal subjects reported having headaches (P = 0.010), double vision (P = 0.037), eye hurt (P = 0.021), eye tired (P = 0.005), dizziness (34.4% vs. 27.3%; P = 0.002), fatigue, and hearing problem (P = 0.048). A significantly larger proportion of students with IA most frequently gratifying site (19.9% vs. 11.6%; P < 0.001), browsed games (38.6% vs. 29.9%; P = 0.010), chat sites (29.7% vs. 22%; P = 0.013), email (54.2% vs. 63.1%; P = 0.36), and research (61.0% vs. 69.2%; P = 0.017).ConclusionThe current study confirmed the of evidence linking problematic internet use with negative fatigue, greater numbers of symptoms, anxiety, sleeping disturbances, depressive and lifestyle risk factors, among vulnerable young children.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The aim of this study was to assess the impact of consanguinity on risk for mental disorders especially in primary health care-PHC settings. It was decided to ascertain prevalence of common mental disorders and consanguinity. We set out to study the burden of commonest psychiatric disorders among consanguineous marriages at PHC using the WHO Composite International Diagnostic Interview (WHO-CIDI) and examine their symptom patterns and co-morbidity in Qatar. A prospective cross sectional study was carried out over a year between November 2011 to October 2012. A total of 2.000 Qatari subjects aged 18 to 65 years were approached; 1.475 (73.3%) gave consent and participated in this study. Prevalence of psychiatric disorders using the WHO Composite International Diagnostic Interview (CIDI, version 3.0) showed that six most common disorders were major depression disorders (18.3%), any impulse control condition (18.3%), any anxiety disorders (17.2%), any mood disorders (16.9%), followed by separation anxiety disorders (15.2%), personality disorder (14.1%). The mean age ± SD of the 1.475 subjects interviewed was 39.3 ± 9.8 years. The rate of consanguinity in the present generation was 31.5% [95% CI = 29.1–33.7]. There were statistically significant differences between consanguineous and non-consanguineous with regards to age, educational status, occupation status, household income as well as BMI, cigarette smoking and sheesha smoking. One-fifth of all adults who attended the PHC center 20% had at least one psychiatric diagnosis. The prevalence of the generalized anxiety disorders; social phobia, specific phobia, major depression, and personality disorders were significantly higher in consanguineous marriages than in non-consanguineous.Disclosure of interestThe author has not supplied his declaration of competing interest.

The aim of this study was to determine the prevalence of co-morbidity with obsessive-compulsive disorder (OCD) among bipolar disorder (BD) patients in order to assess the impact of OCD on the socio-demographic and clinical features of patients in a highly endogamous population. A cohort study was carried out on 396 patients enrolled between November 2011 to October 2013. We employed the WHO Composite International Diagnostic Interview (WHO-CIDI) and Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-IV/Clinical Version for diagnoses, the Yale-Brown Obsessive Compulsive Scale Symptom Checklist for scoring OCD. Patients were grouped in BD patients with OCD (BD-OCD) and BD patients without OCD. Groups were compared for socio-demographic and clinical variables. There were no significant differences for age, gender, BMI, and marital status, between BD patients with and without OCD. We found significant differences in level of education ( P = 0.022), occupation status ( P = 0.025), household income, ( P = 0.049), cigarette smoking ( P = 0.038), sheesha smoking ( P = 0.007), and prevalence of consanguinity ( P = 0.036) among these groups. Number of hospitalizations and Young Mania Rating Scale score were not different among BD patients with or without OCD whereas there were significant differences in Hamilton-Depression score, Clinical Global Impression-BD Score, duration of illnesses, and Global Assessment of Functioning (GAF). Also specific phobia, somatization, depression, mania, any mood disorder, oppositional defiant disorder, ADHD and personality disorder were more common in BD than OCD–BD group. This study confirms that BD-OCD is a common co-morbidity, largely under-recognized in clinical practice, which may significantly change BD presentation and outcome. Disclosure of interest The author has not supplied his/her declaration of competing interest.

ObjectiveMost children experience some degree of fear during their development. Excessive fears can create serious obstacles to children. The aim of this study was to identify the most common fears in a sample of children and adolescents and examine the socio-demographic correlates of fears.Subjects and methodsThis cross-sectional study was conducted during the period July 2010 to February 2012 at Public and Private Schools of the Ministry of Education and Higher Education, in Qatar. Out of 2188 students approached, 1703 students agreed to participate in this study, with a response rate of 77.8%. The questionnaire includes socio-demographic information, academic performance, behaviour at home and various fears.ResultsMore than half of the children experienced fears (56.7%). Most of them were in the intermediate level, 12–15 years old (46.1%). Overall, reported fears were significantly more frequent in girls (62.6%) than boys (37.4%) (P < 0.001). A significant difference was observed between girls and boys who experienced fears in their age group (P < 0.001), education of mother (P = 0.04), household income (P = 0.008) and academic performance (P < 0.001). The most frequent reported fears were fear of someone dying in the family (85.2%), parents getting divorced (84.5%), breaking religious law (82%), being kidnapped (78.2%), family members ill (78%) and dying (76.7%).ConclusionsThe study findings revealed that fears were highly prevalent in Arab children and adolescents in Qatar. Girls reported more fears than boys. There was a significant difference observed between girls and boys in their age group and academic performance for the reported fears.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

ObjectiveThe objective of current study was to investigate whether associaction exist between depression and low BMD during menopausal and post-menopausal period.MethodsA cross-sectional descriptive study and 1650 women aged 45–65 years were included during 1182 women agreed to participate (71.6%). Data on body mass index (BMI), clinical biochemistry variables including serum 25-hydroxyvitamin D were collected. The Beck Depression Inventory (BDI) was administered for depression purposes.ResultsA total of 1182 women agreed to participate and responded to the study. The mean age and SD of the menopausal age were 48.71 ± 2.96 with depressed and 50.20 ± 3.22 without depressed (P < 0.001). Also, the mean and SD of postmenopausal age were 58.55 ± 3.27 depressed and 57.78 ± 3.20 without depressed (P < 0.001). There were statistically significance differences between menopausal stages with regards to number of parity, and place of living. There were statistically significance differences between menopausal stages with regards to BMI, systolic and diastolic blood pressure, vitamin D deficiency, calcium deficiency and sheesha smoking habits. Overall, osteopenia and osteoporosis and bone loss were significantly lower in post-menopausal women than in menopausal women (P < 0.001). Similarly, T-score and z-score were lower with depressed menopause and postmenopausal women (P < 0.001).ConclusionThe multivariate logistic regression analyses revealed that the depression, the mean serum vitamin D deficiency, calcium level deficiency, less physical activity, co-morbidity, number of parity, systolic and diastolic blood pressure and sheesha smoking habits were considered as the main risk factors associated with bone mineral loss after adjusting for age, BMI and other variables.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

Background: The Middle East region is predicted to have one of the highest prevalence of diabetes mellitus (DM) in the world. The risk of diabetes continues to increase worldwide and its public health burden is unevenly distributed across socioeconomic strata. This burden is not only related to health care costs, but also to indirect costs caused by loss of productivity from disability and premature mortality. Aim: This study aims to estimate the economics cost of type 2 Diabetes Mellitus [T2DM] among adults in Qatar using national data, and to quantify the potential effect of a suggested preventive intervention program. Design: It is an observational cohort study. Setting: The survey was based on registry at the Hamad General Hospital and Primary Health Care (PHC) centers in the State of Qatar. Subject: This study consisted of patients above 25 years of age with diagnosed diabetes mellitus registered at Hamad General Hospital and Primary Health Care (PHC) centers during January 2004 to July 2014. Methods: We developed a dynamic model in which actual incidence, prevalence, and life expectancy data are used and alternative assumptions about future trends in these parameters can be incorporated. Linear regression model has been performed to forecast the burden of diabetes in oil-rich country. Results: According to the dynamic model, a 10% increased in the number of diabetic patients in the State of Qatar from 33 610 in 2005 to 122 000 in 2012 (about 1% annually). The annual diabetes incidence rate was higher in women than in men during a period between 2005 to 2015 years. The static model forecasted as 10% increase over 10 years. The relative increase in prevalence of diabetes and number of diabetic people are higher in women than in men (16.6%; 17.5% and 18.4% in men vs. 22.6%; 23.8% and 25.1% in women). Most of the increase in prevalence of diabetes is projected to occur in younger age groups where it is estimated to increase among age groups of 50-59 years and above 60 years, respectively. Conclusion: The burden of diabetes in Qatar is markedly larger than proposed by IDF estimations - suggesting that Qatar would be one of the top 10 countries worldwide in diabetes prevalence. Family history of diabetes, consanguinity marriages', hereditary gene-environment interactions, poor nutrition in utero and in early life plus over nutrition in later life may also contribute to the current diabetes epidemic in Qatari's Arab populations. Finally, continuous training of primary health care professionals on diabetes care and prevention is an essential tool of improving diabetes in Qatar.

AimThe objectıve was to determine correlation between depression, anxiety and stress in menopausal and post-menopausal women and shedding more light on a complex relationship.MethodsA cross-sectional based on Arabian women at the Primary Health Care (PHC) Centers in Qatar during July 2012 and May 2014 and 1101 women agreed to participate and responded to the study. Depression, anxiety and stress were measured using the Depression Anxiety Stress Scales (DASS-21). Data on body mass index (BMI), clinical and other parameters were used.ResultsThe mean age and SD of the menopausal age was 49.55 ± 3.12, and postmenopausal age was 58.08 ± 3.26 (P < 0.001). There were statistically significant differences between menopausal stages with regards to age, ethnicity, educational status, occupation status, and place of living. Also, there were statistically significant differences between menopausal stages with regards to BMI, systolic and diastolic blood pressure, vitamin D deficiency, and diseases. Depression and anxiety were more common among postmenopause women. The multivariate regression analyses revealed that age in years, diastolic BP, consanguinity, regular exercise were predictor for depression. Meanwhile, diastolic BP, occupation and physical activity considered the main risk factors for anxiety. Furthermore, age in years, occupation and sheesha smoking habits were considered as the main risk factors associated with stress.ConclusionA large number of factors were associated with experiencing menopausal and psychosocial problems and which had negative effects on the quality of life among Arabian women. Depression, anxiety and stress should be considered as an important risk factors for osteoporosis.Disclosure of interestThe author ha not supplied his/her declaration of competing interest.

Background: The reported association between vitamin D level and loss of Bone mineral densitometry measurements (BMD) has been controversial.Objective: The objectı;ve of the current study was to determine whether low vitamin D level and BMD are associated with depresive symptoms as burden in Arab women during the menopausal and postmenopausal period.Design and Setting: A cross-sectional descriptive study design was used at the Primary Health Care (PHC) Centers in Qatar.Subjects: A multi-stage sampling design was used and a representative sample of 1436 women aged 45-65 years were included during July 2012 and November 2013 and 1106 women agreed to participate (77.2%) and responded to the study.Materials and Methods: BMD (g/m 2) was assessed at the BMD unit using a Lunar Prodigy DXA system (Lunar Corp., Madison, WI). The antero-posterior lumbar spine (L2-L4) and the mean of the proximal right and left femur were be measured by two technician and then reviewed by one radiologist. Data on body mass index (BMI), clinical biochemistry variables including serum 25-hydroxyvitamin D were collected. The Beck Depression Inventory (BDI) was administered for depression purposes.Results: Of the 1436 women living in urban and rural areas, 1106 women agreed to participate (77.0%) and responded to the study. The mean age and standard deviation of the subjects was 53.8 ± 3.2. The median age of natural menopausal in the present study was 49 years (mean and standard deviation 49.5 ± 3.1 and postmenopausal was 58.1 ± 3.3). There were statistically significant differences between menopausal stages with regards to ethnicity, education level, systolic and dialostic blood pressure, parity, sheesha smoking and depressive symptoms. Overall 30.4% of women were affected with osteopenia/osteoporosis in premenopausal and postmenopausal (24.4% vs 35.7%; P = 0.0442). Osteopenia in premenopausal and postmenopausal (18.7% vs 29.3%; P = 0.030) and Osteoporosis (9.9% vs 15.9%; P = 0.049) were significantly higher in post-menopausal women than in premenopausal women (P = 0.046). Similarly, vitamin D deficiency was more prevalent among postmenopausal women than menopausal women. Overall, only 15.1% of women had optimum vitamin D level and 15.5% had severe, 33.2% had moderate vitamin D insufficiency and 36.3% had mild vitamin D insufficiency in menopausal and post menopausal women (P = 0.021). The study revealed that vitamin D level, hemoglobin level, serum iron fasting plasma glucose, calcium, triglycerides, high density lipid (HDL) cholesterol, low density lipid (LDL) Cholesterol, alkaline phosphate and magnesium were considerably lower in postmenopausal compared to menopausal women (P < 0.001).Conclusion: The current study revealed that there was a strong association between vitamin D level and BMD in Arab women during the menopausal and post-menopausal period.

Background:No study has been conducted to determine the reliability and validity of the Depression, Anxiety and Stress Scale (DASS-21), Hospital Anxiety and Depression [HADS] and Beck Depression Inventory (BDI-II) among the Arab Breast Cancer population.Aim: The aim of this study was to compare the reliability and validity of the Depression, Anxiety, and Stress scale (DASS-21), the Beck Depression Inventory-(BDI-II) and Hospital Anxiety and Depression Scale (HADS) among Breast Cancer women in Qatar.Design: This is an observational cohort hospital based study.Subjects: A list of 1,042 eligible breast cancer patients was prepared, from the disease registry from January 2010 to December 2014 who could be contacted.From the available 1,042 list, 730 breast cancer patients information were available (70.0%) and expressed their consent to participate in the study.Methods: Breast cancer women were screened for depression using DSM-IV criteria, followed by data collection based on 21 items Depression Anxiety Stress Scale (DASS-21), Hospital Anxiety and Depression Scale (HADS) and Beck Depression Inventory (BDI-II) through interviews by trained nurses.Analyses included comparisons between the classifications of women according to the HADS, BDI-II and DASS-21 with classification of breast cancer depression based on DSM IV (Gold standard).Sensitivity, specificity, area under the curve and kappa coefficients was calculated for each scale.Results: The prevalence of postpartum depression was 20% based on DSM-IV criteria while on the other hand the prevalence was 23% based on DASS-21, 21.8% based on BDI-II and 19.7% based on HADS validated tools.Sensitivity was highest for BDI-II (85%) followed by DASS-21 and HADS (78%) based on standard cut off points of ≥17, ≥10 and ≥13 respectively.On the other hand, specificity was highest for DASS-21 (89%) followed by BDI-II (81%) and HADS (80%).The area under the curve (AUC) was 0.86 (95% CI 0.83-0.89)for DASS-21, 0.84 (95% CI 0.80-0.88)for BDI-II and 0.83 (95% CI 0.80-0.86)for HADS scales.There was highest agreement between DASS-21 and HADS (Kappa =0.80 p value <0.001), followed by DASS-21 and BDI-II (Kappa 0.75, p value <0.001) and BDI-II and EPDS (Kappa 0.60, p <0.001).Conclusions: DASS-21, BDI-II and HADS have excellent sensitivity, and specificity to quickly screen for breast cancer women.Agreement is highest among DASS-21 and HADS.Overall, DASS-21 performed better as compared to the other tools based on sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).The Arab version of the DASS-21 exhibited satisfactory psychometric properties and its use for research and health care practice is warranted.Results indicate and support the cross-cultural validity of the DASS-21 in Arab countries.

The aim ofthis study was to assess the prevalence, size and burden of commonestpsychiatric disorders at Primary Health Care (PHC) Centres using the WHO Composite International DiagnosticInterview (WHO-CIDI) and co-morbidity. A total of2,000 Qatari subjects aged 18 to 65 years were approached at PHC and 1,475 (73.3%) gaveconsent. Prevalence and severityof ICD-10 disorders were assessed with the WHO Composite InternationalDiagnostic Interview (CIDI, Version 3.0). The three most common disorders weremajor depression disorders (18.31%), any anxiety disorders (17.29%), any mooddisorders (16.95%), followed by separation anxiety disorders (15.25%),personality disorder (14.1%). Most of the respondentswere in the age group 35-49 years (37.8%), followed by 18-34 years (34%), then50-64 years (19.6%) and above aged 65 years old (8.5%). In the present study, prevalence in women was significantly higher thanmen for the most common psychiatric disorders, specifically generalised anxietydisorder, panic disorder, social phobia, specific phobias, obsessive compulsivedisorders, post traumatic disorder, somatisation, major depressive disorder, bipolar disorder, dysthymia, and oppositional defiant disorder. Of the total 20% had only one psychiatric diagnosisand 12% had two disorders, 9.7% respondents with three diagnoses, and finally4.3% of respondents had four or more diagnoses. One-fifth of all adults who attended the PHC Centre 20% had at least one psychiatric diagnosis. The prevalence of thegeneralized anxiety disorders; socialphobia, specific phobia, major depression, and personality disorders werethe significantly higher in women than inmen.

Background: Patients with schizophrenia are at greater risk for metabolic syndrome (MetS) and other cardiovascular risk factors. Objective: The objective of the study was to examine the prevalence of metabolic syndrome (MetS) and its criteria among patients with schizophrenia (Sz) according to the revised criteria of NCEP ATP III and assess which component contributed to the increased risk of the MetS in schizophrenia patients.Design: This was a matched case-control study.Setting: Outpatient clinics of the Psychiatry department and Primary Health Care (PHC) Centers of the Supreme Council of Health, State of Qatar.Subjects and methods: The study was carried out among patients with schizophrenia (SZ) and healthy subjects above 20 years old. The study based on matched by age and gender of 233 cases and 466 controls. The survey was conducted from June 2010 to May 2011. Face to face interviews were conducted using a structured questionnaire followed by laboratory tests. Metabolic syndrome was defined using the National Cholesterol Education Program - Third Adult Treatment Panel (ATP III).Results: The prevalence of metabolic syndrome among schizophrenic patients (36.5%) were significantly higher than healthy subjects (18.7%) (p < 0.001). The prevalence of MetS in schizophrenic subjects was reported to be two times higher than in the general population. The MetS components were higher among schizophrenic patients than healthy subjects. Among the components of MetS, central obesity (63.9%) was the most common criteria among patients compared to healthy subjects (45.7%) (p < 0.001). Schizophrenic patients (27%) were significantly obese than the healthy subjects (13.1%). Female schizophrenia patients were more likely to have three or more metabolic abnormalities compared to men.Conclusion: The study indicated that metabolic syndrome was highly prevalent in patients with schizophrenia. The female gender was significantly associated with a higher prevalence of metabolic syndrome. The identification and clinical management of this high risk group is of great importance. (C) 2013 Diabetes India. Published by Elsevier Ltd. All rights reserved.

OBJECTIVES:The aim of this study is to investigate bone mineral density (BMD) for a large cross-section of midlife Arab women living in Qatar and to evaluate the association of body mass index (BMI), menopause status, and nationality, on BMD of the spine and femur.STUDY DESIGN:A cross-sectional study was conducted among women aged 40-60 years recruited from nine primary-care health centers in Qatar. BMD (g/m(2)) was assessed at the lumbar spine and the femur.RESULTS:The combined prevalence of osteopenia and osteoporosis was 4% at the femur and 16.2% at the spine. BMI and menstrual status were both independently associated with BMD at the spine and at the femur (all p values < 0.001). As BMI increased, BMD increased at both the spine and femur. Women who menstruated in the past 12 months had 0.82 g/cm(2) and 0.61 g/cm(2) greater BMD at the spine and femur, respectively, compared with women who had not menstruated in 12 months. Nationality was not associated with mean BMD of the spine or the femur.CONCLUSIONS:No significant differences were observed between Qatari and non-Qatari women in terms of mean BMD values at the spine and the femur except for the femur in the age group 55-60, where values were lower among non-Qataris (p = 0.04). Multivariable analyses showed that BMI and menstrual status were found to be strongly associated with BMD levels at the spine and femur. The high prevalence of obesity observed in this sample may explain the low levels of osteopenia and osteoporosis observed.

BACKGROUNDThere is strong evidence in the literature that there is an association between ABO blood group and certain diseases.AIMThe aim of this study was to investigate any association between the ABO blood groups and diabetes mellitus (DM) in Qatar.DESIGNThis was a sex-matched case-control study.SETTINGThis study was carried out in the diabetic outpatient clinics and blood bank of the Hamad Medical Corporation (HMC) from April 2011 to December 2012.SUBJECTS AND METHODSThe study included 1633 diabetic patients and 1650 nondiabetic apparently healthy controls. A total of 2148 adult patients above 18 years of age were selected consecutively from the diabetic clinics of the hospitals and 1633 patients gave consent to take part in this study, thus giving a response rate of 76%. A total of 2150 nondiabetic healthy adults above 18 years of age were recruited from the blood bank and 1650 individuals agreed to take part in this study, giving a response rate of 76.7%. Blood group of the recruited subjects was taken from the database of the Blood Bank, Central laboratory, HMC.RESULTSThe data revealed that the blood group B was significantly more common in diabetic patients as compared with healthy population (25.7% vs. 20.4%; P < 0.001). Blood group O was significantly less common in diabetic patients compared with nondiabetics (38.5% vs. 45.4%; P < 0.001). Among diabetic men, the frequency of only blood group B was significantly higher, while on the contrary among diabetic women the frequency of both A and B (29.7% vs. 24.8%; P = 0.03 and 25.5% vs. 20%; P < 0.009, respectively) were significantly higher as compared with nondiabetic healthy population.CONCLUSIONThe findings in this study suggest that ABO antigens are associated with DM. DM is more common in individuals with blood group B.

Background: It has been reported that ferritin and iron deficiency may be related to the path physiology of attention deficit hyperactivity disorder (ADHD). Aim: The aim of this study was to determine the association between iron deficiency and ADHD and the impact and role of iron deficiency on the development of ADHD in children. Subjects and Methods: The study based on the case-control study age- and sex-matched control and conducted at the School Health and Primary Healthcare Clinics, Qatar. A total of 630 children with ADHD aged 5-18 and 630 controls aged 5-18 years old. Sociodemographic and clinical data were collected, including physician diagnosis. The health status of the subjects was assessed by ascertaining clinical presentations and symptoms, family history, body mass index (BMI), iron deficiency, ferritin, serum 25-hydroxyvitamin D, calcium, magnesium, and phosphorus levels. Descriptive, univariate, and multivariate statistical analysis were performed. Results: Mean age (standard deviation [SD] in years) for ADHD and control children were 11.54 (3.83) versus 11.50 (3.62). There were statistically significant differences between ADHD versus control children for vitamin D [16.81 (7.84) vs. 22.18 (9.00) ng/ml], serum iron [82.11 (13.61) vs. 85.60 (12.47) ng/ml], ferritin [36.26 (5.93) vs. 38.19 (5.61) ng/ml], hemoglobin [12.02 (2.13) vs. 12.89 (2.02) g/dL], magnesium [0.82 (0.08) vs. 0.88 (0.06) mmol/L], serum calcium level [2.35 (0.12) vs. 2.39 (0.14) mmol/L], and phosphorous [1.47 (0.30) vs. 1.54 (0.26) mmol/L]. Of total 630 of ADHD children, 116 (18.4%) had severe vitamin D deficiency (<10 ng/ml). Multivariate logistic regression analysis revealed that serum vitamin D level, serum iron, ferritin, serum calcium level, physical activity, nervous behavior, consanguinity, BMI, and child order were considered as the main factors associated with the ADHD after adjusting for age, gender, and other variables. Conclusion: The study indicates that low serum iron, ferritin levels, and vitamin D deficiency may be associated with ADHD.

Background: Childhood asthma is common in children. It might be associated with behavioral abnormalities of inattention, irritability, or hyperactivity. These abnormalities form the major components of attention deficit hyperactivity disorder (ADHD). Allergic diseases and ADHD are common pediatric conditions associated with learning difficulties and sleep disturbances. There are conflicting research data regarding the association between ADHD and atopic disorders. Aim: The objective of this study was to examine the potential risk factors, especially investigate vitamin D deficiency a strong contributing factor in asthmatic children with ADHD. Design: This was a case-control study. Settings: Hamad General Hospital, Rumeilah Hospital, School Health and Primary Health Care Clinics, Qatar. Subjects and Methods: A total of 520 asthmatic children with ADHD and 520 controls aged 5-16 years old controls were enrolled in this study and matched with age and ethnicity. The study was conducted between June 2011 and September 2013. Data based questionnaire, clinical manifestations, family history, body mass index (BMI), and clinical biochemistry variables including serum 25(OH) vitamin D, calcium, phosphorus, magnesium was obtained. Univariate and multivariate statistical analyses were performed. Results: Severe vitamin D deficiency was significantly higher among asthmatic children with ADHD compared with the healthy controls (18.1% vs. 10.4%; P < 0.001). Furthermore, the proportion of overweight (24.1% vs. 18.1%) and obesity (8.2% vs. 5.4%) was significantly higher among asthmatic children with ADHD than healthy controls (P < 0.001). Mean values of vitamin D (17.25 ± 10.53 vs. 23.91 ± 9.82; P < 0.001), serum iron (81.46 ± 13.61 vs. 87.23 ± 12.46; P < 0.001), hemoglobin (11.68 ± 2.11 vs. 12.87 ± 2.15; P < 0.001), magnesium (0.77 ± 0.12 vs. 0.83 ± 0.13; P = 0.013), potassium (4.22 ± 0.53 vs. 4.58 ± 0.55; P < 0.001), phosphorous (1.53 ± 0.12 vs. 1.66 ± 0.14; P < 0.001) were significantly lower among asthmatic children with ADHD than in controls. There was a significant correlation between vitamin D deficiency and with age (r = −0.224, P = 0.001); calcium (r = 0.256, P = 0.001); phosphorous (r = 0.316, P = 0.001); magnesium (r = 0.288, P = 0.001); and BMI (r = 0.452, P = 0.001) in asthmatic with ADHD children. Vitamin D deficiency (odds ratio [OR] =3.27; P < 0.001), serum iron deficiency (OR = 2.81; P = 0.008), physical inactivity (OR = 2.67; P = 0.005), ferritin (OR = 2.53; P < 0.001) and serum calcium level (OR = 2.04; P < 0.001) were significant leading predictors in asthmatic children with ADHD. Conclusion: The present study revealed that vitamin D was a significant contributing factor in asthmatic children with ADHD followed by serum iron deficiency and physical inactivity compared with healthy controls.

BACKGROUND:Measurement of treatment satisfaction in diabetes is important as it has been shown to be associated with positive outcomes, reduced disease cost and better health.AIM:The aim of this study was to assess the relationship between treatment satisfaction of diabetes patients and socioeconomic, clinical, medication adherence and health-related factors in Qatar.DESIGN:This is a cross-sectional study.SETTING:The survey was carried out in primary health care centers and hospitals from April 2010 to May 2011.SUBJECTS:Of a total of 3000 diabetic patients, 2582 patients gave their consent to take part in the study, with a response rate of 86.1%.MATERIALS AND METHODS:The Diabetes Treatment Satisfaction Questionnaire was used to measure the patient satisfaction. The modified Morisky Medication Adherence was used to measure medication taking behavior. A multivariate stepwise linear regression model was performed to identify factors independently associated with patients' satisfaction instrument.RESULTS:Of the studied patients, majority of the diabetes patients were Qataris (61.2%), married (86.1%), above secondary education (46.9%) and unemployed (28.6%). Diabetes patients who had professional jobs (3.97 ± 0.65; P = 0.009) and those who were staying alone had a significantly higher treatment satisfaction score (4.01 ± 0.64; P = 0.001) compared with the other patients. Patients who were taking tablets were significantly more satisfied with treatment (4.08 ± 0.60; P < 0.001). Diabetes patients of primary health care centers (3.96 vs. 3.80; P < 0.001) were more satisfied with treatment than patients visiting hospitals. Multivariate regression analysis revealed that age of the patient (P < 0.001), expatriates (P = 0.023), patients visiting hospitals (P < 0.001), treatment with insulin (P < 0.001) and any diabetes complications (P < 0.001) were significantly less satisfied with the treatment.CONCLUSION:The study findings revealed that patient satisfaction was positively associated with sociodemographic variables like high income, employment, married individuals and those with higher levels of education. We found a lower treatment satisfaction in patients with diabetes-related complications and insulin treatment.

The prevalence of use of complementary and alternative medicine (CAM) is widespread and is growing worldwide.This cross-sectional study in Qatar examined the use of CAM and its correlates among Arab women in their midlife years.Women aged 40-60 years (n = 814) were recruited at primary care centres in Qatar and completed a specially designed, pre-tested questionnaire.Overall, 38.2% of midlife women in Qatar had used CAM in the previous 12 months.Nutritional remedies and herbal remedies were the most commonly used CAM therapies, followed by physical methods.Qatari nationality and higher level of education were independently associated with CAM use.Menopause transition status was not independently associated with use of CAM.The prevalence of CAM use by women in Qatar was high, consistent with other reports worldwide.It is essential to educate and inform patients and health-care providers about the benefits and limitations associated with CAM.