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Two techniques were applied in this work to minimize the hazards of potentially toxic elements (PTEs) in three contaminated soils namely; chemical remediation represented by rock phosphate (PR) with phosphate dissolving bacteria (PDB), Montmorillonite modified clay mineral (MCM) and mixture of both chemical remediated materials, and intercropping technique represented by Radish (Raphanus raphanistrum) and Turnip (Brassica rapa). The selected soils suffered from different sources of pollution and varied types of heavy metals emitted to the agricultural ecosystem. Tomato (Solanum lycopersicum) plants as an important economic agricultural crop in the studied region were taken in this work as an indicator to evaluate the applied techniques to remediate heavy metals pollution in soils textured from sandy clay loam to clay. The obtained results imply all techniques significantly decreased the concentration of Pb, Cd, Ni, Zn and Cu in the soils, however, chemical remediation technique especially the mixture between the two treatments (T3) were more effective in decreasing the hazards of pollutants in the studied soils. Different mechanisms between both used techniques and heavy metals were discussed.

Background: End-stage kidney disease (ESKD) patients on maintenance renal replacement therapy (RRT) have far lower life spans than those of the general population. No previous studies have been performed to assess the mortality of dialysis patients in the State of Qatar. We designed this study to assess the mortality of dialysis patients in Qatar and the impact of dialysis modality. Methods: All chronic ambulatory dialysis patients (both on hemodialysis (HD) and peritoneal dialysis (PD) between 2014 and 2016) were included in the study, whereas patients undergoing dialysis for less than 3 months were excluded. We reviewed patients’ demographics, comorbidities, and general laboratory investigations through our electronic record system and collected and analyzed them. We identified patients who died during that period and compared them to those who survived. We performed a subanalysis for HD versus PD patients who died. Results: The total number of deceased dialysis patients was 164, with an overall crude mortality rate of 6.4%. They were significantly older than those who survived (p = 0.0001). The mortality rate was significantly higher in female than in male patients (51.2% and 38.9%, respectively) (p = 0.004) but significantly lower in PD than HD patients (1.36%, PD; 5.0%, HD; p = 0.007). It was also significantly higher in natives than in the expats (60.3% and 39.6%, respectively) (p = 0.0008); however, no significant differences were noted between deceased natives and expats in most demographic and laboratory characteristics. The most common cause of patient death was CVD (62 patients, 37.8%), followed by sepsis (44 patients, 26.8%). Diabetes, cerebrovascular accident, and dyslipidemia were more common in HD deceased patients than in PD patients (80.6%, 47%, and 59%, respectively, in HD patients vs 68.5%, 42%, and 31%, respectively, in PD patients). Albumin and potassium levels in deceased PD patients were significantly lower than in HD patients (p = 0.001). Conclusion: Our study found that the high-risk population had a significant mortality, which was higher in HD than PD patients. This is the first study to look at these outcomes in Qatar. We identified multiple mortality associated factors, such as comorbid conditions and old age. We believe that improving treatment and close monitoring for comorbid conditions in the dialysis population might improve survival.

Background: Hamad General Hospital (HGH) is the principal provider of dialysis in the state of Qatar, comprising a total of four facilities in different cities. Infection rates in dialysis patients are increasingly used as a surrogate marker for measuring patient safety and quality of healthcare. These infections are associated with substantial morbidity, mortality, and excess healthcare costs. We observed an elevated rate of hemodialysis catheter-related bloodstream infections (HD-CRBSI) in our outpatient dialysis facilities (1.4/1,000 Central Venous Catheter [CVC] days) in 2011. Our goal was to reduce our HD-CRBSI rate by 80% within a period of four years in HGH ambulatory dialysis facilities. Methods: HD-CRBSIs are defined as the presence of positive blood cultures in a febrile catheter-dependent patient in the absence of alternative sources of infection upon clinical evaluation. The project was led by the HGH quality improvement program director in coordination with a multidisciplinary team (nephrologists, nurses, vascular coordinators, a patient educator, and an infection control team) after implementation of a bundle of infection prevention measures. Results: The rate of HD-CRBSI was reduced from 1.4/1,000 CVC days in 2011 to 0.014 in 2017, achieving a 99% reduction rate (p < 0.001). Conclusions: Strict implementation of our new infection prevention measures bundle is sufficient to significantly reduce HD-CRBSIs.

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