HOSPITALS Magazine issue 51 by The Arab Hospital Magazine

Issue 51 / 162 MARCH-APRIL 2020

THE ARAB HOSPITAL APPLICATION IS AVAILABLE

HRH PRINCESS DINA MIRED

Publisher Arab Health Media Communication

Fighting Coronavirus A tribute to the medical staff and paramedics

Once again, the medical, nursing, and associated missions prove that they are truly the most honorable professions in the world, for those working in these fields sacrifice their lives to save others. Fighting the new Covid-19 coronavirus has revealed the high sacrifice spirit of the medical staff and their unlimited dedication to save the lives of those infected. In China, for example, the increasing number of corona victims is not the only problem. Hundreds of the medical staff have contracted the deadly virus. Beijing said last month that 6 members of the medical staff have died from the infection, 1716 others had contracted the virus, while some had collapsed due to days of continuous work. As the outbreak of the virus has reached more than 65 countries, the pressure on medical staff has increased worldwide. The staff did not hesitate to provide aid at all stages, whether the paramedics involved in transporting the infected people to the medical centers, or the doctors, nursing staff, and administrative personnel working in the hospitals and treatment centers. However, the greatest tribute remains always for this human spirit that doctors, nurses, and paramedics possess, and which is not limited to reviving the patients and treating the infected people, but to always revive the hope that humanity is fine no matter what challenges it has to face. This profession-noble mission remains the bright spot of light in the darkest times. The Publisher

General Manager Simon Chammas schammas@tahmag.com Creative Department Roula Haddad - Georges Habka Creative Director: Jessy E. Hajj Photographer Hanna Nehme Copy Editor Jessica Achkar Editors Aline Debes, Mark Steven, Don Karn, Andrew Weichert, Colette Semaan, Abbas Moussa Advertising & Marketing advertising@tahmag.com Mirna Khayrallah mirna@tahmag.com Business Development Manager Ralph Rahal tahmag@tahmag.com Offices & Adresses AHMC, Lebanon Mansourieh High way, Jihad Wakim center, 3rd floor. T/F: +961 4 53 40 58 M: +961 3 60 61 00 tahmag@tahmag.com Simon Chammas schammas@tahmag.com Dubai Schammas@tahmag.com +967 50 2971007 KSA Elias Aramouni Business Dot Sulaimaniah Ofﬁces building • 2nd ﬂr M: +966 55 1595 000 T: +966 11 4568282 F: +966 11 2253666 P.O. Box: 085092 Riyadh 11691 Printing

Distribution KSA - UAE - OMAN LEBANON - JORDAN SYRIA - KUWAIT BAHRAIN - QATAR - EGYPT

MARCH . APRIL 2020

32 HRH Princess Dina Mired

COVER STORY

26 BD Completes Clinical Trial for BD Libertas™

32 Princess Dina Mired, President of the Union for International Cancer Control (UICC)

NEWS

8 Saudi German Hospitals Group opens hospital in Dammam 10 OKI Europe exhibited at Arab Health 2020 with Pioneering DICOM Medical Printers 12 HOYA Group PENTAX Medical Cleared CE Mark for DISCOVERY™, an AI Assisted Polyp Detector 14 Malaffi unveils its game-changing patient app at Arab Health 2020 18 IRCAD Lebanon contributes to the international development of the medical robotics 20 Al Qassimi Hospital upgraded with UAE’s first deployment of award-winning AIR Technology 24 Global leading Cardiovascular Diseases Institutions gather at Middle East Symposium for the first time

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Wearable Injector 28 Mecomed calls for regionwide overhaul of healthcare models, to deliver better patient outcomes 30 SEHA and Vocera Collaborate to Provide World-Class Clinical Communication Across Integrated Healthcare Network 68 Medtronic and stroke care providers experiencing and designing solutions to enhance stroke patient journey 90 GE Healthcare Unveils New Imaging Tech and Intelligent Apps at Arab Health 2020 106 A focus on research at Weill Cornell Medicine – Qatar 108 Thumbay University Hospital Launches Center for Nephrology & Dialysis Unit 110 The LAU Medical Center-Rizk Hospital gives a special lecture entitled: made in China: the novel virus COVID-19 111 5th Emirates Plastic Surgery Congress Opens in Dubai

Arab Health 2020

Let’s connect care, everywhere Health matters to all of us. While healthcare has come a long way, it’s still not seamless: systems don’t always communicate, clinicians can’t always see the full picture fast enough, and patients can feel lost in the system. Philips is committed to deliver innovation that eliminates the complexity in healthcare from hospitals to homes. Our AI-driven solutions can help seamlessly organize care by connecting people, technology and data to improve patient and staff experience, leading to better health outcomes. This allows patients to get the right care, in the right place, at the right time. There’s always a way to make life better.

MARCH . APRIL 2020

40 Coronavirus FEATURES

40 Coronavirus / COVID-19 72 Medical Tourism 80 Medical Tourism in Turkey 86 IT Healthcare… A New Era in Medicine 92 Stroke Treatment Units 96 Immunotherapy 112 Obesity

INTERVIEWS

46 Özlem Fidanci 50 Elie Chaillot 54 Mr. Mathias Militzer 56 Dr. Haidar Al Yousuf 58 Andrew Civitello 60 Ms. Sultana Afdhal 76 Dr. Fawzi Al-Hammouri

86 IT Healthcare MAR.APR 2020

80 Medical Tourism in Turkey MEDICAL INSTITUTIONS

70 Koç Healthcare

ARTICLES

48 When Your Child Needs Surgery, Everything Matters 62 The Bed is in the Spotlight for Quality Infection Prevention 64 Latest Techniques for the Treatment of Heart Valves at Hôtel-Dieu de France 66 Cutting-Edge Alternative Treatment Method for BPH at Hôtel-Dieu 82 Latest therapies for Pancreatic Tumors 84 A promising method for Pancreatic Cancer! 98 “Religion and Medical Ethics: Palliative Care and the Mental Health of the Elderly” 102 Bleeding Gums... 104 Preterm Labor

112 Obesity

in Turkey.

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NEWS

Saudi German Hospitals Group opens hospital in Dammam

audi German Hospitals (SGH) Group has officially announced the opening of its newest hospital in Dammam, in the presence of His Royal Highness Prince Saud Bin Nayef Bin Abdul Aziz Al Saud, Governor of the Eastern Province. The new facility is SGH Group’s first hospital in the Eastern Province and its 11th hospital in the region. This is in line with the group’s strategic expansion plans which aim to extend the group’s presence in the Kingdom and the region--providing world-class medical care. Makarem Sobhi Batterjee, President, Saudi German Hospitals Group, said: “We are proud to announce the opening of our first hospital in the Eastern Province, which affirms our commitment to reaching to every patient in Saudi Arabia. We aim to provide patients with easy access to premium international healthcare close to home, so that they do not need to travel abroad for medical care.” He added: “This newly opened Saudi German Hospital in Dammam is part of a much bigger project, the Batterjee Medical City. It will include a medical college, housing and specialty hospitals where the highest medical services will be provided. This is of course in line with the

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developments of the healthcare sector as part of the “Saudi Vision 2030.” The newly opened hospital is a state-ofthe-art facility offering comfortable spaces for patients and visitors, equipped with the latest medical equipment and technology. The hospital has a capacity of 300 beds and is staffed by highly trained medical professionals of all kinds of specialties and sub-specialties. The new Saudi German Hospital in Dammam will live up to SGH Group promise of putting patients' experience and wellbeing first.

THE NEWLY OPENED HOSPITAL IS A STATE-OFTHE-ART FACILITY OFFERING COMFORTABLE SPACES FOR PATIENTS AND VISITORS, EQUIPPED WITH THE LATEST MEDICAL EQUIPMENT AND TECHNOLOGY. THE HOSPITAL HAS A CAPACITY OF 300 BEDS AND IS STAFFED BY HIGHLY TRAINED MEDICAL PROFESSIONALS.

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NEWS

OKI Europe exhibited at Arab Health 2020 with Pioneering DICOM Medical Printers Showcasing the award-winning technology with fully integrated DICOM print servers, OKI printers to push the boundaries where the world of healthcare meets

t Arab Health Exhibition 2020, OKI Europe has showcased its revolutionary print solutions for the medical and healthcare sectors. The exhibition took place at Dubai World Trade Centre, from the 27th till the 30th of January 2020, and received more than 105K visitors from 150+ countries. During the exhibition, OKI exhibited the first in digital printer technology; combining the high-quality output of an LED printer with DICOM embedded software. This allows the DICOM printers to talk directly with the medical imaging equipment, presenting many opportunities for printing high-quality, near-diagnostic images in High Definition mono and color on a wide range of media. Delegates who visited OKI Europe at Stand S3.F50 had the opportunity to preview a completely new innovation to revolutionize their medical imaging, as well as discover how customer satisfaction can be improved through

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DURING THE EXHIBITION, OKI EXHIBITED THE FIRST IN DIGITAL PRINTER TECHNOLOGY; COMBINING HIGH-QUALITY OUTPUT OF AN LED PRINTER WITH DICOM EMBEDDED SOFTWARE

personalized A4 and A3 patient leaflets and brochures. They also learned how OKI devices save medical and healthcare businesses time and money in medical imaging and standard office printing. The stand’s visitors have seen live demonstrations of OKI’s DICOM printers and medical printing solutions, which drew the crowds as these machines could also print 1.2m banners. The devices on display included OKI’s ES6410DMe and the ES8431DMe A4/A3 respectively color and mono printers which combine LED technology with embedded DICOM software, and the Pro9431DMe a versatile DICOM embedded printer. OKI Europe delivers unbeatable accuracy and precision printing for the medical industry by removing the requirement for additional hardware that enables DICOM imaging and streamlining support through a single point of contact with a lower cost of ownership. OKI’s embedded DICOM solution provides superior "near" diagnostic image quality with DMe (DICOM Enhanced) and higher quality mono printing for x-ray and ultrasound with its DMe (DICOM enhanced) printers. “We were excited to receive a high number of visitors at our stand who were interested in the revolutionary DICOM embedded OKI medical printers,” said Carine Haddad, Healthcare Manager - MEIT, OKI Europe Ltd. “We showed how OKI DICOM printers are the machines that serve both healthcare staff and patients with all aspects of medical printing; whether the high quality, near-diagnostic images doctors can get immediately without connecting their medical machines to external software or hardware, besides the sharp or clear images and reports that patients can keep. OKI always enables you to print the best of yourself!”

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NEWS

HOYA Group PENTAX Medical Cleared CE Mark for DISCOVERY™, an AI Assisted Polyp Detector user-friendly way. We wanted to give doctors the possibility to use this exciting new technology to strive for a better clinical outcome and maximize the patient care", Mr. Wolfgang Mayer, Managing Director. R & D, PENTAX Medical Augsburg mentioned. PENTAX Medical is committed to continuously exploiting the use of Artificial Intelligence in additional medical fields. By gradually enhancing the product line up, PENTAX Medical has dedicated themselves to leveraging AI for the further support of customers and patients.

ENTAX Medical, a division of the HOYA Group, announced that it has cleared CE mark for DISCOVERY™, an innovative Artificial Intelligence (AI) assisted polyp detector designed to support endoscopists in finding potential polyps during a colorectal examination. DISCOVERY™ is the outcome of a close cooperation between PENTAX Medical research center located in Augsburg, Germany, and expert clinical partners from six of the leading medical institutions across the world. For this next generation development, a total of more than 120,000 files from approximately 300 clinical cases were used for the software training. By this, DISCOVERY™ is able to assist with the detection of potential polyps in real time. The system is built in a flat monitor to provide a high usability as it can be used with any of PENTAX Medical video endoscopy systems to highlight potential polyps. The menu is self-explaining and uses an intuitive touchscreen interface.

"The benefits for the customers are outstanding. Our vision was to bring Artificial Intelligence into the operating room in the most

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PENTAX MEDICAL IS COMMITTED TO CONTINUOUSLY EXPLOITING THE USE OF ARTIFICIAL INTELLIGENCE IN ADDITIONAL MEDICAL FIELDS.

Prof Timo Rath, Professor of Endoscopy and Molecular Imaging, University of Erlangen, Nuremberg, Germany mentioned, "As endoscopists one of our major tasks is to reduce the incidence of colorectal cancer. I'm very confident that the DISCOVERY™ will translate into increasing our own Adenoma Detection Rate and therewith will contribute to reducing colorectal cancer mortality". PENTAX Medical plan to launch in the first markets in spring 2020. PENTAX Medical is a division of HOYA Group. The company's mission is to improve the standard of patient care and quality of healthcare delivery by providing the best endoscopic products and services with a focus on QUALITY, CLINICALLY RELEVANT INNOVATION, and SIMPLICITY. Through providing endoscopic imaging devices and solutions to the global medical community and with its headquartered in Japan, PENTAX Medical has a worldwide focus and a strong presence with R&D, regional sales, service, and in-country facilities in multiple regions around the globe. PENTAX Medical's Triple Aim program strives to deliver on the commitment to supporting its customers and their healthcare organization's wider objectives through a transparent partnership and by providing the highest quality solutions to help them reach their goals.

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NEWS

Malaffi unveils its game-changing patient app at Arab Health 2020

s part of its participation at Arab Health 2020, in collaboration with the Department of Health – Abu Dhabi (DoH), Malaffi exclusively previewed a game-changing and first-of-its-kind patient app. Malaffi is the region’s first unified Health Information Exchange (HIE) platform, created as a Public-Private Partnership between DOH and Injazat Data Systems. This patient app is set to be launched and rolled out later this year. The easy-to-navigate app was developed with patients in mind, putting the patient in need at the heart of the user experience design. Placing a premium on convenience, patients will be empowered to access their Malaffi file which contains a summary of their medical history, test results, key information about their treatment and medication – all accessible from anywhere and at any time. The app will encourage patients to take a more proactive, hands-on approach to manage their own healthcare and will support prevention and increase health awareness. The app will improve the patient experience and the overall quality of healthcare in Abu Dhabi. The app is expected to be met with wide support with a recent survey, conducted by YouGov, showing that 88% of Abu Dhabi residents would be interested in downloading the Malaffi patient application. Commenting on the experience, H.E Mohammed Hamad Al Hameli, Undersecretary of the Department of Health - Abu Dhabi, said: “DoH continues to work in unison with strategic partners in the healthcare sector to set the stage for a future driven by healthcare technology, innovation and artificial intelligence, all in the name of enhancing the quality of Abu Dhabi’s healthcare sector. As such, Malaffi is an example of the critical role of technology in transforming the patient experience and empowering residents to monitor and manage their medical care.”

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Mr. Atif Al Braiki, CEO of Malaffi said: “We look forward to sharing our insights and pioneering practices with the industry over the next few days at Arab Health. We believe that the way to overcome today’s considerable healthcare challenges – particularly in this brave new, digital world – is to develop more advanced and accessible approaches to healthcare delivery. We are extremely proud of the strides we have made so far and remain committed to creating a healthier Abu Dhabi – as exemplified by our Malaffi patient app.” Malaffi will also be demonstrating its portal for providers that are integrated with the electronic medical records of onboarded healthcare facilities. The portal is already accessible to over 15,000 authorized users. Committed to maximizing the benefits for Abu Dhabi healthcare professionals and patients, Malaffi is constantly growing the value of the clinical information available by adding new functionalities, such as laboratory results and medication information. Additionally, Malaffi will be showcasing its analytics dashboards, designed to assist DoH in the monitoring of healthcare quality, as well as providing valuable insights for health awareness and prevention programs while identifying public health risks.

MALAFFI OFFERS THE MEDICAL SECTOR A GLIMPSE INTO THE FUTURE WITH AN EXCLUSIVE PREVIEW OF ITS PATIENT-CENTRED APP

Artificial Intelligence Topics of the 11th Term for Sheikh Hamdan Bin Rashid Al Maktoum Award for Medical Sciences

Since its establishment in 1999, the Sheikh Hamdan Bin Rashid Al Maktoum Award for Medical Sciences has been a significant and creative initiative in establishing the principles of excellence and supporting communication between academic and health institutions in the public and private sectors. His Highness Sheikh Hamdan bin Rashid Al Maktoum, Deputy Ruler of Dubai and Minister of Finance, the patron of the Award, has always envisioned upgrading medical services systems at the local, regional and international levels, adopting the excellent world-class standards. This vision is reflected in the Awardâ&#x20AC;&#x2122;s role in shedding light on innovative and breakthrough concepts, in line with the UAE strategic plans for continuously developing the health sector and fostering the latest technologies, such as Artificial intelligence in diagnosis and treatment. Hence, Artificial intelligence in Healthcare was chosen as the topic of the eleventh term, in collaboration with the UAE National Program for Artificial Intelligence. Grand Hamdan International Award (AI in Healthcare) Artificial intelligence is making a quantum leap in the decision-making process in the health sector, and it is

expected that applications of artificial intelligence will reduce the financial burden of treating diseases. Hamdan Award for Medical Research Excellence: (Artificial Intelligence in Genomics) The efficiency of AI applications relies on the increase in databases volume. However, such data is difficult to access due to privacy concerns. Scientists and regulatory bodies are working on addressing these challenges. AI in Diagnostics Nowadays, the predictions of machine learning models can be used to support the diagnostic decision-making process of clinicians. AI in Therapeutics AI supports the development of new drugs, assists in identifying the patients for clinical trials and increase clinical success by matching drugs to the right patient. The aim of adopting artificial intelligence technology in healthcare is to enable doctors to make more accurate and prompt decisions to serve their patients. The health authorities had recognized this reality early enough. They worked hard to introduce modern technologies to improve healthcare services.

Grand Hamdan International Award

Artificial Intelligence in Healthcare

AWARD TOPICS

Artificial Intelligence in Genomics

2019 - 2020

Artificial Intelligence in Diagnostics

Hamdan Award for Medical Research Excellence

Artificial Intelligence in Therapeutics

The United Arab Emirates, approach in stimulating innovation has succeeded in creating a fertile environment for excellence and prosperity for its citizens in all fields. This approach culminated in making the country a hub for innovative ideas and bright minds launching UAE world ranking in a record time exceeding all expectations. Indeed, this is not peculiar to our government as throughout this challenging era that is replete of accomplishments, the medical sector has been a top priority in UAE

The Dubai International Conference for Medical Sciences

The conference will be organized in late 2020, and will discuss Artificial intelligence in Healthcare with a focus on Genomics, Therapeutics and Diagnostics. The chosen topic is aligned with the UAE strategy and will focus on the best practices in AI. Hopefully, the conferenceâ&#x20AC;&#x2122;s modules will participate in the efforts to regulate or a minimum to put the appropriate road map for the field in UAE.

HE Abdul Rahman Al Owais

Minister of Health & Prevention Chairman of the Board of Trustees

NEWS

IRCAD Lebanon contributes to the international development of the medical robotics The institute’s mission is to train Lebanese, Middle-Eastern and North African surgeons to the minimally invasive procedures ies less invasive, in addition to decreasing pain after every surgical intervention. And since this technology is linked to rapidity and efficiency, the use of surgical robots will guarantee a faster recovery with minimal scarring and lesser risks for the patients. Delayed due to the country’s situation, the official inauguration took place on February 19 at the French Hospital of the Levant in Beirut with the presence of Pr. Jacques Marescaux, President of IRCAD, in addition to a number of personalities, doctors, university directors, insurers and media.

naugurated in October 2019, IRCAD Lebanon, the fourth international branch of IRCAD, the laparoscopic training center, will give the Lebanese, Middle-Eastern and North African surgeons the opportunity to learn and participate in videoconferences about the latest global techniques of the minimally invasive surgeries. Broadcasted live at the Jacques Marescaux auditorium at the French Hospital of the Levant in Beirut, the training will offer both theoretical courses and surgical practices on simulators or animals. For this reason, IRCAD Lebanon has acquired the unique fourth generation Da Vinci Xi robot, used in many specialties like gastroenterology, gynecology, urology, otolaryngology (ENT) or the cardiothoracic surgeries. This technology, used in around one third of the surgeries, all specialties combined, contributes remarkably to the decrease of the postoperative infection risks and the probabilities of blood transfusions. Its goal is to make the urinary, visceral, bariatric, gynecological or other surger-

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THIS CEREMONY INCLUDED A FIRST IN THE COUNTRY: THE LIVE BROADCAST TO THREE CONTINENTS OF A SURGICAL PROCEDURE PERFORMED BY PROFESSOR ALEXANDRE DE LA TAILLE, UNDER THE AUSPICES OF IRCAD FRANCE AND IN COLLABORATION WITH LEBANESE DOCTORS

During his speech, Pr. Marescaux highlighted the importance of Lebanon in forming and training the doctors of the region and he reinstalled his confidence in Lebanon, despite the crisis ravaging the country. The President of IRCAD Lebanon, Dr. Antoine Maalouf emphasized on the notion of non-competition saying, “IRCAD Lebanon will not compete with the different universities in Lebanon, which are the pride of our country”. He reiterated saying, “Our ultimate goal is to cooperate with the Lebanese universities to ensure together, the best teaching and training for the Lebanese and Middle-Eastern surgeons.” This ceremony included a first in the country: the live broadcast to three continents of a surgical procedure performed by Professor Alexandre de la Taille, under the auspices of IRCAD France and in collaboration with Lebanese doctors. And this proves once again the resilience of Lebanon and the constant progress of its medical sector. Since November 2019, IRCAD Lebanon offers training and many opportunities to the local, regional and international surgeons.

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NEWS

Al Qassimi Hospital upgraded with UAE’s first deployment of award-winning AIR Technology

l Qassimi Hospital in Sharjah, a UAE Ministry of Health & Prevention hospital, has upgraded its Magnetic Resonance Imaging (MRI) capabilities to assure the highest standards in diagnostic services and patient care, with the deployment of GE Healthcare’s award-winning AIR technology and the latest SIGNATM Works PX28 software platform for 3T MRI systems. As part of the upgrade, Al Qassimi Hospital has installed the latest SIGNATM WORKS AIRTM Edition. This software platform packs Artificial Intelligence-based algorithms for better patient comfort, versatility, productivity, and industry-leading image quality. The hospital will also be the first in the UAE to utilize AIR™ Technologies. AIR™ Coils, awarded Best New Radiology Device of 2019, serves as the foundation of a simply better MR experience. It has the industry’s first truly lightweight and flexible design, making them comfortable for patients to wear and easy for technologists to handle. AIR™ coils enable scans in positions that were historically very challenging like lateral decubitus spine and fetal imaging. This was accomplished through Unison, the first company in the GCC to introduce the Public-Private Partnership along with the UAE Ministry of Health. The intention is to increase overall patient care in the UAE by decreasing waiting time, improving image quality and accuracy of reporting.

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AIR™ Recon is GE’s new reconstruction algorithms that can reduce background noise and out-ofFOV artifacts with improving Signal-toNoise ratio (SNR). The result is crisper images and faster scan times.

WITH THE ANATOMICALBASED PROTOCOL OPTIMIZATION PER PATIENT, AIR TOUCH OPTIMIZES FOR ANATOMY, PATIENT, AND SCAN PARAMETERS WITH A SINGLE TOUCH, DELIVERING 59% PRODUCTIVITY GAIN.

Dr. Hatem Abouelabbass Ghonim, Medical Director of Unison Capital Investment, said: “Since we formed Unison four years ago, we have worked towards enhancing the operational efficiency of radiology departments throughout the Ministry of Health and Prevention hospital network in the UAE. Strengthening radiology competencies is crucial to boost the speed, quality and reliability of diagnostic services in order to help deliver better patient outcomes. Through the upgrade of Al Qassimi Hospital in Sharjah, Unison once again delivers on its mission to bring the best-in-class technology for UAE’s hospitals that help medical professionals better diagnose and treat disease in our communities.” Ehab Zawaideh, Commercial General Manager- Middle East, GE Healthcare, said: “AIR Technology empowers radiologists and technologists with the ability to position the patient in the most comfortable orientation. They have complete flexibility and the MRI signal does not degrade, meaning great image quality and the most comfortable patient experience. Al Qassimi Hospital is setting the standard for diagnostic patient care.” Tamer Akl, General Manager, ADI, said: “The AIR™ advanced technologies of AIR™ is a game-changer in MR that strengthens clinical power and enables radiologists to achieve improved workflow, enhanced patient comfort and reduced exam times. With the introduction of the advanced solutions, Al Qassimi Hospital becomes one of the leading centers in the region in offering world-class diagnostic services.” AIR Touch™ is part of the predictive and proactive patient recognition solutions. It automatically selects and optimizes element combinations for each patient over the precise area-of-interest. With the anatomical-based protocol optimization per patient, AIR Touch optimizes for anatomy, patient, and scan parameters with a single touch, delivering 59% productivity gain.

NEWS

Global leading Cardiovascular Diseases Institutions gather at Middle East Symposium for the first time Leading American and European Guidelines Experts come together for the first time in the region to present the most recent clinical practice guidelines for cardiovascular disease citizens is a top priority and iCaRE will help the UAE find solutions to reaching our goal of providing the highest quality of healthcare to our people,” said Prof. Abdullah Shehab, Secretary General of the Emirates Cardiac Society and the Vice president Gulf intervention Society.

he Middle East’s Cardiovascular Regional Experts Symposium – iCaRE – has returned for its third edition, gathering leading regional and international experts to share the latest reference points in cardiovascular disease management, as well as best practices and success stories from their fields. At the heart of the discussions were the latest diagnostic methods and tests to detect this non-communicable disease and the participants’ role in their prevention.

For the first time in the United Arab Emirates and the Middle East at large, leading American and European Guidelines Experts came together in the UAE to present the latest clinical practice guidelines for cardiovascular disease cases and provide recommendations. Moreover, since the symposium’s debut in 2017, the comprehensive program also presented practical best practices in the field from centers of excellence across the region including the UAE, the Kingdom of Saudi Arabia, Lebanon, and Egypt. “We are very pleased to be here and support such initiatives that are aligned with the government’s dedication and commitment towards a healthier UAE. The wellbeing of our

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THIRD EDITION OF ICARE UNDERSCORES THE ROLE OF BIOMARKER TESTING IN HEART FAILURE MANAGEMENT AND HEART ATTACKS MANAGEMENT AND HIGHLIGHTS BEST PRACTICES AND SUCCESS STORIES FROM THE MIDDLE EAST.

Cardiovascular diseases refer to various diseases and of the heart and blood vessels and include heart attacks, strokes and cardiac rhythm abnormalities. Cardiovascular diseases are the number one cause of death globally and more people die annually from these diseases than from any other cause. Of these deaths, 85 percent are from heart attacks and strokes. Cardiovascular diseases place a heavy burden on countries in the Middle East, largely due to the high prevalence of risk factors in the region, including smoking, high blood pressure, high cholesterol levels, diabetes and sedentary lifestyles. In the UAE, cardiovascular diseases are the leading cause of death, contributing to 40 percent of total adult mortality. Prof. Shehab said: “Cardiovascular diseases are a serious concern for our nation, hence the importance of symposia like iCaRE, as they provide the opportunity for local and regional healthcare professionals to come together, contribute, and learn about the most recent advances available in the region. They help the UAE continue to work towards improving the lives of patients and providing world-class healthcare.” Held in Dubai to cardiovascular experts from the region, iCaRE is presented by Roche Diagnostics Middle East FZCO (RDME), the leading IVD partner, as it remains dedicated to addressing and providing solutions regarding the prevention, diagnosis and treatment of diseases. This platform is focused on promoting heart health and to finding effective actions and

NEWS

BD Completes Clinical Trial for BD Libertas™ Wearable Injector

D (Becton, Dickinson and Company), a leading global medical technology company, announced the completion of a 50-subject human clinical trial with the BD Libertas™ Wearable Injector.

The award-winning injector* is a subcutaneous drug delivery system, currently in development, that is designed to require no patient assembly and deliver biologics with viscosities up to 50 cP in 2-5 mL and 5-10 mL configurations. The BD independently sponsored and conducted study was designed to evaluate the performance of the 5 mL BD Libertas device in human subjects, including tissue effects, skin reactivity and patient acceptance. The results are expected to be announced early 2020. The study represents the most recent in a series of over 50 BD conducted pre-clinical and clinical studies intended to measure the performance of the BD Libertas™ Wearable Injector, demonstrate feasibility of 2-10 mL biologic injections into subcutaneous tissue and characterize tissue response to large volume injections in human and animal subjects.

Commenting on the study, Peter Nolan, Worldwide President, BD Pharmaceutical Systems, said, “BD is committed to bringing value to our pharma partnerships, including providing them with independent BD sponsored and generated study data to accelerate combination product development. The recent study reflects BD’s continued investment in solutions to meet pharma’s needs by expanding the design space for biologics delivery.”

BD IS COMMITTED TO BRINGING VALUE TO OUR PHARMA PARTNERSHIPS.

Former Surgeon General, Lt General (retd) Professor Martin CM Bricknell joins Prometheus Medical.

rometheus Medical, a world-leading medical company specializing in pre-hospital emergency care, is pleased to welcome Lt General (Retd) Professor Martin CM Bricknell to the team. In his new role as Strategic Medical Advisor, Professor Bricknell will be working closely with key customers and government services to help develop and improve medical services and training, both in the UK and overseas. Professor Bricknell previously served for 34 years in the UK Defence Medical Services, culminating his service as Surgeon General – the professional head of Defence Medical Services and the Defence Authority for end-to-end Defence healthcare and medical operational capability. During his extensive military career, he undertook operation-

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al tours in Afghanistan, Iraq and the Balkans, with multiple additional overseas assignments. Commenting on his new role, Professor Bricknell said: "I am very much looking forward to joining the team at Prometheus Medical. Pre-hospital emergency care has undergone a huge transformation over the past few years. Prometheus is a true innovator, providing world-class equipment, training and services to businesses, medical trusts and governments throughout the world, and I am thrilled to be working with such a well-known industry name". Speaking about the new appointment, Kevin Gallagher, Group CEO said, "We are delighted to have Professor Bricknell join our team. He will be an invaluable asset to Prometheus and our clients in his role as Strategic Medical Advisor".

PROFESSOR BRICKNELL HOLDS THE PRESTIGIOUS APPOINTMENT OF PROFESSOR OF CONFLICT, HEALTH AND MILITARY MEDICINE AT KING’S COLLEGE, LONDON.

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NEWS

Mecomed calls for regionwide overhaul of healthcare models, to deliver better patient outcomes Executives from MEA MedTech trade association lead discussion at Arab Health 2020 on the future of regional healthcare outcomes, urging adoption of new approaches to ensure a bright new era for patients

egional MedTech trade association Mecomed led a vital discussion on the future of the MEA healthcare sector at this year’s Arab Health event, urging industry professionals and other healthcare stakeholders to focus on patient-centered care. In a session called “Shaping the MedTech Industry, while keeping the patient first”, Mecomed called for patient welfare to be at the center of all healthcare strategies, and unveiled a three-pronged strategy for doing so. By bringing patient-centered care into regulations, establishing high compliance standards, and instilling value-based thinking, Mecomed showed how treatment outcomes, information flow and quality of care could be elevated across the region. The talk was led by Mecomed Chairman, Rami Rajab, and the association’s Executive Director, Inna Nadelwais. They unveiled insights from Mecomed’s White Paper on “Value-based Healthcare in the Middle East and Africa”, with Nadelwais shedding light on how the industry can engage into the innovative value-based delivery models. She also called for regional organizations to restructure their processes to reward value and stressed the critical roles leadership and medical technology are playing in accelerating this transformation. “Rising costs and continually evolving regulations are putting regional healthcare providers under extraordinary pressure as they try to improve patient outcomes,” said Rami Rajab. “By adopting a value-based healthcare model, the industry can start to overcome the challenges that stand in the way of better patient care, and drive an evolution in practices that will allow a stronger, more agile industry to take shape.

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In so doing, the region can optimize treatment outcomes and lead the world in patient-centered care.” Arab Health 2020 took place amid a significant growth spike for the Middle East and North Africa (MENA) healthcare sector. Projections by Fitch Solutions suggest that the regional healthcare market will grow from US$ 185.5 billion in 2019 to US$ 243.6 billion in 2023 – a compound annual growth rate (CAGR) of 7.05%. More than 4,250 companies from some 160 countries exhibited at this year's event, which welcomed around 55,000 healthcare and trade professionals. Also at the networking event, Mecomed elaborated on key projects for 2020 and shared its strategy for 2020-2025 that included among other initiatives establishing the organisation as partner of choice across MEA; continuing the development of local ethical codes across the region; growing its membership base to 100 in five years; and helping shape regional legislation affecting Medical Technology industry.

MECOMED IS THE TRADE ASSOCIATION FOR MEDICAL TECHNOLOGY COMPANIES ACROSS THE MIDDLE EAST AND AFRICA (MEA), SERVING AS THE VOICE OF MEDICAL TECHNOLOGY INDUSTRY.

‫َر ْبط الصحة‬ ‫والتعليم‬ ‫والبحوث‬ Linking health, education and research

.‫ لكل مريض من مرضانا‬،‫وفعالة‬ ،‫ وحانية‬،‫تقديم أفضل رعاية صحية آمنة‬ َّ Providing the safest, most effective and most compassionate care to each and every one of our patients.

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NEWS

SEHA and Vocera Collaborate to Provide World-Class Clinical Communication Across Integrated Healthcare Network New Sheikh Shakhbout Medical City is first hospital in SEHA to implement Vocera Platform

ocera Communications, Inc. (NYSE:VCRA), a recognized leader in clinical communication and workflow solutions, is partnering with Abu Dhabi Health Services Company – SEHA, the largest integrated healthcare network in the United Arab Emirates, to implement the Vocera Platform at the new Sheikh Shakhbout Medical City (SSMC). The 732-bed SSMC will be the first hospital within SEHA to standardize care team communication with Vocera solutions. There are future plans for SEHA to deploy the Vocera solution across 11 additional hospitals in the region. Caregivers will use the wearable Vocera Smartbadge and the Vocera smartphone app to communicate hands-free via voice, send and receive secure messages, manage alerts and alarms, and more. The dynamic master directory of the Vocera Platform will enable clinicians to reach colleagues across the network simply by saying a name, role or group. There is no need to remember phone numbers or know who is on call. “Standardizing clinical communication and collaboration on a single, secure platform will ensure we deliver seamless and consistent care across our medical center,” said Dr. Naser Mahmud Ammash, CEO, Sheikh Shakhbout Medical City. The enterprise-grade communication platform will connect more than 1,800 caregivers and 440 physicians across SSMC. The largest hospital in the UAE, SSMC was established as part of the Abu Dhabi Economic Vision 2030 to elevate healthcare services in the Emirate. In 2019, SEHA partnered with Mayo Clinic to operate the 300,000-square-meter hospital, which provides specialist care for the most serious and complex conditions. “Depending on the clinical situation, caregiv-

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ers can use Vocera solutions to quickly connect and collaborate. Vocera solutions are purpose-built to help hospitals and health system improve clinical efficiency, staff response times, quality of care, and patient safety,” said Gerald Francis, CNO, Sheikh Shakhbout Medical City. Vocera solutions integrate with more than 150 clinical and operational systems, including electronic health records (EHR), nurse call systems, physiologic monitors, ventilators and more. Intelligent workflow integrations enable the delivery of relevant and contextual patient information to care team members at the right time on their device of choice, helping them make informed decisions quickly. “Sheikh Shakhbout Medical City is the future of healthcare in the Emirate of Abu Dhabi, and effective care team communication is critical for its success,” said Rashed Al Rumaithi, CIO, Sheikh Shakhbout Medical City. “The intelligent Vocera Platform supports our vision to provide efficient, world-class care.” Aiming to treat nearly 3,000 patients per day, the new SSMC is comprised of four interconnected towers dedicated to distinct specialties, including cardiology, orthopedics, maternity, general and pediatric surgery, critical care and more. The state-of the-art hospital is distinctive for providing advanced burn treatment and is considered a major medical facility specializing in intensive care services with 154 dedicated ICU beds. “Sheikh Shakhbout Medical City is an impressive facility that will help lead new benchmarks in specialized services and critical care,” said Brent Lang, President and CEO of Vocera. “We are proud to provide an advanced communication platform that helps SEHA deliver exceptional care across its many healing environments, which successfully combine high-tech innovations with high-touch services.”

THE LARGEST HOSPITAL IN THE UAE, SSMC WAS ESTABLISHED AS PART OF THE ABU DHABI ECONOMIC VISION 2030 TO ELEVATE HEALTHCARE SERVICES IN THE EMIRATE. IN 2019, SEHA PARTNERED WITH MAYO CLINIC TO OPERATE THE 300,000-SQUAREMETER HOSPITAL, WHICH PROVIDES SPECIALIST CARE FOR THE MOST SERIOUS AND COMPLEX CONDITIONS.

Rethink Obesity® Type 2 diabetes Sleep apnoea

Dyslipidaemia

Cardiovascular disease • Hypertension

Gallbladder disease

• Coronary artery disease • Congestive heart failure • Pulmonary embolism

Cancer (various)

• Stroke

Osteoarthritis

Obesity (BMI ≥40 kg/m2) may reduce life expectancy by 8 to 10 years. BMI=body mass index.

COVER STORY

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United Nations High-level Meetings. Can you tell us more about that? In 2011, I was honoured to have been chosen to deliver the keynote speech on behalf of civil society at the first-ever United Nations Highlevel Meeting on non-communicable diseases (NCDs). Then, in 2018, I was chosen again to speak at the third High-level Meeting on NCDs as “Eminent Champion of the fight against Noncommunicable diseases” on the prevention and control of NCDs including cancer. At those meetings, I called on world leaders to take urgent action on critical concerns about NCDs – including cancer, heart disease, diabetes, and chronic respiratory illnesses – which are responsible for more global deaths than all other causes combined.

rincess Dina Mired, President of the Union for International Cancer Control (UICC) for the term 2018-2020 the first Jordanian, Arab, and non-medical professional to have achieved this honor. ‘Hospitals’ Magazine had the chance to meet with HRH Princess Dina Mired.

Congratulations on your election as President of UICC for the term 20182020. As the first Arab and non-medical professional to have achieved this honor, what is the significance of this achievement? I am both humbled and honoured to have been the first Jordanian, Arab, and non-medical professional to have been elected to be the President of the Union for International Cancer Control (UICC) for the 2018-2020 term. UICC is the largest global organization solely dedicated to reducing the global cancer burden, promoting greater equity, and integrating cancer control into the world health and development agenda. It is comprised of over 1133 organizations from 177 countries, making it the largest cancer-fighting organization in the world.

HRH PRINCESS DINA MIRED, MOTHER OF A CANCER SURVIVOR AND A WELL-KNOWN AND RESPECTED GLOBAL ADVOCATE FOR CANCER CONTROL AND NONCOMMUNICABLE DISEASES (NCD’S)

Your Highness, you have been a trailblazing force behind the King Hussein Cancer Foundation in Jordan, serving as Director-General for fourteen years and transforming the non-profit into an internationally known leader in the global movement for people affected by cancer. What were your greatest obstacles and your greatest achievements? In 2002, when I became Director-General of the Foundation, people did not utter the word cancer, calling it “that disease.” The stigma was so great that even our cancer hospital at the time omitted the word cancer from its name, calling it the “Hope Center.” I would say that the greatest achievement was that I was part of the team that helped transform our cancer hospital into an internationally accredited comprehensive cancer center- The King Hussein Cancer Center.

As a well-known global advocate for cancer control and non-communicable diseases, you have also represented civil society as a keynote speaker at the

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from Yerevan State Medical University (YSMU) in Armenia, and Medical University of AsuncionParaguay.

Despite significant advances in cancer treatment and care, global cancer statistics still talk about cancer and other noncommunicable diseases leading to global deaths. What are the reasons for this?

As you can see, the name now boasts the word “Cancer” right in the middle of its name, not as a message of fear but of real hope. The King Hussein Cancer Foundation’s role was crucial in that it ignited grass-root action across all the community both locally and internationally to fundraise and support the lifesaving journey of our center, thus raising $360 million from 2002-2016. Thanks to this monumental effort from all our donors and supporters, we managed to build our muchneeded two-tower expansion now named “King Salman Bin Abdulaziz” inpatient tower and “Sheikh Khalifa Bin Zayed Al Nahyan” outpatient tower. KHCF is now an internationally known brand and leader in the development, advocacy, public awareness on early detection and prevention, cancer coverage and patient support. KHCF became a role model not only in Jordan but also in the global movement for people affected by cancer.

You have been a recipient of prestigious global awards for your Achievements in Global Leadership in Cancer Control. I am honoured to have been recognized by various global organizations for my work in cancer control. This includes the 2015 Medal of Honor from the International Agency for Research on Cancer (IARC) , Arab Woman of the Year 2018 from the London Arabia Organization, and, most recently, the Patient Advocate Award from the American Society for Clinical Pathology. I was also awarded two honorary doctorates

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Cancer is still the second leading cause of death globally, accounting for an estimated 9.6 million deaths, or one in six deaths, in 2018. 70% of those deaths occur in low- and middle-income countries (LMICs). Many health systems in low- and middleincome countries (LMICs) are not well prepared to manage the cancer burden in addition to other non-communicable diseases. Therefore, many patients cannot access lifesaving treatment, either due to lack of facilities, lack of finances, or lack of awareness of symptoms and signs. So, many do not get their rightful chance for treatment, and if they do, either it is not qualitative treatment, or they present late when the chances for a cure are extremely slim.

WE HAVE AN OPPORTUNITY IN OUR REGION TO SAVE THE LIVES OF MILLIONS OF PEOPLE, ESPECIALLY FOR THE FACT THAT OUR LEADING CANCERS ARE AMENABLE TO EARLY DETECTION (BREAST AND COLORECTAL), AND TO PREVENTION (LUNG CANCER). IN FACT, 90% OF LUNG CANCER IS DIRECTLY ATTRIBUTABLE TO TOBACCO.

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give the impression that it is a matter of choice or preference. But when unhealthy foods are more affordable than the healthy when tobacco that kills is so easily available, and when facilities or space for exercise are non-existent, it becomes not a lifestyle choice, but a life sentence. Therefore, governments have to provide an enabling environment for people to be able to follow a healthy lifestyle. The onus of responsibility, therefore, falls on both the government and the individual. Therefore, millions of patients suffer and die unnecessarily from cancers that could be treated or even cured if detected earlier. In countries where health systems are strong, survival rates are improving thanks to a number of encouraging developments in cancer research, more effective early detection, personalized treatment approaches for many different cancer types, and better care for cancer patients.

What are the short- and long-term solutions for reducing the global cancer burden? We know that 30-50% of all cancer cases are preventable. This means that prevention is a very cost-effective strategy for reducing the incidence and control of cancer. A lot still needs to be done to increase awareness of cancer risk factors. UICC recently conducted a global poll in 20 different countries and found out that irrespective of where people live in the world, those surveyed with a lower education and those on lower incomes are less aware of the main risk factors associated with cancer and are less likely to proactively take the steps needed to reduce their cancer risk than those from a high-income household or with a university education. Governments should, therefore, implement national policies and programs to raise awareness, to reduce exposure to cancer risk factors, and to ensure that people are provided with the information and support they need to adopt the so-called “healthy lifestyles”. “Lifestyle” changes, as they are so-called,

Specifically, what about the role of tobacco? How effective is tobacco control in reducing the cancer burden? We could prevent up to 22% of cancer deaths globally by fighting tobacco alone. There are clear and evidenced-based recommendations set by the WHO MPOWER framework, and countries have committed to taking action under the Framework Convention on Tobacco Control (FCTC). This does not require money but requires political will and commitment to implementing every single line of these recommendations. This includes increasing the price and taxes on all tobacco products to more than 75% of the retail price, creating smoke-free public places, as well as facilitating cessation programs. Countries that are doing so are starting to see declines in the incidence of disease related to tobacco.

SHE IS WELL KNOWN FOR ESTABLISHING AND LEADING THE KING HUSSEIN CANCER FOUNDATION AS DIRECTOR GENERAL FOR 14 YEARS FROM 2002 - 2016.

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From your global experience, what other measures countries have taken to protect the public from risk factors other than tobacco? Other countries implemented taxes on sugar-sweetened beverages, alcohol, and other products that are harmful to our health. Taxing the products that harm us provides a triple win. It reduces the avalanche of new cancer cases, saves future treatment costs, and at the same time, offers new revenues for the budget for health and wellbeing. The investment case for implementing the WHO “best buys” has shown that by investing 1.7 dollars per person per year on a set of interventions to prevent and manage NCDs in LMICs, will yield a return of at least 7 dollars per person by 2030, and a 15% reduction on premature mortality from cancer and other NCDs. All in all, a comprehensive approach that promotes prevention, early detection, effective treatment, and pain control is critical to saving lives and alleviating needless suffering.

What is the status of cancer in our region? According to the latest statistics from the International Agency for Research on Cancer (IARC) through Globocan 2018, in our EMRO region, which spans 22 countries, we see an

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estimated 676,508 new cancer cases each year. Leading cancers regionally for both sexes are: • Breast 17.7% (or 119,985 cases per year) • Colorectal 6.5% (or 43,793 cases per year) • Lung 6.3 % (or 42,942 cases per year) The mortality rate is over 60% reaching 418,955 cases. The tragic issue is that 40% of those cancers could have been prevented, and a further 30% could have been cured if detected early. The reality is that the majority of cancer cases in our region are diagnosed late when treatments are less effective, more expensive, and have greater side effects. We have an opportunity to save the lives of millions of people, especially for the fact that our leading cancers are amenable to early detection (breast and colorectal), and to prevention (lung cancer). In fact, 90% of lung cancer is directly attributable to tobacco. Our region, in particular, suffers tremendously from the scourge of tobacco products, especially cigarettes, shisha and now E cigarettes and other new products. Tobacco is associated with 7.2 million deaths, of the estimated 15 million NCD deaths annually. Governments need to take the necessary steps to fight tobacco to protect their citizens, especially young people.

THE UICC WORLD CANCER LEADERS' SUMMIT AND CONGRESS ARE EXCELLENT HIGHLEVEL PLATFORMS THAT ENABLE US TO CALL UPON WORLD LEADERS, GOVERNMENTS & POLICYMAKERS TO ENSURE THAT THE PUBLIC RECEIVES THE LATEST INFORMATION ABOUT CANCER RISKS AND PREVENTION MEASURES.

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Therefore, if governments do not take firm action on controlling risk factors are known to cause cancer such as tobacco, sugar, lack of physical exercise as well as controlling exposure to other environmental carcinogenic chemicals, our region is set to experience the highest increase of cancer incidence of all WHO regions, with a projected doubling of cancer cases by 2030. We know what needs to be done; we just need to get it done.

What are UICC's efforts in raising health awareness? We at UICC through our extensive membership, as well as our strategic partners, work on multiple fronts: raising awareness for governments, policymakers, and the public. We utilize our global platforms such as World Cancer Day and our Global Cancer Leaders' Summit and Congress. World Cancer Day, which is spearheaded by UICC, takes place every year on 4 February to unite global initiatives under which the world comes together to raise the profile of cancer in a positive and inspiring way. The day aims to save millions of lives each year by raising awareness and improving education about the disease while calling for action from governments and individuals across the world. Our region participated extensively in this World Cancer Day, with many lighting up their famous monuments such as Petra, The Torch of Qatar, AUB medical center and others. The UICC World Cancer Leaders' Summit and Congress are excellent high-level platforms that enable us to call upon world leaders, governments and policymakers to ensure that the public receives the latest information about cancer risks and prevention measures, as well as and urging governments to establish and implement costed cancer control plans.

How far are we from reaching an effective treatment of cancer / is there an end of cancer in sight? The knowledge of cancer has greatly improved in the last two decades. Researchers have found significant differences between not only different types of cancer but also between patients with the same type of cancer.

It seems increasingly clear that there won't be a single 'cure'; rather, each patient will be treated according to their specific needs. New approaches are being developed that help the immune system identify and attack tumors; a field is known as immuno-oncology. Personalized vaccines, cell therapy, gene editing, and microbiome treatments are technologies that have serious potential to change the way cancer is treated. Most of these new technologies still have to prove their effectiveness in clinical trials. Even in the bestcase scenario, it will be several years until they are available. However, we are on track to reach a future where cancer treatment is personalized, and the chances of beating the disease are higher than ever. However, the global cancer burden can only be tackled if the right systems are in place to ensure that everyone has access to timely and quality cancer treatment and care, regardless of how much money you have or where you live. This also requires investing in better prevention and screening programs. In 2019, we saw leaders around the world adopt a political declaration to support Universal Health Coverage (UHC) and make a real commitment to increasing spending on health, which will hopefully see a greater focus placed on investment in cancer control.

CURRENTLY, PRINCESS DINA IS THE FIRST ARAB TO HAVE BEEN ELECTED TO LEAD AS PRESIDENT OF THE LARGEST CANCER-FIGHTING ORGANIZATION; THAT OF THE UNION FOR INTERNATIONAL CANCER CONTROL (UICC).

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THE 2020 WORLD CANCER CONGRESS OFFERS A TRULY THRILLING PROGRAM OF ACTIVITIES & EVENTS WITH BRAND NEW & INNOVATIVE FEATURES.

Join the movement

worldcancercongress.org Hosted by

UICC is holding its first-ever global Cancer Congress in the Middle East Region in Muscat Oman on October 20-22, 2020. What is the importance of this event? The World Cancer Congress is an awardwinning global conference organized by UICC, which encourages effective knowledge transfer, and best practices exchange amongst over 3,500 cancer control and public health experts from 130 countries. It aims to strengthen the participants' actions and impact on national, regional, and international scales through a multidisciplinary

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program that features the latest successful interventions in cancer prevention, diagnosis, treatment, and care. It will be the first time that the Congress is held in our region. Under the theme 'The way forward', it aims to highlight the need for the region and other parts of the world to work towards reducing the burden of cancer. The 2020 edition of the Congress is hosted by the Oman Cancer Association (OCA) and the National Oncology Centre, Royal Hospital Muscat. It will take place in the Oman Convention and Exhibition Center.

I STRONGLY ENCOURAGE CANCER CONTROL REPRESENATIVES FROM OUR REGON TO REGSITER AND ATTEND THIS CONGRESS.

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OUR REGION SHOULD UTILIZE AND BENEFIT FROM THE RICH CAPACITY BUILDING AND TRAINING OPPORTUNITIES AT THIS GLOBAL CONGRESS. learnings. Also, it is also an opportunity for us in the region to showcase the successful work that we as a region have also achieved in cancer control. The networking opportunity is so rich.

What are the main themes highlighted at the World Cancer Congress in Oman? The 2020 World Cancer Congress offers a truly thrilling program of activities and events with brand-new and innovative features. The program will be split across nine theme rooms allowing you to take a deep dive into a wide range of topics covering the entire cancer control spectrum. It will provide the opportunity to come face-to-face with cuttingedge ideas presented on the Spotlight Stage. You will also have the chance to hear from field experts in our dedicated space for physicians, entitled 'International Clinical Oncology Update.' Stakeholders from the entire cancer control spectrum, health ministers, mayors, finance ministers, oncologists, representatives from NGOs, patient groups, universities, and the private sector will engage in debates and conversations about public health and cancer issues.

How will participants from our region benefit from attending the World Cancer Congress? Can you be more specific?

Capacity Building and Training opportunities Most importantly, participants and organizations will also benefit from unique capacity building and training opportunities to strengthen and increase their impact. There will be over 100 interactive sessions on cancer prevention, diagnosis, treatment and care, governance, fundraising, and leadership. There are also Master Courses to acquire specialized knowledge in a specific area of cancer control, programs for CEOs, and other learning opportunities in the lead up to and during the Congress. The Congress will bring everyone to the table to share their experiences and views on what works and what does not is incredibly enriching for everyone. Participants of previous Congresses have told us how much they learned and appreciated the exchanges and the networking among experts.

EARLY BIRD REGISTRATION RATES ARE AVAILABLE UNTIL 31 MARCH.

This is a golden opportunity for us in the region to benefit from both the expertise and experience from the wealth of knowledge that these events bring together all under one roof.

Rich Networking opportunities The participants will have the chance to connect with global leaders, experts, and other organizations, sharing experiences, and

ARTICLE FEATURES . Coronavirus

Coronavirus COVID-19 Early containment and prevention are crucial to stop and control disease outbreak

he new coronavirus has spread outside China and started to emerge and move from one country to another, until it has become a global concern due to its rapid transmission and spread among people. Every day we hear about new coronavirus cases in countries and the new disease been declared a public health emergency of international concern (PHEIC) by the World Health Organization. The World Health Organization said the coronavirus outbreak that has swept from China

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to a number of countries in Asia, the Middle East, and Europe is not yet a pandemic, but it urged countries to prepare for its arrival on the assumption that a declaration may come. Director-General Tedros Adhanom Ghebreyesus said countries should be working to protect health workers, engaging groups that are at highest risk—for instance, the elderly— and striving to contain spread of the virus to the highest degree possible to slow its arrival in countries that don’t have the means to respond to its threat.

THE COVID-19 VIRUS MAY SURVIVE ON SURFACES FOR SEVERAL HOURS, BUT SIMPLE DISINFECTANTS CAN KILL IT.

ARTICLE FEATURES . Coronavirus

Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). Middle East respiratory syndrome (MERS) is a viral respiratory disease caused by a novel coronavirus (Middle East respiratory syndrome coronavirus, or MERS‐CoV) that was first identified in Saudi Arabia in 2012. Coronaviruses are a large family of viruses that can cause diseases ranging from the common cold to Severe Acute Respiratory Syndrome (SARS). Hundreds have now died from the COVID-19 virus, which first appeared in the Chinese city of Wuhan in December 2019. Tens of thousands of cases have been confirmed in China, and experts say they expect the numbers to rise further. Like the flu, COVID-19 is spread primarily via respiratory droplets—little blobs of liquid released as someone coughs, sneezes, or talks. Viruses contained in these droplets can infect other people via the eyes, nose, or mouth—either when they land directly on somebody’s face or when they’re transferred there by people touching their face with contaminated hands. Because respiratory droplets are too heavy to remain suspended in the air, direct person-to-person transmission normally only happens when people are in close contact—within about six feet of each other, according to the US Centers for Disease Control and Prevention (CDC). It could also occur in a medical setting, if someone has to handle respiratory secretions such as saliva or mucus from an infected person. According to studies assessing the environmental stability of other coronaviruses, the severe acute respiratory syndrome coronavirus (SARS-CoV) is estimated to survive several days in the environment, and the Middle East respiratory syndrome-related coronavirus (MERS-CoV) can withstand more than 48 hours at average room temperature (20°C) on plastic and metal surfaces. The analysis of 22 studies reveals that human coronaviruses such as Severe Acute Respiratory Syndrome (SARS) coronavirus, Middle East Respiratory Syndrome (MERS) coronavirus or endemic human coronaviruses (HCoV) can persist

on inanimate surfaces like metal, glass or plastic for up to 9 days, but can be efficiently inactivated by surface disinfection procedures with 62–71% ethanol, 0.5% hydrogen peroxide or 0.1% sodium hypochlorite within 1 minute. As no specific therapies are available for SARS-CoV-2, early containment and prevention of further spread will be crucial to stop the ongoing outbreak and to control this novel infectious thread.

FACEMASKS SHOULD BE USED BY PEOPLE WHO SHOW SYMPTOMS OF COVID-19 TO HELP PREVENT THE SPREAD OF THE DISEASE TO OTHERS.

Transmission of coronavirus infection The virus is thought to spread mainly from person-to-person: Between people who are in close contact with one another (within about 6 feet) or through respiratory droplets produced when an infected person coughs or sneezes. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads. Cold- or flu-like symptoms usually set in from 2–4 days after a coronavirus infection and are typically mild. However, symptoms vary from person-to-person, and some forms of the virus can be fatal. Symptoms include sneezing, runny nose, cough, fatigue, fever and sore throat. At the end of the first week, the disease develops and enters a more serious stage

ARTICLE FEATURES . Coronavirus

that closely resembles the symptoms of SARS, which is severe pneumonia, leading to difficulty breathing, kidney failure and weakening of the heart muscle, while death often occurs due to lung problems.

Misconceptions The panic that has afflicted societies around the world has led to widespread misconceptions about how this virus spreads among people. One of the misconceptions is that the new coronavirus is transmitted through mosquito bites, which is not true. The virus is transmitted through direct contact with respiratory droplets of an infected person (generated through coughing and sneezing), and touching surfaces contaminated with the virus. The COVID-19 virus may survive on surfaces for several hours, but simple disinfectants can kill it.

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Some believed that cold and snow could kill the emerging coronavirus, which is completely false information because snow cannot transmit the emerging virus, as the normal human body temperature ranges between 36.5 and 37 degrees Celsius, regardless of external temperature or weather. The risk of developing an emerging coronavirus (2019-nCoV) as a result of contact with things, including coins, banknotes, or credit cards, is very low. Initial information indicates that the emerging corona virus (2019-nCoV) can survive on the surfaces for a few hours or more. And something can be exposed to contamination of the virus emerging from the person infected with infection in the event of coughing, sneezing or in contact with it. The risk of infection with the emerging coronavirus, as a result of contact with things, including coins, banknotes, or even credit cards, is very low if the rules of hand hygiene

POLYMERASE CHAIN REACTION (PCR) ANALYSIS IS A LABORATORY TECHNIQUE. THE PURPOSE OF PCR TESTING IS TO FIND SMALL AMOUNTS OF DNA IN A SAMPLE, USING A PROCESS KNOWN AS AMPLIFICATION.

ARTICLE FEATURES . Coronavirus

are properly adhered to. Cleaning your hands frequently with an alcohol-based hand sanitizer or washing them with soap and water is the best way to protect yourself from the virus. Wrong concept: Droplets secreted by a person when coughing or sneezing can transmit the emerging corona virus (2019-nCoV) for a distance of up to 8 meters. Fact: Respiratory droplets reach one meter from the person who coughs or sneezes. When infected persons sneeze or sneeze, the virus is transmitted in droplets that can travel a certain distance from that person. Hence, it is necessary for the patient not to leave the house and isolate himself in a well-ventilated room even if they have no symptoms. Among the misconceptions is that UV sterilizers can kill the new coronavirus, which is false. UV lights should not be used to sterilize hands or other parts of skin as UV radiation can cause skin irritation and allergic reactions. Spraying the body with alcohol or chlorine will not eliminate viruses that have already entered your body. It may even be harmful to clothing or mucous membranes (such as the eyes and mouth). However, both alcohol and chlorine may be beneficial for disinfection of surfaces but they should be used according to appropriate recommendations.

Relation between the emerging coronavirus and SARS or MERS virus The Wuhan coronavirus, also known as SARSCoV-2 or 2019-nCoV, is a close relative to the severe acute respiratory syndrome (SARS) virus that caused an outbreak in 2003 (SARS-CoV-1), as well as the Middle-East respiratory disease virus (MERS-CoV) that emerged in 2012. All of these viruses cause flu-like symptoms and, frequently, pneumonia. SARS was discovered in 2002 in mainland China and spread to a number of other countries. It infected a little more than 8,000 people, and killed 774 people. No cases of SARS have been reported worldwide since 2004. The Middle-East respiratory disease virus (MERS-CoV) was first discovered in 2012 in Saudi Arabia affecting more than 1,200 people, 449 of whom died. The disease still affects some people from time to time, mainly in the countries of the Middle East.

Protective Measures The World Health Organization has shared some basic protective measures against the new coronavirus. Regularly and thoroughly clean your hands with an alcohol-based hand rub or wash them with soap and water. Maintain at least 1 metre (3 feet) distance between yourself and anyone who is coughing or sneezing. When someone coughs or sneezes they spray small liquid droplets from their nose or mouth which may contain virus. If you are too close, you can breathe in the droplets, including the COVID-19 virus if the person coughing has the disease. Avoid touching eyes, nose and mouth because hands touch many surfaces and can pick up viruses. Once contaminated, hands can transfer the virus to your eyes, nose or mouth. From there, the virus can enter your body and can make you sick. Make sure you, and the people around you, follow good respiratory hygiene. This means covering your mouth and nose with your bent elbow or tissue when you cough or sneeze. Then dispose of the used tissue immediately. Droplets spread virus. By following good respiratory hygiene, you protect the people around you from viruses such as cold, flu and COVID-19. Facemasks should be used by people who show symptoms of COVID-19 to help prevent

WASHING YOUR HANDS FREQUENTLY WITH SOAP AND WATER IS THE BEST WAY TO PROTECT YOURSELF FROM THE VIRUS.

ARTICLE FEATURES . Coronavirus

the spread of the disease to others. The use of facemasks is also crucial for health workers and people who are taking care of someone in close settings (at home or in a health care facility). Health workers are at the front line of any outbreak response and as such are exposed to hazards that put them at risk of infection with an outbreak pathogen (in this case COVID-19). Hazards include pathogen exposure, long working hours, psychological distress, fatigue, occupational burnout, stigma, and physical and psychological violence. Health worker rights include that employers and managers in health facilities assume overall responsibility to ensure that all necessary preventive and protective measures are taken to minimize occupational safety and health risks, provide information, instruction and training on occupational safety and health, including refresher training on infection prevention and control(IPC); use, putting on, taking off and disposal of personal protective equipment(PPE); provide adequate supplies (masks, gloves, goggles, gowns, hand sanitizer, soap and water, cleaning supplies) in sufficient quantity to healthcare or other staff caring for suspected or confirmed.

What is the PCR test? Polymerase chain reaction (PCR) analysis is a laboratory technique. The purpose of PCR testing is to find small amounts of DNA in a sample, using a process known as amplification. During PCR amplification, the DNA of interest is copied repeatedly until there is enough of it for analysis and detection. Current tests for SARS-CoV-2, the virus that causes COVID-19, look for genetic material of the virus, for instance in saliva or nasal, oral, or anal swabs, using the polymerase chain reaction (PCR). However, they only give a positive result when the virus is still present. The tests canâ&#x20AC;&#x2122;t identify people who went through an infection, recovered, and cleared the virus from their bodies.

Thermal Sensors Chinese authorities are using infrared thermometers to screen people for the illness, as the devices have become synonymous with trying to

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contain deadly outbreaks. Airports have instituted temperature checks to identify potential patients and prevent the virus's spread. To do this, many governments and businesses rely on thermometer guns â&#x20AC;&#x201D; devices that use infrared sensors to measure a person's surface temperature without touching their skin. There are several factors that can affect the reading of thermal imaging devices, including the person's activity immediately before the test, the timing of the test, and the device's distance from the person concerned, as well as significant changes in temperature outside the body. If the goal is to search for a viral infection, it is important to have a sufficiently sensitive instrument to detect tiny changes in temperatures, to ensure the best results. Sufficient number of pixels (spatial resolution) is required for a thermal camera to accurately measure the skin surface temperature. With the limited amount of pixel resolution available, this poses a challenge when imaging a subject, even at a modest distance. Most cameras deployed for elevated body temperature screening have a resolution around 320 x 240 pixels or 640 x 512. This is very low when compared to traditional surveillance cameras.

CURRENT TESTS FOR SARS-COV-2, THE VIRUS THAT CAUSES COVID-19, LOOK FOR GENETIC MATERIAL OF THE VIRUS, FOR INSTANCE IN SALIVA OR NASAL, ORAL, OR ANAL SWABS, USING THE POLYMERASE CHAIN REACTION (PCR).

INTERVIEW

Chief Executive Officer, Philips Middle East & Turkey

Özlem Fidanci “We believe we can bring healthcare to individuals, we need to cover people beyond hospitals, beyond clinics so we can help improve lives”

hilips Middle East & Turkey is a diversified health and technology company, focused on improving people’s lives. Since joining Philips, Özlem Fidanci has been integrally involved in driving the company’s strategic objectives and growth across the region. She shares with “Hospitals” magazine her journey and the mission of Philips healthcare in the region. Below is the full interview:

Africa (META) in 2011 based in Dubai. As the company began to give greater emphasis on healthcare, I wanted to take part in this interesting domain so, I took the role as Senior Vice President and General Manager Philips Health Systems MET and as of January 2018 I’m Chief Executive Officer of Philips Middle East and Turkey.

We will start with a brief about your background, and your career path at Philips?

How the shift to healthcare did impact your career? As we know Philips mission is to make the world healthier, how do you implement this mission?

I started at Philips in 1998, in Turkey 22 years ago, I worked as a marketing manager focusing on domestic appliances and personal care, then I assumed the role of General Manager, Philips Household Appliances, and Personal Care Products Group. In 2008 I took the role in merging Consumer Electronics and Domestic Appliances & Personal Care organizations of Philips and has become the General Manager for Consumer Lifestyle, Philips Turkey. Later, I became the Head of Marketing and Strategy in Philips Emerging Markets in Singapore before being appointed Vice President and General Manager for Philips Consumer Lifestyle, Middle East, Turkey and

I feel like I have always been in healthcare, because this field is so rich, so many opportunities and challenges. And because our mission is to improve lives, we can experience it with our new innovations and measure results on how we are truly touching the daily lives of individuals. We are always bringing global propositions to our region. We work with hospitals to bring them integrated solutions, to help them facilitating their tasks. Not only in diagnostics, but also in IT combined with digital. This will allow them to be able to deliver the best care and accuracy in diagnostic. We aim to improve the lives of 3 billion people a year by 2030. So innovation is in our DNA.

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OUR STRATEGIC PRIORITIES IS TO BRING SOLUTIONS WHICH MEETS THE DEMANDS OF OUR CUSTOMERS, FOR THEM TO BE ABLE TO OFFER THE BEST CARE TO THE PATIENTS

INTERVIEW

What about implementing your mission in the region? I believe that every region has its own uniqueness, but the market in region is evolving and it is adopting new technologies faster. Healthcare systems around the world are under immense pressure to deliver high-quality and efficient care to growing populations, but the financial and human resources to deliver that care are becoming increasingly stretched. At the same time, aging populations and the rise of chronic conditions like heart disease and respiratory ailments are driving up the demand for healthcare. These global trends are driving a shift to value-based healthcare – a system that focuses on what patients value, and allocates resources according to the health outcomes delivered by the system. It aims to address the ‘quadruple aim’: better health outcomes, an improved patient and staff experience, and lower cost of care. We believe we can bring healthcare to individuals, we need to cover people beyond hospitals, beyond clinics so we can help improve lives.

Home care is a very important part of your healthcare solutions? Can you tell us more about it? We have devices to monitor people in their home, we are very active in sleep apnea care, and it is the most common problem in our region. Awareness about sleep apnea is 2.5% it is a very serious disease and can lead to other health problems like heart diseases, stroke, diabetes and obesity. It is a huge problem undermined by people, we are trying to create solutions that patients can use at home to improve their sleep, so they can reduce the impact of that condition. It is an important area where we can improve and prevent many diseases.

What are the latest technologies you are showcasing during the Arab health Show? Many of our innovations include AI, which has the great potential to improve patient’s outcomes. And the efficiency of care delivery with the ability of shortening the patient stay. The Philips eICU program is one of our top

innovations, it combines predictive analytics, data visualization an advance reporting techniques to deliver crucial information about the patient vital situation. It allows faster information delivery and early intervention via advanced Audi-visual technology. This smart technology can predict early deterioration in health, giving the experts a chance to interfere at an early stage and advice on the best treatment from wherever they are located.

AI; artificial intelligence is taking a major role in healthcare, how do you evaluate its role? One of the area where artificial intelligence can have a major role is in healthcare, in different areas managing hospital performance, because hospitals is comprised of different technologies, software solutions, services and lot of units that can be optimized by AI. It increases the accuracy of diagnostics and it has a potential to integrate various data together. Bringing data together is a hassle but with the help of AI solutions we can bring together data with a better accuracy and shorter time. Data can be compared to other cases through the cloud, and patients will have a chance for better diagnostic and personalized treatment.

What are the strategic priorities of Philips for the next 5 years in the region? Our strategic priorities are to bring solutions which meet the demands of our customers, for them to be able to offer the best care to the patients. We want to focus on solutions not only selling state-of-the-art technologies. We are not in the business of just selling and our ultimate aim is to improve the health of the population. We will collaborate with our partners to find best solutions for them. We also would like to collaborate with clinicians to help them perform their mission in a more efficient and accurate way. I would like to invite our partners and customers to continue sharing with us the challenges they are facing in healthcare, this is the only way for us to be able to work on our technologies and leverage the outcome of our innovations.

WE ARE ALWAYS BRINGING GLOBAL PROPOSITIONS TO OUR REGION. WE WORK WITH HOSPITALS TO BRING THEM INTEGRATED SOLUTIONS, TO HELP THEM FACILITATE THEIR TASKS

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When Your Child Needs Surgery, Everything Matters How Nationwide Children’s Hospital Turns Best Practices into Best Outcomes

Come inside the operating room to see baby Owen's cleft lip repair. NationwideChildrens.org/Owens-Story

rom the tiniest peripheral nerve connections to the most complex craniofacial reconstructions, every child deserves collaborative, holistic care from a communicative and organized interdisciplinary team. The Department of Plastic and Reconstructive Surgery at Nationwide Children’s Hospital has earned national and international acclaim for its unique combination of clinical expertise and a relentless focus on best outcomes.

World-Renowned Cleft Care Nationwide Children’s Hospital’s Cleft Lip and Palate Center have earned its international reputation through tireless work to improve the quality and outcomes of cleft lip and palate surgery. Each patient receives a comprehensive care plan with consultative input from multiple

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subspecialists throughout their development. The center’s team has included three former presidents of the American Cleft Palate-Craniofacial Association, and Chief of Plastic and Reconstructive Surgery Richard E. Kirschner, MD, FACS, FAAP is co-editor of the textbook Comprehensive Cleft Care.

Fixing Cleft-Related Speech Problems Some children born with a cleft palate have speech that is difficult to understand or that is characterized by leakage of air through the nose — a condition known as velopharyngeal dysfunction (VPD). VPD must be carefully diagnosed and precisely treated. Surgeons and speech pathologists in the hospital’s VPD Program excel in managing this condition and are key participants in a Na-

CHILDREN WITH 22Q11.2 DELETION SYNDROME EXPERIENCE A WIDE RANGE OF PHYSICAL AND DEVELOPMENTAL CONCERNS AFFECTING NEARLY EVERY BODY SYSTEM

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tional Institutes of Health (NIH) grant to measure speech outcomes after cleft palate repair.

Improving Life with 22q Children with 22q11.2 deletion syndrome experience a wide range of physical and developmental concerns affecting nearly every body system. Patients of the 22q Center at Nationwide Children’s Hospital see an expert team of clinicians who address their specific needs — often in a single day. The team develops a comprehensive treatment plan for each child that includes diagnostic testing, medical/surgical care, therapy and ongoing psychosocial support. Reconnecting Nerves to Regain Function and Feeling The hospital’s Center for Brachial Plexus and Peripheral Nerve Surgery offers highly specialized, complex pediatric procedures to reconnect or redirect peripheral nerves to healthy tissue. This surgery can help children with nerve damage caused by conditions such as acute flaccid myelitis (AFM), brachial plexus injuries and congenital facial paralysis regain the ability to walk, use their hands or smile.

A Uniquely Collaborative Approach The primary plastic and reconstructive surgery team include four pediatric plastic surgeons, three nurse practitioners, two Ph.D. speech scientists and two craniofacial orthodontists, all working hand-in-hand with experts from numerous other disciplines. Faculty members are investigators on three NIH-funded grants and have 26 clinical research projects underway. They publish dozens of chapters and peer-reviewed articles each year and have trained surgeons and other providers from around the world. In the past 10 years, patients have traveled from 45 states and 21 countries to receive reconstructive surgery at Nationwide Children’s Hospital. Every member of the care team meets to discuss each case, resulting in a truly coordinated approach to achieving the best possible outcomes for all aspects of a child’s clinical, developmental and psychosocial health.

The program serves patients with any reconstructive surgical needs. Additional centers of excellence and areas of expertise within the department include: • • • • • •

Center for Complex Craniofacial Disorders Hemangioma and Vascular Malformations Clinic Treatment of Giant Congenital Nevi Ear Reconstruction Adolescent Breast Reconstruction Craniofacial Orthodontics

About Nationwide Children’s Hospital Nationwide Children’s Hospital is located in Columbus, Ohio. It is the second-largest children’s hospital in the United States and consistently ranks among the nation’s 10 best children’s hospitals. With convenient access to the city’s international airport, downtown food and cultural attractions, Nationwide Children’s Hospital offer global visitors world-class care and a comfortable, welcoming place to call home during treatment.

SOME CHILDREN BORN WITH A CLEFT PALATE HAVE SPEECH THAT IS DIFFICULT TO UNDERSTAND OR THAT IS CHARACTERIZED BY LEAKAGE OF AIR THROUGH THE NOSE - A CONDITION KNOWN AS VELOPHARYNGEAL DYSFUNCTION VPD.

Learn more at NationwideChildrens.org/Global-Patient-Services, or contact Global Patient Services at GlobalPatientServices@NationwideChildrens.org or +1 614 362 9127 for more information.

INTERVIEW

President & CEO of GE Healthcare, Eastern Growth Markets

Elie Chaillot “Our vision is to be the leading innovator enabling precision health”

EARLY DETECTION BEGINS WITH PRECISE TECHNOLOGY

s a leading global medical technology and life sciences company, GE Healthcare helps improve outcomes for healthcare providers and for therapy innovators around the world. “Hospitals” magazine had the privilege to meet with Mr. Elie Chaillot, President and CEO of GE Healthcare, Eastern Growth Markets to talk about his career path, GE Healthcare’s mission and vision, among other things. Below is the full interview:

Tell us briefly about your career path and when you joined GE? I intended to become a doctor, but early on in medical school realized my preference towards the technology and business aspects of healthcare. I enrolled at Lille II University Law & Health in France and as part of their undergraduate degree program in biomedical engineering, was able to learn more about the technological, clinical and business facets of healthcare. I then completed my Master of Business Administration in Healthcare Management at Institut Lillois de L’Ingenierie de la Sante (ILIS). During my studies, I was lucky enough to complete several internships with GE Healthcare and eventually joined the company full-time as an Account Manager in Paris, France. In my more than twenty years with the company, I’ve had opportunities that have allowed me to grow and experience new challenges. I’ve worked in product management, services, and regional commercial roles in Europe, the Middle East and Africa. I spent two years as Chief Commercial Officer of our business in Japan before my appointment as

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INTERVIEW

chief executive of this region, which we call the Eastern Growth Markets. I’ve enjoyed every opportunity GE has given me—it’s a great company with great people that work to deliver on a common purpose that has impact in every city and community we touch.

What are GE Healthcare’s mission and vision? How are you implementing this in the region? Our vision is to be the leading innovator enabling precision health. Our purpose is to improve lives in the moments that matter, and elevate our customers’ ability to deliver on their mission of providing the best patient care possible. For our region this means we’re focused on advancing healthcare. We want our region to have the best-in-class healthcare providers, service and technology so that patients get the best treatment possible without having to fly abroad. We are raising the bar on patient safety and helping caregivers become more productive and efficient so they can focus on what matters most: patients. As a company, I want GE Healthcare to be an employer of choice, attracting and growing talent that contribute to a successful healthcare ecosystem. I believe that when you invest in the right talent and empower winning teams, customer satisfaction is inevitable. There is a strong pool of local healthcare talent in this region and it is our duty to give them opportunities to contribute to the advancement of our healthcare ecosystem.

Early diagnosis and early disease detection is key to better health. How would you evaluate GE’s role in this area today? Early detection begins with precise technology. This technology, for example, enables clinicians to detect benign tumors before they become problematic or identify lesions that could answer favorably to treatment. However, I cannot overemphasize that we all have a responsibility to understand lifestyle-related risks and their impact on our health, and know how to recognize symptoms

AT ARAB HEALTH, WE LAUNCHED MORE THAN 30 NEW IMAGING INTELLIGENT APPLICATIONS AND SMART DEVICES THAT WILL HELP DRIVE CLINICAL EFFICIENCY, ENHANCE PATIENT COMFORT AND IMPROVE WORKFLOW— RIGHT HERE IN OUR DIVERSE REGION.

and seek timely professional intervention. One of my first jobs at GE was as a product manager for magnetic resonance and healthcare digital. These are areas in which innovation is driving early diagnosis and care. Only recently, one of our long-standing customer in Kuwait, Images Diagnostic Center, implemented ViosWorks, a groundbreaking new AI-based MR software system that completes a cardiovascular scan in 10 minutes or less—significantly less than the 45 minutes to an hour it usually takes to scan a beating heart. The software and algorithms in ViosWorks not only speed up the cardiac imaging process, they provide higher quality images. This first for the region is used to diagnose and intervene earlier in cardiovascular diseases, while helping surgeons know exactly what needs to be repaired, or even indicate that surgery is unnecessary. This is but one example. We’re innovating across our portfolio and setting the bar high for the industry.

What are the latest innovations you showcased at Arab Health 2020? At Arab Health, we launched more than 30 new imaging intelligent applications and smart devices that will help drive clinical efficiency, enhance patient comfort and improve workflow—right here in our diverse region. If I had to highlight just a few, I’d begin with what Time Magazine named one of the ‘Best Inventions of 2019’, the Senographe Pristina with Dueta™. Many women avoid mammograms because of fear, anxiety and exam discomfort. The Pristina Dueta™ puts patients in control of their compression, using a wireless remote. The research shows that as a result, most women actually apply more pressure than a technician would, improving image quality. Another is the Revolution™ Maxima CT, which just last week was awarded ‘Best New Radiology Device’ by industry mainstay, AuntMinnie. This powerful, high-performing CT uses innovative AI-based auto positioning to automatically center patients for a completely hands-free positioning experience. Our award-winning Air™ Technology were also on show. These industry-first, lightweight,

INTERVIEW

flexible coils are the foundation of a better MR experience. They are light, form-fitting and easy to position—it’s the closest clinicians can get to total positioning freedom with 360-degree coverage. The last solution we showcased that I’d highlight are our Command Centers, which equip hospitals with real-time decision support tools and along with process improvement targeted using digital twins of patient flow. These Command Centers feature anywhere from 5 to 20 decision support applications, or ‘tiles’ to pinpoint opportunities to reduce length of stay, increase imaging utilization, get ahead of patient bottle-necks or issues and much more, all in near real-time and in some cases, predicting issues before they occur. Overall, what really set our latest innovations apart was that many of these devices and applications were developed using Edison, GE Healthcare’s secure intelligence platform that help both our own developers and select strategic partners to design, develop, manage, secure and distribute advanced applications, services and AI algorithms quickly.

Artificial intelligence is taking over healthcare. What are the benefits of AI in healthcare, and how is GE using it to enable greater precision? It is clear that Artificial Intelligence (AI) and analytics will be the game changers that drive positive outcomes for patients as well as providers, caregivers and other stakeholders across the health ecosystem. One of the biggest assets of any health ecosystems is the availability of data—patient records, archival imaging data, digital pathology, etc. Add to this the data from connected devices and wearables. These application need to be integrated seamlessly into existing workflows and care areas to provide real value to clinicians. Right now this data is siloed and fragmented. By integrating data, intelligent software applications and smart devices, we’ll enable clinicians to make faster, more informed decisions. GE is making significant investments in applying AI and analytics to healthcare data to uncover insights that improve patient

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GE HAS DONATED APPROXIMATELY $2.8M WORTH OF RESOURCES AND MEDICAL EQUIPMENT TO SUPPORT CHINA, INCLUDING THE WUHAN RED CROSS. THIS INCLUDES OUR REVOLUTION™ MAXIMA CT, WHICH WAS JUST INSTALLED IN A NEW HOSPITAL IN WUHAN AND CAN PLAY AN IMPORTANT ROLE IN DETECTION OF COVID-19.

outcomes, reduce waste and inefficiencies, and eliminate costly and harmful errors. We are also integrating these technologies into our leading imaging and monitoring equipment, like the examples I just gave you. Bringing together medical device and digital capabilities, the clinical and domain knowledge, combined with our deep relationships and long history in the healthcare industry, gives us a unique role to play in driving the future of health around the world.

Coronavirus is in the headlines around the world. What is GE Healthcare doing on this? Our first priority is the health and safety of our colleagues and partners. Our supply chain is global and we’re able to serve the market from different origins. The GE Healthcare team is fulfilling the urgent need for medical equipment by providing, installing and servicing technology where it’s needed most. In fact, GE has donated approximately $2.8m worth of resources and medical equipment to support China, including the Wuhan Red Cross. This includes our Revolution™ Maxima CT, which was just installed in a new hospital in Wuhan and can play an important role in detection of COVID-19.* We continue to closely monitor this very dynamic situation and do everything we can to support our employees, partners and communities around the world.

Anything else you’d like to add as a final message about GE and future strategies? We’ve been in the region for more than 80 years, and we will continue supporting our public and private sector partners in delivering the best patient care possible. We will continue innovating to help improve productivity and efficiency. We will continue investing in robust partnership models and solutions that, combined with our technology, add tremendous value for our customers. And we will continue to be a proud employer in the region, attracting and retaining the best talent and investing in the development of the next generation of leaders. *Updated on date of interview, March 3, 2020

Shaping the industry, keeping the patient first.

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For enquiries please contact: +971 4 513 6977 | info@mecomed.com

www.mecomed.com

INTERVIEW

Regional Vice President (Middle East, India, Turkey & Africa) - OKI Europe

Mr. Mathias Militzer “Our OKI devices save medical and healthcare businesses time and money in medical imaging and standard office printing with unbeatable accuracy and printing quality at the same time"

uring Arab Health, “Hospitals” magazine had the chance to meet with OKI Europe Regional Vice President Mr. Mathias Militzer, to discuss the healthcare industry challenges in the region and about OKI's role in helping the health business improve their efficiency by reducing time and cutting costs but mostly ensuring a better patient satisfactory outcome.

Can you tell us more about your background and when did you join OKI Europe? I have been in the printing sector for more than 20 years. But my beginnings were in agriculture. I worked for Mars Inc. for 9 years then I shifted from the food industry to Sharp electronics, and finally before I joined OKI Europe I held the position of General Manager for the Middle East and Africa at Lexmark International. I was appointed as Regional Vice President of OKI Europe for the Middle East, India, Turkey and Africa in April 2016.

What are the challenges you are facing in the region? The region is growing, we are facing huge challenges that differ from the European market, but of course, at the same time, we see many opportunities ahead. What is really driving the growth in the region is the opening of the people in embracing new technologies. The growing healthcare sector is one of the region's government’s priorities, and with the

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OUR PRIORITY IS TO FURTHER DEVELOP OUR MEDICAL IMAGING SYSTEM TO IMPROVE OUR QUALITY AND EFFECTIVENESS

unique products, we have the ideal imaging and printing solutions.

What are OKI printing solutions bringing to the healthcare sector? The healthcare sector is becoming more and more demanding when it comes to technologies and quality care. OKI met these challenges by offering the sector with an exceptional print quality with DICOM embedded solutions. Our latest secure printing software enables healthcare givers and clinicians to

INTERVIEW

store documents on the printer and when hardcopies are needed they have easy access with superior quality imaging. With this paper solution, the quality of the paper can last 20 to 30 years without compromising quality. Our clients are saving time, at a lower cost. All our printers are "One size fits all" you can connect a single printer to many modalities you have, like ultrasounds, CT scans MRI and many other machines.

Why healthcare providers should shift to this technology of papers instead of the traditional one? The moment you decide to go from the technology of a film printer to paper, you won’t let it go anymore. The level of satisfaction from our customers is proof that our product is unique and it helped healthcare teams maximize productivity and efficiency while meeting the general compliances and security requirements. The new generation of doctors and radiologists don’t have time to go to the illuminated boxes to check radiography, they need to have reports supported by high-quality pictures, 8 out of 10 cases it would be enough for them for diagnosis. If not, and they need deeper investigations, they can check the screen. That's why we started integrating our DICOM embedded printers with screen suppliers to provide our customers with both solutions, where they won't be needing anything else for better quality and effective diagnostic.

What are your priorities for the coming 5 years? Our priority is to further develop our medical imaging system to improve our quality and effectiveness. Customer satisfaction is at the top of our list of priorities. Our OKI devices save medical and healthcare businesses time

ALL OUR PRINTERS ARE "ONE SIZE FITS ALL" YOU CAN CONNECT A SINGLE PRINTER TO MANY MODALITIES YOU HAVE, LIKE ULTRASOUNDS, CT SCANS MRI AND MANY OTHER MACHINES.

and money in medical imaging and standard office printing with unbeatable accuracy and printing quality at the same time. We are very proud of what we have already achieved in this area and will keep on optimizing our product quality in the future.

What about your company’s environmental protection plan? Is shifting to paper technology can negatively affect the environment? Being paperless is not the most environmentally friendly thing, because being paperless means you have a server and you have screens that require electricity. The generation and transmission of electricity affect the environment. I will give you an example of digitalization; the communications and information industry could use 20% of all the world’s electricity by 2025. So the industry power demand is increasing on a daily basis as we speak. What I can say is that switching from film printing to paper is the first step in protecting the environment, because papers are recyclable and films are not.

INTERVIEW

Managing Director of Al-Futtaim Health

Dr. Haidar Al Yousuf “Our priority is to develop a sustainable healthcare model that delivers good quality care for many years to come”

l-Futtaim Health strives to redefine the healthcare experience by delivering high-quality, smart and integrated care. It brings specialized care to residents across the country. “Hospitals” magazine had the honor to meet with Dr. Haidar Al Yousuf, Managing Director of Al-Futtaim Health to talk about how Al-Futtaim Group decided to get into the healthcare sector, the HealthHub and its added value for the healthcare sector, among other things. Below is the full interview:

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You have been recognized as one of the most important leaders in healthcare, can you tell us more about yourself? I graduated as a specialist family physician (Scotland UK), and around 2006 I moved into management. The executive council asked me to establish an organization called Takamul that basically focuses on people with special needs; it was considered first of its kind in the region. After the successful completion, my next project was to set up the Community

INTERVIEW

Development Authority (CDA) in Dubai. My responsibilities included the completion and implementation of its first stage. From there I moved to Dubai Health Authority (DHA) in 2008 where I led the restructuring of the health insurance system law for Dubai. In 2018, I moved to Al- Futtaim Group to set up the healthcare division infrastructure.

How did Al-Futtaim Group decide to get into the healthcare sector? Al-Futtaim Group always wanted to get into the healthcare sector, they were just waiting for the right time and the best place to start. As a regulator, and looking at the overall market situation, we realized that in 2013 the health insurance market in Dubai was 2.5 billion per year and by 2017, it reached 11 billion per year. We could see that the main gap in the market was affordable good quality healthcare. In the market, you have players who provide very expensive healthcare services, without proper measurements of quality and you have other players who provide low cost healthcare services but with questionable quality. The market requires a player that has absolutely no compromise on quality with very reasonable prices. We are focusing on delivering good quality healthcare that is sustainable and affordable to people.

What is the HealthHub and its added value for the healthcare sector in the UAE? What are the specialties you offer? The smart HealthHub is a chain of affordable clinics that accept all categories of health insurance and at the same time are affordable to visitors who are not covered by insurance. We have launched a number of specialized clinics to offer the latest technology-driven, affordable healthcare in Dubai. The clinics specialize in Cardiology, Dentistry, Dermatology, ENT, Endocrinology, Family Medicine, Gastroenterology, General Medicine, Internal Medicine, Obstetrics &

Gynecology, Orthopedics and Pediatrics, Physiotherapy and laboratory services. We are now expanding into HealthHub pharmacies and hospitals that are now under construction and will be completed by 2021. The idea behind it is to build a worldclass healthcare system that reaches out to the patients and provide them with a unique experience at an affordable cost.

What is your future vision for Al-Futtaim Healthcare? Our future vision is to be one of the top five healthcare providers in the Middle East; Al-Futtaim Group is one of the largest groups in the region, and we operate in almost 30 countries and ultimately each of these countries is a potential destination for us. We want to be able to deliver good quality healthcare to all these countries in a way that responds to the uniqueness of their population. Our plans must be tailored to the needs of each country.

WE ARE NOW EXPANDING INTO HEALTHHUB PHARMACIES AND HOSPITALS THAT ARE NOW UNDER CONSTRUCTION AND WILL BE COMPLETED BY 2021.

How do you evaluate the UAE governmentâ&#x20AC;&#x2122;s effort in investing in the healthcare industry? What is your role in supporting the UAE Vision? I believe that the healthcare sector in the UAE has come a long way, and the government initiatives have led to a remarkable growth in the industry. The healthcare industry cannot be the sole responsibility of the government; the private sector must play a role in partnering with the government to provide better healthcare services in the country. Therefore, Al-Futtaim decided to take part in this responsibility in line with the Dubai Strategic Plan and Vision in making the health sector one of the best in the world. Our priority is to develop a sustainable healthcare model that delivers good quality care for many years to come. We believe that projects like ours will contribute to putting the UAE on the map as a medical tourism hub in the region.

INTERVIEW

Medical Director of the Heart Transplant Program at Baylor St. Luke’s Medical Center, Co-director of Advanced Heart Failure Center of Excellence and Director of the Advanced Heart Failure Fellowship Program

Andrew Civitello “We are one of the nation’s largest cardiovascular centers, the Texas Heart Institute performed the first successful heart transplantation in the United States”

ith more than 20 years of practice, “Hospitals” magazine had the chance to meet with Dr. Civitello to discuss further our concerns about heart failure and heart transplant.

We would like to know more about your educational journey in Cardiology? I received my medical degree from the University of Texas Health Science Center at Houston, followed by fellowships in Cardiology and Interventional Cardiology at Baylor College of Medicine and the Texas Heart Institute. My interests reside in interventional cardiology, advanced heart failure management, transplantation and mechanical circulatory support and heart transplant.

What is Cardiovascular Disease? It is anything involving the heart or the vas-

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OUR AIM IS TO PROVIDE PATIENTS WITH THE BEST HEART CARE POSSIBLE FROM PREVENTION TO TREATMENT OF CARDIOVASCULAR DISEASES.

cular system. It is a class of diseases that involve the heart and blood vessels. It could be a heart muscle disease called cardiomyopathy which is a progressive heart disease that often leads to heart failure. It could be a heart rhythm disorder or arrhythmia, where the heart tends to beat too slow or too fast. Also, we have heart valve diseases that can lead to problems with blood flow into and out of the heart. Finally, there are diseases of the blood vessels where a substance called plaque builds up in the walls of the arteries. This build-up makes it harder for blood flow through the artery. It also makes it more likely for a clot to form at the area of build-up, which in the coronary arteries can lead to a heart attack and in the cerebral arteries may lead to a stroke. These buildups can also decrease blood flow in the legs and feet, leading to pain with walking and a higher risk of amputations.

INTERVIEW

What are the symptoms of heart failure? The major symptoms of heart failure include fatigue and weakness; you feel that you are easily out of breath while you are doing the regular activities that you used to do like walking or going up the stairs. Swelling in the legs, ankles and feet could be also a sign, reduction in the ability to exercise with a rapid or irregular heartbeat. The symptoms could happen at a very slow pace where people won’t realize they have a problem, that’s why when they come to us looking for answers it would already be clear to us that they have a heart failure.

What is congestive heart failure and what are the treatment options people have? Congestive heart failure is the inability of the heart to pump blood to the different parts of the body as it should. It is a chronic condition that affects the pumping power of the heart muscle. The treatment options start with lifestyle modifications like low salt intake, quitting smoking, exercising more and having their blood pressure and blood sugar under control. We also have a wide range of medications which are very effective in managing heart failure disease. Sometimes we use device therapy, like implantable cardiac defibrillator, which has become essential in the management of life-threatening arrhythmia, and to prevent sudden cardiac death. With worsening heart failure and after using the common therapies without any success, it will become crucial to use device therapy to avoid sudden death in patients.

Which patient is considered for heart transplant and what are the steps to take? First, we have to make sure that we did everything else and we failed to improve the patient’s situation. If he is still very symptomatic with a very low life expectancy, we could start considering heart transplant. The average life expectancy after a transplant is 10 years. So if we have a young patient, we try to avoid heart transplant as much as we can unless it is the only option we have. Although we had some excep-

WE HAVE 8 BOARD-CERTIFIED HEART FAILURE SPECIALISTS AND 3 SURGEONS DEDICATED TO OFFERING THE BEST TREATMENTS AVAILABLE TO OUR PATIENTS, ALONG WITH AN EXPERIENCED GROUP OF NURSES, ASSISTANT SPECIALISTS, PHARMACISTS AND PHYSICAL THERAPISTS. OUR VISION IS TO BECOME LEADERS IN THIS AREA.

tions, some heart transplant patients made it between 25 to 30 years after the operation but the average is 10 years and some unfortunately didn’t survive beyond 2 years. To evaluate a patient for transplant, we have to do specialized testing to make sure that the patient is a good candidate, and then we need to find an appropriate match and this is the hardest part. Most importantly, we look at the blood type, antibodies, the size of the heart and the age of the donor.

What are the complications expected after a heart transplant? Complications involve balancing between the risk of rejection and the risk of infection. The immediate risk that we face is rejection, where we use immunosuppressive drugs to lower the body’s ability to reject the transplanted organ. Because the body knows that the new heart is foreign, it will try to attack the new heart and try to damage it. After 5 to 10 years the risk of rejection will become very low, but the use of immunosuppressive drugs places the patient at increased risk of infection. Immunosuppressant drugs decrease the ability of the body to fight infection, but also they increase the risk of developing cancer. Taking these medications will put the patient at a greater risk of both infection and cancer over time.

Can you tell us more about the heart failure center and the services you offer? We are one of the nation’s largest cardiovascular centers; the Texas Heart Institute performed the first successful heart transplantation in the United States. We are recognized for our outstanding clinical and scientific research programs. Our aim is to provide patients with the best heart care possible from prevention to treatment of cardiovascular diseases. We have 8 board-certified heart failure specialists and 3 surgeons dedicated to offering the best treatments available to our patients, along with an experienced group of nurses, assistant specialists, pharmacists and physical therapists. Our vision is to become leaders in this area.

INTERVIEW

CEO of World Innovation Summit for Health (WISH)

Ms. Sultana Afdhal “We hope that we can continue to push the boundaries and further our learning, and that of our community, on complex issues surrounding healthcare”

he World Innovation Summit for Health (WISH) is a global initiative whose aim is to promote and facilitate innovation in healthcare delivery around the world. “Hospitals” magazine had the privilege to meet with Ms. Sultana Afdhal, CEO of World Innovation Summit for Health (WISH) to talk about the inception of the Summit, the ways to manage palliative care without disregarding the religious ethics, among other things. Below is the full interview:

Can you tell us who was behind the idea of this Summit? And why? The Summit was conceived from a conversation that I had with Archbishop Vincenzo Paglia, who is the President of the Vatican’s Pontifical Academy for Life, during an interfaith workshop that we co-hosted with Georgetown University in Doha in January 2019

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MENTAL HEALTH IS INCORPORATED INTO THE SEVEN PILLARS OF QATAR'S NATIONAL HEALTH STRATEGY, EMPHASIZING ITS IMPORTANCE TO THE COUNTRY.

on palliative care. We felt that the workshop had introduced new insight that we wanted to expand on. Considering that a new platform with more expansive perspectives would further enrich this discourse, we suggested Rome as a setting for a symposium and to collaborate with Archbishop Paglia and his team to bring to the event a range of people from different faiths and from the healthcare community. Archbishop Paglia said he was very pleased to accept and proved to be a wonderful host for the event, helping us gather people from around the world to explore ways to better acknowledge the importance the role of faith plays when people are facing serious healthrelated difficulties in their lives, and to make sure that the spiritual health of an individual, their families and friends, and healthcare professionals is taken into account alongside their physical health and mental wellbeing.

INTERVIEW

The symposium is entitled: Relationship between religion and medical ethics, donâ&#x20AC;&#x2122;t you think this issue is way too complicated especially because it involves many religions views? Yes and no, some fundamental structures or thoughts between the religions were easy to understand, such as the basic need to provide dignity and support to our loved ones, during the end of their lives or during mental illness. The more complex issues gave us a rare insight into how the three monotheistic religions interpret life-defining healthcare decisions. While we could not fully examine every aspect, we believe the inclusivity and platform we provided for open discourse of often emotive and difficult topics gave participants in our event the opportunity for further learning and to build upon.

Palliative care and mental health of the elderly was the focus during the first day of the symposium. How is Qatar handling this issue and what are the ways to manage palliative care without disregarding the religious ethics? To answer this, I can give the example of Qatar, my home country and the country where WISH, being an initiative of Qatar Foundation, is based. Medically speaking, Do Not Attempt Resuscitation (DNAR) Orders became part of Qatarâ&#x20AC;&#x2122;s health protocol 15 years ago, and were revised in 2017. DNARs were the subject of a fatwa (number 12086), issued in 1989 by the Council of Senior Scholars. This fatwa suggested that withdrawing life-sustaining treatments can be acceptable, and clearly stated that the authority to take CPR-related decisions is exclusive to a medical team consisting of three physicians. However, while a clear framework exists for palliative care, doctors in Qatar come from various religions and ethnic backgrounds, and I believe that more can be done to ensure they all have the same type of training and

understanding to effectively administer medical and emotional support for palliative care patients and their families. Mental health is incorporated into the seven pillars of Qatar's National Health Strategy, emphasizing its importance to the country. This also included the mental health of the elderly. Dr. Hanadi, the National Lead for Healthy Ageing for Qatar's Ministry of Public Health and someone who was present at our Rome event, has been instrumental in ensuring every aspect of the care of the elderly is adequately addressed, and is working to create a support system that will also provide care for their mental health issues.

After the Vatican symposium, what are the next steps you are considering to take this issue forward? During the closing of the symposium, we committed to supporting the palliative care training of healthcare practitioners. We are now beginning to map out timelines and reach out to stakeholders to begin this work. We are also considering the various ways that we can simplify the messaging around palliative care, and provide healthcare practitioners the basic understanding of how patients' view medical decisions through the lens of religion.

DURING THE CLOSING OF THE SYMPOSIUM, WE COMMITTED What are your final thoughts regarding TO SUPPORTING the symposium? How do you evaluate it? THE PALLIATIVE I felt it was a wonderful gathering of CARE TRAINING religious scholars, academics, healthcare OF HEALTHCARE professionals, and people who wanted to PRACTITIONERS. express their thoughts and openly discuss WE ARE NOW difficult and life-changing issues. BEGINNING We hope that the breadth of discourse TO MAP OUT provided some learning and insight to all the TIMELINES AND participants. REACH OUT TO We, at WISH, felt very privileged to be part STAKEHOLDERS TO of this event, and hope that we can continue to BEGIN THIS WORK. push the boundaries and further our learning, and that of our community, on complex issues surrounding healthcare.

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The Bed is in the Spotlight for Quality Infection Prevention

n early March, the WHO reported more than 110,000 cases of people infected with COVID-19 and a total of 3,831 deaths due to the infection outside of China. The prevalence of the disease has intensified mainly in European countries, the Eastern Mediterranean region and the large Asian states. Hygienic prevention represents the most effective means of eliminating infections. Although the sources of many infections are the patients themselves, infections are often spread by touch, via the hands of healthcare personnel. The droplet route of transmission is less frequent but contact with infected sites is dangerous.

Focus on Hospital Beds The hospital bed represents one of the sites of most frequent contact, not only by staff but also by the patients and visitors. Although the extent and spectrum of microbial contamination of a bed depends primarily on the character of the given institution, the valid anti-epidemic mea-

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sures, and the thoroughness with which these are followed, the bed should provide favourable conditions for perfect and rapid disinfection. Logically, the highest risk of contamination of a bed involves areas frequently touched by the patient, staff or visitors as well as sites exposed to contaminating fluids (blood, urine, infusions). “Infection Control has long been one of our priorities. Some of our technologies, for example, the lifting column unit, represent a fundamental step forward ” states Jitka Stranska, Managing Director of LINET MEA.

Innovations for Infection Control The lifting mechanism of LINET columns involves smooth aluminium sections, the surface of which is adapted so as to absolutely minimise the adhesion of any impurities. The seals within the supporting columns prevent the seepage of fluids inside the columns and actuators. This construction also enables unlimited access to all parts and sections of the bed so they can be easily cleaned. The bed’s height adjustment and the special

THE HOSPITAL BED REPRESENTS ONE OF THE SITES OF MOST FREQUENT CONTACT, NOT ONLY BY STAFF BUT ALSO BY THE PATIENTS AND VISITORS.

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examination position can be set by the foot control. This allows the nurse to control the bed settings without having to make physical contact with the most frequently touched areas of the bed with her hands. The smooth surfaces of the bed lack any joints and thus facilitate rapid decontamination and easy maintenance. The number of small parts used in the construction of LINET beds is kept to a minimum. Surfaces that prevent the adhesion or growth of microorganisms represent a modern preventive measure that effectively prevents the spread of infection. LINET now offers a brand new innovation, antibacterial adaptation of the most frequently used plastic parts of the bedthe side rails and the bed ends. Technologically, this involves a unique admixture with antibacterial properties from the specialist Swiss company Sanitized®. This mixture contains active components including particles of silver, which prevent the adhesion and growth of bacteria. The efficacy of the Sanitized® antibacterial surfaces has been clinically tested and their effect has been confirmed especially against problematic, resistant microorganisms such as e.g. MRSA, VRE, and NDM-1. Some hospitals prefer to decontaminate

beds in special washers. Therefore, LINET Group has developed the Image 3 w bed, which is specially adapted for the extreme environment of washers with a reinforced cover and isolation of its electrical components.

LINET NOW OFFERS A BRAND NEW INNOVATION, ANTIBACTERIAL ADAPTATION OF THE MOST FREQUENTLY USED PLASTIC PARTS OF THE BED- THE SIDE RAILS AND THE BED ENDS. TECHNOLOGICALLY, THIS INVOLVES A UNIQUE ADMIXTURE WITH ANTIBACTERIAL PROPERTIES FROM THE SPECIALIST SWISS COMPANY SANITIZED®.

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Latest Techniques for the Treatment of Heart Valves at Hôtel-Dieu de France

Dr. Antonio Frangieh

new year has begun carrying with it various challenges for hospitals and the health sector, given the difficult circumstances that Lebanon is going through. However, regardless of the prevailing socio-economic crisis, Hôtel-Dieu de France remains firmly committed to ensuring the highest quality of healthcare for its patients, and to keeping pace with the latest innovations in the medical field, therefore asserting one of its missions that calls for participating in medical advances.

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THE TAVI CONSISTS ON INSERTING THE TRANSCATHETER HEART VALVE THROUGH THE FEMORAL ARTERY.

Pursuant to this commitment, the Department of Cardiology at Hôtel-Dieu has maintained its excellence through its continuous achievements. The Department recently focused on keeping up with the latest progress in treating heart valve diseases. Treating or replacing the calcified stenotic aortic valve, for example, resorts traditionally to surgery, the surgical aortic valve replacement (SAVR) commonly known as "open-heart surgery”. The minimally invasive percutaneous alternative is

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evolving rapidly and requires modern medical technologies that rely on transcatheter aortic valve implantation (TAVI) or replacement (TAVR), as known in the United States. The TAVI consists on inserting the transcatheter heart valve through the femoral artery (in more than 95% of the cases) and mainly uses local anesthesia and conscious sedation to implant the new aortic heart valve inside the old one. Thanks to this technique, it has now become possible to treat aortic valve stenosis in a safe and efficient way, without the need for surgery that the patient cannot usually tolerate and that poses a significant risk to him due to his advanced age or other health problems. After this intervention, which takes around 30 to 60 minutes, the medical staff monitors the patient in the intensive or intermediate care unit (ICU) for 24 hours. In most cases, the patient could be discharged from the hospital after one or two days, at most, without experiencing any serious problems or fatigue, and he will be able to return to his regular life much faster. However, the TAVI procedure could dislodge embolic debris that can include pieces of arterial wall, valve tissue, calcification, foreign material and both acute and organizing thrombus. Left unaddressed, the debris may cause blockages in cerebral arteries, which could lead to peri-procedural stroke. This is an uncommon condition, but it may occur in 1 to 3% of the cases, according to different studies. Avoiding these complications may be possible today to a great extent, thanks to technical and technological advancements in the medical field and particularly with the cerebral protection system SENTINEL™, which was available for the first time in Lebanon and the Middle East and North-Africa (MENA) region. The SENTINEL™ Cerebral Protection System, introduced percutaneously through the right radial artery, is indicated for use as an embolic protection device to capture and remove thrombus/debris dislodged during TAVI procedures. On Friday, January 03, 2020, the Department of Cardiology team at Hôtel-Dieu de France used the first embolic protection device in Lebanon and the region, better known as SENTINEL™,

The team of cardiology department of Hôtel-Dieu de France with the chief of the department Prof. Rabih Azar for an 83-year-old TAVI patient, with excellent results. The device is not mandatory based on international recommendations, but the medical team may suggest it to the patient in order to prevent the risk of peri-procedural stroke. Furthermore, the transcatheter treatment of heart valves is not limited to treating the aortic valve, but also includes treating the mitral valve and atrial and ventricular septal defects, etc… In addition to the TAVI procedure, percutaneous mitral valve repair with the MitraClip™ device is also available at Hôtel-Dieu de France. This procedure provides an efficient treatment for mitral regurgitation and reflects positively on improving the patients’ quality of life and his survival rate as well. Cutting-edge technologies for the percutaneous treatment of heart valve diseases, whether the aortic, mitral or other valves, are now available in Lebanon and performed by highly skilled and specialized physicians. This gives hope to a large number of patients who did not have previously any chance to get the necessary treatment.

TREATING OR REPLACING THE CALCIFIED STENOTIC AORTIC VALVE, FOR EXAMPLE, RESORTS TRADITIONALLY TO SURGERY, THE SURGICAL AORTIC VALVE REPLACEMENT (SAVR) COMMONLY KNOWN AS "OPENHEART SURGERY”.

Finally, the Department of Cardiology at Hôtel-Dieu de France strives to provide the most advanced and cutting-edge therapies to improve the quality of care offered to its patients. Thanks to the leading equipment available at Hôtel-Dieu and the expertise and competence of its medical team, this Department remains a leading cardiovascular institution in Lebanon and the Middle East.

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Cutting-Edge Alternative Treatment Method for BPH at Hôtel-Dieu

Dr. Charbel Chalouhy, Urologist and the Surgical team

nlarged prostate, also called benign prostatic hyperplasia (BPH), is a common age-related urological condition that mostly affects 40% of men in their 50s and 90% of men over their 90s. BPH may result in bladder outlet obstruction, which can also cause lower urinary tract symptoms such as poor stream, difficulty urinating, dribbling and frequency, besides other sexual side effects. It can also have a significant negative impact on patients’ quality of life. The management algorithm consists of conservative approaches including lifestyle modifications, pharmacotherapy with common drugs, like alpha-blockers that allow urine to flow more easily or other drugs that might shrink the prostate, and surgical interventions as well. However, prostate medications can produce unsatisfactory symptom relief and have adverse effects like postural hypotension, asthenia and reduced sexual functions. Despite new and selective drugs, surgical intervention remains a mainstay treatment.

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THE DEPARTMENT OF UROLOGY AT HÔTEL-DIEU DE FRANCE IS HIGHLY SPECIALIZED AND EQUIPPED TO PROVIDE EFFICIENT AND SAFE TREATMENT FOR MEN SUFFERING FROM UROLOGICAL CONDITIONS.

There are many surgical interventions and options available to treat prostate enlargement, for example holmium laser enucleation of the prostate, treatment with the UroLift® system, prostate artery embolization and transurethral resection of the prostate (TURP) that is still considered the gold standard intervention for BPH. A new wave of BPH treatment, called Rezum, has been recently adopted after being approved by the Food and Drug Administration (FDA) in 2015. The Department of Urology at Hôtel-Dieu de France has introduced this novel technology, on January 21, 2020, for the first series of cases in the Middle East, thus delivering state-of-the-art patient care and affirming its status as a leading medical destination. Rezum is a minimally invasive innovative technology that uses water vapor to treat BPH. Water vapor is delivered through a retractable vapor needle via special emitter holes. Every treatment cycle requires a nine-second burst that will diffuse evenly throughout the target tissue of the prostate. Upon contact with body temperature, the vapor will condense and this shift to a liquid state will dispense concentrated energy to the surrounding cells causing prostate cells to shrink. The average number of cycles is six, which makes this new technique a fast and efficient procedure compared to lengthy other classical surgical approaches. Since the FDA approval in 2015, Rezum has been a potential alternative for treating patients with prostatic disease with minimal side effects. In the last few months, many patients complaining of symptoms related to their enlarged prostate were treated at Hôtel-Dieu de France and reported great improvement in their symptoms and successful outcomes, owing to the expertise of the hospital’s highly specialized medical team. The Rezum procedure provides a number of advantages. It is a day case procedure that could be done in an outpatient setting. It can also be performed under very light sedation

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and has a strong short-term safety profile. By resorting to Rezum, physicians are noticeably avoiding the risk of retrograde ejaculation in 65% of patients treated with other modalities, especially TURP. Other complications seen with TURP like urethral strictures, urinary tract infections, bleeding requiring transfusion, and urinary incontinence have not been reported after the REZUM procedure. There are no reports of de novo sexual dysfunctions with the REZUM technique, as erectile dysfunction affects 10% of men undergoing TURP. In addition, it is a short-time procedure suitable for patients with median lobe (a case in which the prostate grows inside the bladder). The treatment showed good improvement in quality of life, in urinary stream and a notably reduced post-void residual. It represents an exciting technique with limited drawbacks for younger men who suffer from BPH and prostat-

ic symptoms and who were very reluctant previously to undergo surgery with older techniques. Nevertheless, patient selection is very important in treating men with the Rezum water vapor system as very large prostate size (120 g) and patients with acute urinary retention are not suitable candidates for this procedure. It is with no doubt necessary for men to consult their urologist as soon as they suffer from urological symptoms in order to benefit from these minimally invasive procedures without affecting their erectile and ejaculatory function typically associated with other treatment modalities. The Department of Urology at HÃ´tel-Dieu de France is highly specialized and equipped to provide efficient and safe treatment for men suffering from urological conditions, as their highly qualified medical and surgical team remains at the forefront of innovation hence offering patients the best quality of care.

THE REZUM PROCEDURE PROVIDES A NUMBER OF ADVANTAGES. IT IS A DAY CASE PROCEDURE THAT COULD BE DONE IN AN OUTPATIENT SETTING. IT CAN ALSO BE PERFORMED UNDER VERY LIGHT SEDATION AND HAS A STRONG SHORT-TERM SAFETY PROFILE. BY RESORTING TO REZUM, PHYSICIANS ARE NOTICEABLY AVOIDING THE RISK OF RETROGRADE EJACULATION IN 65% OF PATIENTS TREATED WITH OTHER MODALITIES, ESPECIALLY TURP.

NEWS

Medtronic and stroke care providers experiencing and designing solutions to enhance stroke patient journey tient outcome. 3. LAUMC Stroke Unit pathway optimization and training center. 4. Stroke Care Economix: A new approach for patient access. The meeting started with a presentation from Medtronic Chairman and CEO, Omar Ishrak, highlighting the role that Medtronic plays in providing innovative and disruptive technologies that enhance the clinical outcomes and economic value.

n alignment with its mission to alleviate pain, restore health, and extend life, Medtronic hosted a stroke care symposium in Dubai that focused on Acute Ischemic Stroke optimizationa serious condition that health systems and authorities in the region are keen to establish and enhance stroke standard of care. The â&#x20AC;&#x153;Experiencing And Designing Solutions To Enhance Strokeâ&#x20AC;? themed symposium was attended by officials and healthcare professionals from Central eastern Europe, the Middle East and Africa. More than 10 countries were represented by key opinion leaders who are working together with their government to optimize stroke care.

Key topics and sessions addressed at the symposium were: 1. Acute Ischemic Stroke requirement in hospital and at a country level. 2. Bridging the gap between pre-hospital setup and in-hospital treatment for better pa-

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MEDTRONIC CALLS ON THE HEALTHCARE SYSTEMS TO ENGAGE AND COLLABORATE TO SET NEW STANDARDS THAT HELP TRANSFORMING THE CARE CONTINUUM OF STROKE.

The symposium moderator, Dr. Suhail Abdulla Mohamed Al-Rukn, Associated Prof. Neurology, Consultant Neurologist, Head of Stroke Center at Rashid Hospital Dubai, highlighted Acute Ischemic Stroke requirement and solutions in hospital and country setting. A key highlight was the UAE optimization programs that the government is deriving with healthcare professionals with focus on artificial intelligence and RAPID software created at Rashid Hospital, a comprehensive stroke center. Dr. Marc Ribo MD, PHD, Fellow of the EBNI, a key player in setting up stroke management in Barcelona which is now the benchmark worldwide, addressed the gap between pre-hospital setup and in-hospital treatment, for a better outcome. He explained the importance of setting up a prehospital pathway and the need to creating clear protocol and framework for team collaboration to optimize time and improve outcomes.

NEWS

Omar Ishrak A key highlight of the symposium was a detailed stroke patient simulation, from symptom to Angiosuite. The simulation was performed by Prof Robert Mikulik, MD, PhD, FESO , Head of Comprehensive Stroke Center, Director of Stroke Research Program and Deputy Director for Research and Science at St. Anne’s University Hospital in Brno, Czech Republic and VERONIKA SVOBODOVA, MA, Head of Stroke Simulation Program and a Stroke Research Manager at International Clinical Research Center at St. Anne’s University Hospital Brno, Czech Republic. Dr. Raghid Kikano Md, MS Assistant Professor in the Department of Radiology at the Lebanese American University Medical Center-Rizk Hospital and School of Medicine in Beirut, Lebanon. shared the story of LAUMC Centre Pathway Optimization and how they were able to set up in 3 months a comprehensive stroke center and training center in collaboration with Medtronic and other companies. Dr. Fahmi Al Senani MBBS, MHA, MSc National MOH Stroke Lead, Vice President of Healthcare Delivery, Interventional Vascular Neurologist elaborated on stroke care economics, a new approach for patient access and how he was able to apply stroke economics to design & optimize national stroke networks in Saudi Arabia. Dr Fahim explained the importance of health economic model in helping Saudi ministry of health to identify the gaps and put a plan to overcome them by building a solid 10-year program for the Kingdom.

As per Dr. Fahmi: “Stroke care economic “lens” made the Saudi ministry consider:

Rob ten Hoedt • • • •

The complete patient's journey. Where to cut waste. Where to focus on resources . Assessing gaps in workforce & infrastructure. • Added momentum to the Saudi MOH Stroke Project . He concluded sharing the latest update of Saudi stroke management progress and how they started implementing the pathway optimization plan. The closing was with Matthieu Cuche, Health Economics & Reimbursement Director at Medtronic who introduced Stroke Care Economix, a Medtronic health-economics solution to support physicians, administrators and/or payers to assess the economic impact and clinical outcome benefit of one or multiple optimization actions of stroke care with the aim to improve the funding allocation for stroke. This model as per Mr. Cuche started in Saudi as Pilot and now is expanded in several countries across EMEA region like Barcelona. Also, Mr. Cuche shared how Medtronic is committed to providing stroke care solutions across the patient pathway to improve and optimize the patient benefit such as: patient pathway optimization consultancy and building of capabilities, RAPID software implementation in hospitals, Medical education workshops and trainings, Stroke Care Economix and a comprehensive portfolio of devices for stroke treatment.

THE “EXPERIENCING AND DESIGNING SOLUTIONS TO ENHANCE STROKE” THEMED SYMPOSIUM WAS ATTENDED BY OFFICIALS AND HEALTHCARE PROFESSIONALS FROM CENTRAL EASTERN EUROPE, THE MIDDLE EAST AND AFRICA. MORE THAN 10 COUNTRIES WERE REPRESENTED BY KEY OPINION LEADERS WHO ARE WORKING TOGETHER WITH THEIR GOVERNMENT TO OPTIMIZE STROKE CARE.

As the proven partner for world-class stroke care solutions, Medtronic calls on the healthcare systems to engage and collaborate to set new standards that help transforming the care continuum of stroke.

www.koctransplant.org/en

mena@kochealthcare.org

ARTICLE FEATURES . Medical Tourism

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ARTICLE FEATURES . Medical Tourism

UAE INCREASING GROWTH HAS CEMENTED THE COUNTRY'S PLACE AT THE HEART OF THE GLOBAL MEDICAL TOURISM MAP

he UAE provides a high-quality medical experience that combines the patientsâ&#x20AC;&#x2122; needs by offering integrated health services, ranging from comprehensive and advanced healthcare services including travel visas, transportation and hotel services for patients and their families in addition to local expertise from doctors and healthcare providers as well as the availability of state-of-the-art medical technology. Today, the UAE has become a regional hub and a primary destination for those who want to receive treatment in the best specialized centers in light of the presence of a large number of internationally accredited medical institutions. The UAE falls within the list of the 14 largest countries in the world in the medical tourism sector, including Singapore, Thailand, Malaysia, India and Indonesia. Studies in this regard indicate that this sector is witnessing 15% annual growth. Recently, a smart medical tourism application has been launched, which provides users with the opportunity to learn about the leading specialized medical centers and hospitals in the treatment of diseases that are located within the UAE, and introduce them to doctors visiting the country instead of traveling abroad to receive treatment, which cements the UAEâ&#x20AC;&#x2122;s place at the heart of the global medical tourism map. Medical tourism sales in the UAE increased 5.5 percent year-over-year to reach AED 12.1

billion in 2018, with growth supported by several government-led initiatives and the rising number of medical tourists in the country, new analysis released by Dubai Chamber of Commerce and Industry revealed. Growth momentum behind medical tourism in the UAE is expected to continue over the years, with sales in this sector projected to grow at a compound annual growth rate, CAGR, reaching an estimated value of AED19.5 billion by 2023. The analysis highlighted the rapid growth of the UAE's therapeutic healthcare sector and a number of vital indicators for the growth of the sector, with 154 hospitals in the UAE and more than 25,000 highly qualified physicians working in the UAE, mostly foreign residents. State hospitals performed 119,897 surgeries in 2018.This number increased at a cumulative annual rate of about 0.7% between 2013 and 2018. Dubai and Abu Dhabi ranked 16th and 25th respectively as the best global destinations for medical tourism in the world, according to the latest data of the medical tourism index. These tourists choose the UAE because of the short waiting times in hospitals and the high quality of healthcare services. The analysis pointed out that the UAE, especially Dubai, has a good tourist infrastructure and hospitals provide cosmetic surgery, eye care, fertilization, artificial insemination, arterial care, prosthetic surgery, and other therapeutic services.

ARTICLE FEATURES . Medical Tourism

JORDAN WORLD-CLASS REPUTATION

ourism is one of the most important activities in Jordan notably contributing to the expansion of the national economy. Moreover, healthcare and medical tourism based on natural and modern resources has led to attract many medical tourists from different countries. Jordan has the largest natural spa on earth, and the Dead Sea, which is the lowest point on earth, and has healing powers for many diseases and many patients come for treatment at the Dead Sea. Jordanâ&#x20AC;&#x2122;s medical sector has gained a good reputation for many reasons, including the quality of services provided at the medical facilities, which are equipped with the latest medical technology that exceeds the need of local patients and is able to receive a large number of patients. The concerned authorities in this field have worked to implement the directives of His Majesty King Abdullah II Bin Al Hussein to boost Jordan's medical tourism and open new markets for it by setting a strategic medical tourism plan and issuing the medical responsibility law in addition to facilitating visa applications for restricted nationalities, establishing a board of trustees for health tourism and amending the Jordan Tourism Board law to include the health and hospital sectors. Jordan enjoys security and stability and its hospitals have been recognized for the advanced care they provide, the quality of their services and excellent reputation. The workforce in the kingdom's medical sector is skilled, highly trained

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and professional, and hospitals in Jordan follow international standards. Jordanian medical services also pride themselves on having facilities ready for patients without the hassle of a waiting buffer time. Jordanian hospitals take responsibility of hotel accommodation, travel plans for follow-ups, transportation as necessary and general patient well-being in addition to the relevant medical procedure that has been recommended for the patient during his or her stay in the country. The components of medical tourism in Jordan vary from tourist site to another. Some sites feature mineral sands and the other is characterized by using the Dead Sea in the hospitalization by bathing in the water and burial in the sand, and there are many natural resources such as: mineral springs water, healthy weather, natural and traditional treatment methods, which help to improve human health, prosperity and development of therapeutic resorts. Among the most prominent elements of medical tourism in Jordan, sulfur water and sand of special nature, and provide security and stability, and highly experienced professionals doctors, and excellent tourist services. The hospitals of the Hashemite Kingdom of Jordan have been keen on developing the quality of health services provided to patients, improving and developing human resources, and urging the development of legislations, government policies and regulations for the interest of the Jordanian citizen while providing him with the best medical services.

ARTICLE FEATURES . Medical Tourism

KSA DISTINGUISHED HOSPITALS WITH STATE-OF-THE-ART EQUIPMENT

he health sector in the Kingdom of Saudi Arabia is looking to be one of the most competitive sectors in the medical tourism field in the region. Healthcare is considered one of the most important elements mentioned in the Saudi Vision 2030, which will put Saudi Arabia at the forefront of the world. The Saudi health sector is witnessing an unprecedented boom, as hospitals seek to limit the travel of the Saudi citizen to travel overseas in order to receive treatment by introducing more developments to the Kingdom's hospitals, which are equipped with the latest technology and trained professionals. The private sector provides a part of healthcare services and has a growing role in caring for Saudi citizens and legal permanent

residents. The Ministry of Health manages the healthcare sector and undertakes planning and organization while also overseeing private healthcare facilities. Among the components of health tourism and hospitalization in Saudi Arabia are local and foreign medical talents from all medical specialties that work in distinguished hospitals, while reputable specialized hospitals in the region are also available in treating a number of chronic diseases. The Kingdom of Saudi Arabia also enjoys geographical diversity and the availability of natural resources such as mountains, seas, etc., the presence of the Two Holy Mosques and their spiritual importance to Muslims; speaking in both Arabic and English languages in the Kingdom's hospitals in addition to the affordable cost compared to western countries.

INTERVIEW

Chairman of the Private Hospitals Association, Honorary President of the Global Healthcare Travel Council

Dr. Fawzi Al-Hammouri “We are expanding our efforts in marketing Jordan as a medical tourism destination”

edical tourism has flourished all around the world in light of the medical globalization we live in, which has contributed to easy access and communication with hospitals and medical institutions. "HOSPITALS” Magazine met Dr. Fawzi AlHammouri, Chairman of the Private Hospitals Association, and the Honorary President of the Global Healthcare Travel Council.

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We would like to learn about the medical services and facilities you provide to patients? Jordan possesses all the elements that made it one of the leading countries in the region as a destination for treatment, as it has competitive advantages that are not available collectively in any of the other countries. These advantages include high availability of well-educated and

INTERVIEW

trained medical and healthcare staff, as well as the quality of services provided in the Jordanian private hospitals and the implementation of international, in addition to competitive prices with no waiting time. Not to mention Jordanâ&#x20AC;&#x2122;s security stability, no language barrier and many common cultural traditions with the neighboring countries. Jordan has also gained a good reputation in various medical fields including treatments for cardiovascular, cancer, infertility, obesity, plastic surgery, orthopedics, neurology and organ transplants such as liver, kidney, and bone marrow, in addition to treatments for the nose, ear and throat, as well as dentistry, mental and addictive disorders. Medical tourism in the Kingdom of Jordan is expected to rise higher by providing comprehensive and integrated packages of attractive products and services to raise the competitiveness of the private hospital sector in the field of medical tourism.

What are the advantages of medical tourism that you have? Whether at a level of services provided or at the country level? It must be pointed out here that Jordan is considered as the gateway to the Middle East and one of the most attractive countries for medical investments and wellness resorts due to having several advantages which include medical and wellness tourism, healthcare resorts, biomedical research, production and sales of pharmaceutical products and medical equipment as well as the production of natural skin care products extracted from the Dead Sea and rich in concentrated natural minerals that are used to treat a number of skin diseases. There are currently 119 hospitals in Jordan that provide services to Jordanian and non-Jordanian patients. The number of private hospitals constitutes 60 percent of the total number of hospitals operating in the Kingdom of Jordan, which is a high percentage compared to other countries worldwide, and these hospitals provide patients with various medical specialties. The abundance and high quality of qualified

medical & nursing staff in the fields of medicine and nursing, as well as in pharmacy and medical engineering is one of the most important factors for the development of medical tourism and its progress in Jordan, along with competitive medical costs, no waiting period, the quality of medical services provided and the application of infection control. In addition to having regulatory bodies that supervise all hospitals as well as reliable and effective health insurance systems and also the fact that a number of Jordanian hospitals have obtained international accreditation and have advanced medical devices and equipment from radiology centers, laboratories, oncology centers, nuclear medicine, and many more. Many other factors encourage patients from other countries to come to Jordan, including the security stability where Jordan ranks the thirteenth safest among 132 countries as well as the political stability and the presence of good diplomatic relations with the majority of countries in the world in addition to the possibility of many nationalities entering Jordan without a visa and that the citizens of Jordan have the ability to speak more than one language. All these factors help patients feel comfortable with the quality and safety of the treatment services they receive. Jordan is also famous for its natural wellness and spa resorts that have hot water springs and waterfalls alongside the largest natural spa in the world which is the Dead Sea. These natural resorts are surrounded by a large number of investments that include five-star hotels and physiotherapy centers that meet global standards in terms of modernity, hospitality, hotel and wellness services provided. Also it must be pointed out the importance of the Jordanian governmentâ&#x20AC;&#x2122;s decision to facilitate procedures for granting visas to patients of restricted nationalities and to take practical measures to support medical tourism in the Kingdom, where patients from restricted countries can easily obtain an electronic visa online or from Jordanian embassies, airline offices, tourism and travel offices, as well as the Jordanian private hospitals.

MEDICAL TOURISM IN THE KINGDOM OF JORDAN IS EXPECTED TO RISE HIGHER BY PROVIDING COMPREHENSIVE AND INTEGRATED PACKAGES OF ATTRACTIVE PRODUCTS AND SERVICES TO RAISE THE COMPETITIVENESS OF THE PRIVATE HOSPITAL SECTOR IN THE FIELD OF MEDICAL TOURISM.

INTERVIEW

Many Hospitals work on preparing special programs for patients arriving for treatment to facilitate their access and provide them with medical services. Do you have accredited programs in this field? What are they? Yes, most private hospitals offer comprehensive treatment packages with competitive prices that include booking airline tickets and accommodation, visa assistance, airport pickup for patients and their companions, providing personalized assistance for patients during their stay in Jordan, coordinating contact between the patient and the doctor over the phone or online, and receiving medical reports and responding to them, in addition to organizing tourism and leisure activities for patients and their companions to relax and recuperate. In addition to that, hospitals send price offers, insurance bills and arrange the transfer of medical records to patients. Also note that Jordan also has an Air Ambulance center that transfers emergency cases resulting from accidents in remote areas to advanced hospitals in Amman, using specially equipped helicopters enabling the medical team to provide intensive medical care during ambulance flights. Recently, Health and wellness office opened at Queen Alia international airport in order to assist patients and their companions seeking treatment in Jordan and to facilitate their arrival procedures which will contribute significantly to the development to this type of tourism.

What about your business strategy and vision in this field? Starting with the government’s awareness regarding the importance of medical tourism in the Kingdom and hence removing obstacles that hinder its development in the face of competition in this field from countries in the region. In September 2018 the Jordanian government approved a strategic plan for medical and wellness tourism prepared by a national team formed for this purpose and this team included representatives from concerned

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public and private sectors, including the Private Hospitals Association. This strategy includes several segments, the most important of which is ensuring the quality of the services provided, facilitating the entry of patients of restricted nationalities into the Kingdom and issuing and amending legislations and regulations that regulate medical tourism, including the medical liability law, as well as optimal marketing of medical tourism in Jordan. In addition to that, recently a Board of Trustees was established that includes the various sectors concerned with medical and wellness tourism including the Private Hospitals Association to manage a unit operating under the Jordan Tourism Board in a step which aims at strengthening the marketing efforts for Jordan as a destination for medical and wellness tourism, as well as following up on all matters related in this sector. During the Jordanian Strategies Forum which was held in Amman recently and attended by the Prime Minister Dr. Omar AlRazaz along with a number of other ministers, the government launched an initiative to launch promotional campaigns for Jordan as a destination for medical tourism and in relation to this field it was also agreed upon to enhance cooperation between the Jordan Tourism Board and the private sector in launching promotional campaigns for medical tourism. The Private Hospital Association, after organizing the International Healthcare Travel Forum 2019 which took place in Amman on October 2019 and was attended by over 750 participants from 48 countries are currently working on expanding our efforts in marketing Jordan as a medical tourism destination based on the “Amman Declaration” to expand the concept of healthcare travel, which was adopted and launched at the conclusion of the Global Healthcare Travel Forum organized by the Private Hospitals Association in 2017. The eight segments of Amman Declaration includes Medical Tourism, Dental Tourism, Wellness Tourism, Spa Tourism, Culinary Tourism, Sports Tourism, Assisted Residential Tourism and Accessible Tourism.

JORDAN HAS AN AIR AMBULANCE CENTER THAT TRANSFERS EMERGENCY CASES RESULTING FROM ACCIDENTS IN REMOTE AREAS TO ADVANCED HOSPITALS IN AMMAN, USING SPECIALLY EQUIPPED HELICOPTERS ENABLING THE MEDICAL TEAM TO PROVIDE INTENSIVE MEDICAL CARE DURING AMBULANCE FLIGHTS.

ARTICLE FEATURES . Medical Tourism in Turkey

TURKEYâ&#x20AC;Ś A global hub for medical tourism

urkey has been one of the major global destinations in medical tourism, as it has seen an influx of medical tourists over the past year that reached 470 thousand patients, making it a destination for hundreds of thousands of people annually. Turkey is aiming to bring in $20 billion in health tourism revenue in the upcoming years. Improved services with cutting-edge technology, competent experts and affordable prices have recently made Turkey an attractive destination among world citizens who are seeking treatment. The country has achieved significant momentum in healthcare tourism, offering a wide array of services and generating revenue. Today, Turkey is among the top five countries around the world in medical tourism, thanks to its geographical location in close proximity to Europe, Asia and the Middle East, and the short flight distance to these regions, which contributes to attracting more medical tourists. Underlining that Turkey has been rendering health services in European standards in recent

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years thanks to its modern hospitals, trained manpower, specialist doctors, technological infrastructure and experience, the service quality of many private hospitals in Turkey has been approved by world-renowned accreditation agencies. Turkey is also distinguished by its top services in the medical field in terms of the quality of health services and lower prices compared to other countries. It has occupied a prominent position among the countries of the world as one of the leading health centers thanks to its qualified and trained manpower, competitive prices and state-of-the-art medical technology, in addition to providing services based on reliable diagnosis in accordance with international standards. Turkey has worked over the past years to strengthen its position as a global hub for medical tourism, supported by the development of its health facilities and professional manpower, in addition to providing important natural facilities for treatment, such as hot springs. The medical tourism is one of the most important pillars of the Turkish economy, and

HOSPITALS OPERATE IN ACCORDANCE WITH THE NATIONAL ACCREDITATION SYSTEM AND ARE AUDITED TWICE A YEAR BY THE MINISTRY OF HEALTH OF TURKEY TO ENSURE QUALITY, SAFETY AND SERVICE STANDARDS

ARTICLE FEATURES . Medical Tourism in Turkey

a major source of national income, which relied heavily on the prosperity of medical tourism. Turkish healthcare system has been stated to show significant improvements regarding wider access to healthcare facilities, and the quality and efficiency through the introduction of Health Transformation Program. The new system achieved nearly universal coverage and many health outcomes enhanced significantly. Hospitals operate in accordance with the national accreditation system and are audited twice a year by the Ministry of Health of Turkey to ensure quality, safety and service standards. Moreover, numerous health facilities are accredited by international organizations. A great number of health facilities in Turkey own ISO 9001 certificate, JCI accreditation, etc. for their clinical services and they also offer 5-star hotel comfort for their international guests. Guests become a member of family in Turkey. Thatâ&#x20AC;&#x2122;s why it is one of the top destinations for international tourists each year. International patient departments of health facilities arrange pre-interview, travel planning, accommodation, translation and other relevant needs of patients for 7/24. Istanbul also serves as Turkeyâ&#x20AC;&#x2122;s biggest medical establishment, with the greatest number of hospitals, education and research institutions, the highest number of JCI-accredited medical facilities and largest tourist arrivals for medical treatment in the country.

The exceptional central location of Turkey, its healthcare facilities, skilled and educated doctors and staff in the healthcare sector, supported by its hot springs and natural beauty is attractive in terms of health tourism. With both the cultural and historical richness, as well as the level of expansion in the field of health, Turkey is one of the most popular countries in the region when it comes to. Many procedures are provided by our medical centers such as liposuction, orthodontics, Lasik, rhinoplasty, breast augmentation can result in savings of up to 50%- 60% as compared to what they are costing in the US and in Europe. Among other procedures for which patients travel abroad are dental treatments and surgery, eye operations, plastic, reconstructive and cosmetic surgeries.

Medical tourism in Turkey is popular because of quality that equals European hospitals and the incredibly low cost of medical treatments. Thermal facilities in Turkey have generated approximately $1 billion in revenue from some 3 million tourists, including 750,000 foreigners, throughout 2019.

ARTICLE

Latest therapies for Pancreatic Tumors Interview with Prof. Dr. Güralp Onur Ceyhan

very day, approximately 1,200 people worldwide receive the pancreatic cancer diagnosis. Out of the total of 18 million cancer cases registered globally in 2018, nearly 450,000 were patients with malignant tumors located in one of the most important glands in the body: the pancreas. Pancreas has two important roles in the body, besides other functions: it secretes insulin to maintain the optimum blood glucose level and secretes several enzymes required for digestion. The pancreas can develop tumors, but unfortunately, until now, there are no screening tests that can highlight the cancer in an early stage. Risk factors for pancreatic cancer include smoking, obesity, chronic pancreatitis, and genetic inheritance. There are two major types of tumors of the pancreas: some can affect the main pancreatic duct, others may affect smaller ducts. Those that affect the primary duct are associated with a higher risk of cancer than those located on smaller ducts. In the case of tumors affecting the primary duct, the treatment is like that for the cancers, so we do a resection. The ones on the smaller ducts are not so aggressive, so there is still de-

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bate on this topic: monitoring or surgery. Besides these types of tumors, there are also the neuroendocrine ones, active or non-active. Another condition we diagnose is chronic pancreatitis, an inflammatory tumor mass that is not cancer and which we have to treat properly. There is a tumor called insulinoma, responsible for insulin production in excess. There are times when diabetes can be a sign of pancreatic cancer: it’s the case of patients who had normal blood sugar constantly and suddenly they got diabetes. If we operate these patients and remove malignant tumor, diabetes disappears, too. Therefore, suddenly installed diabetes can be a symptom of pancreatic cancer. Now we can diagnose these types of tumors more easily than they were 20 years ago when we could not see them with the imaging techniques available at the time. That's why the number of cases with these types of tumors is increasing because we can diagnose them

ONE OF THE TOP EXPERTS IN THE WORLD WHO SUCCESSFULLY TACKLES SUCH CASES IS PROFESSOR GÜRALP ONUR CEYHAN, WHO IS CURRENTLY PART OF PHYSICIANS TEAM AT ACIBADEM MASLAK HOSPITAL IN ISTANBUL TURKEY

ARTICLE

much easier. One of the top experts in the world who successfully tackles such cases is Professor Güralp Onur Ceyhan, who is currently part of physicians team at Acibadem Maslak Hospital in Istanbul Turkey. The modern therapy protocol includes neoadjuvant chemotherapy that reduces tumors and surgeries through state-of-the-art methods and technologies that reduce the risk of side effects.

What are the advances in early diagnosis of pancreatic tumors? There is no routine checkup to detect the tumors of the pancreas. Pancreatic cancer can be detected only by chance: the patient goes to a checkup, the doctor sees something on the ultrasound and then the diagnosis is confirmed. There are also tumor markers, such as CA 19-9, an antigenic determinant associated with various types of tumors. Its value may be increased in pancreas cancer. After the tumor removal operation, the value of this marker decreases. Increased CA19-9 values can also be associated with other problems in the body such as inflammatory processes so it can’t be used extensively to detect early stage pancreatic cancer, as is the PSA marker for prostate cancer.

Modern technology helps and assists you successfully in achieving successful operations? If patients refer to a specialist center in pancreas or liver surgery, the success of the interventions is provided by a multidisciplinary team. The presence of an experienced surgeon in the team is important, but equally important is the presence of a specialist in interventional gastrointestinal surgery and an interventionist imaging specialist. They form a team that successfully intervenes in both chronic pancreatitis, pancreatic cancers and advanced hepatic tumors. Currently, in some cases of pancreatic cancer, we can use robotic surgery to remove tumors. That means fewer side effects, better recovery and less scarring.

What is the latest treatment protocol for pancreatic cancer? This is an extremely exciting subject today, because things are changing in the approach to pancreatic cancer. First, let’s look at the patients: for 20 percent of them, the cancer is distinctively located at the head, body, or tail of the gland, there are no metastasis, infiltrations in the vessels. In these patients, we do resection, we apply chemotherapy, and the prognosis is good enough. Then, in another patient category, representing 20-25 percent of all patients, the cancer is advanced: there are vascular infiltrations in the portal or mesenteric veins or there are tumors around the arteries, the super mesenteric, in the celiac trunk. A few years ago, this second category of patients was similar to the third group, representing between 50 and 55 percent, with pancreatic cancer and metastasis. 15 years ago, these two categories were treated in the same way, with palliative chemotherapy. Now, things have changed: if the second group receives neoadjuvant chemotherapy with Folfirinox or Gemcitabine Abraxane, two substances that have proven to be effective, then cancer becomes resectable in more than 50 percent of patients, who were not candidates for resection and could not be saved before. With the help of these latest therapies, some tumors can decrease, and we can do surgery.

THERE ARE TIMES WHEN DIABETES CAN BE A SIGN OF PANCREATIC CANCER: IT’S THE CASE OF PATIENTS WHO HAD NORMAL BLOOD SUGAR CONSTANTLY AND SUDDENLY THEY GOT DIABETES

ARTICLE

A promising method for Pancreatic Cancer! Another milestone has been reached for a scary type of cancer! It hits the bull’s eye Imagine a moving target and you are shooting arrows at them. Normally, the arrows may hit on any point of the target, or you can at least hit anywhere in a wide area. However, MR Linac device sees the tumor and determines a very narrow target area around it and since we act in cooperation with the patient, we can hold the tumor within the bull’s eye by controlling the respiration. Since the movement is limited and MRI scanner provides a very clear image, we hit the bull’s eye and peripheral tissues are not damaged.

Patient plays an active role in treatment

echnological developments are associated with prolonged survival and boosted quality of life in every aspect of oncology. One of them is pancreatic cancer. Thanks to MR Linac method, a promising progress has been made in pancreatic cancer that progresses very quickly, stays asymptomatic due to its insidious nature and can only be diagnosed at the terminal stage. “This is a very exciting development, but we should remember that these are extremely novel technologies. So far, the most important clinical effect was achieved in pancreatic cancer. Literature reports that the success rate of local control raised from 10% to 90%. In the upcoming years, we will witness its effect also on other tumors, especially the ones that are not eligible for surgical treatment and hard to remove” says Professor of Radiation Oncology Banu Atalar, M.D at Acıbadem Maslak Hospital in Istanbul Turkey, and adds that the revolutionary MR Linac method had brought a chance of treatment for tumors which were considered incurable in the past. Professor Atalar explained MR Linac method, its five benefits for the patients and made important warnings and recommendations.

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Patients having MR Linac therapy are given a prismatic eyeglass which allows them to watch the treatment from monitor. Seeing the area of treatment, the patient is able to regulate respiration and takes an active part in treatment. As a result, patients enjoy their contributions to their treatment and physicians complete the treatment in shorter time, thanks to the cooperation with the patient.

Even effects of heart beats are eliminated Ability to acquire images of the target site is one of the important advantages offered by

MR LINAC HAS THE MOST ADVANCED IMAGING FEATURE AMONG ALL RADIOTHERAPY DEVICES USED AROUND THE WORLD. IN THIS METHOD, THE TISSUES INVOLVED BY THE TUMOR ARE MORE CLEARLY IMAGED

ARTICLE

MR Linac. Conventional methods do not allow real-time tumor imaging. However, MR Linac can clearly localize the tumor by showing even the effects of heartbeat, respiration or passage of gas through bowels.

Tumors can be irradiated at high dose This high-end method offer better tumor control by delivering high-dose radiation. Thanks to its pin-point accuracy, higher doses are now delivered to tumors more safely. Thus, we aim to have a better tumor control and minimize the damage to healthy tissue, namely adverse effects.

Interventional procedures are avoided “Conventional methods required certain painful interventions, such as placing certain substances or metals between organs in order to

locate the target lesion, especially for soft tissue tumors. What’s more, these procedures were costly. Thanks to the superior imaging capability of MR Linac device, none of them are needed" says Professor Atalar, M.D. MR Linac has the most advanced imaging feature among all radiotherapy devices used around the world. In this method, the tissues involved by the tumor are more clearly imaged, as an MRI scanner is combined with a radiotherapy device and the changes arising out of respiration, organ movements or patient's movement can be immediately regulated. It is, therefore, called “smart radiotherapy”. “Thanks to the superior imaging capability offered by MR Linac, it is now possible to achieve successful results, particularly in tumors of pancreas, lung, prostate gland and abdomen as well as liver cancers and metastases and some other tumors” says Professor Banu Atalar, M.D.

MR LINAC CAN CLEARLY LOCALIZE THE TUMOR BY SHOWING EVEN THE EFFECTS OF HEARTBEAT, RESPIRATION OR PASSAGE OF GAS THROUGH BOWELS

ARTICLE FEATURES . IT Healthcare

IT Healthcare… A New Era in Medicine A major role in raising the level of quality and improving the medical service

ith the development of information technology and its accompanying medical discoveries, it was necessary to take advantage of them in order to raise the level of medical services provided to patients. IT entered hospitals and medical institutions and witnessed a new era of development that contributed to raising the level of quality of medical services at all levels whether diagnostic, therapeutic, or the mechanism of work within the hospital and others. In the healthcare industry, the dependence on information technology and medical technology devices has had a prominent role in bringing about a fundamental change in the quality of healthcare. Hospitals have worked over the past years to develop clear and comprehensive plans of action and strategies to take advantage of information technology to conform with the operating model and the hospital’s medical practices.

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Hence, a new concept has emerged that combines technology and medicine, which is “health information technology” that aims primarily to improve the quality of healthcare and increase its efficiency while reducing medical errors and raising the efficiency of healthcare providers and medical management while activating the mechanism of communication between them, and working as much as possible to reduce the costs. Health information technology (HIT) has been defined as “the application of information processing involving both computer hardware and software that deals with the storage, retrieval, sharing, and use of healthcare information, data, and knowledge for communication and decision-making.”

Telemedicine Telemedicine is the use of medical information that is exchanged from one site to another through electronic communications. It includes

IT ENTERED HOSPITALS AND MEDICAL INSTITUTIONS & WITNESSED A NEW ERA OF DEVELOPMENT THAT CONTRIBUTED TO RAISING THE LEVEL OF QUALITY OF MEDICAL SERVICES

ARTICLE FEATURES . IT Healthcare

varying types of processes and services intended to enrich the delivery of medical care and improve the health status of patients. The medical community in the world has benefited from information technology to reach specialized doctors outside the country for medical advice and learn about the patient's condition, and today some remote operations are being performed in addition to improving communications and coordinating care between members of the healthcare team and patients. Modern technology has made it possible to improve the quality of healthcare and reach more people. Telehealth may provide opportunities to make healthcare more efficient, better coordinated and closer to home. Telehealth is the use of digital information and communication technologies, such as computers and mobile devices, to access healthcare services remotely and manage your healthcare. These may be technologies you use from home or that your doctor

uses to improve or support healthcare services. There are also wearable devices that automatically record information such as heart rate, blood glucose, walking, posture, tremors, activity or sleep patterns. In addition to home monitoring devices for elderly or people with dementia, it detects changes in normal activities such as falling. The concept of telemedicine also includes smart health applications that anyone can download on their smartphone, as a large number of applications have been designed that help organize medical information in one safe place. Digital applications allow you to store health records, download information from devices, such as a blood glucose monitor or blood pressure bracelet, and share information with your healthcare providers. Some applications provide the patient with personal notifications and recommendations. Devices, such as blood pressure monitors, can also connect to the Internet for direct face-

ARTICLE FEATURES . IT Healthcare

to-face interaction with healthcare providers. Home Health Monitoring is the use of IT and telecommunications to remotely monitor the health of patients in their homes. It may be especially helpful for people who suffer from chronic diseases, such as heart disease, as well as those who live in rural or isolated areas. The benefit also includes great access, reduced number of clinic visits, and easy access to care and medical advice. Telehealth can be non-interactive, i.e. the patient is examined and the information is sent to the doctor in order to write the report; it can be for the purpose of monitoring only so the doctor monitors the patient’s health condition by uploading his information and transmitting it wirelessly. In that type, we use wearable devices that monitor the heart rate, blood glucose, posture, activity and sleep patterns. The most important type is interactive healthcare, in which a physi-

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cian can intervene while examining the health condition, and guide those around to provide help that may save the patient's life.

Medical Imaging Diagnostic medical imaging was one of the fields that most benefited from the development of technology, where medical companies have worked over the past years to produce high-quality imaging devices that give very accurate results. To complement this development, printers emerged that are equivalent to this technological development in medical imaging for diagnostic image printing in the field of digital printing. Today, the diagnostic process only requires a few minutes and the final image appears in front of the radiologist thanks to advanced computer programs that specialize in reading medical images. The doctor can also split the image and according to specific pro-

AN EHR SYSTEM IS BUILT TO GO BEYOND STANDARD CLINICAL DATA COLLECTED IN A PROVIDER’S OFFICE AND CAN BE INCLUSIVE OF A BROADER VIEW OF A PATIENT’S CARE

ARTICLE FEATURES . IT Healthcare

grams, he can take a section of the image, the kidneys, for instance, and put it on the screen to check its details by enlarging it and reducing it as much as he wants. Today, we can see the fetus inside its mother's womb while it is still in its early stages of formation and development, with the possibility of determining whether it suffers from health conditions. Also, fetal surgeries can be performed inside the mother’s womb. Positron emission tomography (PET) uses small amounts of radioactive materials called radiotracers or radiopharmaceuticals, a special camera and a computer to evaluate organ and tissue functions. By identifying changes at the cellular level, PET may detect the early onset of disease before other imaging tests can. Nuclear medicine imaging uses small amounts of radioactive material to diagnose, evaluate or treat a variety of diseases. These include many types of cancers, heart disease, gastrointestinal, endocrine or neurological disorders and other abnormalities. Because nuclear medicine exams can pinpoint molecular activity, they have the potential to identify disease in its earliest stages. They can also show whether a patient is responding to treatment. Technology in this field provided the opportunity for interventional therapies as some tumors can be treated by a radiologist who specializes in interventional radiology and today it represents the trend of modern medicine in terms of reducing surgical interventions.

medications, treatment plans, immunization dates, allergies, radiology images, and laboratory and test results, allow access to evidence-based tools that providers can use to make decisions about a patient’s care and automate and streamline provider workflow. One of the key features of an EHR is that health information can be created and managed by authorized providers in a digital format capable of being shared with other providers across more than one healthcare organization. The advantages of electronic health records in the clinical setting are numerous and important. The use of an electronic health records system offers numerous clinical advantages including no bulky paper records to store, manage and retrieve, easier access to clinical data, the ability to establish and maintain effective clinical workflows, fewer medical errors, improved patient safety and stronger support for clinical decision-making, the ability to gather and analyze patient data that enables outreach to discreet populations and the opportunity to interact seamlessly with affiliated hospitals, clinics, labs and pharmacies.

Electronic Health Record Electronic Health Records (EHRs) are built to share information with other healthcare providers and organizations – such as laboratories, specialists, medical imaging facilities, pharmacies, emergency facilities, and school and workplace clinics – so they contain information from all clinicians involved in a patient's care. While an EHR does contain the medical and treatment histories of patients, an EHR system is built to go beyond standard clinical data collected in a provider’s office and can be inclusive of a broader view of a patient’s care. EHRs are a vital part of health IT and can contain a patient’s medical history, diagnoses,

NEWS

GE Healthcare Unveils New Imaging Tech and Intelligent Apps at Arab Health 2020 that Deliver Significant Cost Savings and Enhanced Productivity

t Arab Health 2020, GE Healthcare launched more than 30 new imaging intelligent applications and smart devices designed to drive efficiency in clinics and hospitals, aiming to double productivity and cost savings for systems by 2025. For healthcare executives, the new offerings help save costs, improve technology utilization, and increase patient volumes. Clinicians will also benefit from intuitive workflows, improved diagnostic confidence and less rework, allowing them to devote more time for patients. “Now, more than ever, clinicians face tremendous pressure to deliver optimal patient care and clinical outcomes with fewer resources,” said Kieran Murphy, President and CEO of GE Healthcare. “By integrating data, intelligent software applications, and smart devices, we’re enabling clinicians to make faster, more informed decisions to give them time with what matters most: their patients.”

Healthcare inefficiencies lead to nearly $1 trillion of annual financial waste in the United States alone.1 Healthcare executives report costs and transparency as their number one concern and need new solutions to help solve these challenges.2 Recognizing the opportunity to reduce waste and increase efficiency across the healthcare industry, GE Healthcare presented new intelligent applications and smart devices at Arab Health 2020 that was held until January 30 at Dubai World Trade Center. Several of these new smart devices and intelligent applications were developed using Edison, GE Healthcare’s secure intelligence platform that helps both GE Healthcare developers and select strategic partners to design, develop, manage, secure and distribute advanced appli-

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cations, services and artificial intelligence (AI) algorithms quickly.

The innovative solutions include: AIR™ Recon DL3, an Edison application providing True Fidelity images, is a GE-first, deep- learning MRI reconstruction technology application designed to improve signal-to-noise and image sharpness and enable shorter scan times. This application was developed using a neural network trained on tens of thousands of images using GE’s Edison AI Platform. Critical Care Suite is an industry-first, FDA cleared collection of AI algorithms embedded on a mobile X-ray device for triage. Builtin collaboration with clinical partners, using GE Healthcare’s Edison platform, the AI algorithms help reduce the turn-around time for radiologists to review a suspected pneumothorax, a type of collapsed lung. Additionally, Critical Care Suite’s quality AI algorithms help technologists reduce image quality errors and improve efficiency by simultaneously auto-rotating images as well as analyzing and flagging protocol and field of view errors on-device. The Intelligent Auto Rotate AI alone can save highly-trained technologists at a medium to large

OVER THE PAST YEAR, GE HEALTHCARE SOLUTIONS HAVE HELPED HEALTHCARE SYSTEMS ACHIEVE MORE THAN $250 MILLION IN SAVINGS IN THE UNITED STATES ALONE.

NEWS

size hospital more than 70,000 manual clicks4 – that amounts to nearly 20 hours, or three working days a year spent rotating chest images on portable X-ray machines. Edison™ Open AI Orchestrator is designed to orchestrate AI at scale for imaging workflows. The new Edison Open AI Orchestrator simplifies the implementation, deployment, support and scaling of multiple AI applications including from partners iCAD and MaxQ. Designed to seamlessly integrate clinical applications into the radiology PACS reading workflow, this offering reduces the complexity of multiple systems and algorithms working together that could lead to error and risk if implemented incorrectly. Revolution™ Maxima with AI-Based Auto Positioning5 is a powerful, high performing and reliable CT that maximizes every step of the CT workflow, from referral to report. Enabled with AI-based Auto Positioning technology, Revolution Maxima uses real-time depth-sensing technology to generate a 3D model of a patient’s body to pinpoint the center of the scan range and automatically align it to the isocenter of the bore. Altogether, it is designed to simplify, streamline and automate the entire CT experience for one-click, hands-free patient positioning. OEC Touch for OEC Elite CFD features a new control panel located right on the C-arm. During a variety of clinical procedures, C-arm technicians often move back-and-forth between the C-arm. While these movements are necessary, they can disrupt the surgical flow and cause inefficiencies and block the surgeon’s view of the images during procedures. The new control panel, OEC Touch, is designed to eliminate the need to move to a separate workstation and reduce disruption during surgery. Embo ASSIST6 with Virtual Injection is an Edison application designed to help clinicians perform complex embolization procedures. It helps analyze the vasculature and simulate injections dynamically to help determine the

embolization strategy to avoid embolizing healthy tissues in the brain or prostate with just one click. It is designed to provide clinicians with an intuitive solution to support clinical decision-making and drive efficiency in the interventional suite. Clinical Command Centers are designed to improve outcomes and efficiency with new real-time decision support tools along with process improvement targeted using digital twins of patient flow. Each Clinical Command Center features 5–20 decision support apps or “Tiles” which are used systemwide as well as in the command center to pinpoint opportunities to reduce the length of stay, increase imaging utilization, get ahead of patient bottlenecks or issues and much more. Updates to GE Healthcare’s portfolio follow the launch of the Edison Developer Program which expands the Edison ecosystem to accelerate the adoption and impact of advanced applications and developer services across health systems. The Edison Developer Program helps healthcare providers gain easier access to market-ready algorithms and applications by directly integrating these technologies into existing workflows.

WITH THE GOAL OF DOUBLING THESE SAVINGS BY 2025, THE NEW OFFERINGS WILL HELP DRIVE CLINICAL EFFICIENCY, ENHANCE PATIENT COMFORT AND IMPROVE WORKFLOW.

REFERENCES 1. https://www.medicaleconomics.com/news/ new-study-estimates-us-healthcare-wastecosts-nearly-1-trillion-each-year 2. https://hitconsultant.net/2019/09/13/ top-10-challenges-issues-and-opportunities-healthcare-executives-will-face-in-2020/#. XbChT-hKg2x 3. 510(k) pending at FDA. Not available for sale in the United States. 4. GE Healthcare Data on File. 5. 510(k) pending at FDA. Not available for sale in the United States. 6. Embo ASSIST solution includes FlightPlan For Embolization, Vision 2, VesselIQ Xpress, Autobone Xpress and requires AW workstation with Volume Viewer, Volume Viewer Innova. These applications are sold separately. FlightPlan for Embolization is 510(k) pending at FDA. Not available for sale in the United States.

ARTICLE FEATURES . Stroke Treatment Units

lurred vision, temporary paralysis or numbness of the face and stuttering are warning signs of a stroke, which requires immediate medical attention and the patient should be taken to the nearest hospital in order to reduce brain damage and prevent further complications. The medical orientation today is to work on establishing special departments in hospitals or preparing a specialized team in the emergency department to deal with stroke patients with the aim of reducing the difficulties related to stroke and preserving the patient's life by enabling him to reach the specialized centers in a timely manner, which achieves better and faster treatments.

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Hence, health professionals mainly focus on educating citizens about the risks of stroke and learn about its signs and symptoms and how to prevent it. The work of the specialized team in these units is based on caring for the patient and giving him treatment in a timely manner and without any delay, as two million brain cells die every minute until blood flow is restored. Thus, every minute is a golden minute for a patient suffering from a stroke. A stroke occurs when the blood supply to part of your brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. Brain cells begin to die in minutes. A stroke is a medical emergency, and prompt treatment is crucial. Early action can reduce brain damage and other complications.

THE ACUTE STROKE UNIT IS CLOSER TO THE INTENSIVE CARE UNIT THAT PROVIDES SPECIALIZED SERVICES FOR PEOPLE WHO HAVE HAD A NEW STROKE.

ARTICLE FEATURES . Stroke Treatment Units

The World Health Organization has put in place some steps that help prevent developing a stroke, including: • • • • •

Take regular physical activity Eat a healthy diet Avoid tobacco use Maintain a healthy weight Monitor your blood sugar levels, blood pressure and blood lipids

Stroke Units Stroke has been highlighted in recent years as well as the possibility of saving the patient if he received immediate medical care; thus, hospitals started establishing specialized and fully equipped units to care for stroke patients and deal with this critical medical condition quickly as it is an emergency different from other urgent cases. The problem is that stroke occurs suddenly without any prior warning, as it is possible that the patient is completely healthy and does not feel any sign or symptom and yet he suffers from stroke; this increases the difficulty of rapid intervention, and damage is irreversible. Adequate awareness of the patient or those around him makes early medical intervention more effective. The Acute Stroke Unit is closer to the Intensive Care Unit that provides specialized services for people who have had a new stroke. People in charge of these units are well trained to deal with this group of patients and they are highly competent not only to deal with the medical

emergency but also to act quickly with the condition because time is the gold standard for such cases. In addition to the nursing staff specialized in the care of stroke patients, this department includes doctors, emergency specialists, interventional radiologists, neurosurgeons, physiotherapists, intensive care professionals and dietitians. In such fully equipped departments, the medical team is able to deal with all patients' needs such as in ischemic and hemorrhagic stroke. It is known that there are two types of stroke, an ischemic stroke happens when a blood vessel (artery) supplying blood to an area of the brain becomes blocked by a blood clot while a hemorrhagic stroke happens when an artery in the brain leaks or bursts (ruptures). Medical intervention in such specialized departments is carried out according to treatment protocols intended for stroke patients that begins with an assessment of the condition and determination of the type of stroke so that appropriate treatment is provided to them in record time according to specific criteria required in this unit. Among the medical services provided are emergency medical care, the provision of appropriate treatment for stroke, MR neurography and the presentation of results and their analysis by experts at the appropriate time. When the patient is transferred to the room, the specialized medical team will provide the necessary care

ARTICLE FEATURES . Stroke Treatment Units

after assessing the medical condition and determining the type of physical therapy needed. The patient also receives interventional radiology services to assist in the treatment of stroke with high-quality images of the brain and blood vessels and to remove the clot if the patient arrives early to the emergency department. These specialized medical departments and units, like all hospital departments, are subject to quality control where all cases are monitored to check if they are handled with necessary speed and quality in order to improve the quality of work and ensure that the working mechanism is in accordance with international protocols to deal with stroke patients while keeping pace with the latest scientific developments that help in providing the best medical practices. The type of stroke is determined precisely to give the patient the appropriate treatment. Specialists and the nursing team treat clots for up to 4.5 hours after symptom onset and patients are carefully selected. Other conditions may require an interventional therapy for stroke by removing the clot using special devices. All patients undergo close monitoring for 72 hours for possible

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complications. The stroke units in hospitals and medical facilities are similar to the ICU, but are only specialized in the care of stroke conditions and feature an organized medical team, which includes a certain number of beds on which patients are placed and closely monitored for days in order to avoid the complications that often appear at a later stage, not immediately when a stroke occurs. Fear is from the complications that appear with the development of the condition several hours later. During this time, a specialized team monitors the patient's vital functions during and after a stroke occurs. The unit allows the highly trained and competent medical and nursing team to manage cases of strokes and provide the needed healthcare for acute stroke patients. Among the benefits of the Stroke Treatment Units is improving the level of healthcare, reducing mortality, and most importantly, reducing the time between the patientâ&#x20AC;&#x2122;s arrival to the hospital and starting treatment from 62 minutes to 39 minutes. Stroke Treatment Units have proven to be the effective choice for lowering death rates from acute stroke.

STROKE TREATMENT UNITS PROVIDE COMPREHENSIVE TREATMENT INTERVENTION IN A TIMELY MANNER IN ACCORDANCE WITH GLOBAL TREATMENT PROTOCOLS

ARTICLE FEATURES . Immunotherapy

Immunotherapy

A revolution in the fight against cancer

mmunotherapy has achieved major breakthroughs and distinguished results during the past ten years. It has contributed to the treatment of many types of cancer that conventional treatments have not been able to achieve. The introduction of this type of advanced treatments played an important role in updating the adopted treatment protocols for types of cancer and immunotherapy strongly took part in the fight against this malignant disease. According to medical research and studies, the future holds further achievements in this regard.

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At the beginning of this article, we should emphasize that the selection of appropriate cases for immunotherapy should be made by first making the patient undergo accurate DNA tests. Genetic testing can reveal changes (mutations) in your genes that may cause illness or disease. Immunotherapy and genetic testing together constitute the primary step in accurately diagnosing the disease and determining treatment. The goal of treatment is to save the patient's life and increase his life expectancy in the first place, in addition to improving the quality of life

IMMUNOTHERAPY WORKS ACCORDING TO A SPECIFIC CODE CALLED PD-1/ PD-L1, A SYSTEM IN WHICH CELLS SPEAK AMONG THEMSELVES

ARTICLE FEATURES . Immunotherapy

by alleviating the negative effects that may result from undergoing types of treatments while supporting him psychologically. Immunotherapy works according to a specific code called PD-1/PD-L1, a system in which cells speak among themselves. This treatment is very effective for some types of cancer, such as skin and lung cancer, and a certain number of breast, stomach and colon cancer, and the work is in full swing to find more, based on the idea that the immune system is the first line of defense against cancer cells. Hence, research was launched for this type of treatment that indicates a variety of treatment strategies designed to stimulate the patient's immune system to fight the tumor. Immunotherapy is a type of cancer treatment that uses a person's own immune system to fight cancer. It can boost or change how the immune system works so it can find and attack cancer cells. It uses substances made by the body or in a laboratory to improve or restore immune system function. Immunotherapy may work by stopping or slowing the growth of cancer cells. However, these cancer cells can deceive the immune system by secreting molecules, such as programmed cell death protein 1 (PD-1) or cytotoxic T-lymphocyte-associated protein 4, which makes it believe to be normal cells. Then, the immune system is reassured and stops functioning; at this point, immunotherapy comes in. By targeting programmed cell death protein 1 (PD-1) or cytotoxic T-lymphocyte-associated protein 4, immunotherapy re-activates the immune system that will destroy tumor cells. The mechanism of action of this treatment is revolutionary because it does not attack cancer cells directly, as is the case with chemotherapy or targeted therapies, but allows patients to eliminate cancer cells through the immune system. Today, immunotherapy is one of the most promising ways of treating cancer, but at the

same time this method of treatment must also correspond fully to each patientâ&#x20AC;&#x2122;s condition. Immunotherapy is based on the body defending itself against cancer cells. In this way, doctors can use the patient's immune system to produce vaccines for specific tumors, or they can eradicate the cells of the immune system, which helps boost the immune system to attack and fight the tumor. Oncologists are now resorting to the widespread use of immunotherapy in the treatment of different types of tumors affecting the skin, lungs, kidneys, brain and neck tumors. Given that cancer cells are characterized by a set of methods and mechanisms that allow them to evade the immune system, several types and patterns of immunotherapy have been developed to help the body cope with these preventive mechanisms and enhance the capabilities of the immune system to recognize the tumor. Immunotherapy for cancer in its advanced stage helped reduce the risk of a new relapse and recurrence of the disease after treatment and also contributed to prolonging the survival period, while many patients reached the final stage of recovery.

Combination of immunotherapy and targeted chemotherapy The combination of immunotherapy with other treatments has had significant positive effects, as the combination of two types of treatments in a specific way such as chemotherapy and immunotherapy or targeted therapy has proven highly effective in fighting cancer, and research promises further developments in treatment combination. Among the new indications is the use of immunotherapy with chemotherapy for non-small cell lung cancer, as research has shown that this combination of drugs contributes to a longer life without increasing the usual side effects of chemotherapy. Thus, immunotherapy combined with targeted chemotherapy help boost tumor control, and also promotes anti-tumor immune response. The combination chemo-immunotherapy may lead to a strong immune response for a longer period of time. It also gives the immune system opportunities to fight cancer for a long time.

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“Religion and Medical Ethics: Palliative Care and the Mental Health of the Elderly” Joint symposium between Wish and the Pontifical Academy for Life in Rome

Archbishop Vincenzo Paglia

Ms. Sultana Afdhal

he principle of palliative care for the elderly is reflected in the provision of protection and integrated care in addition to improving the quality of life for this group of society that is continuously increasing as a result of the higher life expectancy in light of the medical progress that has contributed to treating several diseases and safely coping with them. The world’s population is ageing at a fast pace, and by 2050, one in five people will be over 60 years, according to WHO estimates. The number of people aged over 80 years is projected to triple from 143 million people in 2019 to 426 million people in 2050. The elderly deserve to receive the necessary care through the provision of medical, nursing, psychological and social support among others, by providing a decent life for the elderly who suffer from chronic diseases as well as cancer patients in a manner that maintains their sense of dignity and improves their quality of life. Medical ethics as well as international and religious conventions urged that the patient should live with his family properly and pain-free

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in his final stages of life. Here comes the role of palliative care that should be provided by an experienced team in this field that evaluates the patient’s home and family. In addition, the patient’s needs are identified in order to develop a comprehensive care plan according to the pain and symptoms he is experiencing in addition to his psychological and social needs. The treating physician will be contacted to ensure the comprehensiveness of work with the patient and his family because the patient's family is an integral part of the care plan. The World Innovation Summit for Health (WISH), an initiative of Qatar Foundation (QF), and the Vatican’s Pontifical Academy for Life held a joint symposium titled ‘Religion and Medical Ethics: Palliative Care and the Mental Health of the Elderly’, in Rome from December 11-12, 2019. At the end of the symposium, Ms. Sultana Afdhal, CEO of WISH, said that she had led the Qatar Foundation Initiative (QFI) to make three commitments to improving the implementation of palliative care in Qatar.

THE DESIRED GOALS OF APPLYING PALLIATIVE CARE LIE IN PROVIDING A BETTER HEALTHY LIFE FROM VARIOUS ASPECTS THAT CONCERN THE PATIENT, WHETHER PHYSICAL OR PSYCHOLOGICAL.

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“We will develop religion and medical ethic training sessions for healthcare workers that emphasize how spirituality needs to be considered as integral to holistic care, in addition to dedicating targeted workshops, including one on palliative care for children,” she vowed.

Honoring the elderly All religions recognized the importance of honoring the elderly, caring for them and protecting human life, because life is a sacred right recognized by religions that must be adhered to by norms and laws. Therefore, palliative care should take into account the patient's spiritual side. In this context, all religions agree that human values, spiritual faith and compassion are the basis of palliative care. During the symposium held in the Vatican, discussions addressed the habits of palliative care in the Islamic and Christian religions, to highlight the differences, and inform healthcare workers about mixed religious approaches. These discussions also focused on the important role of the mixed religious approach in the field of palliative care. Dealing with elderly patients who need palliative care should not only be from the perspective of “disease”, however, the patient should be treated as a person who has his own point of view in this life, his own thoughts, and his convictions that he believes in. Hence, it is important

for people to receive the best possible care that complies with their individual beliefs. Discussions and presentations during the symposium focused on the mental health of the elderly. Speakers and delegates examined the significant potential benefits of religion and spirituality in improving elderly patients’ well-being and quality of life, and explore, from an interfaith perspective, the opportunities and challenges related to improving quality of life through religiously-informed mental health service provision.

What is palliative care? Palliative care has become a new science for providing comprehensive care to patients in all stages of the disease or after treatment discontinuation, and includes medical, social, psychological and spiritual care. The desired goals of applying palliative care lie in providing a better healthy life from various aspects that concern the patient, whether physical or psychological, with the possibility of communicating with family members in order to provide him with psychological support, in addition to urging the patient to lead a normal life as much as possible and work to increase his physical activity. The medical community has witnessed in recent years an increased interest in palliative medicine after it has proven its effectiveness in

MEDICAL ETHICS AS WELL AS INTERNATIONAL AND RELIGIOUS CONVENTIONS URGED THAT THE PATIENT SHOULD LIVE WITH HIS FAMILY PROPERLY AND PAIN-FREE IN HIS FINAL STAGES OF LIFE.

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managing disease and reducing the suffering of patients. There are many countries in the Gulf and the Middle East that put this new type of medicine at the top of their priority list after realizing its importance in managing the disease and relieve the suffering of patients. Palliative care aims to improve the quality of life of patients and their families, and this type of care is provided along with the medical treatments the patient needs for his medical condition. The palliative care team must examine the patient and assess his medical, psychological and social condition in order to determine the path of care to be provided to remove any feeling of loneliness and depression while working to reduce pain. Palliative treatment must be comprehensive and integrated, mainly taking into account the patient, respecting his interests, and involving his family in making decisions as required by the patient.

End-of-life care It may be one of the most important stages in which the patient needs palliative care, given the sensitivity of this period and the patient's urgent need for the necessary support to relieve his pain. He also needs significant psychological support that enables him to be patient during his suffering. Palliative care services at this stage aim to help patients as much as possible to enjoy their

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lives until the moment of their death. In light of the medical progress that has made it possible to extend the lives of patients with cancer, palliative care services can alleviate the symptoms of the disease and allow dying patients to better cope with pain while still enjoying life.

Painkillers Receiving high-quality palliative care in the advanced stages of illness or in the dying period requires painkillers to reduce the severity of the pain as well as the use of sedatives because they do not constitute an addiction to the patient unless used incorrectly. The patient in his last stages of life must be given sedatives to relieve pain, and should not be exposed to a significant amount of medicine and devices that may not be useful.

PALLIATIVE CARE SERVICES AT THIS STAGE AIM TO HELP PATIENTS AS MUCH AS POSSIBLE TO ENJOY THEIR LIVES UNTIL THE MOMENT OF THEIR DEATH.

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Bleeding Gums...

Why and How to prevent it?

ave you seen a bit of blood in your sink when you brush your teeth lately? That bleeding can be one of the first warning signs that you’ve got gum disease.

Dr. Mohammed Issa / Department of Trauma and Orthopaedics at Al Ahli Hospital

ten goes hand in hand with shrinking gums.With receding gums, the sensitive part of the tooth is exposed -- called the dentin -- causing sensitive teeth when exposed to cold water and air. Wiggly or shifting teeth: Does your smile look a little different lately? Gum disease can attack the bones that hold your teeth in place, making them loosen or move. Periodontitis is the main cause, and it can even change the way your teeth fit together when you bite.

The mild variety is called gingivitis. When you have that, only your gums are infected. If you don’t treat it, the infection can travel below your gum line and into your bone. Then it becomes a more serious form of gum disease called periodontitis. Both gingivitis and periodontitis have been shown to raise your risk of things like diabetes. Early detection is your best bet.

Gum disease is preventable. Here are a few ways you can help keep your gums healthy.

Symptoms

1. Dental Floss

You can find and treat the problem before it gets serious if you know what to look for. Take note if you notice: Red, swollen gums: That’s one of the first signs your gums need attention. Gum diseases typically start with inflammation along the gum line, they may also feel tender or painful and bleed easily when you floss or brush. Bad breath: Your mouth is a nice, warm, and went home for millions of bacteria. They feed on the plaque, so the more of that you have, the bigger the buffet. Bacteria release toxins that can irritate the gums and teeth and have a foul smell. It can also be a symptom of serious gum disease. Your breath usually doesn’t change much if you’ve got gingivitis. Gums that get smaller: If your teeth look longer than they used to, chances are they’re not growing -- your gums are shrinking. [When] bone starts to break down, the gums start separating from the tooth, creating a pocket,. This pulling away is called receding gums. Sensitive teeth: If a sip of a cold drink makes you wince, your teeth may be telling you something. That’s a symptom of gum disease that of-

Floss at least once a day. This helps remove the plaque and food that’s beyond your toothbrush’s reach, according to the ADA. It doesn’t matter when you floss. Do it at night, do it in the morning, or do it after lunch... just do it!

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2. Get regular dental cleanings Your dentist can detect early gum disease symptoms if you see them on a regular basis. That way symptoms can be treated before they become more serious. Professional cleaning is the only way to remove tartar. It can also get rid of any plaque you missed when brushing or flossing. If you have gingivitis, brushing, flossing, and regular dental cleanings can help reverse it.

3. Quit smoking Yet another reason for smokers to quit: Smoking is strongly associated with the onset of gum disease. Since smoking weakens your immune system, it also makes it harder to fight off a gum infection, say the Centers for Disease Control and Prevention (CDC). Plus, smoking makes it more difficult for your gums to heal once they’ve been damaged.

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4. Brush twice a day Brush your teeth after every meal. This helps remove the food and plaque trapped between your teeth and gums. Scrub your tongue too, since it can harbor bacteria. Your toothbrush should have soft bristles and fit in your mouth comfortably. Consider a battery-powered or electric toothbrush. These can help reduce gingivitis and plaque more than manual brushing. Swap toothbrushes or toothbrush heads every three to four months, or sooner if the bristles start to fray.

5. Use fluoride toothpaste As for toothpaste, store shelves are lined with brands that claim to reduce gingivitis, freshen breath, and whiten teeth. How do you know

which one is best for healthy gums? Make sure to choose toothpaste that contains fluoride and has the ADA seal of acceptance. After that, the flavor and color are up to you!

6. Use a therapeutic mouthwash Usually available over the counter, therapeutic mouthwashes can help reduce plaque, prevent or reduce gingivitis, reduce the speed that tartar develops, or a combination of these benefits, according to the ADA. Plus: A rinse helps remove food particles and debris from your mouth, though itâ&#x20AC;&#x2122;s not a substitute for flossing or brushing. Look for the ADA seal, which means itâ&#x20AC;&#x2122;s been deemed effective and safe. We should always floss first, then brush and last do mouthwash or rinsing. Just do a good job and use the right products.

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Preterm Labor

Dr. Asmaa Abdul Salam / Consultant Obstetrics and Gynecology at Al Ahli Hospital

t is true labor occurring between 20- and 37-weeks’ gestation, in the form of true painful functioning uterine contractions at least 2 contractions /10 minutes associated with cervical dilatation of at least 2 centimeters and 80% effacement.

• •

Etiology

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There are risk factors for preterm birth including Social characteristics such as teenage pregnancy or women over age 35, socioeconomic status, tobacco use, or drug abuse, stress and depression. Causes can be: • Induced iatrogenic preterm labor, when the medical staff induces labor for any reason artificially before 37 weeks. • Spontaneous preterm labor

Spontaneous Preterm Birth (Etiology) There are some medical and pregnancy characteristics that are known to predispose to premature birth, those include short time between pregnancies, history of delivering a preterm baby. PROM (Premature rupture of membranes) is the most common cause of preterm labor in addition to the following medical conditions • Multiple gestation (twins & triplets). • Amnionitis (infection inside uterine cavity).

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Maternal infections. Maternal medical problems e.g. severe pre-eclampsia. Maternal thyroid disease, obesity, asthma, diabetes, high blood pressure, assisted reproductive technology and uterine infection. Bleeding late in pregnancy due to abruption of the placenta or placenta previa. Fibroid (uterine Leiomyoma). Cervical incompetence.

Complications Maternal: Psychological trauma and 40% possibility of preterm labor in the future. Neonatal: Respiratory Distress Syndrome (RDS) is the most serious and common complication: • Patent Ductus Arteriosus (heart disorder) • Intra ventricular bleeding (bleeding inside the brain) • Infections • • Retrobulbar fibrosis (eye problems). • Increase neonatal mortality • Babies who survive can have breathing, digestive and intracranial bleeding problems. Long-term problems may include

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developmental delay and lower performance in school.

Diagnosis To start with: woman should be properly evaluated by the medical team; Is she in labor? Our membranes are ruptured? Is the fetus preterm and to what degree? What risk factors are present? Taking proper patient history and first of all last menstrual period and the accurate estimation of gestational age based on early obstetrical ultrasound during first trimester of pregnancy in addition to the history of the present complaints, history of fluid leakage, dating of pregnancy, reviewing history of risk factors or other medical problems, assessment of social history and home support. Physical examination: Maternal vitals including blood pressure / pulse/ temperature and respiratory rate / general physical examination, fetal heart rate pattern / contractions pattern/ Fetal size and presentation and NO cervical examination if membranes rupture suspected. Sterile speculum examination: Assessment of membrane rupture by pooling of the fluid in the vagina and Nitarzine and fern test Assessment of the cervix visually/ obtain cervical culture /obtain wet preparation for vaginitis if no premature rupture of membranes /obtains gram streptococci GBS culture of outer vagina and rectum. The additional test includes: complete blood count, CRP, ESR and urinalysis of the mother to assess maternal infection, arrange for ultrasound to assess the gestational age and amniotic fluid index and cervical length by vaginal ultrasound. Cervicovaginal swab for fibronectin; if it is found positive after 24 weeks the delivery there is high risk of delivery within the coming 7 days provided that there was no digital examination within the previous 24 hours.

Treatment First: Hospitalization: Initial treatment includes: assessment of condition of the fetus, imminence of delivery, availability of local resources, and availability of safe transport to referral center as maternal transport between 32-34 weeks to well-equipped facility decreases the neonatal mortality by 60%.

Second: Use of Tocolysis (Medicine that can stop uterine contractions and prolong pregnancy) like Ritodrine and Magnesium Sulphate. No evidence to support long-term suppression of labor, tocolytics can be effective for 24 – 48 hours to allow for maternal transfer or administration of steroids that help fetal lung maturation. Women who can be given tocolysis are: • Those without contraindications to the drug. • If there are no contraindications for prolongation of pregnancy as in case of severe pre-eclampsia and eclamptic fits. • The fetus is currently healthy. • In the presence of a clear diagnosis of preterm labor. • The cervix is less than 4 cm and gestational age between 24-34 weeks. Third: Antibiotics Giving empirical antibiotics in preterm labor with intact membranes is controversial in delaying delivery with no clear evidence on short- or long-term benefits. Fourth Corticosteroids Effectively reduce respiratory distress syndrome and intraventricular hemorrhage and neonatal mortality at 24-34 weeks. Fifth: Delivery Limit maternal narcotics when possible, anticipate mal-presentations, and anticipate delivery at < 10 cm. an alert neonatal care team of impending delivery. Elective cesarean section is not supported by evidence and should not be routine for all preterm deliveries.

In conclusion Reducing preterm birth is a public health priority, various strategies are used to reduce preterm birth. Those include providing women access to healthcare before and between pregnancies, choosing single embryo transfer as appropriate when undergoing in vitro fertilization, preventing unintended pregnancies and waiting at least 18 months between pregnancies, identifying women at risk for preterm delivery and offering effective treatments to prevent preterm birth, discouraging deliveries before 39 weeks without clear medical indication, and the creation of networks of teams working to improve the quality of care for mothers and babies.

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NEWS

A focus on research at Weill Cornell Medicine – Qatar

Dr. Javaid Sheikh, Dean of WCM-Q, said Qatar would soon embark on a major drive forward in research

Dr. Khaled Machaca, Senior Associate Dean for Research, Innovation and Commercialization at WCM-Q, gave an overview of the college's major research milestones

he research efforts of Weill Cornell Medicine – Qatar (WCM-Q) over the past year were highlighted as the college held its 10th Research Retreat.

and RDI talent in the country will be enhanced. There is also going to be increased emphasis on both risk capital and venture funding, and ultimately there will be a focus on RDI governance.

The annual event is an opportunity for scientists in Qatar to spend a day hearing about the work of their colleagues and about the cutting-edge studies that are conducted each year. The Research Retreat was officially opened by Dr. Javaid Sheikh, Dean of WCM-Q, followed by an overview of the major milestones WCMQ has reached on the research front presented by Dr. Khaled Machaca, Senior Associate Dean for Research, Innovation and Commercialization.

“Dr. Machaca and his team are already providing foundational research, producing RDI talent and accessing innovation enterprise; they really are leading the charge in biomedical research.”

Dr. Javaid Sheikh said Qatar would soon be embarking on a major drive forward in research, development and innovation (RDI). “There is going to be a road map of major elements in terms of RDI strategy within Qatar,” he said. “There will be foundational research - of which I’m very proud to say that Weill Cornell has really led the charge. There will be a spotlight on innovation

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Dr. Machaca spoke of the Research Division’s many achievements since the launch of the biomedical research program just ten years ago. These include 1,182 academic publications from WCM-Q, many in high-impact journals, which have been cited 39,375 times. He also spoke of the 37 Qatari nationals who have been trained in biomedical research and have bolstered local research capacity – five of whom are employed by WCM-Q and 30 of whom are working in the biomedical sector in organizations around Qatar. Drs. Sheikh and Machaca also acknowledged the invaluable support from both Qatar Foundation

WCMQ RECENTLY INSTITUTED THE MARIAM ASTROLABI AWARD FOR BIOMEDICAL RESEARCH ADVANCEMENT, AN AWARD FOR INSTITUTIONS AND/OR INDIVIDUALS WHO HAVE HAD AN INDELIBLE IMPACT ON ADVANCING THE BIOMEDICAL RESEARCH ENTERPRISE IN QATAR, IN SUPPORT OF WCMQ EFFORTS AND MISSION.

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and Qatar National Research Fund for their unwavering backing over the last decade and their commitment to extending human scientific knowledge. WCMQ recently instituted the Mariam Astrolabi Award for Biomedical Research Advancement, an award for institutions and/or individuals who have had an indelible impact on advancing the biomedical research enterprise in Qatar, in support of WCMQ efforts and mission. This year’s awardee was Dr. Asma Al-Thani, the Founding Dean of the College of Health Sciences at Qatar University and the Founding Director of Qatar University’s Biomedical Research Center (BRC). Mariam Astrolabi, after whom the award is named, was a 10th century Arab Muslim scientist who made important contributions to the development of astrolabes, which were essential navigation instruments in the day. Dr. Asma Al-Thani was recognized this year for her heroic contributions to the establishment of both the Qatar Genome Project and the Qatar BioBank. Both of these institutions have greatly benefited biomedical research and personalized medicine efforts in Qatar including researchers at WCM-Q. The award further recognizes Dr AlThani’s leading role in the establishment of the BRC at Qatar University. The Research Retreat then heard from keynote speaker Dr. Gordon Lauc, professor of biochemistry and molecular biology at the University of Zagreb, co-director of the Human Glycome Project, and the founder of Genos - a biotech company that is currently a global leader in high-throughput glycomics. Dr Lauc spoke about the importance of glycans in human health and their involvement in the future of personalized medicine. The retreat this year featured presentations from young and established researchers at WCM-Q who have built a significant portion of their career in Qatar with considerable success. This asserts the contribution to scientific capacity-building nationally and the ability of scientists to develop successful careers in Qatar. This was followed by the poster session

that featured close to 100 posters from students and scientists at WCM-Q. The session was highly engaging with significant discussions. The posters were judged by scientists from various institutions in Qatar, including Hamad Bin Khalifa University, Sidra Medicine, Carnegie Mellon University in Qatar, Anti-Doping Lab Qatar, Hamad Medical Corporation, Qatar Biomedical Research Institute, Qatar University and Qatar Foundation.

The winners of the poster presentations this year are: Category 1 – Students – Short Term 1. Zain Burney 2. Amal Abdelatif 3. Mohamed Hussine

Category 2 – Students – Long Term

DRS. SHEIKH AND MACHACA ACKNOWLEDGED THE INVALUABLE SUPPORT FROM BOTH QATAR FOUNDATION AND QATAR NATIONAL RESEARCH FUND FOR THEIR UNWAVERING BACKING OVER THE LAST DECADE AND THEIR COMMITMENT TO EXTENDING HUMAN SCIENTIFIC KNOWLEDGE.

1. Sabiha Khan 2. Huda Alalami 3. Fatima Al-Khawaja

Category 2 – Research Specialists 1. 2. 3. 4.

Ayat Hammad Muneera Vakayll Nayra Al-Thani Manale Harfouche

Dr. Khaled Machaca (center left), and Dr. Nayef Mazloum (far left), with some of the poster presentation winners

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Thumbay University Hospital Launches Center for Nephrology & Dialysis Unit to Serve Growing Number of Patients with Kidney Diseases

humbay University Hospital, the largest private academic hospital in the Middle East region officially launched its ‘Center for Nephrology & Dialysis Unit’ on 3rd February 2020. Mr. Ahmed Mismar, Secretary General of Dubai Charity Association was the chief guest of the launch program held at the hospital in Thumbay Medicity, Al Jurf, Ajman, in the presence of Dr. Thumbay Moideen – Founder President of Thumbay Group, Mr. Akbar Moideen Thumbay – Vice President of the Healthcare Division, Dr. Mohammad Faisal - COO of Thumbay University Hospital and dignitaries from government and private organizations, the healthcare sector, and representatives from various sections of society. Speaking at the launch function, Mr. Akbar Moideen Thumbay said, “We are happy to launch Thumbay University Hospital’s Center for Nephrology and the Dialysis Unit. Thumbay

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WITH THE ADDITION OF THE NEW 10BED DIALYSIS UNIT, THUMBAY GROUP’S HEALTHCARE DIVISION IS NOW ONE OF THE LARGEST IN TERMS OF DIALYSIS CAPACITY, WITH 26 BEDS ACROSS AJMAN, DUBAI AND FUJAIRAH

Group’s Healthcare Division is committed to improving patient care and experience and we are confident that the new dialysis unit will enable UAE residents and medical tourists to avail outstanding dialysis services with the latest technology in a pleasant environment, with improved comfort and privacy.” He also thanked the charitable/philanthropic organizations for their support to the dialysis patients and for their outstanding work for the betterment of the community. Thumbay University Hospital’s Center for Nephrology is a state-of-the-art facility with advanced technology and an expert team. Services range from basic to critical nephrology care. “The Center is well-equipped to serve patients with CKD (Chronic Kidney Diseases), Electrolyte Disorders, Acute Kidney Diseases, Renal Stones, Glomerular Diseases, Lupus Nephritis,

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Diabetic Nephropathy, Proteinuria, etc.,” said Dr. Anass Ahmed Qasem, Consultant - Internal Medicine. The Dialysis Unit has 10 beds, and it will be linked in future with the Center for Nephrology’s Renal Transplant Program through dedicated transplant theatres. “The Dialysis Unit has been developed taking into consideration that many patients require dialysis several times a week. By enabling patients to receive dialysis close to their community, in a spacious and comfortable environment, we hope to help them improve their quality of life. The Center for Nephrology plans to set up support groups for dialysis patients to bring them together so that they motivate each other and minimize anxieties and concerns,” said Dr. Mohammad Faisal, adding, “Furthermore, to celebrate the launch of the Center for Nephrology & Dialysis Unit, Thumbay University Hospital has announced specially discounted dialysis packages. We have also launched free pick-up and drop-off services for dialysis patients in and around Ajman, on request.” Thumbay University Hospital also launched special ‘Holiday Dialysis’ packages through its medical tourism department, enabling tourists enjoy their vacation in the UAE without worrying about timely dialysis, offered by the hospital in safe and hygienic settings without affecting the pleasure of their holidays. Packages would also include on-request translator services, accommodation services, customized treatment packages, preferred cuisine, travel arrangements, priority appointments, free airport pickup and drop-off, etc. The Dialysis Unit is monitored by an infection control team, with senior personnel supervising compliance with infection control protocols. Patient convenience is a key feature, and the hospital gives special attention to the personal and social needs of the patients, as a part of which they are encouraged to experience the relaxing atmosphere of its Therapeutic Garden, as well as amenities within the hospital like the movie theatre, multi-cuisine Thumbay Food Court and the premium Blends & Brews Dolci coffee shop.

The Center for Nephrology & Dialysis Unit and the patients will benefit greatly from Thumbay University Hospital’s international collaborations with global centers of excellence such as Villa Beretta, Facility of the Valduce Hospital in Como – Italy; Children’s Mercy Hospitals and Clinics – Kansas City, US; IMO – Spain; Gruppo Ospedaliero – San Donato, Italy; Hopitaux Universitaries – Paris Sud, France; Hopital Universitaire Mere Enfant – France; Hopital Paul Brousse – France; Institut Cochin – France and BK Plastic Surgery – Korea.

FREE PICK-UP AND DROP-OFF FACILITY FOR THE CONVENIENCE OF PATIENTS AND DIALYSIS SUPPORT GROUP FOR BETTER CLINICAL OUTCOMES

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The LAU Medical Center-Rizk Hospital gives a special lecture entitled: made in China: the novel virus COVID-19 Doctors, medical staff and personnel were all present and eager to listen when Dr. Roula Husni Samaha gave a special lecture about the outbreak caused by the novel virus COVID-19 at the LAU Medical Center-Rizk Hospital. there is a close cooperation with the Ministry of Health to keep track of all passengers who are coming to Lebanon from zones where COVID-19 has been diagnosed and to eventually put these passengers in quarantine once they arrive to Lebanon.

n light of the recent outbreak caused by the novel virus, the LAU Medical Center-Rizk Hospital organized a special lecture entitled Made in China: the novel virus COVID-19 that was led by Dr. Roula Husni Samaha clinical professor and Division Head of Infectious Diseases on Thursday February the 13th. The primary objective of this lecture was to summarize the epidemiology, clinical manifestations and prevention methods of COVID-19, as well as to provide the attendees with the right health measures to be taken when traveling. Dr. Roula Husni Samaha presented the latest findings and research that were available with regards to the outbreak caused by the novel virus. Several points were discussed including the origin of COVID-19 and the health measures that were undertaken by the World Health Organization to address it. During the lecture, Dr. Mokhbat, Chair of the Internal Medicine Department made a small intervention and assured the public that

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THE PRIMARY OBJECTIVE OF THIS LECTURE WAS TO SUMMARIZE THE EPIDEMIOLOGY, CLINICAL MANIFESTATIONS AND PREVENTION METHODS OF COVID-19.

The lecture ended with a series of questions and answers that showed the great interest and engagement that residents and doctors of the LAU Medical Center-Rizk Hospital had in the subject at hand. Last but not least and in order to spread awareness to the bigger LAU community which includes faculty, staff and students, the Health Services Office, a division under the Dean of Students office at LAU, collaborated with the Infectious Diseases Division and Travel Clinic and organized awareness activations campaigns around the novel virus COVID-19, Influenza B, H1 N1, hand-wash and hand-rub and flu vaccinations in both LAU Beirut and Byblos campuses.

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5th Emirates Plastic Surgery Congress Opens in Dubai

nder the patronage of His Highness Sheikh Hamdan bin Rashid Al Maktoum, Deputy Ruler of Dubai, Minister of Finance and President of the Dubai Health Authority (DHA), Dr. Younis Kazim, CEO of Dubai Healthcare Corporation officially opened the 5th edition of the Emirates Plastic Surgery Congress, (EPSC), which is being held from the 16th to the 18th of this month at the Raffles Dubai. The 3-day premier plastic surgery event, running under the theme ‘Science and Art in the field of Plastic, Reconstructive and Aesthetic Surgery’, aims to shed new light on the latest advances, trends and key breakthroughs in this highly evolving field. Following the opening ceremony, Dr. Younis Kazim accompanied by a number of doctors, surgeons and senior officials from the healthcare industry in the region and abroad toured the exhibition, where they learned about the latest research, new approaches and treatment patterns in Plastic, Reconstructive and Aesthetic Surgery. The delegation was also briefed by representatives from the biggest brands in the field about how the introduction of new technologies are greatly helpful for surgery specialists, which gives them an insight on how to adopt new treatment methods and approaches. This year, the Emirates Plastic Surgery Congress presents a rich comprehensive agenda featuring 130 scientific lectures on key trending topics including plastic, aesthetic and reconstructive surgery while 30 peer-reviewed research papers showcase the latest research and updated knowledge about new studies in plastic surgery.

In addition, the Congress this year brings together 25 international expert speakers from the USA, Europe, Asia and Latin America, while 15 speakers represent the best plastic surgery minds from the Middle East and Asia such as Kingdom of Saudi Arabia, Oman, Kuwait, Iran, Iraq, Bahrain and India in addition to 20 speakers coming from the UAE, who offer their insights and experiences on their specialized fields of expertise. Over the next 3 days, the premier medical congress is expected to attract more than 500 visitors and participants from 25 countries.

THE EMIRATES PLASTIC SURGERY CONGRESS PRESENTS A RICH COMPREHENSIVE AGENDA FEATURING 130 SCIENTIFIC LECTURES ON KEY TRENDING TOPICS INCLUDING PLASTIC, AESTHETIC AND RECONSTRUCTIVE SURGERY WHILE 30 PEER-REVIEWED RESEARCH PAPERS SHOWCASE THE LATEST RESEARCH AND UPDATED KNOWLEDGE ABOUT NEW STUDIES IN PLASTIC SURGERY

While offering his remarks during the opening ceremony, Dr. Younis Kazim, CEO of Dubai Healthcare Corporation said, “Without a doubt, the changes in the plastic surgery field around the world, and the increasing demand for such surgeries, has directly impacted the health tourism market and the industry, especially with the emergence of new medical services that did not exist a while ago. At the same time, plastic surgeries are not merely “business” anymore or a source of rich income, as others may think. As we believe that our doctors and specialists are the best to translate the true picture of this medical specialty, which contributes to returning the smile, hope and life of people with deformities and accident victims, and even those who suffer from diseases related to obesity, and other health problems that affect the general appearance of men and women alike.” Dr. Younis Kazim added, “The Dubai Health Authority greatly realizes the value of cosmetic medicine and its importance on the healthcare system, it also recognizes the need to continue to develop medical protocols, legislation and policies that clearly define the responsibilities assigned to doctors, and which preserve the medical profession with its sanctity, ethics and noble mission. In conclusion, we would like to emphasize that we are confident that the conference will achieve its goals, and scientific recommendations that can be used, and work accordingly, to achieve further development in the specialty of plastic surgery, whether in the DHA’s facilities, hospitals, centers and the private clinics - The strategic partner of the Dubai Health Authority.”

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ARTICLE FEATURES . Obesity

OBESITY One of the causes of hypertension and type 2 diabetes

besity is a complex disease involving an excessive amount of body fat. It isn't just a cosmetic concern but also a medical problem that increases your risk of other diseases and health problems, such as heart disease, diabetes, high blood pressure and certain cancers. The good news is that even modest weight loss can improve or prevent the health problems associated with obesity. Dietary changes, increased physical activity and behavior changes can help you lose weight, thus reducing your risk of developing diseases. Obesity is diagnosed when your body mass index (BMI) is 30 or higher. It is a simple calcu-

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BMI = KG/M2 WHERE KG IS A PERSON'S WEIGHT IN KILOGRAMS AND M2 IS THEIR HEIGHT IN METERS SQUARED

lation using a person's height and weight. The formula is BMI = kg/m2 where kg is a person's weight in kilograms and m2 is their height in meters squared. Experts around the world agree that physical activity and exercise help burn calories. The amount of calories burned depends on the type, duration, and intensity of the activity. It also depends on the personâ&#x20AC;&#x2122;s weight. Increased physical activity or exercise is an essential part of obesity treatment. Most people who are able to maintain their weight loss for more than a year get regular exercise, even simply walking. Weight-loss success depends on your commitment to making lifelong changes in your eating and exercise habits that will prevent you from developing diabetes and hypertension.

ARTICLE FEATURES . Obesity

Diabesity

How does obesity cause type 2 diabetes? Diabesity is a term for diabetes occurring in the context of obesity given the relation between the two diseases. This term includes a wide range of health problems. Obesity increases the risk of major chronic diseases, including heart disease, diabetes, depression, and many cancers, as well as premature death. Overweight and obesity have genetic, behavioral, socioeconomic, and environmental origins. Obesity is believed to account for 80-85% of the risk of developing type 2 diabetes, while recent research suggests that obese people are up to 80 times more likely to develop type 2 diabetes than those with a BMI of less than 22. When in “fight or flight” mode, cortisol prepares the body by increasing blood sugar to provide an energy source to muscles. To prevent blood sugar from being stored, cortisol slows insulin production. This allows blood sugar to be used immediately. On one hand, cortisol secures quick energy in the form of glucose for the body to use during stressful times. On the other hand, cortisol also reduces the effects of insulin. Insulin is a hormone made in the pancreas with a major responsibility of regulating blood sugar. Insulin acts as the “key” needed to unlock a cell so that sugar can enter it. This can be used for energy rather than stay in the bloodstream where it can damage cells. Eating more calories than the body needs will lead to excess glucose levels. Insulin resistance occurs when excess glucose in the blood reduces the ability of the cells to absorb and use blood sugar for energy. This increases the risk of developing prediabetes, and eventually, type 2 diabetes. After you eat, cells in your pancreas are signaled to release insulin into the bloodstream. If you have more sugar in your body than it needs, insulin helps store the sugar in your liver and releases it when your blood sugar level is low or if you need more sugar, such as in between meals or during physical activity. Therefore, a healthy meal is the ideal solution for stabilizing blood sugar levels in a diabetic person while sticking to a regular eating schedule helps keep your blood glucose levels in check.

In response to an increase in blood glucose, the pancreas releases the hormone insulin, which acts like a key and unlocks the cell allowing glucose to enter and to be used for energy.

ANGIOTENSIN STIMULATES THE RELEASE OF ALDOSTERONE FROM THE ADRENAL CORTEX TO PROMOTE SODIUM RETENTION BY THE KIDNEYS

After eating a meal, food is broken down to glucose and absorbed into the bloodstream.

Hypertension

Treating obesity is a fundamental part of treating hypertension and its complications Recent studies show a link between high levels of fat and an increased risk of high blood pressure, which is a disease of the modern era. High blood pressure occurs as a result of several factors, including obesity, lack of activity, extreme fatigue, stress and anxiety; studies show that being overweight by ten kilograms increases hypertension by four to six mm Hg, and eating more than 2 grams of salt per day raises blood pressure in adults and the elderly. Obesity increases the levels of fat in the body thus causing atherosclerosis, sometimes called “hardening of the arteries”. This occurs when fat, cholesterol, and other substances build up in the walls of arteries. These deposits are called plaques. Over time, these plaques can narrow or completely block the arteries and cause problems throughout the body, decreasing blood flow to your heart. Eventually, the decreased blood flow may cause chest pain (angina), shortness of breath, or other coronary artery disease signs and symptoms. A complete blockage can cause a heart attack. Hence, the percentage of body fat will increase as a result of less physical activity and an increase in the amount of food. Thus, blood pressure will remain high. Studies and medical research that links obesity with high blood pressure has led to the availability of several drugs that treat the blood

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ARTICLE FEATURES . Obesity pressure of people suffering from obesity, such as medicines that reduce the activity of angiotensin, which is a protein hormone that causes blood vessels to become narrower. It helps to maintain blood pressure and fluid balance in the body. Angiotensin is the best treatment for people suffering from hypertension and obesity, because this group of drugs reduces inflammation and improves the use of insulin in the body while protecting other body organs, such as the kidneys and heart, from the complications caused by obesity and hypertension. Angiotensin is a peptide hormone that causes vasoconstriction and an increase in blood pressure. It is part of the renin–angiotensin system, which regulates blood pressure. Angiotensin also stimulates the release of aldosterone from the adrenal cortex to promote sodium retention by the kidneys. Too much angiotensin can cause the body to retain too much fluid or to have elevated blood pressure levels not caused by other problems. High angiotensin levels can also cause the heart to grow, leading to heart failure. Angiotensin blockers can help in these situations by blocking the receptor sites that take up angiotensin, but this can lead to too much potassium retention. On the other hand, low angiotensin levels can also be problematic. Angiotensin deficiency can prevent the regulation of blood volume and

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OBESITY INCREASES THE LEVELS OF BODY FAT THUS CAUSING ATHEROSCLEROSIS, SOMETIMES CALLED “HARDENING OF THE ARTERIES”

pressure, increase retention of potassium, and lead to a loss of sodium and more urine output, as the body releases needed fluid. This causes a lower blood pressure. In addition to drug therapy, making some lifestyle changes is enough to control blood pressure. Perhaps the most important advice that doctors give is to try to avoid excessive stress, anxiety and nervousness as much as possible given their negative impact on all parts of the body; high blood pressure is one of its main complications.

Advice given by doctors to their patients in order to reduce high blood pressure: • •

•

• • •

Reducing salt consumption Consuming lots of vegetables, fruits, unsaturated fats, whole grains, and foods rich in fiber, with at least 300 grams of fruits and vegetables per day. Losing extra weight because high blood pressure is closely related to excess body weight. Aiming for at least 30 minutes of moderate physical activity every day. Avoiding extreme stress and anxiety. Quitting smoking completely as it is a major cause of high blood pressure in addition to its negative effects on the heart and other parts of the body.

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WELCOME TO MALAFFI CONNECTING HEALTHCARE

Malaffi, the Abu Dhabi Health Information Exchange, will connect all public and private healthcare providers in the Emirate of Abu Dhabi, to create a unified patient file and to improve healthcare quality and patient outcomes.