HOSPITALS Magazine issue 56

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Issue 56/ 172 JAN-FEB 2021

THE ARAB HOSPITAL APPLICATION IS AVAILABLE

DIGITAL TRANSFORMATION IN THE TIME OF CORONAVIRUS Obesity and Weight Management

The Role of Antibody Testing for SARS-CoV-2?

Ventilators and COVID-19

GE Healthcare Announces First X-ray AI to Help Assess Endotracheal Tube Placement for COVID-19 Patients Next level IVF treatment: What is in store for the future? Insights by an expert from Acibadem Healthcare Group in Istanbul


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Publisher Arab Health Media Communication

AMID THE WAR AGAINST THE CORONAVIRUS Pioneering Arab achievements

General Manager Simon Chammas schammas@tahmag.com Creative Department Roula Haddad - Georges Habka Creative Director: Jessy E. Hajj Photographer Hanna Nehme

With the world moving into the vaccination stage against Covid-19, the Gulf Arab States appeared at the forefront of initiating vaccination and organizing these processes supported by a leading health system made up of the public and private sectors. In this context, the United Arab Emirates was among the first countries in the world to inoculate its citizens. The UAE is also the first Arab country to announce the emergency registration of the Covid-19 vaccine. Dubai ruler His Highness Sheikh Mohammed bin Rashid Al Maktoum announced on his official Twitter account that “According to a questionnaire for the Global Soft Power Index issued by Brand Finance from Britain that included tens of thousands of people in 105 countries around the world. The UAE ranked first in the Middle East and 14th in the world in the efficiency of dealing with the COVID-19 pandemic.” He also stated that the “UAE will be the fastest country in the world to recover.” Commenting on the achievements of the UAE and the Gulf countries at the health level in general and fighting against coronavirus in particular, observers praise these measures and confirm that achieving impressive outcome while protecting the society are due to proper planning, diligent effort and great wisdom, thus, these countries earned the success and praise. We, at the “Hospitals” magazine, wish the best of luck and reiterate the words of Sheikh Mohammed bin Rashid, commenting on the global questionnaire outcome: “Our institutions have proven their ability to adapt; efficiency and good performance that the world attests to, putting a bright imprint on our history.” Let us all hope that the dark clouds of the coronavirus will soon pass and we pray for the safety of the health workers who are making concerted efforts to protect the people.

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

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

All rights reserved by the HOSPITALS magazine. No part of this publication can be reproduced in any form without prior permission in writting from the publisher.

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JAN . FEB 2021

44 Digital transformation in the time of coronavirus

NEWS

14 COVID-19 Patient with Irreversible Lung Damage Recovers After Double Lung Transplant 18 Webinar highlights Dubai’s latest health tourism opportunities and offerings 28 Malaffi platform to use predictive analytics technology to improve the health of Abu Dhabi residents 32 Diabetes Technology: The Dexcom G6 Makes Its Regional Debut at GluCare Integrated Diabetes Center 34 Hundreds of Thousands of Cervical Cancer Cases Could Be Prevented with HPV Vaccines and Pap Smear Tests 40 Hamdan Medical honors 10 winners for its 11th term

INTERVIEWS

52 Dr. Stavros Malas 76 Didier Raoult 80 Noubar Afeyan

ARTICLES

20 Stay With Us to Make Your Bed Connected 22 Covid-19: Protecting Staff, Protecting Patients 24 The implementation of Vocera has helped clinicians deliver high-quality care amid the pandemic 42 Mubadala inaugurates fully integrated health network 50 PocramĂŠ, the start-up at the forefront of the fight

Alfardan Medical with Northwestern Medicine is now open Advanced Medicine. Premium Care. Call 40046000 to book an appointment

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SafetyMonitor

Every bed will be connected

Ready to prevent

100 % of bed related falls1

Using integrated bed sensors allows continuous monitoring of the main safety features of all the beds in a ward. Contactless technology pairs bed data with the patient’s EMR data.

SafetyMonitor reduces the cost of injuries

Improved patient safety

€124 389/year Can be saved by equipping a 100-bed facility with beds beds that have SafetyMonitor installed2

Enhanced Prevention

Intuitive user interface

HL7 v2 standard

of the risk of falls

compatibility

1 Based on 6 month field test at the University Hospital Vinohrady – Department of Anaesthesiology and Resuscitation II 6 month field test at the Medizine Hochschule Hannover – Department of Neurology. Nurses confirmed that SafetyMonitor did help prevent up to 5 falls. No falls were documented during the period of field tests. 2 Hoffman, et al. Claims-based Identification Methods and the Cost of Fall-related Injuries Among US Older Adults. Medical Care. Volume 54, Number 7, July 2016.

@LINETMEA

www.linet.ae


JAN . FEB 2021

48 Mobile X-ray equipments against the coronavirus and all its variants 58 GE Healthcare Announces First X-ray AI to Help Assess Endotracheal Tube Placement for COVID-19 Patients 62 How to future proof investment in the digital transformation of healthcare 66 Cutting-edge technology in treating cardiovascular diseases 74 Fakeeh Care invests $500 million to bring medical excellence to Dubai Silicon Oasis with 350-bed Fakeeh University Hospital 84 Next level IVF treatment: What is in store for the future? 88 10 important rules for living with a Covid-19 positive patient 90 Why was Hôtel-Dieu de France chosen as the first Lebanese hospital to join the international “Breast Centres Network”?

70 Obesity & Weight Management 92 How to treat obesity in children 96 A critically-located rare spinal tumor, successfully removed in a 10-year-old child, at Al-Ahli Hospital 97 Diagnostic Imaging of Acute Abdominal Pain 104 People Activation in an Uncertain World

FEATURES

44 Digital transformation in the time of coronavirus 48 Mobile X-ray equipments 64 The impact of the coronavirus pandemic on the future of medicine 70 Obesity & Weight Management 78 The Role of Antibody Testing for SARS-CoV-2 98 A New Strain of Coronavirus

Alfardan Medical with Northwestern Medicine is now open Advanced Medicine. Premium Care. Call 40046000 to book an appointment

JAN.FEB 2021

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- Cardiology & Cardiac Surgery - Dental center - Chiropractic - Pediatrics - Obstetrics & Gynecology - Neurology - Internal medicine - Physiotherapy and Rehabilitation - Endocrinology - Ophthalmology - Anesthesiology - General Surgery - Dermatology - Travel Clinic - Emergency - Rheumatology - Coronary Care Unit (CCU) - Intensive Care Unit (ICU) - Neonatal Care Unit (NICU) - Gastroenterology - Speech Therapy - Pulmonary & chest - Dietary - Nephrology - Psychiatry - Hearing & Balance - Urology - ENT surgery - Orthopedic and Traumatology - Hemodialysis Unit

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For more information please call :

+974 44898888 or +974 44898000




NEWS

COVID-19 Patient with Irreversible Lung Damage Recovers After Double Lung Transplant

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aylor St. Luke’s Medical Center recently performed its first lung transplant on a coronavirus patient whose lungs had been severely damaged by the virus. Paul Rodriguez, a young father with no pre-existing conditions, contracted the virus and pneumonia back in July in his hometown of San Antonio and had been hospitalized ever since. Not long after being admitted to an area hospital in San Antonio, Rodriguez required intubation and the use of a ventilator. In late July, Rodriguez was stabilized on ECMO support, but his condition continued to deteriorate. Dr. Jeffrey Dellavolpe, Medical Director of the Adult ECMO Program at Methodist Hospital in San Antonio, contacted Dr. Puneet Garcha, Medical Director of Lung Transplantation at Baylor St.

DRS. GARCHA AND LOOR, WHO ARE ALSO ASSOCIATE PROFESSORS AT BAYLOR COLLEGE OF MEDICINE, SPECIALIZE IN THE CLINICAL EVALUATION AND MANAGEMENT OF PATIENTS WITH END-STAGE LUNG DISEASES AND LUNG TRANSPLANTATION.

Luke’s Medical Center, as it became clear that a lung transplant was his only chance of survival. Rodriguez was transferred to Houston’s Baylor St. Luke’s Medical Center in mid-September for lung transplant evaluation. After undergoing an extensive evaluation, the medical review board approved him for a transplant and within a week of listing – on October 15 – Rodriguez had a brand-new set of lungs. Rodriguez’ transplant was performed by the surgical team led by Dr. Gabriel Loor, Surgical Director of Lung Transplantation at Baylor St. Luke’s Medical Center. He was successfully weaned off the ventilator and oxygen support. Rodriguez underwent rehabilitation at Baylor St. Luke’s before being discharged on November 24 and is expected to continue the rehabilitation program as part of his recovery. Rodriguez recently celebrated his 52nd birthday and a marriage proposal. He married his bride while hospitalized before his transfer to Houston. Rodriguez is the first double lung transplant the hospital has performed on a coronavirus patient since the pandemic began. To date, only a handful of transplant centers in the U.S. have performed lung transplants on patients due to irreversible lung damage caused by the virus. Drs. Garcha and Loor, who are also associate professors at Baylor College of Medicine, specialize in the clinical evaluation and management of patients with end-stage lung diseases and lung transplantation. They lead a world-class lung transplant team at Baylor St. Luke’s.

For more information: www.stlukeshealth.org/bslmcinternational l international@stlukeshealth.org l +1.832.355.3350

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Being ranked nationally in adult specialties means a lot to us. And it could mean a lot to you.

This year, U.S. News & World Report ranked us as one of the best hospitals in the country in multiple adult specialties: cardiology & heart surgery, neurology & neurosurgery, gastroenterology & GI surgery, cancer and geriatrics. The best doctors, in one of the best hospitals, are here for you.

StLukesInternational.org international@stlukeshealth.org Tel: +1 832-355-3350 Texas Medical Center, Houston, Texas – U.S.A


NEWS

Saudi German Hospitals Group introduces a new range of highly specialized medical services gram, while the new hospital in Dammam has introduced diabetic foot care, a varicose veins clinic and treatment for pediatric and adult asthma. In addition to this wide array of subspecialties that have been introduced to the Group’s Hospitals in KSA, a breast clinic and diabetic foot care are also now available at Saudi German Hospital Cairo, in Egypt.

Makarem Sobhi Batterjee

S

audi German Hospitals (SGH) Group has announced that its hospitals in the Kingdom of Saudi Arabia have introduced a range of highly subspecialized services across its hospitals to support the needs of the communities they serve. With hospitals strategically located across Saudi Arabia and the rest of the MENA region, the Group lives up to its promise of delivering patient-focused services. In Jeddah, the hospital has introduced treatment for arrhythmia, a breast clinic, diabetic foot care, and a varicose veins clinic, while diabetic foot care and facial cosmetics surgery were introduced in Riyadh, in addition to clinics specializing in asthma, breast care, movement disorders, varicose veins and gynoplasty. Furthermore, the hospital in Aseer introduced clinics specializing in varicose veins, epilepsy, sleep disorders, asthma, sickle cell and thalassemia treatments, breast care and gynoplasty. Treatment for diabetic foot, various heart conditions, sleep disorders and sports injuries are offered by SGH in Madinah as well as a smoking cessation program. In addition, SGH in Hail introduced diabetic foot care, an epilepsy clinic, and a smoking cessation pro-

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WITH HOSPITALS STRATEGICALLY LOCATED ACROSS SAUDI ARABIA AND THE REST OF THE MENA REGION, THE GROUP LIVES UP TO ITS PROMISE OF DELIVERING PATIENTFOCUSED SERVICES.

Makarem Sobhi Batterjee, President and Vice Chairman, Saudi German Hospitals Group, said: “In line with our aim to provide worldclass, innovative and personalized healthcare services, we are proud to offer unique and highly specialized treatments at our new subspecialty clinics. The move is part of our continuing efforts to innovate our approach to medical care.” He further added: “Having a long-standing reputation as a world-class healthcare provider in the region, it is our mission to lead the regional medical community into the future without losing sight of the wellbeing of our patients. We remain steadfast in offering customized and personalized care to patients to meet their specific medical needs.” Patients can find out more about the new specialties and book an appointment by contacting Saudi German Hospitals Group call centre at 920007997 in KSA.


An upstart on the global stage. A consistent leader in the U.S. Here in Columbus, Ohio, we have it all: world-class cultural attractions, cuisine and pediatric specialty care that makes us a leading destination for patients from around the world. From advanced, minimally invasive neurosurgical procedures to the most complex, life-changing craniofacial reconstructions, our surgical and medical experts run internationally recognized programs. Add that to our novel therapies for pediatric cancers and our renowned gene therapy research — aimed at making neuromuscular disorders a thing of the past — and it’s clear that our commitment to innovative clinical research makes an unmistakable impact on care quality. Reach out to our Global Patient Services team to learn more about our unique combination of a welcoming city and remarkable care. Learn more, refer a patient or plan a trip: NationwideChildrens.org/Global-Patient-Services GlobalPatientServices@NationwideChildrens.org +1 614 362 9127 Nationwide Children’s Hospital, Columbus, Ohio - USA

W205735

AMERICA’S SECOND

LARGEST CHILDREN’S HOSPITAL

* Based on CHA survey of utilization and financial indicators


NEWS

Virtual event targets travel agents from West Africa region

Webinar highlights Dubai’s latest health tourism opportunities and offerings

T

he Dubai Health Authority (DHA), represented by the Health Tourism Department, recently participated in a webinar organized by the Department of Tourism and Commerce Marketing in Dubai for travel agents and tour operators from West Africa. The virtual event was held to explore the promising opportunities in the African market, which benefits from Dubai’s advanced health tourism programs. Following the lifting of travel bans to the emirate, many African tourists are looking forward to traveling to Dubai for wellness or medical reasons. They are keen to resume their travel plans to seek treatment or consultation in various specializations such as orthopedic, dental aesthetics and ophthalmology. The webinar, which sought to increase the awareness of African travel agencies about the various health tourism offerings of Dubai, was attended by Mohamed Al Mheiri, Director of the Health Tourism Department of DHA, a representative from Department of Tourism and Commerce Marketing (DTCM), Dubai Health Experience (DXH) group members, which include the American Hospital, NMC Healthcare, and the Armada Healthcare Group, also took part in the forum.

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MOHAMED AL MHEIRI REAFFIRMED THAT DUBAI’S SUCCESSFUL REOPENING TO TOURISTS INDICATED THE EMIRATE’S DETERMINATION TO RESUME ITS EFFORTS TO GAIN A STRONG LEADERSHIP IN THE GLOBAL HEALTH TOURISM INDUSTRY. HE URGED HEALTH TOURISTS TO COME TO DUBAI, SAYING IT IS A SAFE DESTINATION WHERE THEY CAN SEEK HEALTH AND WELLNESS SERVICES.

Mohamed Al Mheiri reaffirmed that Dubai’s successful reopening to tourists indicated the emirate’s determination to resume its efforts to gain a strong leadership in the global health tourism industry. He urged health tourists to come to Dubai, saying it is a safe destination where they can seek health and wellness services. Mohamed Al Mheiri said: “We will continue to provide health visitors with the best healthcare solutions that meet their expectations. These include the free second medical opinion service available on DXH.ae, an online portal dedicated to health tourists who need an expert’s view of their condition. They can be assured that their case gets reviewed and their diagnosis verified. The website can also suggest appropriate and personalized treatment plans, as well as alternative methods provided by medical professionals in Dubai.” He reiterated that the UAE has implemented strong COVID-19-related preventive measures, which are being strictly observed by government and private healthcare institutions, to ensure the safety and security of all residents and visitors. On its part, DTCM affirmed that the seminar formed part of the continuing efforts to reinforce Dubai’s position as a leading global tourism destination. Through the event, they presented before its partners from African travel agencies about Dubai’s world-class health tourism programs. The virtual event successfully captured its target audience in Africa, a key market for them. The emirate recognizes the huge potentials of emerging markets in Africa, as such, it is working diligently to explore newer markets within the continent.” The virtual session also saw the attendees discussing Dubai’s efforts to enforce health and safety measures and provide holistic health tourism packages.



ARTICLE

Stay With Us to Make Your Bed Connected

Jitka Stranska, Managing Director LINET MEA

H

ealthcare has undergone rapid development in recent decades. The development of science, technology, and techniques brings immense benefits. We can take care of patients who would not have a chance to survive in the past because new methods, technologies, and devices are available to doctors and nurses. On the other hand, this entails extraordinary demands - healthcare professionals have to cover and consume a large amount of information and work with technically advanced and complex devices. All of this is coupled with an extreme increase in the administrative agenda. In addition, despite all the progress, hospital-acquired complications have not disappeared. Falls remain one of the most serious risks, they cause health complications for patients, an increase in the work of health professionals, and raise the cost of hospitalization. The overload of health professionals is always a real threat that limits the functioning of health systems, not only during a pandemic. LINET's SafetyMonitor system provides benefits for all parties. The patient is safer because the risk of falls and injuries is reduced. The hospital staff, including nurses and doctors have online information about their patients clearly displayed on a monitor, tablet,

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DIGITIZATION AND INTEGRATION OF INFORMATION IN THE ONLINE ENVIRONMENT CAN ELIMINATE THESE PROBLEMS. WE, AT LINET, HAVE JOINED THIS TREND. FOR INTEGRATION WITH THE DIGITAL ENVIRONMENT, OUR BEDS ARE EQUIPPED WITH SENSORS THAT CAN MONITOR SAFETY PARAMETERS, THE PRESENCE OF THE PATIENT ON THE BED, AND EVEN THE POSITION OF THE BED ITSELF. EVERYTHING IS IMMEDIATELY REPORTED TO THE STAFF, INCLUDING ALERTS THAT WARN OF RISKY SITUATIONS. RECORDS ARE THEN EVALUATED AND EXPORTED DIRECTLY TO HOSPITAL SYSTEMS.

or mobile phone. This increases their efficiency because they can schedule and organize their time better without becoming overloaded. Data analysis and evaluations are essential for good management and service which is why SafetyMonitor uses the HL7 v2 standard for transmitting messages. It can be connected to any 3rd party system (nurse call, HIS, etc.) compatible with HL7 v2. From a managerial point of view, financial benefits are also key. According to the meth-


ARTICLE

odology evaluating the consequences of falls in hospitals, it was calculated that by installing SafetyMonitor on 100 beds, the hospital can save more than $ 100,000. The big advantage is the simplicity, clarity, and intuitiveness of the whole system. Based on several long-term field tests, it was confirmed that the SafetyMonitor application is considered by users, ie. nurses as useful, trustworthy, user-friendly, and most importantly functional. 65% of nurses claim SafetyMoni-

tor's bed control is user-friendly and helped increase overall patient safety. I am glad that we have a simple and functional tool that has positive feedback from users. It is a confirmation of the importance and usefulness of smart technologies, which is an area that we intensively focus on as an innovative company. Stay with us to make your bed connected.

LINET'S SAFETYMONITOR SYSTEM PROVIDES BENEFITS FOR ALL PARTIES.

www.linet.ae

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Covid-19: Protecting Staff, Protecting Patients By Ben Kanter, MD, FCCP, Chief Medical Information Officer, Vocera

C

linicians and nurses contend with infectious diseases every day. The COVID-19 pandemic is highlighting this stressful aspect of care, partly because it’s highly contagious, and also because it’s creating unprecedented demand to protect hospital staff coupled with the need to optimize patient flow.

Optimizing Throughput and Capacity

Caregivers Shouldn’t Risk Contamination for Communication Without effective communication, patients cannot be moved through a hospital. And, yet, with a highly infectious virus, the simple act of communicating using conventional tools puts caregivers at risk. If you are a nurse wearing personal protective equipment (PPE) while treating a patient behind closed doors and must urgently contact someone for assistance, you’re faced with a problem. You may have to interrupt caring for your patient to communicate using the intercom. If there is no intercom, you will need to leave the patient’s bedside and remove your PPE, risking self-contamination and delaying your ability to have the necessary discussion. The less you need to temporarily remove PPE, the safer you are. Additionally, by not removing PPE to communicate, you will preserve your valuable, but limited, supply of protective gear. Here is where Vocera technology can provide you with an ideal solution: our wearable, hands-free devices.

Communication technology is an integral component of PPE Worn under PPE, our classic Vocera Badge and the new Smartbadge give you and your staff access to a clear, secure, hands-free communication channel that will keep everyone safer whether they are working in a triage tent, ICU, an isolation room, or elsewhere in the hospital. And it enables care teams to provide safer, high-quality patient care. Using a voice interface to connect care team members - either by name, role, location or group (“Call Robert Jones”, “Call room 101 nurses”, “Call lab”, or “Broadcast to rapid response team”) - eliminates the need to remove PPE or touch a device, and allows for unfettered, efficient communication.

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WORN UNDER PPE, OUR CLASSIC VOCERA BADGE AND THE NEW SMARTBADGE GIVE YOU & YOUR STAFF ACCESS TO A CLEAR, SECURE, HANDS-FREE COMMUNICATION CHANNEL THAT WILL KEEP EVERYONE SAFER.

Effective communication is essential for optimizing throughput and capacity, which are key to managing patient surges anticipated during a pandemic of this scale. A hospital must be able to move patients through the continuum of care quickly and safely. As an example: whether a patient tests positive or negative for COVID-19, it’s vital that care teams are notified immediately. Patients who test negative can be moved out of isolation rooms, freeing them up - and potentially other resources - for other patients. When a hospital’s communication and clinical systems are integrated, processes can be automated, reducing the risk of communication delays or errors and shortening the time to react. Automatic alerts sent when certain triggers occur means caregivers don’t need to constantly monitor the EHR for status updates. Critical lab results, as an example, can be sent directly to the right care team member in real-time. Patient care is expedited, throughput is improved, and clinicians have less to remember, alleviating cognitive burden. Deploying notifications intelligently reduces the toil and stress on care teams. In this challenging time, it has never been more critical to keep staff and patients safe and in touch with each other. By taking advantage of systems integrations, intelligent workflows, and hands-free communication devices, hospitals can advance their protection efforts now.

Vocera is here to take care of you as you continue to take care of your staff and patients. Visit our COVID-19 resource page for more helpful resources and information: https://www.vocera.com/our-mission/covid-19


When teams provide care for COVID-19 patients, HAI reduction and efficient workflow are crucial. The VoceraŽ Platform safely streamlines real-time communication for frontline providers and staff by operating hands-free, under PPE. Trusted by health systems worldwide, Vocera’s intelligent communication solution provides proven value for pandemic response and beyond.

For more information, call 800-0182438 or visit vocera.com/covid


ARTICLE

Interior Health deploys integrated communications for effective care

The implementation of Vocera has helped clinicians deliver high-quality care amid the pandemic

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nterior Health, located within British Columbia’s interior, had just completed bringing the Vocera communications platform to its acute hospitals and long-term care homes when the COVID-19 pandemic struck with full force in March of this year. It was excellent timing, as the technology enables staff and clinicians to instantly call each other by using hands-free badges, even when wearing personal protective equipment. The user can touch a button on the badge and simply

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say call Dr. John Smith, and he or she will be quickly connected. Users can even find a person by role. For example, you can ask for the on-call cardiologist, and the system will find the person on its own. That was a big help when it came to managing patients and keeping staff free from infection. “When COVID hit, we had to respond quickly,” said Andrew Povah, Manager of Mobility and Conferencing Services at Interior Health, who spoke at a webinar on Real-Time Communica-

WHEN COVID HIT, WE HAD TO RESPOND QUICKLY. WE LET THE STAFF KNOW THAT COMMUNICATIONS WOULD BE ESSENTIAL. ANDREW POVAH


ARTICLE

tion Systems in Healthcare, in October. “We let the staff know that communications would be essential.” Interior Health serves a population of 801,000 in British Columbia and comprises numerous hospitals and long-term care homes, 44 of which utilize Vocera. It has an annual operating budget of $2.6 billion. During his webinar presentation, Povah gave specific examples of how the Vocera platform has helped staff and clinicians with patient care in the time of COVID. He discussed the case of the region’s Princeton General Hospital, a community facility just outside Penticton, BC. While the centre is wellequipped for acute care and has an emergency department and its own lab, it didn’t have isolation rooms for patients infected with COVID-19. The staff at Princeton General improvised and quickly created an isolation room, but it lacked windows, telephony and intercoms. “So, facilitating effective communication in this room was a huge challenge,” said Povah. Phones or intercoms to communicate with patients could have been installed, but it would have taken a fair amount of time. “When you’re cabling and you’ve got contractors coming in, it’s not a matter of days that you need, it’s weeks,” Povah noted. He said that since the facility was already using Vocera, the I.T. staff asked why they hadn’t extended it into the isolation room. It turned out that clinicians were using highly plasticized, protective gowns, and the heavy PPE generated noise that made it hard to work with the Vocera badges, especially when used underneath the gowns. A solution was found in wearing the badges outside the gowns and using a special protocol for cleaning the devices afterwards. Soon, it was found that clinicians could continue wearing the badges under their gowns by retraining the Vocera system to understand their muffled voices.

as a wireless intercom. “It meant we didn’t have to take badges in and out of the room anymore,” said Povah. Instead, staff outside the room could converse with clinicians who had entered, as well as with the patient. “This was a very successful implementation, and we took the learnings and used them at our other sites in British Columbia,” said Povah. Meanwhile, at the Kelowna General Hospital, a large tertiary facility, Povah said there was significant demand from clinicians who wanted streamlined communications. The strategy was to increase the number of devices being used by clinicians, such as in the emergency department. “This greatly improved their ability to communicate about the flow of patients in the ER,” said Povah. Another group that hadn’t previously been onboarded were the respiratory therapists. With COVID-19 being a respiratory disease, their services were crucial. “This deployment was extremely helpful,” said Povah. He noted that the platform was also useful to security personnel and those controlling the

Andrew Povah, Manager of Mobility and Conferencing Services, Interior Health

As well, a badge was installed in the room using the auto-answer feature, so that it acted

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entrances and exits of the hospital. The purpose here was to assess visitors and determine whether they could come in. These staff members quickly found that they had a need to communicate amongst themselves. “Being a large facility with multiple entrances and exits, staff wanted to communicate about personnel levels and resource requirements – and to communicate about visitors who may have been prevented from entering, due to COVID-19 restrictions, at one entrance by trying to enter through another.” Using the backend programming of the Vocera system, role-based communications were deployed and became important. This occurred in logistics and was helpful in replenishing PPE. As there were constraints in the supply of PPE, the wards were being stocked on an as-needed basis. “That meant when you needed top-ups, you needed them very quickly,” said Povah. “That role was very effective in getting the PPE to the right place and the right time.” Another important role, and perhaps an unexpected one, was elevator cleaning. “After a patient transfer, we had to clean the elevator and communicate that it had been completed to ensure the safety of our staff and patients,” he said. “Vocera played a key role there.” At Noric House, a long-term care home in Vernon, BC, visits to the facility were limited, and at times were completely prohibited. However, the facility used the Vocera system to connect patients to visitors – outside their windows – by deploying a Vocera badge in the room of the patient. As with the Princeton General Hospital, the badge was set to auto-answer, so the patient didn’t have to manually operate the device. Visitors outside could be connected, even using their own cell phones, and they could communicate with their loved ones inside. “It bridged the communication gap while we weren’t allowing visitors inside,” said Povah. Dr. Ben Kanter, Chief Medical Information Officer at Vocera, asserted that an integrated

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communication system is essential for hospitals to respond quickly to a variety of patient alerts, and to connect staff and clinicians. Clinicians shouldn’t have to pause to look up a number, contact the switchboard, or find out who is on call in a hospital. An integrated system should be able to do this work for the clinician or staff member. “The quicker a message gets through to a nurse or other healthcare professional, the more likely there will be a good outcome,” said Dr. Kanter, who also spoke at the webinar. Indeed, Dr. Kanter said that “shortening the time to act – for clinical and operational processes – is critical to overall healthcare delivery.” He noted that Vocera can be used to integrate the large number of alerting systems used in hospitals – such as cardiac monitors, telemetry and lab results – and when appropriate, to direct them to the right person, so the situation can be normalized. If a person is busy or doesn’t respond, the system can escalate the message to the next available and appropriate person. “To accomplish this, hospitals need technologies that can monitor systems and using rules and logic, can distribute information to staff based on their various roles and responsibilities.” Without a system of logical handoffs, he observed, a nurse could otherwise receive five alarms from five different systems in the space of five minutes. “That can be chaotic,” said Dr. Kanter. “To alleviate this, the Vocera platform monitors clinical and operational systems, uses rules-based determinations to determine if information is actionable, and if so, makes sure it’s delivered to the most appropriate person or team.” He noted that messages can be sent to any and all devices, from hospitals with a BYOD strategy, to Vocera’s own badges or standard tablets, phones and desktops. Moreover, using the Vocera devices, communication can be done hands-free, using voice recognition and activation. “We’ve been doing this for 20 years,” said Dr. Kanter. “Long before Amazon and Google.”

Dr. Ben Kanter Chief Medical Information Officer, Vocera

THE QUICKER A MESSAGE GETS THROUGH TO A NURSE OR OTHER HEALTHCARE PROFESSIONAL, THE MORE LIKELY THERE WILL BE A GOOD OUTCOME. DR. BEN KANTER

Credit “Courtesy of Canadian Healthcare Technology magazine, www.canhealth.com


Leadership Series for Professionals in the Healthcare Industry

Monday, March 1

5pm EET 3pm GMT 10am EST

Monday, March 8

5pm EET 3pm GMT 10am EST

Cyber Threats in the Era of Digital Healthcare Part 1 Presented by Prof. Neophytos Karamanos and Cyber Security Expert Kyriakos Costa This webinar will discuss cyber security challenges within the Healthcare Industry considering recent attacks and data breaches along with risk mitigation strategic plans.

The Benefits of Family Medicine for a Nation’s Heath and Efficiency of Health Service Presented by Prof. Kevork Hopayian and Prof. Ourania Kolokotroni This webinar will discuss how a strong primary care sector can improve patients’ health and provide efficiencies across a nation’s health care services.

Monday, March 15

5pm EET 3pm GMT 10am EST

Monday, May 10

5pm EEST 3pm BST 10am EST

Monday, May 31

5pm EEST 3pm BST 10am EST

What have we learned from the Covid-19 pandemic so far? Presented by Prof. Peter Karayiannis and Dr. Christiana Demetriou This webinar will discuss the success factors and multiple approaches to pandemic management that have been instigated over the last year and the anticipated evolution of public health in response to this novel virus.

Cyber Threats in the Era of Digital Healthcare Part 2 Presented by Prof. Neophytos Karamanos and Cyber Security Expert Kyriakos Costa This webinar will discuss cyber security challenges within the Healthcare Industry considering recent attacks and data breaches along with risk mitigation strategic plans.

Not Just a GP Presented by Sir David Haslam and Prof. Ourania Kolokotroni This webinar will discuss how a General Practitioner (GP) plays many roles in the delivery of primary care, and how a GP bridges gaps across a national healthcare system through their personal practice and extensive knowledge.

Visit University of Nicosia Medical School website to register to attend med.unic.ac.cy


NEWS

Malaffi platform to use predictive analytics technology to improve the health of Abu Dhabi residents almost 83% of all hospitals and a total of 814 healthcare facilities in Abu Dhabi, which accounts for 77% of all episodes in the Emirate. The centralised database stores 175 million patient records, for over 5 million unique patients.

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he Department of Health – Abu Dhabi (DOH) and Malaffi, the region’s first Health Information Exchange (HIE), showcased a population risk management analytics platform at GITEX. The technology will empower the healthcare sector to support care management, improve population health and assist in ensuring continuity of care. The risk management solution, which is supported and provided by Malaffi, uses advanced AI analytic technologies such as machine learning, to build predictive models based on the clinical data and create algorithms that run in near real-time to predict cost, admissions, emergency department visits, readmissions, and diseases. Drilling down from the population to the physician and individual level, the insights will be used to predict risk, improve overall efficiencies and health outcomes. The analytics dashboards will enable the DOH to gain insights into and manage certain risk categories such as risk of emergency room visits or complications of chronic conditions such as diabetes. It will further visualise the population risk distribution and trends and will provide benchmarking against best practice guidelines. For the first time, real-time monitoring of health indicators and new data points will be available to improve quality through customised benchmarks, in addition to standard performance and utilisation reports. Malaffi currently connects

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MALAFFI WAS LAUNCHED IN 2019 AS PARTNERSHIP BETWEEN THE DEPARTMENT OF HEALTH – ABU DHABI AND INJAZAT. MALAFFI IS WORKING TO CONNECT ALL, MORE THAN 2000, HEALTHCARE PROVIDERS IN ABU DHABI BY 2021.

Commenting on the new developments, H.E Dr. Jamal Mohammed Al Kaabi, Undersecretary of the Department of Health – Abu Dhabi, said: “We are proud to have built a healthcare infrastructure that is on par with the most advanced in the world. The addition of such sophisticated analytic technology to Malaffi is further testament of the DOH’s dedication to improving outcomes for the people of Abu Dhabi. Adoption of the latest technological advancements, which support further improvements to patient care, has always been a key part of our ambitious journey, and reaffirms the Emirate’s position as a true healthcare technology leader. Access to insights that support management of the health status of the population, will strengthen our response to public health risks and enhance the Emirate’s emergency preparedness, and ultimately ensure excellence in healthcare now and in the future.” Mr. Atif Al Braiki, Chief Executive Officer of Abu Dhabi Health Data Services said: “Malaffi is the first HIE in the MENA region, and thanks to the support we have had from the Abu Dhabi healthcare sector, in a short time we have demonstrated the true value that connected healthcare can offer all our stakeholders. The addition of such sophisticated analytics platforms only expands on the benefits that Malaffi offers and maximises the data collated. Advanced technologies such as this will provide insights that will empower both the DOH and healthcare providers, to improve their population health and care management efforts. The ability to analyse large data sets to identify risk at an early stage and by improving overall efficiencies, we can be one step ahead in improving quality of healthcare and outcomes for our patients. The next stage in the Malaffi journey is an exciting one.”


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.

www.malaffi.ae /Malaffi


NEWS

SENER is working with the Severo Ochoa Center for Molecular Biology (CSIC-UAM) to detect the SARS-CoV2 virus in enclosed spaces predict the environmental conditions (depending on the weather forecast, the service to be provided and other factors) and then apply a mode of operation to the ventilation units in order to ensure the air quality and lower the heat index, while also minimizing electricity consumption inside the structure.

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ENER, responsible for the innovative RESPIRA® system to improve ventilation inside facilities, has signed a contract with the CSIC, and specifically with the Severo Ochoa Center for Molecular Biology, to use the capabilities of the RESPIRA® control system to verify how ventilation affects the risk of contagion in enclosed spaces and to detect SARS-CoV2 in air samples. This collaboration between SENER and the CBMSO (CSIC-UAM) started in October, sponsored by the Deputy Office for Knowledge Transfer (VATC in its Spanish Acronym) of the CSIC. Since then, teams of engineers and scientists from both entities have been working together to produce an effective control system that reduces the risk of contagion from Covid-19 in enclosed spaces, which will be compared against measurements taken by the CBMSO (CSIC-UAM). If the system is shown to work correctly, it could be installed in spaces where large numbers of people congregate, such as airports, stations, public transport vehicles, shopping centers, sports stadiums, auditoriums, schools, hospitals, museums, exhibition centers, etc. RESPIRA® is an artificial intelligence platform that is capable of improving the air quality inside an enclosed structure by defining several criteria and reading parameters in real time, such as the indoor temperature, humidity and air quality, and the efficiency of electrical consumption. These data are used by a dynamic algorithm to

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The SENER engineering and technology group and the Spanish Council for Scientific Research (CSIC) have signed a partnership agreement to jointly develop a project to identify the risk of contagion from SARS-CoV2 in enclosed spaces. Under this agreement, SENER is providing its RESPIRA® artificial intelligence system, which can be used to dynamically control ventilation in enclosed spaces. The Severo Ochoa Center for Molecular Biology (CBMSO, CSICUAM) is providing its equipment for capturing airborne viruses and microorganisms, as well as its procedure for identifying SARS-CoV2 in filters using optimized PCR methods.

SENER's Innovation Director, Òscar Julià, says that "RESPIRA® applies smart ventilation control to maximize the supply of fresh, outside air to enclosed, complex spaces, such as shopping centers, airports, train stations and hospitals, reducing the risk of proliferation of microorganisms. In this regard, this collaboration with the CBMSO (CSIC-UAM) is going a step further in detecting the SARS- CoV2 virus in the air. As a result, we hope to be able to offer the users of these facilities a system to guarantee a safer space with the lowest possible risk of contagion." And he added: "At SENER, we view the digital transformation as integrating new technologies into the environment, the ultimate goal being to make them available to society. We are looking for sustainable and environmentally friendly innovations that can improve people's lives. RESPIRA® is an example of how an Artificial Intelligence solution can help mitigate the impact of this pandemic." For Antonio Alcamí, a CSIC researcher involved in the project: "This collaboration is an opportunity to complement the system developed by SENER and the methods for detecting airborne SARS-CoV2 that we have optimized at the CSIC in order to reduce the risk of contagion and improve our health." For Ángela Ribeiro, Deputy Vice-President of the CSIC Knowledge Transfer: "The CSIC has once again shown its strong commitment to the effective transfer of the quality work carried out in its centers and institutes. In this case, we looked for the appropriate framework to establish an important public- private partnership that is already starting to yield results."


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HELPING DELIVER BETTER OUTCOMES. A more efficient lab can lead to faster results, which in turn can improve patient outcomes. Across the healthcare continuum, BD combines advanced automation with fully integrated products, expertise from pre- to postanalysis, and sophisticated informatics to streamline lab workflows and accelerate turnaround times for more accurate results. This also helps measurably drive down costs across the entire lab for chemistry, microbiology, molecular and clinical flow cytometry. From discovery to the delivery of care, this is the difference of a broad portfolio of BD solutions, insights and global partnerships. Discover the diagnostic difference one company can make. Discover BD.

Learn more about BD at bd.com/en-mena/our-products bdbiosciences.com/en-eu/instruments Not all products, services or features may be available in your local area. Please check with your local BD representative.

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NEWS

Diabetes Technology: The Dexcom G6 Makes Its Regional Debut at GluCare Integrated Diabetes Center

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luCare Integrated Diabetes Center, the world’s first healthcare provider to empower patients through Remote Continuous Data Monitoring as part of its standard care model, and the region’s first healthcare provider to use Digital Therapeutics, is announcing that it is the first in the region to offer diabetes patients the Dexcom G6 Continuous Glucose Monitor (CGM). First introduced to diabetes patients in 1999, CGMs are wearable technology that track the wearer’s glucose levels throughout the day and night. Unlike the traditional blood glucose monitors (BGM) that provide a single reading at a particular moment via a fingerstick, CGMs provide dynamic and real-time information on the wearer’s blood glucose levels. For those with diabetes, keeping their blood glucose levels in an acceptable range is a key part of maintaining health. Blood glucose data also signals diabetes patients when to take insulin and other medications, and as part their self-management, helps them to avoid various serious, and potentially fatal, complications. Among the key benefits of the Dexcom G6 CGM is that the new model eliminates the need for fingerstick calibration which previously would see users draw blood via a fingerstick, twice daily. Used within GluCare’s model of care, the center’s team of healthcare professionals are able to track patient's glucose readings, and correlate them with their movement, diet, weight, physiological parameters, mental wellbeing and sleep patterns.

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All data, including that of the G6 is collected and collated in a proprietary phone app that, combined with self-reported factors such as photos of meals and questionnaires, are sent back in real-time to GluCare’s team of experts. The data is also subject to artificial intelligence and machine learning to identify individual risk factors for various diabetes complications or comorbidities. GluCare’s expert care team of doctors, health coaches and nutritionists have access to this information in realtime, allowing them to make timely decisions regarding the patient’s care – especially between routine visits.

For GluCare Co-Founder and Managing Director, Dr Ihsan Almarzooqi, there is an immediate and pressing need for new and improved diabetes technologies and care models as the number of diabetics in the MENA region is expected to grow from 55 million, to 108 million by 2045: “Diabetes is a 24/7 condition that requires a tremendous amount of self-management and as we can see from the rapidly growing prevalence, current models of care and technologies have not kept pace until now. At GluCare we use technology to empower both our patients and us, as providers with comprehensive, real-time data. The Dexcom G6 is a game-changing diabetes management technology that fits perfectly into our model of care as it not only provides more precise data but does so in a way that reduces additional self management.” Among the other benefits of the Dexcom G6 are new customizable alerts and alarms, including a new Urgent Low Soon alert which can warn users up to 20 minutes in advance of an urgent hypoglycemic event, so they can take steps to prevent it, a 10-day sensor allowing for longer wear (3 days longer than the previous generation Dexcom CGM), a slimmer transmitter with a lower profile for more discreet wearability, an auto-applicator designed to make sensor insertion simple with the touch of a button, a newly designed receiver with a touchscreen display (optional display device), and a new sensor membrane that enables acetaminophen use without any effect on glucose readings. As part of GluCare’s model of care which uses both CGM and BGM technology, the Dexcom G6 will be offered to patients either on an ongoing basis, or for a set period of time, dependent individual patient requirements and care plans. The G6 integrates with GluCare’s ‘continuous healthcare’ model seamlessly as it joins other technology within the model: a wearable “band” that measures heart rate and heart rate variability, respiration rate, physical activity, skin temperature, and sleep patterns; and dependent on individual patients, a smart blood pressure monitor and smart weight scale.



NEWS

Hundreds of Thousands of Cervical Cancer Cases Could Be Prevented with HPV Vaccines and Pap Smear Tests CERVICAL CANCER IS A LEADING CAUSE OF DEATH OF YOUNG WOMEN, BUT CAN BE EASILY PREVENTED AND TREATED IF CAUGHT EARLY SAYS EXPERT FROM AMERICAN HOSPITAL CLEVELAND CLINIC.

CCF Dr Robert DeBernardo

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undreds of thousands of cervical cancer cases per year could be prevented through widespread vaccinations for human papillomavirus (HPV) and annual pap smear tests, says an expert at a top American hospital, Cleveland Clinic, marking Cervical Cancer Awareness Month in January. Dr. Robert DeBernardo, Section Head of Gynecologic Oncology and Vice Chair Subspecialty Care for Women’s Health at Cleveland Clinic, said: “Cervical cancer is one of the leading causes of cancer-related death for young women, but is also entirely preventable between widespread HPV vaccinations and early and frequent annual screenings with pap smear tests. HPV vaccines can protect both men and women from HPV infections; women from cervical cancer; and men from many types of head and neck cancer, too.” Cancer of the cervix is the fourth-most common cancer among women worldwide, according to the World Health Organization. About 570,000 women are diagnosed with cervical can-

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cer every year, and 311,000 die from the disease annually. The United States’ National Cancer Institute reports recent research found widespread HPV vaccinations reduced cervical cancer by 90 percent. It is estimated that 99 percent of cases of cervical cancer are caused by human papillomaviruses (HPV), frequently acquired through sexual contact, although only specific types of HPV are a risk factor for cervical cancer. Dr. DeBernardo recommends that women should see a gynecologist annually from the age of 21 onwards and take pap smear tests when recommended by their gynecologist. Pap smear tests are simple tests involving swabbing from the cervix to collect cells, which are then analyzed for the presence of high-risk HPV types in cells and pre-cancer changes in the cervical cells. “Cervical cancer can develop slowly over many years, with pre-cancerous cells becoming cancerous, which is why screening is vital,” added Dr. DeBernardo. “The good news is that cervical cancer is very treatable, especially if it’s caught early on. In developing countries that may lack the testing infrastructure, there is strong potential for low-cost take-home pap smear tests. Women can take the tests at home, and if they test positive, can undergo follow-up medical exams.” In the initial stages, cervical cancer can be treated by surgical removal of the cancerous tissue or radiation therapy. Cleveland Clinic cites a five-year survival rate of more than 90 percent if it is caught in the earliest stage. Later-stage treatment options can include surgery, radiation, and chemotherapy. Supporting treatment innovations, Cleveland Clinic has trialed new medical devices to treat pre-cancer lesions, including a non-gas cryotherapy machine to freeze the lesions, and one that uses heat, rather than cold, to remove the lesions. These devices can be especially useful in developing countries with limited access to hospital facilities and to the cryogenic gas to freeze lesions.


‫َ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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Nicklaus Children's Hospital Achieves Accreditation with Excellence from the Global Healthcare Accreditation (GHA) Program

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nowledge Bylanes -- Nicklaus Children's Hospital https://www.nicklaushealth.org/ home in Miami, Florida, has been awarded Accreditation with Excellence for a three-year term by the Global Healthcare Accreditation (GHA) Program (http://globalhealthcareaccreditation.com/) for its Medical Travel Services Program. Founded in 1950, Nicklaus Children's Hospital is the first children's hospital to achieve GHA accreditation and is South Florida's only licensed specialty hospital exclusively for children. The 309-bed hospital is renowned for excellence in all aspects of pediatric medicine, with many programs routinely ranked among the nation's best by U.S. News & World Report, since 2008. According to Dr. Andrea Maggioni, Director of Global Health at Nicklaus Children's Hospital, "It is a great honor for Nicklaus Children's Hospital to be formally recognized as the first pediatric program to meet the high standards of the Global Healthcare Accreditation Program. Our fundamental vision has always been "to be where the children are", we are very proud of the accomplishments of our Global Health team to meet and exceed the unique needs of our extended international patient families, as well as the medical travel partners that support them throughout the continuum of care. We sincerely thank GHA for providing the tools and quality framework needed to measure and improve the fulfilling work we do every day." The Global Healthcare Accreditation (GHA) Program was established with the goal of enhancing the patient experience for medical

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THE ACCREDITATION SURVEY AT NICKLAUS CHILDREN'S HOSPITAL WAS CONDUCTED REMOTELY DUE TO THE CURRENT COVID-19 PANDEMIC. THE VIRTUAL ACCREDITATION PROCESS WAS DEVELOPED BY GHA TO FACILITATE SEAMLESS COMMUNICATION, OBSERVATION, AND DATA SHARING TO MAXIMIZE SURVEYOR-CLIENT INTERACTIONS AND ULTIMATELY PROVIDE ORGANIZATIONS WITH A SIMILAR LEVEL OF VALUE AS WOULD BE PROVIDED DURING AN ONSITE SURVEY.

travelers across the entire Medical Travel Care Continuum. GHA standards, accredited by ISQua (through the International Society for Quality in Health Care External Evaluation Association), provide concrete and measurable value to patients by ensuring that the hospital or clinic has instituted processes that are customized to the medical travelers' unique needs and expectations and are consistently monitored for improvement. Additionally, GHA provides healthcare organizations with a unique opportunity to not only acquire skills and competencies designed to strengthen their medical travel services, but also impact business performance. The accreditation survey at Nicklaus Children's Hospital was conducted remotely due to the current COVID-19 pandemic. The virtual accreditation process was developed by GHA to facilitate seamless communication, observation, and data sharing to maximize surveyor-client interactions and ultimately provide organizations with a similar level of value as would be provided during an onsite survey. Karen Timmons, Chief Executive Officer of the Global Healthcare Accreditation Program stated, "Traveling patients and payers are increasingly demanding a high-quality patient experience. GHA strives to assure that the patient is actively engaged and that the organization is proactive in managing cultural sensitivities and communication at each touch point along this medical travel care continuum. We congratulate Nicklaus Children's Hospital for achieving GHA Accreditation with Excellence and for its commitment to supporting the needs of medical travel patients, their parents and companions."


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NEWS

NYU Abu Dhabi researchers shed new light on mysteries behind the light emission of fireflies Bioluminescence is an energy-conserving process of natural production of cold light that many lower organisms use for communication, capturing prey, or mating

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color light is emitted by wild-type and mutant luciferases, the enzymes that generate light. They also demonstrate that it is possible to build a library of bioluminescent enzymes in the future, which will enable researchers to control the color and intensity of light emission by engineering luciferases at will.

team of researchers from the NYU Abu Dhabi’s (NYUAD) Smart Materials Lab (SML) led by Professor of Chemistry Panče Naumov has conducted a thorough review of the scientific literature surrounding the natural production of light, called bioluminescence, and developed conclusions that will help others in the field direct their research to uncover the mysteries behind this fascinating natural phenomenon. In the new study The Elusive Relationship Between Structure and Color Emission in Beetle Luciferases, which is featured on the cover of the journal Nature Reviews Chemistry, Naumov and colleagues provide the most comprehensive critical overview of the field of the bioluminescence of beetles, including fireflies, to date. The NYUAD researchers, including the Naumov group’s post-doctoral associates César Carrasco-López and Stefan Schramm, and undergraduate student Nathan M. Lui, identify the intricate structural factors that govern what

Understanding the chemical reactions responsible for bioluminescence could lead to the development of new bioanalytical tools, such as those for early discovery of cancer & diagnostics of other diseases.

This wondrous phenomenon has long fascinated scientists and the public, but many details of the chemical reactions used to produce light remain unclear. For example, it remains uncertain why various beetle species can emit different colors of light, despite using very similar lightproducing enzymes.

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“Learning from nature will provide us with tools to engineer luciferases that can emit colors within a large range of energies,” said Naumov. “This will eventually help us expand the range of application of these and similar enzymes for some exciting applications in biology and medicine, including early diagnosis and prevention of diseases.” Throughout human’s history, bioluminescence has been an inspiration to scientists, artists, and laypersons. Glowing fungi or ostracods have been used by tribes and soldiers as lanterns to guide their way through jungles without the need of electricity, and fireflies were used by miners as safety lights. The Nobel Prize in Chemistry in 2008 was awarded for the discovery of the green fluorescent protein, a bioluminescent protein found in the jellyfish Aequorea victoria. Today, bioluminescence is the basis for a great number of bioanalytical methods, such as cell imaging, cancer research, and control of food contamination, and a way to efficiently convert the energy stored in chemical bonds into light that can be easily detected. For example, bioluminescence of some bioluminescent bacterial strains is used to monitor water toxicity and contamination. The fluorescent proteins are genetically inserted into cells and animals to analyze important aspects of dynamics of some diseases. The latest research from the NYUAD’s Naumov team is poised to solve some of the mysteries surrounding the chemistry of bioluminescence and to bring this research closer to applications.


BD CAN HELP YOU GET YOUR MEDICATION MANAGEMENT TECHNOLOGIES ON THE SAME PAGE, AND YOUR TEAM DOING WHAT MATTERS MOST. At BD, we know medication management is incredibly complex. Aligning people, technologies and systems to get a single medication safely to a patient is daunting. But there’s a better way, one that enables IT professionals to get all the players, parts and processes on the same page. At the heart is our integrated approach that connects our medication management solutions with each other - and with the EMR. The result? Improved efficiency and greater visibility across your enterprise, so your clinicians can get back to what matters most: your patients. Discover medication management that takes less management. Discover BD.

Discover connected medication management by visiting bd.com/connected-tech BD, the BD Logo and HealthSight are trademarks of Becton, Dickinson and Company or its affiliates. Š 2021 BD. All rights reserved. 1910004695 (04/20) BD-17226


NEWS

From the top of Burj Khalifa:

Hamdan Medical honors 10 winners for its 11th term to join the galaxy of distinguished scientists who have been honored in its previous terms. At the end of his speech, he thanked His Highness Sheikh Hamdan, the Patron of the Award, for his keenness, and continuous and unlimited support for the Award. He also thanked the members of the Board of Trustees, members of the General Secretariat of the award, the scientific committees, and all attendees.

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.E Abdul Rahman Al Owais, Minister of Health and Prevention, and Chairman of the Board of Trustees of the Sheikh Hamdan bin Rashid Al Maktoum Award for Medical Sciences, emphasized the significance of choosing Artificial Intelligence (AI) in healthcare as the topic for this term of the Award. He said that this choice reflects His Highness Sheikh Hamdan bin Rashid Al Maktoum’s vision, as the driving force leading the Award’s adopting innovation in healthcare and scientific research.

His Excellency mentioned this in his speech at the ceremony held to announce and honour the winners of the 11th term of the Sheikh Hamdan bin Rashid Al Maktoum Award for Medical Sciences. The ceremony was held virtually and witnessed the honoring of ten winners across the various categories of the award. His Excellency also praised the fruitful cooperation between the Award and the Office of the National Program for Artificial Intelligence, affiliated to the Prime Minister’s office, especially His Excellency Omar Sultan Al Olama, Minister of State for Artificial Intelligence and Digital Economy, as well as members of the joint scientific committees. He also conveyed the congratulations of His Highness Sheikh Hamdan to all the winners of this term,

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HIS EXCELLENCY OMAR SULTAN AL ULAMA EXPRESSED HIS HAPPINESS TO PARTICIPATE IN THIS DISTINGUISHED MEETING TO CELEBRATE THE ACHIEVEMENTS OF THE WINNERS OF THE SHEIKH HAMDAN BIN RASHID AL MAKTOUM AWARD FOR MEDICAL SCIENCES.

During his speech, His Excellency Omar Sultan Al Ulama expressed his happiness to participate in this distinguished meeting to celebrate the achievements of the winners of the Sheikh Hamdan Bin Rashid Al Maktoum Award for Medical Sciences. He also extended his appreciation to all the workers in the health sector headed by His Excellency Abdulrahman Muhammad Al Owais, Minister of Health and Protection, and Chairman of the Board of Trustees of the Sheikh Hamdan bin Rashid Al Maktoum Award for Medical Sciences.He also stressed that the UAE has embodied a vision to invest in the most advanced Artificial Intelligence technologies and tools, and their applications in the various vital sectors, especially the Medical Sector, thereby promoting a healthy lifestyle for all the members of society. At the end of his speech he said “In the end, I can only express my sincere thanks, appreciation and gratitude to H.H. Sheikh Hamdan bin Rashid Al Maktoum, Patron of the Award for his continuous support and his vision to empower scientists and the sciences, and his relentless pursuit of innovations in this field. May Allah grant him success and grant us all the power to serve the interests of the people”. During the ceremony, a movie about Sheikh Hamdan Bin Rashid Al Maktoum Award for Medical Sciences and its achievements over the past 20 years was screened. Patronized by H.H. Sheikh Hamdan bin Rashid Al Maktoum, the Award has contributed to innovative and creative initiatives in the advancement of medical and health sectors within the country and abroad. This was followed by an announcement of the winners of the 11th


NEWS term of the awards across the different categories, and a presentation reviewing their achievements that have delivered a qualitative leap in healthcare services around the world. The Grand Hamdan International Award was bestowed on Prof. Dr. Bradley Nelson, Head of Department of Mechanical and Process Engineering at ETH Zurich in recognition of his research on micro-robotics and nanorobotics, highlighting its applications in biology and medicine. The Hamdan Award for Volunteers in Humanitarian Medical Services was awarded to the Supreme National Committee for Volunteerism during Crises, in recognition of the committee’s achievements in developing an integrated and sustainable system for volunteer work in the UAE during crises, and in cooperation with all parties concerned with volunteer work in the country, including individuals and institutions. In the Arab World Awards category, the Hamdan Awards for best Medical College, Institute, or Centre in the Arab World was given to the Dasman Diabetes Institute which has strived to address the diabetes epidemic in Kuwait through focused research, integrated prevention, training, and education. Professor Khalid Matar Al-Otaibi was awarded the Hamdan Award for Honoring Distinguished Personalities from the Arab World. Prof. Al-Otaibi is a urologic surgeon, endoscopy consultant, and full Professor at Imam Abdul Rahman bin Faisal University, Dammam. He was the first surgeon in the Middle East to perform laparoscopic surgery to remove kidney tumors. He also succeeded in performing rare surgeries, including the interventional kidney stone surgery. Among the UAE awards, the Hamdan Award for outstanding Clinical Department in the public Sector in UAE was given to the Radiology department at Rashid hospital, which provides radiology services to the biggest hospital in Dubai embracing 24/7 emergency.

DURING THE CEREMONY, A MOVIE ABOUT SHEIKH HAMDAN BIN RASHID AL MAKTOUM AWARD FOR MEDICAL SCIENCES AND ITS ACHIEVEMENTS OVER THE PAST 20 YEARS WAS SCREENED. PATRONIZED BY H.H. SHEIKH HAMDAN BIN RASHID AL MAKTOUM, THE AWARD HAS CONTRIBUTED TO INNOVATIVE AND CREATIVE INITIATIVES IN THE ADVANCEMENT OF MEDICAL AND HEALTH SECTORS WITHIN THE COUNTRY AND ABROAD.

affiliated with the United Nations. He was the Regional Director of the World Health Organization (WHO) for the Eastern Mediterranean Region, a position that is the equivalent of Minister of Health for all 23 countries of the region. Dr. Abdul Rahim Mustafawi, a prominent native persona in the medical community of UAE, who currently works with Al Jalila Children’s Hospital as a Consultant Pediatric Surgeon. Dr. Khalil Qayed , Advisor to the Training and Development Center at the Ministry of Health and Prevention in the United Arab Emirates. Two research papers won the Hamdan Award for the best research published in the Hamdan Medical Journal. The first of these authored by Dr. Abdulaziz Tlili and his team is entitled “Two new mutations, ESPN c.2257T>C and ESRRB c.10583 C>A, cause hearing loss in UAE families. The second research paper, by Dr. Haider Raza and team, is entitled” Streptozotocin-induced molecular and metabolic targets in pancreatic beta-cell toxicity”.

The ceremony concluded with a unique, distinctive and dazzling display of all the winners of the eleventh session on the façade of the Burj Khalifa, the tallest building in the world, in honor of their achievements in the field of medicine and scientific research.

The winners of the Hamdan Award for Distinguished Medical Personalities in the UAE are: •

Late Dr. Mahmoud Mohamed Fikri, who was the first Emirati to hold a high executive position in a global organization

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NEWS

Mubadala inaugurates fully integrated health network Hasan Jasem Al Nowais appointed CEO to lead Mubadala Health

TO ADDRESS THE CHALLENGES OF POPULATION HEALTH IN THE UAE, INNOVATION IS ONE OF THE KEY PILLARS OF MUBADALA HEALTH. ITS MULTIPLE CENTERS OF EXCELLENCE ACROSS THE SIX ASSETS INCLUDE DIAGNOSTIC AND TREATMENT AREAS THAT ADDRESS THE MOST PRESSING CLINICAL NEEDS BOTH, LOCALLY AND REGIONALLY, REDUCING THE NEED FOR TRAVEL ABROAD FOR COMPLEX MEDICAL CARE.

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ubadala Investment Company, Abu Dhabi’s strategic investment vehicle, announced it will bring together six of its wholly-owned medical assets in the United Arab Emirates into an integrated network to serve patients seeking specialized care. Mubadala Health, the integrated healthcare network is focused on enhancing the patient experience, seeking innovative solutions, driving collaboration across the sector and forging global partnerships to elevate clinical outcomes. The six Mubadala Health facilities - Abu Dhabi Telemedicine Centre (ADTC), Amana Healthcare, Capital Health Screening Centre (CHSC), Healthpoint, Imperial College London Diabetes Centre (ICLDC), and National Reference Laboratory (NRL) - will work together to contribute to the health and wellbeing of the communities served through an integrated clinical approach. In addition, Cleveland Clinic Abu Dhabi will remain an integral part of the network, and col-

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lectively, alongside the six organizations, address some of the most vital health and diagnostic issues in the region. This includes long-term care and rehabilitation, telemedicine and corporate medical screening, treatment of chronic diseases, comprehensive lab and testing services, and a range of patient care including specialties such as endocrinology, orthopedics, cardiology, neurology, dentistry, and digestive diseases. Hasan Jasem Al Nowais has been appointed as the CEO of Mubadala Health and will direct a diverse team of clinical and non-clinical caregivers across the network. Commenting on the announcement, he said, “Through our vision to transform the regional healthcare landscape, and with the commitment to always putting patients first, Mubadala Health enables all members of our community to consistently receive the highest standard of care and the best possible patient experience across the network. The network’s leadership team brings an entrepreneurial energy and focus to the healthcare sector. We will optimize our resources and increase efficiencies with our partners to deliver value-based healthcare.” To address the challenges of population health in the UAE, innovation is one of the key pillars of Mubadala Health. Its multiple centers of excellence across the six assets include diagnostic and treatment areas that address the most pressing clinical needs both, locally and regionally, reducing the need for travel abroad for complex medical care. Together, Mubadala Health’s assets will continue to build a strong referral network for a more seamless patient experience. Mubadala Health is developing a number of training and education programs for Emirati caregivers to contribute to the sustainability of the country’s healthcare sector. Collaboration with industry partners and leading educational institutions will also enable Mubadala Health to deliver new treatments and regional ‘firsts’ in patient care.


NEWS Mubadala Health’s launch comes in parallel to the end of one of the most challenging years for regional and global healthcare, during which the healthcare sector addressed unanticipated issues from the need for telemedicine solutions to unprecedented screening and lab testing volumes. Building on the decades of experience of its caregivers as well as the successful clinical outcomes of its assets, Mubadala Health is comprised of: 13 centres of excellence & expertise, with more to launch in 2021, including: • Musculoskeletal (encompassing orthopedics and sports medicine, rheumatology, physiotherapy and rehabilitation, spine care and podiatry), • Bariatric and metabolic surgery, • Dental care, • Diabetes management, • Long-term, transitional, and specialized home healthcare, • Inpatient rehabilitation, • Skilled nursing care,

MUBADALA HEALTH IS DEVELOPING A NUMBER OF TRAINING AND EDUCATION PROGRAMS FOR EMIRATI CAREGIVERS TO CONTRIBUTE TO THE SUSTAINABILITY OF THE COUNTRY’S HEALTHCARE SECTOR.

• •

Residential care for people of determination, Telemedicine and contact centre, and Testing in anatomic pathology, flow cytometry, molecular diagnostics and genomics, infectious diseases, special coagulation, human leukocyte antigen (HLA), and protein studies/special chemistry

More than 3,800 caregivers of more than 50 nationalities, including UAE nationals, across the six healthcare assets More than 25 regional and international accreditations across the network, including Joint Commission International (JCI), College of American Pathologists, and Commission on Accreditation of Rehabilitation Facilities (CARF). Mubadala Health’s partners include: Imperial College London, Medgate, and Wooridul Spine Centre, alongside Cleveland Clinic Foundation in relation to Cleveland Clinic Abu Dhabi.

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ARTICLE FEATURES . Digital transformation in the time of coronavirus

Digital transformation in the time of coronavirus The health sector is the biggest winner

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he health sector has undoubtedly benefited from the digital transformation that is gaining ground due to the precautionary measures that have taken over all countries of the world, prompting many hospitals and medical centers to adopt digital transformation strategies in line with the global change imposed by the coronavirus pandemic. Digital health technologies have significantly grown and we have been relying on them tremendously in the time being.

Specialized companies have rushed to develop programs and work mechanisms that ensure that the patient and the hospital alike have access to the necessary facilities for communication, case diagnosis and other benefits. Hence, telemedicine has become a tangible reality with the help of electronic health records, online consultations and other innovations. Doctors and hospitals have adopted digital communications, health platforms and applications during complete lockdown, therefore, the concept of global digital health has expanded, which includes telemedicine, electronic pharmacies, wearable devices and many others, at a time when the demand for digital health services is still growing so that healthcare providers can benefit from the available technical options in addition to the advanced systems and programs. Patients can benefit from remote healthcare thanks to the digitization provided by health institutions that provide remote medical services, hence, the patient receives immediate medical consultations with the ability to closely monitor and follow up on the medical condition remotely, especially for those who suffer from chronic diseases and are unable to leave their house.

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THE CORONAVIRUS PANDEMIC HAS LED TO THE GROWTH OF DIGITAL HEALTH TECHNOLOGIES.


ARTICLE FEATURES . Digital transformation in the time of coronavirus

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ARTICLE FEATURES . Digital transformation in the time of coronavirus

Digitization in Hospitals Smart hospitals rely on digitization in their operations by adopting digital healthcare solutions, which has evolved even more with the coronavirus outbreak, especially in terms of patient data and records through the electronic personal health records that collect information about the patient’s health that includes test results, clinical notes, diagnoses and health problems that the patient suffers from in addition to the medications he takes, procedures he underwent, etc. Smart hospital infrastructures rely on a wide range of devices necessary to automate and digitize work to enhance productivity and increase healthcare accuracy. The modern methods available today for telemedicine give the patient a speedy response by the medical team following up on his condition by connecting the home device with the hospital, so the patient gets clinical monitoring

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at home, but remotely, which guarantees his access to medical services through coordination with the medical team with improved patient participation. Most importantly, the patient receives a medical consultation without the need to leave the house. This type of services would reduce the burden on healthcare systems and doctors, so the patient does not always have to go to the doctor’s clinic, saving effort and time on the one hand, and increasing the productivity of healthcare providers on the other hand. In addition, telemedicine enables people who live in distant locations to receive the medical service they need without the hassle of commuting.

Telemedicine Dependence on telemedicine and remote consultations has increased in light of the coronavirus pandemic, and it has proven to be a preferred method for many patients to practice

MOST HEALTHCARE INSTITUTIONS AND HOSPITALS IN THE REGION REALIZED THE DANGER OF THE EMERGENCE OF THE CORONAVIRUS, SO THEY WORKED TO ACTIVATE WEBSITES AND TURN THEM INTO A PLATFORM THAT ALLOWS THE PATIENT TO COMMUNICATE WITH THE DOCTOR.


ARTICLE FEATURES . Digital transformation in the time of coronavirus

home quarantine and social distancing by saving the hassle of commuting to the hospital and waiting at a time when we urgently need it. Most healthcare institutions and hospitals in the region realized the danger of the emergence of the coronavirus, so they worked to activate websites and turn them into a platform that allows the patient to communicate with the doctor, from anywhere and around the clock, in order to obtain remote medical consultations and answer their inquiries, which contributes to providing patients with healthcare services and avoiding being in a crowded place as one of the precautionary measures taken to prevent the spread of the virus. Today, health institutions and hospitals have advanced programs run by health professionals and human resources working with a high level of professionalism, as they have demonstrated high competence and professionalism in terms of communicating with the patient or his family through video technology with the aim to provide medical consultations, lab test results and radiology results, and give the necessary prescription. Remote medical consultations provide the opportunity to connect the patient with the specialist physician to carry out the necessary and accurate consultations about the disease, so that the doctor listens to the complaint and type pf pain with the help of the data and information provided. The coronavirus pandemic and the accompanying home quarantine and the difficult patient access to hospitals and doctors' clinics was a strong driver behind the unprecedented increased demand for electronic medical platforms, after a large number of patients relied on those platforms in search of the right doctor. The advanced mobile technology has helped in the growth of telemedicine to provide healthcare services such as initial diagnostics, consultations, and comprehensive monitoring of the patient's health condition, among others.

THE USE OF WEARABLE DEVICES HAS EXPANDED AT THE PRESENT TIME, WHICH LED TO ITS TECHNICAL DEVELOPMENT. WEARABLE TECHNOLOGY CAN BE WORN AS CLOTHES OR ACCESSORIES, SUCH AS WATCHES, GLASSES AND CLOTHES, AS THESE DEVICES CAN PROVIDE INSTANT INFORMATION THAT SUITS SPECIFIC CONTEXTS, THROUGH DATA RECORDING, ANALYSIS AND DELIVERY.

expanded, so that the information issued is transmitted directly to the personal doctor, enabling him to closely monitor the medical condition through data collection and analysis by artificial intelligence algorithms in order to identify diseases and health problems. The aim is to obtain an early diagnosis, successful treatment, while reducing complications that may result from the development of the condition. This technology has been able to change many trends in healthcare industry, as it has become possible to monitor the patient's vital functions from home and there is no need for him to be permanently in the hospital, through small devices that the patient can wear anytime and anywhere, enabling the medical staff to follow up on his health condition while receiving detailed and real-time information about blood pressure or heart rate, for instance. The use of wearable devices has expanded at the present time, which led to its technical development. Wearable technology can be worn as clothes or accessories, such as watches, glasses and clothes, as these devices can provide instant information that suits specific contexts, through data recording, analysis and delivery. These devices monitor and analyze the health of individuals according to several indicators such as heart rate, blood pressure and others.

Wearable Devices The market of wearable devices and tools containing sensors to quickly monitor vital signs and various conditions of the human body has

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ARTICLE FEATURES . Mobile X-ray equipments

Mobile X-ray equipments High in demand at hospitals in light of the coronavirus pandemic

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he novel coronavirus has brought about drastic changes in the radiology departments in hospitals in general, so the companies involved in the production and manufacture of medical imaging devices have been ready to fight this pandemic by enhancing their production capacity and producing mobile X-ray devices that limit the movement of patients and communication with them. X-rays can be performed near the patient's bed while obtaining a high-quality clinical image.

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ARTICLE FEATURES . Mobile X-ray equipments

Most hospitals, especially those specialized in receiving coronavirus patients, realized the key presence of mobile imaging devices and proceeded to acquire them since the beginning of the crisis, that is, during the first quarter of this year. It was obvious that they definitely needed this type of medical imaging devices for early diagnosis of Covid-19 patients and to follow-up on their condition. In response to keeping pace with the coronavirus pandemic and the precautionary measures it imposed, medical imaging companies have doubled their production of mobile devices that allow the radiologist to photograph the patient and diagnose his condition while in bed without the need to transfer him to another room and expose others to the risks of spreading the infection, especially in advanced cases in intensive care and the difficulty of transporting the patient to the imaging department. Mobile medical imaging is an urgent need today in light of the pandemic outbreak, which prompted manufacturers to increase their production capacities in order to manufacture portable imaging devices. The radiologist brings the imaging device to the side of the patient's bed whenever needed and obtains high-resolution digital images. Mobile X-ray devices have been at the forefront of devices used to care for coronavirus patients and diagnose their condition, taking into account prevention factors, as this device can be used in several places within the hospital, such as the emergency room, intensive care units, isolation and quarantine departments, and even regular rooms. This type of imaging device has facilitated the possibility of transferring the device from one department to another within the hospital or even from one hospital to another, according to the diagnostic needs, provided that sterilization is one of the basic conditions for the transfer of the device in order to preserve the safety of the radiologist, the patient, and other healthcare providers within the hospital. In light of the application of social and physical distancing, mobile devices have thus provided effective solutions to reduce the spread of

MOBILE MEDICAL IMAGING IS AN URGENT NEED TODAY IN LIGHT OF THE PANDEMIC OUTBREAK, WHICH PROMPTED MANUFACTURERS TO INCREASE THEIR PRODUCTION CAPACITIES IN ORDER TO MANUFACTURE PORTABLE IMAGING DEVICES.

This device can be used in several places within the hospital, such as the emergency room, intensive care units, isolation and quarantine departments, and even regular rooms.

infection, as medical imaging has been available at the side of the patient's bed, which was of great importance for coronavirus patients on the one hand and facilitated the work of healthcare providers on the other hand at a time when they are in dire need of this type of support in light of the overcrowding in coronavirus departments and the extent of the risk of infection transmission. Manufacturers have been able to introduce several features to such devices in order to help reduce contamination and to be smoothly sterilized after each use allowing the radiologist to use them again quickly, between one patient and another. Those companies were also keen to take into account the easy transportation of the device, as it was designed to be small and lightweight. Portable digital X-ray devices are used extensively to monitor the condition of pneumonia patients that coronavirus patients suffer from, after the device is placed at the side of the bed, allowing it to be used in emergency rooms and in the intensive care unit. This type of digital radiography has several benefits, such as providing faster and less expensive imaging services than other methods, with the same accuracy and quality, which makes it an effective alternative to a fixed radiography room, allowing the radiologist to bring the device to the patient instead of having to bring the patient to the device. Bringing the device to the side of the patient greatly helps in saving effort, time and fear of transmitting infection in serious Covid-19 cases, which will positively affect the increase in efficiency in the workflow and the protection of everyone in the hospital. In addition, the easyto-use device in several hospital departments is very important in reducing the spread of infection. The use of this type of imaging device requires strict conditions. Firstly, the radiologist must wear personal protective equipment (PPE) and take the utmost precautionary measures of sterilization and others, and then apply the highest level of cleaning, sterilization and disinfection to all parts of the device and surfaces.

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ARTICLE

Pocramé, the start-up at the forefront of the fight against the coronavirus and all its variants

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he MephiLab, a real mini medical analysis lab, gives a result in just 22 minutes and is developed by the Pocramé company at the IHU-Méditerranée Infection. Two analysis and infection prevention tools have witnessed unprecedented success in 2020 within hospitals in the South region, faced with the Covid-19 pandemic. A look back at a Provençal success story which has mainly benefited Provençal people for the time being! POCRAMÉ, is short for Point Of Care RAoult MÉditérannée.

Zeina Trad, Marseille

THE FIRST, CALLED MEPHILAB, IS A MINI MEDICAL ANALYSIS LABORATORY ON ITS OWN. CAPABLE OF IDENTIFYING A MYRIAD OF PATHOGENS (VIRUSES, BACTERIA, FUNGI, PARASITES) FROM A SIMPLE SWAB, IT OBVIOUSLY RECOGNIZES SARSCOV-2 BY PCR, EXCEPT THAT IT GIVES RESULTS IN JUST 22 MINUTES, FOR AN ESTIMATED COST OF AROUND 10 EUROS PER TEST.

The year 2020 will undoubtedly remain associated with the Covid-19 pandemic in the minds of most people around the world. For Pocramé, a start-up incubated since 2014 at the Institut Hospitalo-Universitaire (IHU) Méditerranée Infection, 2020 will also be remembered as the year when its business boomed, with sales exceeding 3 million euros for the first time. This success is obviously due to the sudden Sars-Cov-2 outbreak all over the world and the exponential needs for microbiological tests induced by this pandemic. Because the only two products marketed (for the moment) by Pocramé meet the current needs. Without the “IHU bashing” following the media coverage of its iconic boss, Didier Raoult, these innovations could have even made it possible to accelerate the deployment of tests throughout the country in the spring.

A mini mobile medical analysis laboratory The first, called MephiLab, is a mini medical analysis laboratory on its own. Capable of identifying a myriad of pathogens (viruses, bacteria, fungi, parasites) from a simple swab, it obviously recognizes Sars-Cov-2 by PCR, except that it gives results in just 22 minutes, for an estimated cost of around 10 euros per test. Used by the IHU's healthcare teams, there is a good reason that MephiLab was used in Marseille in terms of tests. For a long time,

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this hospital specializing in infectious diseases was even the only French enterprise capable of mass testing and delivering results in a few hours. But this was not enough to open up national prospects for MephiLab, their deployment during the crisis having been limited to a handful of medium-sized enterprises in Bouches-du-Rhône, Vaucluse and Hautes-Alpes (1). However, this machine could have rendered great service, when a large number of doctors


ARTICLE

across the country wanted to subject their patients to a Covid-19 test and the ministry claimed that it was technically impossible, if not unnecessary. The CMA / CGM was not mistaken. The 3rd largest shipping company in the world has equipped around sixty of its container ships for two years, in order to be able to establish a reliable and precise diagnosis when a crew member or a passenger falls ill at sea. Because the Marseille-based company obviously cares about the health of its employees and customers, and also because such a tool aboard a ship makes it possible to resort to a helicopter evacuation or a medical deviation only with full knowledge of the facts. When you know the cost of an additional day at sea for a container ship, CMA / CGM's decision also seems to be the result of economic thinking. Billed between 5,000 and 12,000 euros each depending on the options, a misery for stateof-the-art medical equipment, a MephiLab can indeed provide the shipowner with substantial savings. Not to mention the cost of a deviation or helicopter winching in the open sea.

How does this mobile lab work? The secret of MephiLab? It has a PCR analyzer, a device capable of determining several hundred or even several thousand germs in a biological sample. Thus, it embodies a diagnostic strategy developed over many years at the IHU, namely, the syndromic approach. It consists of listing a patient's symptoms, comparing them with the known symptoms of one or more diseases and looking in the patient's sample for pathogens that correspond to these diseases. A technique which makes it possible to know very quickly and almost certainly what exactly the patient is suffering from. In order to secure test results, each MephiLab, whether on land or aboard a ship, is connected to the IHU, where a biologist can continuously check the data sent by these mobile laboratories.

THE SECRET OF MEPHILAB? IT HAS A PCR ANALYZER, A DEVICE CAPABLE OF DETERMINING SEVERAL HUNDRED OR EVEN SEVERAL THOUSAND GERMS IN A BIOLOGICAL SAMPLE. THUS, IT EMBODIES A DIAGNOSTIC STRATEGY DEVELOPED OVER MANY YEARS AT THE IHU, NAMELY, THE SYNDROMIC APPROACH. IT CONSISTS OF LISTING A PATIENT'S SYMPTOMS, COMPARING THEM WITH THE KNOWN SYMPTOMS OF ONE OR MORE DISEASES AND LOOKING IN THE PATIENT'S SAMPLE FOR PATHOGENS THAT CORRESPOND TO THESE DISEASES.

Fighting against hospital-acquired infections The second tool developed by Pocramé, the MephiBox, also achieved considerable success in 2020, with several thousand units sold during the year and more than 450 units ordered to be delivered. Installed in the corridor of a hospital ward, at the door of a hospital room or a nursing home, the MephiBox allows healthcare workers to permanently have disposable protective equipment against infections (gloves, masks, glasses, gowns, etc.) and to manage them in the best safety conditions for them, for inpatients and for their visitors. Developed with the aim of preventing hospital-acquired infections, which are diseases contracted in hospitals where pathogens are inevitably more present, the MephiBox is very useful in the control of Sars-Cov-2 and its dissemination in hospitals or in nursing homes for the elderly. The MephiLab and the MephiBox are both manufactured in the South of France, not far from Marseille. Regarding the former, the PCR machine which is at its core, is manufactured at the IHU, before being mounted on a mobile chassis at ACA Plastiques in Signes (Var), in a body conceived and designed by Idéact in Géménos (Bouches-du-Rhône). As for the MephiBox, they involve the same subcontractors, generating new jobs.

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INTERVIEW

Professor of Mammalian Developmental Neuroscience and Genetics at the University of Nicosia Medical School

Dr. Stavros Malas “The Financial Times ranked Nicosia as the number one city under 500,000 in Europe for lifestyle and education”

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OSPITALS magazine had the privilege to meet with Dr. Stavros Malas, Professor of Mammalian Developmental Neuroscience and Genetics at the University of Nicosia Medical School to talk about his background and career, and tell us more about the University of Nicosia Medical School, their affiliations among others. Below is the full interview:

Let's start with a little background info about your career, and how you ended up here at the University of Nicosia Medical School? Having finished my studies in London, I have worked for several years at the UK Medical Research where I developed several projects in how specific sets of genes control fetal brain development in mice. I have continued this work in Cyprus, where I founded the first and only unit for producing genetically modified animals. In 2011, I have taken a short break from academic life and served as a Minister of Health of the Republic of Cyprus for a period of fourteen months. As a strong believer in quality Medical Education, I had pushed through the legal and regulatory framework, which led to the establishment of three Medical Schools, one public (national) and two private (international). I am pleased to see all three Schools thriving, training between them more than 300 students annually making a very positive financial and reputational contribution to Cyprus. Two years ago, I have been recruited by the University of Nicosia to help in the development of a Veterinary School, to run alongside the Medical School. These are exciting times for the University, which aspires to become a leading regional

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educational establishment of international programs in such highly competitive fields of study, as Human and Animal Medicine.

How many people do you administer? Can you tell us about the staff and doctors who teach at your university? The School has more than 600 contributing staff and faculty. As a multicultural University, our staff and faculty reflect this diverse background. We have clinical placements in four countries, so our clinical education department is similarly diverse which impacts students' holistic understanding of medicine being able to learn and work with global professionals.

What are the medical programs you offer at the institute? In which language you teach? And what admission test a student needs to get into your school? We offer the six medical programs below, which are all taught in English:

Medical Programs •

Doctor of Medicine (MD), a 6-year undergraduate-entry degree quality assured by the World Federation for Medical Education (WFME) via the Cyprus Agency of Quality Assurance

WE HAVE A LONG-STANDING PARTNERSHIP WITH ST GEORGE’S, UNIVERSITY OF LONDON. THIS 250+-YEAR-OLD UNIVERSITY IS THE ONLY SPECIALIST MEDICAL AND HEALTHCARE HIGHER EDUCATION INSTITUTION IN THE UNITED KINGDOM.


INTERVIEW

and Accreditation in Higher Education (CYQAA) and awarded by University of Nicosia Medical School. St George’s, University of London Bachelor of Medicine and Bachelor of Surgery (MBBS), a 4-year graduate-entry British medical degree quality assured by the UK General Medical Council and awarded by St George’s, University of London.

Postgraduate Degrees •

Master of Public Health (MPH), a fully online degree for working professionals and new graduates. • Master in Family Medicine (MSc FM), a degree for practicing doctors delivered entirely online. • Master of Science in Health Services Administration (MHSA), a fully online degree for working professionals and new graduates. • Doctorate in Medical Sciences (Ph.D.), for research in all disciplines or specialties of Medicine. The admissions requirements vary depend-

ing on the program, so you can visit our website for specifics.

What are the conditions for students to apply and get accepted at the medical school? And what about the foreign students coming from abroad? The University of Nicosia Medical School is truly multicultural, so foreign students come from around the world to attend. We host more than 1,000 students from 64 countries, coming from as far away as the United States, Canada, Australia and New Zealand. Parents are comforted by the fact that Cyprus is ranked the safest country in the world for people aged 15 to 29 by the World Health Organization, and its people are famous for the warm and friendly welcome they extend to visitors. The Financial Times ranked Nicosia as the number one city under 500,000 in Europe for lifestyle and education. The majority of our programs begin in the autumn, so prospective students must complete their application and other requirements to be considered for entry prior to the start of the academic term.

THE UNIVERSITY OF NICOSIA CONTINUES TO STRIVE FOR EXCELLENCE GLOBALLY. THE 2020 TIMES HIGHER EDUCATION (THE) UNIVERSITY IMPACT RANKINGS, RANKED THE UNIVERSITY OF NICOSIA (UNIC) AS THE NUMBER 42 UNIVERSITY IN THE WORLD IN THE CORE AREA OF QUALITY EDUCATION, AND AMONG THE TOP 301-400 UNIVERSITIES GLOBALLY IN TERMS OF ITS OVERALL SOCIAL AND ECONOMIC IMPACT.

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INTERVIEW

Do you have any affiliations with medical schools outside Cyprus?

We have a long-standing partnership with St George’s, University of London. This 250+-yearold university is the only specialist medical and healthcare higher education institution in the United Kingdom. Partnering with the University of Nicosia (UNIC), the largest university in Cyprus, St George’s offers students the graduate-entry 4-year MBBS (Bachelor of Medicine and Bachelor of Surgery) program in Nicosia, Cyprus since 2011. This truly patient-centered program provides students with a global approach to medicine.

• • •

Below are some of our other international partnerships:

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UK Royal College of General Practitioners (RCGP) Karolinska Institutet, Sweden Universidad de Oviedo, Spain Royal College of Surgeons of England

What are the advantages you offer to students compared to other med schools and where do you position yourself in the ranking worldwide? The University of Nicosia continues to strive for excellence globally. The 2020 Times Higher Education (THE) University Impact Rankings, ranked the University of Nicosia (UNIC) as the number 42 university in the world in the core area of Quality Education, and among the top 301-400 universities globally in terms of its over-

IT WAS THE FIRST UNIVERSITY IN THE EU TO BE AWARDED 5 QS STARS IN DISTANCE EDUCATION AND THE FIRST UNIVERSITY GLOBALLY TO RECEIVE TRIPLE ACCREDITATION FOR ITS ONLINE LEARNING QUALITY.


INTERVIEW

all social and economic impact. It was the first University in the EU to be awarded 5 QS Stars in Distance Education and the first university globally to receive triple accreditation for its online learning quality. Our University has been a pioneer in online/distance learning education in Europe, supporting both its own degree programs, as well as those of its joint degree partners. This online expertise has proved exceptional to curricula delivery while transitioning to blended learning to meet public health regulations during the pandemic.

In comparing other med schools, there are several advantages: With such a global population of students, we are proud of our graduates practicing as physicians across the world, including the USA, Canada, UK, Australia, EU countries, Israel, Lebanon and others. The Medical School Careers Office is devoted to student success evident by the 99% post-graduate placement rate at medical centres worldwide. More specifically, the Doctor of Medicine (MD) graduates have reached an absolute 100% employability record and for the Bachelor of Medicine and Bachelor of Surgery (MBBS) graduates this percentage was 99.35%. Students are matched with a personal tutor from day one and have regular one-on-one meetings with our career advisers to track their studies, steps to practice in the country they wish to work. By outlining these pathways to practice, all students can plan with Career Advisers to put together timelines and application

requirements based on the country and specialty they are seeking to practice in the future. All incoming students at the University of Nicosia Medical School are guaranteed accommodation in our brand-new student residences which redefine modern student living. They consist of three separate complexes – SIX, U and TRIANGLE – which are among the most stunning student accommodations constructed in Europe. The combination of a multicultural population, modern infrastructure, English language knowledge, reasonable cost of living, rich history and a beautiful natural environment makes it an ideal place to study for our global student body.

What kind of research opportunities do you offer to your students? Students have many opportunities for research at our school: 1. Students in the MBBS, MD and Master’s programs can do research projects as part of their degrees. 2. We also run the Students in Research Programme in which students can engage with research projects outside their curriculum. Faculty offers a variety of research projects which include original research projects (e.g. lab-based projects, questionnaire surveys, systematic reviews and narrative reviews, etc.). 3. Students can also engage in ongoing research projects by contacting faculty directly or by contacting the Associate Dean for Research.

THE UNIVERSITY OF NICOSIA MEDICAL SCHOOL IS TRULY MULTICULTURAL, SO FOREIGN STUDENTS COME FROM AROUND THE WORLD TO ATTEND. WE HOST MORE THAN 1,000 STUDENTS FROM 64 COUNTRIES, COMING FROM AS FAR AWAY AS THE UNITED STATES, CANADA, AUSTRALIA AND NEW ZEALAND.

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Dr. Jessica Adam in an exclusive interview with The Arab Hospital Magazine “Alfardan Medical with Northwestern Medicine is a new healthcare concept in Qatar and the region.” “We adopt an American patient-centric model where the patient always comes first.” Alfardan Medical with Northwestern Medicine (AMNM) has recently opened its doors to patients looking to access advanced medicine and world-class medical services. The new ambulatory care center is not just a continuation of the impressive growth momentum Qatar has seen in the past decades, but a new concept for healthcare in the region. AMNM’s focus on patient centricity and service excellence nurtures personalized healthcare experiences and ensures that patients are actively involved in their healthcare journey at every step of the way, said Dr. Jessica Adam, AMNM Chief Medical Officer, in an exclusive interview with The Arab Hospital Magazine.

Advanced Medicine. Premium Care.

Praising the medical team at AMNM, Dr. Adam said: “AMNM’s world-class healthcare services are powered by a multinational collective of specialized medical staff and professionals from leading markets, including a large contingent from the U.S.A. We are responsible for the selection of medical staff and specialists, in compliance with Northwestern Medicine’s stringent talent recruitment and development standards.” Dr. Adam noted that the unique collaboration between Alfardan Group and Northwestern Medicine leverages both organizations’ complementary strengths: Alfardan Group’s legacy and scale in offering hospitality and luxury experiences, and Northwestern Medicine’s longstanding history and leadership in the medical field. Integrating the merits and experiences of both organizations truly differentiates AMNM as a premier healthcare provider in Qatar and the region, she added.

Details from the interview: The Arab Hospital Magazine: What services does AMNM provide? Dr. Jessica Adam: AMNM is an ambulatory care center that provides high-quality, multidisciplinary medical care, and patient service. At AMNM’s state-of-the-art treatment facility, advanced and patient-centric care, from a multinational multidisciplinary medical team, is combined with service excellence. AMNM is currently welcoming patients looking to access high quality evidence-based medical services in Dermatology, Internal Medicine, Gastroenterology, Reproductive Endocrinology, Infertility and Gynecology, Dentistry, Ear Nose and Throat, Orthopedics, Physical Medicine and Rehabilitation. Highly credentialed allied health professionals specialized in Exercise Physiology, Physiotherapy, Clinical Nutrition and Diagnostic Imaging and Lab are also available. This further reinforces AMNM’s patient-centric approach to healthcare that is buttressed by collaborative multidisciplinary teamwork. Other AMNM medical specialties that will be introduced in the near future include: Executive Health, Ophthalmology and Plastic and Cosmetic Surgery, among others.

How is your American model different from other models?

Dr. Jessica Adam Chief Medical Officer

AMNM’s mission builds on the American patient-centric model of designing a seamless healthcare journey for the wellbeing of patients through infrastructure, architecture, and services. Designed around human connections, AMNM has created an end-to-end healthcare experience for patients. From welcoming and guiding patients around the facility, to overseeing patient conditions, AMNM services are attuned to the comfort and needs of the patients.


amnm.com The expert medical team at AMNM is dedicated to realizing patients’ individuality, values, and preferences and aligning healthcare decisions with their needs and comfort.

What kind of medical experts are available at AMNM?

AMNM’s world-class healthcare services are offered in the heart of Lusail, Qatar’s city of the future and the embodiment of a national vision that strives towards a sustainable and healthy society. Strategically located at the iconic Burj Alfardan, AMNM spans over six dedicated floors.

AMNM’s world-class healthcare services are powered by a multinational collective of highly credentialed, specialized medical staff and professionals from leading markets, including a large contingent from the U.S.A.

For appointments or more information, you can contact the center on 6000 4004 or visit its website amnm.com.

AMNM’s high-caliber physicians and experienced multidisciplinary medical team offer patients a holistic wellness experience that is stemmed from the interdisciplinary collaboration between the different departments at AMNM, and when needed, includes expertise input from Chicago-based Northwestern Medicine.

Facebook, Instagram, and Twitter: @amnm_qa.

You can also follow AMNM’s social media channels on

How are AMNM’s medical facilities different? At AMNM, patients receive world-class medical care from highly credentialed doctors and medical staff using state-of-the-art, U.S.A. Food and Drug Administration (FDA) approved equipment. The introduction and application of medical technological solutions at the ambulatory care center extends further than its specialties and can also be found across AMNM diagnostic services, laboratory medicine and radiology, and operating rooms. We have implemented advanced technological solutions to an array of our specialties, including innovations by industry pioneers such as Phillips, Olympus, ZEISS and many more. AMNM’s efficient 1.5T Magnetic Resonance Imaging (MRI) system, aims to make patients feel comfortable and secure, and provides higher-quality images in a shorter amount of time. Our 128 Slice Computerized Tomography (CT) scan machine maximizes CT capabilities with its intuitive advancements and reduces time to offer results with %19 adaptive intelligence at every step of the scan. Additionally, we have a flexible solution that helps us perform vertical, horizontal, and seated tests, as well as additional angulated views that contribute to accurate diagnoses. For our Ear, Nose, and Throat (ENT) specialty, the HD video rhino-laryngoscope allows HD image quality visualization of the nose, pharynx, and larynx. With its protective frame, disposable components, convenient instrument management, and hygienic maintenance of the unit, the Otopront hygiene solution unit for ENT diagnostic and treatment is practical for any and all hygiene issues. Technological solutions offered in our operating rooms include the C-arm, which is used for diagnostic imaging during surgical procedures. The C-arm delivers excellent image quality and increases the efficiency of surgical operations at AMNM, allowing our surgeons to obtain necessary imaging intra-operatively for better surgical outcomes. Additionally, the endoscopy systems set new standards for technologies by focusing on advancing control and workflow, lend convenience to the team with their high-resolution images and extended recording time of endoscopic procedures. AMNM’s highly anticipated Executive Health specialty, which encompasses preventive health screening, is inclusive of several lifestyle consultations with a Clinical Dietitian and an Exercise Physiologist. The unit is equipped with the Bod Pod test for body composition, which is highly accurate and accessible for all and supplements the measuring and monitoring of risk for obesity. In addition, the unit is fully equipped to provide health and fitness assessment using tools to investigate underlying mechanisms of physical activity to produce exercise programs tailored for each client. Our Dental specialty offers an optimized patient experience with its high-tech intraoral cameras, which are small yet powerful devices that capture photos of inside the mouth, leading our team to better diagnosis and results. The specialty is also furnished with state-of-the-art Dental Chairs, which are comfortable, versatile, and user friendly. The chairs ensure the safety of both patients and staff by reducing any risk of cross-contamination and comes with the Full Touch panel which give users full access over the sanitization process. AMNM’s Reproductive Endocrinology, Infertility and Gynecology specialty utilizes an ultra-modern technology that enables a safe and stable environment for embryos and allows them to be analyzed with minimal disturbances.

AMNM’s Dermatology, and Plastic and Cosmetic Surgery specialties are powered with the Duetto MT Quanta Laser Machine for hair reduction, which performs hair removal processes and rejuvenation treatments. The Dermatology specialty also operates with the innovative and unparalleled Q-Switched ND YAG laser, which is useful in the treating of pigment-related issues such as the removal of moles, freckles, and even pigmented lesions and tattoos. Fractional CO2 lasers are also used in non-invasive procedures to remove the outer layers of damaged and aged skin. Realizing the need for efficiency and accuracy in achieving diagnoses, AMNM’s laboratories and are equipped with the latest technological solutions that help in time-sensitive situations. Our laboratory microscopes help the AMNM team document, prepare and tweak cells samples, and help them evaluate the characteristics of the samples. The way AMNM has incorporated technological solutions as part of its highly advanced specialties contributes to the overall comfort and assurance patients feel when they interact with our services, further leading to our one-of-a-kind patient-centric healthcare experience.

How can people from the region benefit from AMNM? Regional and international patients can receive comprehensive healthcare advice within their planned stay in Qatar. Introducing specialized programs such as Executive Health to the region enhances Qatar’s position as a hub for premium medical services and medical tourism. AMNM’s Executive Health services offer a personalized medical assessment, which determines the presence or absence of risk factors associated with diseases of high complexity through a series of tests and procedures of early detection and diagnosis. Tailored for convenience and to support busy schedules of executives, business owners and entrepreneurs, AMNM’s Executive Health service provides an efficient yet complete medical evaluation to help maintain good health in years to come.

Which insurance providers are accepted at AMNM? AMNM partnered with QLM Life and Medical Insurance Company (QLM), a subsidiary of Qatar Insurance Company (QIC) Group, and AlKoot Insurance & Reinsurance company (AlKoot), a leading insurance solutions provider in Qatar, to offer their cardholders access to AMNM’s innovative, tech-powered, and patient-centric healthcare. We have several other agreements with major insurance providers underway.


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GE Healthcare Announces First X-ray AI to Help Assess Endotracheal Tube Placement for COVID-19 Patients JAN.FEB 2021

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E Healthcare announced a new artificial intelligence (AI) algorithm to help clinicians assess Endotracheal Tube (ETT) placements, a necessary and important step when ventilating critically ill COVID-19 patients. The AI solution is one of five included in GE Healthcare’s Critical Care Suite 2.02 an industry-first collection of AI algorithms embedded on a mobile x-ray device for automated measurements, case prioritization and quality control.

Healthcare. “The pandemic has proven what we already knew – that data, AI and connectivity are central to helping those on the front lines deliver intelligently efficient care. GE Healthcare is not only providing new tools to help hospital staff keep up with demand without compromising diagnostic precision, but also leading the way on COVID-era advancements that will have a long-lasting impact on the industry, long after the pandemic ends.”

Research shows that up to 25 percent3,4,5,6,7 of patients intubated outside of the operating room have misplaced ETTs on chest x-rays, which can lead to severe complications for patients, including hyperinflation, pneumothorax, cardiac arrest and death. Moreover, as COVID-19 cases climb, with more than 50 million confirmed worldwide8, anywhere from 5-15 percent require intensive care surveillance and intubation for ventilatory support9.

Up to 45% of ICU patients, including severe COVID-19 cases, receive ETT intubation for ventilation10,11,12. While proper ETT placement can be difficult, Critical Care Suite 2.0 uses AI to automatically detect ETTs in chest x-ray images and provides an accurate and automated measurement of ETT positioning to clinicians within seconds of image acquisition, right on the monitor of the x-ray system. In 94% of cases the ET Tube tip-to-Carina distance calculation is accurate to within 1.0 cm13. With these measurements, clinicians can determine if the ETT is placed correctly or if additional attention is required for proper placement. The AI generated measurements – along with an image overlay

“Today, clinicians are overwhelmed, experiencing mounting pressure as a result of an ever-increasing number of patients,” said Jan Makela, President and CEO, Imaging at GE

CRITICAL CARE SUITE 2.0 HELPS BEDSIDE STAFF AND RADIOLOGISTS ASSESS ENDOTRACHEAL TUBE (ETT) PLACEMENT FOR INTUBATED PATIENTS, INCLUDING CRITICAL COVID-19 PATIENTS A FEW MINUTES.

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– are then made accessible in a picture archiving and communication systems (PACS). Improper positioning of the ETT during intubation can lead to various complications, including a pneumothorax, a type of collapsed lung. While the chest x-ray images of a suspected pneumothorax patient are often marked “STAT,” they can sit waiting for up to eight hours for a radiologist’s review14. However, when a patient is scanned on a device with Critical Care Suite 2.015, the system automatically analyzes images and sends an alert for cases with a suspected pneumotho-

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rax – along with the original chest x-ray – to the radiologist for review via PACS. The technologist also receives a subsequent on-device notification16 to provide awareness of the prioritized cases. “Seconds and minutes matter when dealing with a collapsed lung or assessing endotracheal tube positioning in a critically ill patient,” explains Dr. Amit Gupta, Modality Director of Diagnostic Radiography at University Hospital Cleveland Medical Center and Assistant Professor of Radiology at Case Western Reserve

UP TO 45% OF ICU PATIENTS, INCLUDING SEVERE COVID-19 CASES, RECEIVE ETT INTUBATION FOR VENTILATION10,11,12.


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University, Cleveland. “In several COVID-19 patient cases, the pneumothorax AI algorithm has proved prophetic – accurately identifying pneumothoraces/barotrauma in intubated COVID-19 patients, flagging them to radiologist and radiology residents, and enabling expedited patient treatment. Altogether, this technology is a game changer, helping us operate more efficiently as a practice, without compromising diagnostic precision. We will soon evaluate the new ETT placement AI algorithm, which we hope will be equally valuable tool as we continue caring for critically ill COVID-19 patients.” To make the AI suite more accessible, Critical Care Suite 2.0 is embedded on a mobile x-ray device – offering hospitals an opportunity to try AI without making investments into additional IT infrastructure, security assessments or cybersecurity precautions for routing images offsite.

Furthermore, the on-device AI offers several benefits to radiologists and technologists: ETT positioning and critical findings: GE Healthcare’s algorithms are a fast and reliable way to ensure AI results are generated within seconds of image acquisition, without any dependency on connectivity or transfer speeds

to produce the AI results.

Eliminating processing delays: Results are then sent to the radiologist while the device sends the original diagnostic image, ensuring no additional processing delay.

Ensuring quality: The AI suite also includes several quality-focused AI algorithms to analyze and flag protocol and field of view errors as well as auto rotate the images on-device. By automatically running these quality checks ondevice, it integrates them into the technologist’s standard workflow and enables technologist actions – such as rejections or reprocessing – to occur at the patient’s bedside and before the images are sent to PACS. GE Healthcare and UC San Francisco co-developed Critical Care Suite 2.0 using GE Healthcare’s Edison platform, which helps deploy AI algorithms quickly and securely. Critical Care Suite 2.0 is available on the company’s AMX 240 mobile x-ray system.

NEW AI SUITE INCLUDES ALGORITHMS THAT HELP RADIOLOGISTS PRIORITIZE CRITICAL CASES AND AUTOMATE PROCESSES TO HELP CUT AVERAGE REVIEW TIME FROM UP TO EIGHT HOURS1.

For more information on GE Healthcare and Critical Care Suite 2.0 visit gehealthcare.com Clinicians can also test the Critical Care Suite 2.0 algorithms by uploading their own chest x-ray images to www.gexray.ai

References 1. Rachh, Pratik et al. “Reducing STAT Portable Chest Radiograph Turnaround Times: A Pilot Study.” Current Problems in Diagnostic Radiology Vol. 47, No. 3 (n.d.): 156–60. https://www.sciencedirect.com/science/article/abs/pii/S0363018817300312?via=S0363018817300312?via=ihub. 2. Critical Care Suite 2.0 is only available in the United States. Not cleared or approved by the FDA. Distributed in accordance with FDA imaging guidance regarding COVID-19 public health emergency. 3. Jemmett ME, Kendal KM, Fourre MW, Burton JH. Unrecognized misplacement of endotracheal tubes in a mixed urban to rural emergency medical services setting. Acad Emerg Med 2003;10:961–5. 4. Katz SH, Falk JL. Misplaced endotracheal tubes by paramedics in an urban emergency medical services system. Ann Emerg Med 2001;37:32–7. 5. Lotano R, Gerber D, Aseron C, Santarelli R, Pratter M. Utility of postintubation chest radiographs in the intensive care unit. Crit Care 2000;4:50–3. 6. McGillicuddy DC, Babineau MR, Fisher J, Ban K, Sanchez LD. 7. Is a postintubation chest radiograph necessary in the emergency department? Int J Emerg Med 2009;2:247–9. 8. WHO Coronavirus Disease (COVID-19) Dashboard. Published June 17, 2020. Retrieved November 10, 2020, from https://covid19.who.int/. 9. Möhlenkamp S, Thiele H. “Ventilation of COVID-19 patients in intensive care units.” Nature Public Health Emergency Collection. 2020 Apr 20 :1–3 10. Hannah Wunsch, Jason Wagner, Maximilian Herlim, David Chong, Andrew Kramer, and Scott D. Halpern. ICU Occupancy and mechanical ventilator use in the United States. Crit Care Med. 2013 Dec; 41(12): 10.1097/CCM.0b013e318298a139. 11. Dawei Wang, Bo Hu, Chang Hu, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-1069. doi:10.1001/jama.2020.1585 12. Lingzhong Meng, M.D.; Haibo Qiu, M.D.; Li Wan, M.D.; Yuhang Ai, M.D.; Zhanggang Xue, M.D.; et al. Intubation and Ventilation amid the COVID-19 Outbreak: Wuhan’s Experience. Anesthesiology 6 2020, Vol.132, 1317-1332. 13. GE Healthcare data on file. 14. Rachh, Pratik et al. “Reducing STAT Portable Chest Radiograph Turnaround Times: A Pilot Study.” Current Problems in Diagnostic Radiology Vol. 47, No. 3 (n.d.): 156–60. https://www.sciencedirect.com/science/article/abs/pii/S0363018817300312?via=ihub. 15. Algorithm also available with GE Healthcare’s Critical Care Suite 16. The technologist on-device notification is generated after a delay, post exam closure, and it does not provide any diagnostic information, nor is it intended to inform any clinical decision, prioritization, or action.

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How to future proof investment in the digital transformation of healthcare By Sara Dalmasso, Vice-President and General Manager, Omnicell International, a leading provider of supply and medication management solutions and adherence tools for healthcare systems and pharmacies

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here is widespread acknowledgment that there has been a deep-rooted lack of investment in healthcare technologies especially when compared with other industries. This was overwhelmingly confirmed in a 2019 survey by Omnicell which found that 87% of pharmacists believe their profession has been slow to adopt new technology. Yet, in recent years, more and more administrative tasks have been added to the workload of healthcare providers while the number of pharmacists and support staff has, in all probability, remained the same. What makes this lack of investment all the more confusing, is the fact that on the face of it, there is no shortage of evidence that digital solutions can directly improve the quality and efficiency of healthcare. The ‘Autonomous Pharmacy’ vision for example shows clearly how technology will result in a reduction in time spent on manual distribution and administrative tasks and responsibilities, enabling a more patient-centric model with a focus on direct patient safety and care. Within the hospital setting medications will be sorted, picked, labelled, and reconciled at every point of use by innovative technology, significantly reducing the risk of error. All of this will be powered by a connected pharmacy cloud infrastructure which will transform the healthcare environment, providing real-time data insights and predictive analytics. This is an achievable vision and we need to be asking the question what are the barriers preventing investment in these types of technologies and solutions which can save lives, improve productivity, and drive efficiencies in this vital sector?

Risk versus reward The investment required for the digital transformation of the healthcare sector is significant, and not without risk. Perhaps the biggest of these risks, and the most daunting for any healthcare

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Sara Dalmasso, Vice President and General Manager, Omnicell International

provider, is how to integrate new technologies within their existing workflows without causing significant disruption. Change management is difficult for any organisation in any industry – it requires a level of cultural and behavioural change driven by very specific expertise. It is little wonder, therefore, that many healthcare organisations shy away from it unless it becomes critical. And what if, after a large change management process the investment doesn’t deliver as expected? Anyone with a smartphone is already familiar with the pace at which technology moves on – when that challenge is multiplied at an organisational level with significant investment, it is imperative that careful consideration and long-term thought has to be put into any decisions around major technology investments. The question, therefore, is how can healthcare providers minimise the risk in this investment especially if that isn’t their particular area of expertise? We all know that the digital transformation of healthcare is not optional – it is already happening and those that ignore this movement will quickly be left behind. Harnessing new technology can help to drive much needed efficiencies within the hospital environment, as well as ensuring unparalleled standards of patient safety especially in the key area of medication and medical inventory management and administration. How can hospitals ensure they are maximising the value of new technology and what steps can they take to future-proof their spending?

Looking outside the sector To understand potential solutions to this challenge, it is valuable to look at other industries which have long-established models for offsetting large capital costs, to the advantage of both the manufacturers and their customers. An example of this is the aerospace industry, where engine manufacturers often don’t actually


ARTICLE stand how to integrate products into customer environments and workflows in order to develop a successful digital strategy to generate the desired outcomes. It is a process we have done many times as it is in our best interests to leverage this functional knowledge on behalf of our customers. This description of a partnership approach is still far from the aerospace example which I discussed earlier. For that, the manufacturer and customer critical success factors need to be much more deeply interwoven, and therefore the risk much more evenly spread. Perhaps, however, the healthcare sector might review and consider alternative payment models? These could be based, at least in part, on the associated cost savings and efficiencies achieved from implementing the new technology. This model would have the potential of revolutionising the supply chain, changing spending habits and driving better decision-making.

sell engines to airlines – instead they sell ‘flying hours’. For an airline, this removes the burden of engine maintenance and transfers associated risk back to the manufacturer. Instead, the airline can concentrate their efforts on their core business outcome of servicing passengers and/or carrying cargo. For the manufacturer, it is within their interest to ensure the engines are in service as much as possible to attain flying hours, guaranteeing their business model is in complete alignment with that of their customer. Furthermore, as the original manufacturer of the engine, with all of this unrivalled knowledge and expertise, there is nobody better placed to get the best possible performance out of the product. While this “technology as a service” model is not yet widespread in the healthcare sector the move towards it is well underway. Already, most healthcare providers expect far more from manufacturers than simply to receive a product and then run with it independently, with minimal back-up service or support. There is limited value in having the best technologies in the world if your in-house team aren’t as effective as possible with it. We know from experience that when Omnicell partner with a hospital and spend time getting to know their different workflows we are often able to make significant time efficiencies and associated cost savings very quickly.

Getting the most out of technology

Working towards shared goals This partnership approach is essential to give healthcare providers the confidence to invest in technologies which will transform their ways of working. For example, an automated pharmacy can ensure that the right dose of medication is given to the right patient at the right time. This equals better healthcare outcomes for patients and a more efficient system for staff. It can also help to tackle soaring healthcare costs by reducing the risk of medication errors and effectively managing medication stock levels. The technology manufacturer and service provider must take responsibility for gaining a deep level of understanding and insight into a customer’s needs including patient and staff safety, finance, efficiency, and regulatory compliance during the engagement and consultation process. Implementation, too, is a hands-on process. At Omnicell our team of experts include industry certified project managers, clinicians, pharmacists, and change specialists who under-

References 1. Survey of 63 pharmacists commissioned by Omnicell, April/May 2019

To truly get hospital providers engaged and excited about technology as an investment rather than a ‘necessary evil’, they need to understand what is coming next, because in truth we are still only on the cusp of what is possible with the Internet of Things, Big Data and Machine Learning. Through every connected device and machine that hospitals use, they are constantly gathering vast amounts of data on performance. Combined with advanced analytics, this can enable us to proactively plan maintenance and repairs to minimise disruption and to recommend changes to workflows, which ultimately helps to achieve the very best outcomes for patients. This digital transformation is comparable to the successful application of technology across many industries. Technology presents the healthcare sector with the opportunity to reduce costs, improve efficiency and enhance safety and clinical performance. So, while there are good reasons for hospitals to be cautious, with the right partners they can minimise risk and start sharing and celebrating long-term success.”

For more information visit: omnicell.com/Omnicell.co.uk/Omnicell.fr

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ARTICLE FEATURES . Healthcare Sector in 2020

The impact of the coronavirus pandemic on the future of medicine A global trend towards further investments

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he year 2020 was exceptional for the health sector after controlling the novel coronavirus, hence, healthcare systems were the focus of global policies, which led to a change in the global trend towards more investments in the health sector and further technology use in the future.

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ARTICLE FEATURES . Healthcare Sector in 2020

The coronavirus pandemic has dominated the whole world during the year 2020, so healthcare systems have responded to deal with this emerging virus by using technology, artificial intelligence and telemedicine. Although this technology was present in the pre-coronavirus phase, relying on it has become fundamental at the moment, as investment rates in the health and technology sectors have grown, and expectations indicate a rise in these investments in the coming period. This pandemic imposed a new reality, urging hospitals and healthcare companies to adopt further technological solutions and innovations that were not used before. It is true that there are some gaps that appeared with the beginning of the emergence of the virus as a result of its rapid spread and the unreadiness to deal with such a pandemic, but the rapid response and honing the motivation played a major role in flattening the curve in many countries of the region. Healthcare systems around the world have benefited from enhancing data collection and analysis, as well as concerted efforts to develop clinical practices to fight the global pandemic by pumping more money into digital investments to reduce the gap between medical services and modern technology. The main sectors that have witnessed a major boom in this crisis around the world are the healthcare and pharmaceutical sectors in addition to the technology sector to fight the coronavirus outbreak and limit its negative effects on the rest of the various sectors. This pandemic demonstrated the important role of technology in the service of medicine, along with the need for cooperation between the public and private sectors. Today's medical trend is centered around digital health technologies that involve mobile devices, social media, artificial intelligence, holograms, wearable devices, and remote surgery, as these technologies have evolved into an integrated system in light of the coronavirus crisis that helped shed more light on the importance of digital health and investing in it in the future. The coronavirus pandemic imposed a new type of investment related to telemedicine, virtual medicine and electronic platforms, in addition to investment in

THE PANDEMIC IMPOSED A NEW HEALTH REALITY AND THE HEALTHCARE SYSTEM WAS PLACED AT THE TOP OF PRIORITIES AFTER IT WAS PROVEN TO BE A GUARANTEE OF SOCIAL STABILITY AND ONE OF THE MOST IMPORTANT PILLARS IN SOCIETY, WHICH WILL LEAD TO AN EXPANSION OF HEALTH INVESTMENTS IN THE COMING PERIOD.

the provision of medical devices and protective equipment as well as the expansion of hospital infrastructure to accommodate coronavirus cases and other patients at the same time.

Safe Hospitals With patients’ reluctance to go to hospitals, in fear of catching the virus, health institutions have devoted most of their attention to transforming into safe, virus-free hospitals in order to attract patients by adopting infrastructure that allows the application of social distancing policies, and the development of mechanisms to deal with suspected cases, thus contributing to reducing the spread of infection, which has shaped the global trend for the future of hospitals. The transformation of these medical institutions, hospitals and medical centers into safe virus-free institutions while demonstrating the steps it takes to fight the spread of infection is one of the most important opportunities that the coronavirus crisis has provided for the development of therapeutic institutions in the future. The global trend of future healthcare systems requires strategies and mechanisms for early pandemic detection, rapid intervention, use of smart technology to track virus activity, and increasing scientific research in the field of epidemiology. Investing in healthcare and health systems is a strategic investment to save lives in the first place, as well as pumping more money by launching many remote healthcare programs and benefiting from various digital technologies. The expansion in the field of investment in the health sector and the profits that the investor can reap, as well as meeting the health needs of the population, are all factors that confirm that investment in this field is profitable. This matter did not come out of nowhere, but is rather the result of studies conducted by companies operating in the field of medical supplies and devices and other authorities specialized in medicine that unanimously agreed on the success of investment in the health sector and the growth of medical industries and its additional benefits in terms of expanding health services, primary care and preventive medicine, etc.

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Cutting-edge technology in treating cardiovascular diseases

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ardiovascular death remains the first cause of death worldwide in both males and females. Tremendous advancement in the cardiovascular field has been witnessed.

New cutting-edge technologies are nowadays available in the different cardiovascular fields mainly in: • • •

Specialist Cardiologist Clemenceau Medical Center (CMC) Dubai

Righab Hamdan, MD, MSc "We are proud and delighted at Clemenceau Medical Center Hospital of Dubai to receive our cardiac patients in a state-of-the-art cardiology department and provide them with the newest innovations and medical experience"

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Interventional cardiology Electrophysiology which is specialty managing cardiac arrhythmias Cardiovascular surgery: although the need for open heart surgery has decreased significantly with the advances in interventional cardiology, cardiac surgery remains one of the most life-saving therapies available, it has also witnessed improvement in the surgical techniques, especially in the assist devices area or artificial hearts implantation

The reasons of cardiovascular diseases are not always detectable, nevertheless there are five primary cardiovascular risk factors well established in the development of atherosclerosis or arteries blockage and infarction. These factors include cigarettes smoking, close family history of coronary artery disease, hypertension or high blood pressure, high blood cholesterol level, and diabetes. There are secondary risk factors such as sedentary lifestyle and obesity. Beside these risk factors involved in atherosclerosis formation there is other cardiac abnormalities not related to arterial blockage such as valvular heart disease that might result from rheumatic disease in childhood or from aging, in addition to heart muscle disease that can be familial, or result from viral illness, pregnancy … The best way to prevent cardiovascular diseases is to screen and control the cardiovascular risk factors, have a healthy lifestyle, smoking cessation and routine cardiac check-up in healthy individuals at risk.

INTERVENTIONAL CARDIOLOGY IS A REVOLUTIONARY SPECIALTY IN CARDIOLOGY, IT WAS DIRECTLY RESPONSIBLE FOR AN IMPORTANT DECREASE IN CARDIOVASCULAR MORTALITY INCLUDING SUDDEN CARDIAC DEATH, THROUGH THE YEARS AS WELL AS SIGNIFICANT IMPROVEMENT IN THE PATIENT’S OUTCOME AND QUALITY OF LIFE.


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Interventional cardiology is a revolutionary specialty in cardiology, it was directly responsible for an important decrease in cardiovascular mortality including sudden cardiac death, through the years as well as significant improvement in the patient’s outcome and quality of life. Interventional cardiology treats the blockage in the coronary arteries with direct balloon angioplasty and stent implantation, which will reopen the diseased artery without the need of open heart surgery. The novelties in this field include treating even the most difficult arteries such as totally essential arteries (left main artery previously treated only by bypass surgery), occluded arteries, very calcified arteries in addition to patients with previous bypass surgeries who have recurrent blockage. This fundamental impact of interventional cardiology on human lives expanded in the last

decades beyond treating the arteries alone, it developed to treat structural heart diseases interventionally, which means treating the most common valvular heart disease without surgery especially for patients in whom the surgery is not feasible or deemed at high surgical risk, two major techniques are now well established and are commonly used worldwide: the TAVI technique or the changing of the aortic valve percutaneously for severely narrowed aortic valve and mitral clip technique which means the repair of mitral valve regurgitation also without the need of surgery. We are proud and delighted at Clemenceau medical center hospital of Dubai to receive our cardiac patients in a state-of-the-art cardiology department and provide them with the newest innovations and medical experience.

THE BEST WAY TO PREVENT CARDIOVASCULAR DISEASES IS TO SCREEN AND CONTROL THE CARDIOVASCULAR RISK FACTORS, HAVE A HEALTHY LIFESTYLE, SMOKING CESSATION AND ROUTINE CARDIAC CHECKUP IN HEALTHY INDIVIDUALS AT RISK.

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ARTICLE FEATURES . Ventilators and COVID-19

Ventilators & COVID-19 Vigorous efforts to produce large quantities in order to meet global demand to counter the novel coronavirus

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he demand for ventilators has increased in light of the coronavirus outbreak and the need for these machines in the intensive care units for Covid-19 patients. The global demand for the production of a new generation has increased, urging global producing companies to play an effective role in this field to help patients with coronavirus stay alive and to meet the global demand after the virus had spread all over the world. Since the beginning of the pandemic, the producing companies have intended to produce thousands of ventilators that meet the needs of most patients with coronavirus.

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THE VENTILATOR TAKES OVER THE BODY’S BREATHING PROCESS, WHICH GIVES THE PATIENT TIME TO FIGHT THE VIRUS AND RECOVER.

What is a ventilator? How important is it for patients with coronavirus? Are there certain characteristics that must be available in order to meet these needs? A ventilator is a machine that provides mechanical ventilation by moving oxygenated air into the lungs to help patients who cannot breathe on their own.


ARTICLE FEATURES . Ventilators and COVID-19

This machine is not a cure for a disease. Doctors resort to it to stabilize the patient's condition until he becomes better and able to fight the virus while taking the necessary drug treatments to reduce the worsening of the health situation. Usually, most of the patients with coronavirus use ventilators for a period of one to two weeks. The machine takes over the body's breathing process, which gives the patient time to fight the virus and recover. The ventilator introduces oxygen into the lungs and expels carbon dioxide via a tube placed into the lungs through the mouth or nose. In some serious or long-term cases, the breathing tube is placed through a small surgically made hole in the neck and into the trachea. It is known that this new virus primarily attacks the respiratory system, causing the patient to lose his ability to breathe normally. The virus may damage the lungs, causing the immune system to expand blood vessels to allow more white blood cells in. This expansion may introduce fluids into the lungs, which increases the

THE VIRUS MAY DAMAGE THE LUNGS, CAUSING THE IMMUNE SYSTEM TO EXPAND BLOOD VESSELS TO ALLOW MORE WHITE BLOOD CELLS IN.

difficulty of breathing and reduces the levels of oxygen in the body. As the medical condition worsens, the respiratory system needs to be supported by using simpler means such as providing oxygen-rich air to the body through a face mask. However, more severe cases require more advanced options. If the patient suffers from severe respiratory distress, a tube connected to the ventilator is inserted into the bottom of the trachea to support the respiratory system. Here comes the role of the ventilator that pushes air into the lungs and increases the levels of oxygen. Today, there is a new type of smart ventilators that work automatically and consist of a computer that is installed on a wheeled cart that contains screens, data cables, power wires, and air tubes. This type of ventilator helps the medical team to provide a high level of medical care, as it is modern and advanced and has several features such as the respiratory rate, setting the mode (AC or SIMV), tidal volume, FiO2, and PEEP.

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ARTICLE FEATURES . Obesity and Weight Management

Obesity & Weight Management The goal is to reach and maintain a healthy weight

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ost of the global health institutions and hospitals have moved towards establishing centers and departments specialized in obesity and weight management to provide comprehensive services in this field. Studies have shown a strong association between obesity and several diseases, especially chronic ones such as diabetes, heart disease, high blood pressure and others. But the work of the centers specialized in the treatment of obesity is no longer limited to losing excess weight and treating obesity as much as it is to help the patient maintain weight loss. Thus, losing weight steadily and keeping it

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off is better than losing it rapidly and regaining it.Today, many studies confirm that maintaining the lost weight is key to weight management, rather than focusing on just dropping pounds. The goal of obesity treatment is not only to lose weight, but to work on managing it through important methods that the patient must adopt so they become a lifestyle, such as exercise, physical activity and a healthy eating pattern in general. The goal of these specialized centers is not limited to obesity treatment and weight loss, but rather includes the development of the health aspect and reducing obesity-related health complications. Therefore, it is essential

THE MAIN GOAL OF KEEPING THE WEIGHT OFF AFTER DIETING IS TO COMBINE PROPER AND REGULAR DIETARY HABITS WITH REALISTIC EXPECTATIONS AND ACHIEVABLE GOALS IN ORDER TO BE ABLE TO STICK TO THEM FOR LIFE.


ARTICLE FEATURES . Obesity and Weight Management

to focus on weight management by providing patients with comprehensive, multidisciplinary and long-term healthcare. The main goal of keeping the weight off after dieting is to combine proper and regular dietary habits with realistic expectations and achievable goals in order to be able to stick to them for life. Therefore, the specialists in those centers and departments develop comprehensive programs for individual care and weight management to help patients achieve their goals and reach a healthy weight in a well-considered way through scientific analysis of the weight gain causes, while reducing the risk of obesity-related complications. It is known medically that people with a BMI of 30 and higher are at risk of developing serious health problems, but once the patient realizes the factors that contribute to weight gain, the healthcare professional can help set appropriate weightloss goals. The obese patient finds in these centers an integrated team that includes obesity and internal medicine consultants, behavioral therapy, nutrition and exercise specialists, who adopt the latest methods and approaches to treat obesity and provide solutions and options that suit the medical condition. Obesity experts as well as endocrinologists and surgeons develop a holistic approach to treat obesity cases. These centers provide doctors specializing in mental disorders and sports medicine in diagnosis and treatment, so everyone works as one team to determine individual medical and psychological causes of obesity, provided that weight loss programs are established and include physical activity as well as physical and psychological support. Some obesity cases may require some type of weight-loss surgery, depending on the body mass index and according to the patient’s age and general health status. The surgeries are carried out with the latest technology in operating rooms specially designed for this type of patient. But we always start by searching for the causes of obesity, so the specialized medical team carries out a clinical examination and listens to the patient's family history. Then the

patient undergoes various laboratory tests, while a diet, behavioral and sports program are being developed to suit the patient's condition. Different weight loss programs are developed by introducing diet changes and increasing physical activity. Proper treatment methods depend on the level of obesity that the patient suffers from, that is, according to his BMI in addition to his general health and most importantly, the desire to get rid of the extra weight.

LOSING WEIGHT STEADILY AND KEEPING IT OFF IS BETTER THAN LOSING IT RAPIDLY AND REGAINING IT.

Obesity treatment plans include: • • • •

Diet changes Physical activity and exercise Behavioral changes and psychological support Weight loss surgery

Diet Changes A customized diet plan for each person is the first step that must be adopted by a nutritionist in order to reduce the number of calories as a start to get rid of the extra pounds and prevent obesity. Experts stress the need to follow an appropriate healthy diet and not follow a diet that leads to rapid weight loss.

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ARTICLE FEATURES . Obesity and Weight Management

Experts agree that losing weight slowly and steadily over an extended period of time is safer than rapid weight loss because this ensures to keep the weight off. Unrealistic practices in terms of extreme diets and drastic diet changes should also be avoided. A typical low calorie diet ranges from 1,200 to 1,500 calories per day for women and 1,500 to 1,800 calories per day for men. You should avoid consuming fast food and replace it with healthy foods such as fruits, vegetables, whole grains, legumes, lean meats, dairy products, fish and poultry. You should also choose nutrient-rich foods instead of calorie-rich foods, and avoid trans fats, sugary foods, soft drinks and processed foods.

Physical activity and exercise Exercise increases the effectiveness of the diet and help you lose weight while changing your body shape. Exercise is an essential part of fighting obesity. An obese person needs about 150 minutes a week of moderate-intensity aerobic activity to avoid weight gain in the future or maintain weight loss. When losing weight, more physical activity increases the number of calories your body uses for energy or “burns off.” The burning of calories through physical activity, combined with reducing the number of calories you eat, creates a calorie deficit that results in weight loss. Most weight loss occurs because of decreased caloric intake. However, evidence shows the only way to maintain weight loss is to be engaged in regular physical activity. It's important to start each workout with a warm-up and end with a cool-down — and that goes for true beginners, seasoned pros, and everyone in between.

Behavioral changes and psychological support The obese patient must know that a healthy diet combined with exercise should be a lifestyle that he must follow throughout life in a balanced way without feeling deprived. But this behavioral change may have psychological consequences and could lead to depression, so the obese patient in such cases needs psychological support by mental health professionals who are trained to deal with such

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medical conditions to provide assistance on how to deal with behavioral and emotional problems associated with eating. Psychological support helps the obese patient to overcome these obstacles so that he learns healthy ways to reduce the depression he is going through. It also helps him know how to monitor his diet and exercise as well as understand the triggers for eating and deal with intense craving for food that one experiences from time to time, especially after being on a diet for a long time.

Weight loss surgery If the BMI is above 40, and when diet and exercise do not work, or when obesity causes a serious health problem, the best solution is weight loss surgery after studying the case in general and making sure that there are no health problems that prevent it from being performed. There are several types of weight loss surgery; the specialist surgeon determines the best type of surgery depending on the case. The most common bariatric surgery procedures are gastric bypass, sleeve gastrectomy, adjustable gastric band, and biliopancreatic diversion with duodenal switch. The patient should be aware that bariatric surgery does not eliminate the introduction of permanent healthy diet changes and exercise in order to help ensure the longterm success of bariatric surgery.

OBESITY TREATMENT CENTERS OFFER A HOLISTIC APPROACH TO ACHIEVING AND MAINTAINING A HEALTHY WEIGHT.


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ARTICLE

Fakeeh Care invests $500 million to bring medical excellence to Dubai Silicon Oasis with 350-bed Fakeeh University Hospital

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akeeh Care, a pioneering healthcare provider from Saudi Arabia is bringing its renowned medical excellence offering to the UAE with a 350-bed Fakeeh University Hospital in Dubai Silicon Oasis. With world-class care that is administered by the region’s leading medical practitioners across 55 specialties, this state-of-the-art healthcare facility will serve communities in the heart of the UAE and the wider region. Fakeeh Care’s foray into Dubai also marks the launch of its onsite teaching and research hospital. With a 42-year legacy that has been built on a “patient first” philosophy, Fakeeh Care has amassed several achievements in Saudi Arabia, which are the result of prioritizing patient care above all. The group has championed medical expertise and pioneering technologies at par with some of the best in the world, enabling it to successfully complete the first heart transplant in KSA’s Western Region; the first renal transplant; and the first successful IVF treatment in KSA’s private sector. Spanning one million square feet across four independent yet interconnected buildings, Fakeeh University Hospital offers 55 clinics across

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FAKEEH UNIVERSITY HOSPITAL OFFERS A COMPLETE SUITE OF SERVICES TO ENSURE A HIGHLY EVOLVED PATIENT EXPERIENCE.

the healthcare spectrum – including primary, secondary, and tertiary care all under one campus. Estimated to treat 700,000 patients every year, the hospital channels the healing properties of nature, with all areas allowing for natural sunlight, greenery, and water features to create an optimal healing environment. Dr. Mazen Fakeeh, President and Chairman of the Board of Fakeeh Care said, “Fakeeh University Hospital brings to Dubai, the best of Fakeeh Care’s legacy as a leading Saudi healthcare provider, to support the UAE’s ambition to be a leader in ensuring the people of the country have the best quality of life in the world.” “For 42 years, Fakeeh Care has built strong and lasting relationships with the communities it serves. We have embraced innovation, which, combined with our expertise, has allowed us to ensure that medical excellence is at the heart of everything we do. Our team of doctors are driven by their passion to deliver positive patient outcomes. Through our integrated healthcare model using smart technologies, we reaffirm our commitment to making a positive contribution to the development of the healthcare sector in the UAE.”


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Next generation of doctors Fakeeh University Hospital is a teaching facility, aimed to develop the future generation of doctors and nurses within the UAE. With an academic and research facility affiliation, the university will help foster innovation in medical education and training, to bring the first teaching hospital to Dubai.

New frontiers in healthcare As a technology-driven, patient-centric facility, Fakeeh University Hospital functions as a smart hospital, with a fully automated robotic pharmacy - the first of its kind in Dubai - to dispense medication, minimizing human errors and reducing wait times. The hospital has also developed an app that acts as a gateway to efficiency, bringing health management to patients’ fingertips. Through the app, patients can book appointments, generate a token prior to arriving at the hospital, access medical records, laboratory results, and see doctor’s prescriptions live, as it is being prescribed. Future plans include an unmatched hospital navigation system to help patients move around the clinics and campus with ease.

Integrated care Fakeeh University Hospital offers a complete suite of services to ensure a highly evolved patient experience. This includes hospital visits, tele-consultation, and home visits. The hospital also uses a multidisciplinary team approach, using a team of doctors to assess, plan and manage the needs of patients jointly, enabling precise diagnosis, better outcomes, and faster recoveries.

FOR 42 YEARS, FAKEEH CARE HAS BUILT STRONG AND LASTING RELATIONSHIPS WITH THE COMMUNITIES IT SERVES. WE HAVE EMBRACED INNOVATION, WHICH, COMBINED WITH OUR EXPERTISE, HAS ALLOWED US TO ENSURE THAT MEDICAL EXCELLENCE IS AT THE HEART OF EVERYTHING WE DO.

Dubai’s largest emergency department in the private sector Spread across 35,000 square feet, Fakeeh University Hospital’s emergency department is the largest in the emirate in the private sector, equipped with operating theaters, radiology, diagnostics, and more. These are located next to each other to accelerate patient transfers and save vital time - critical to preventing fatalities and maximizing recovery. The facility is also fully integrated with smart ambulances, allowing vital information to be transmitted to attending doctors and nurses as the patient is being transferred. This will enable timely and effective responses when addressing severe conditions like strokes. Dr. Fakeeh added, “We have carefully selected doctors and caregivers who embody the values and heritage that Fakeeh Care represents. At the heart of our patient experience is a smart and customised mindset to ensure that the best decisions are taken with our patients’ interests at heart. To this end, we have struck the right balance between leading medical excellence and technology, harnessing the power of innovation and personalised attention to ultimately benefit our patients. With our physician-led approach, we are confident of quickly becoming a trusted healthcare partner in Dubai Silicon Oasis, and the wider communities of Dubai, the UAE, and the wider region.”

State-of-the-art birthing units Amongst other highlights is the hospital’s birthing units, featuring eight all-inclusive birthing centres. Expectant mothers will be provided optimal care to go through all stages of birthing within the confines of one room – from delivery to nursing and recovery. The centre also features eight water birthing pools, operating theatres, intensive care and more. The hospital also includes an isolated birthing suite for patients who have tested positive with COVID-19. The four-buildings campus is designed for quick isolation, ready to effectively face any disease outbreak while ensuring healthcare continuity for elective procedures.

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INTERVIEW

Director of IHU Méditerranée Infection

Didier Raoult “What we do know is that the sooner the patient is treated the faster the recovery outcome” By Zeina Trad-Marseille for "Hospitals" magazine

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hanks to Didier Raoult, Marseille is home to one of the largest infectious and tropical diseases teams in the world with more than one hundred nationalities within its URMITE (the Research Unit on Emerging Infectious and Tropical Diseases). Pfizer, Moderna, AstraZeneca…For the past several weeks, laboratories have been in a mad dash to know who will have the biggest announcement. Vaccines being developed at a surprisingly rapid rate have remarkable effectiveness rates, yet still lack evidence of their future ability to contain the epidemic. Worse yet, there is no guarantee that they will not cause side effects either. And once the euphoria has passed, many media outlets need to be scandalized by the emerging reserves, Professor Didier Raoult, Director of the University Hospital Institute of Infection (IHU) in Marseille received us to provide an update on the COVID-19 epidemic.

After a year of COVID19 do we know everything about the Virus? No, we don't know everything yet. We continue to find out. What we do know is that the sooner the patient is treated the faster the recovery outcome. We also know that 1% of patients are less seriously impacted if treated early. The people who die are those who have a high morbidity rate. We also know that the recent variants in Europe were due to infection between humans and mink. It is a new disease. These viruses have an extraordinary mutation ability like all RNA viruses. They also have the ability to infect other animals and if the virus results in a high-density epidemic in animals, mutations can build up and we can see a new mutant emergence infecting us and creating a second epidemic that stems from another source than the one we had, and therefore

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creating a second epidemic as the one we know in Europe today.

Why do some people get sick and others don’t? Everyone is affected more or less. Some experience mild symptoms and others more severe ones. If you are treated very early from the onset of symptoms, you will not develop severe symptoms. Otherwise, there is a good chance it will get worse. This disease affects the elderly population and those with a high morbidity rate (cancer, diabetes, etc.)

Do we know the long-term health consequences of infection? Yes, we are starting to see neurological, pulmonary and venous complications. But for the moment, we do not have enough hindsight yet

WE DO NOT HAVE SUFFICIENT STUDIES ON THE CONSEQUENCES OF RNA. I AM WAITING FOR LABORATORIES TO SEE THE REAL DATA FOR MODERNA AND PFIZER.


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to analyze all the long-term complications.

How long might immunity last? We do not know, but we have seen people who were infected during the 1st episode of the disease, in March-April and who returned 4 months later with a new form of virus variant. Infection with the first variant does not protect against the last variant (variant 4). Depending on the country, there are different variants. What we are currently seeing in France today is the variant 4 because we did the genomes sequencing, the last variant (the 4) also comes from Denmark where there are a lot of minks and there was an epidemic among these animals. The people caring for the minks got sick and the latter is suspected to be the cause of variant 4. In Denmark, they killed 13 million minks! RNA viruses mutate very fast, but that doesn't mean it's more serious. The monitoring of these clones should reflect on the vaccine composition, which must integrate several variants to make sure people are protected.

In your opinion, what is the best protocol in treating Covid19? And is it still the combination of hydroxychloroquine, the antimalarial drug, and azithromycin, a common antibiotic?

What can we expect from the vaccines that are starting to be used? We do not yet have sufficient studies on the consequences of RNA vaccines. I'm waiting to see the real data from Moderna and Pfizer laboratories. I prefer the traditional Chinese vaccine method because we have enough hindsight on this type of vaccine, like the flu vaccine. Moderna and Pfizer's vaccines are completely new techniques and we don't know the side effects yet.

Will the pandemic end in 2021? I can't predict this type of thing. We cannot predict a disease progression and mutation. I have always said since January, I am not a psychic. I describe what I see at a moment. I stick to reality. I am a doctor and a scientist. My primary role is to treat sick people who come here and that’s what I keep doing.

Are we going to see the virus still circulating after the pandemic is over?

WE SET UP PCR TESTS WITH RESULTS IN 20 MINUTES. MANY COUNTRIES HAVE USED THIS PROTOCOL EARLY, AT THE ONSET OF THE DISEASE, AND THUS HAVE SEEN THE FATALITY RATE DROP BY 0.5%! EARLY TESTING AND EARLY MANAGEMENT IS WHAT NEEDS TO BE DONE.

Yes, it is possible, like Rhinoviruses which are RNA viruses that we see every season because they have a high mutation rate. With the variants, the future is still uncertain

Yes, we continue to treat with this protocol with the addition of a zinc supplement. The people who receive care early, recover quickly. In France, we are prevented from doing research for old, unprofitable molecules. There is a power drift between people who have very little scientific experience and real researchers. You have to pay attention to the power of influence. The IHU in Marseille published the highest number of studies on Covid-19 in France (See https:// pubmed.ncbi.nlm.nih.gov). we have developed PCR test with results in 20 minutes. Many countries have used this protocol early, at the onset of the disease, and thus have seen the fatality rate drop by 0.5%! Early testing and early management is what needs to be done.

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ARTICLE FEATURES . The role of COVID-19 antibody testing

The Role of Antibody Testing for SARS-CoV-2 Will recovered Covid-19 patients be spared from the Vaccine?

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he antibody testing reveals the neutralizing antibodies that the human body creates to fight the coronavirus by examining its proteins, mainly the “S protein�. These antibodies are significantly related to the immune responses of individuals who have recovered from the infection, as the body produces them to fight the infection, and this is similar to what happens in the body when a vaccine is taken, in which immunity is formed against the virus. Serological tests measure the amount of antibodies or proteins present in the blood when the body is responding to a specific infection. It helps to better understand the virus and know how to respond to it, and provides an opportunity to track the spread of the virus and determine its extent. Thus, the antibody testing plays a major role in the coronavirus pandemic because it can provide information about the spread of the virus among the population and the frequency of asymptomatic infection.

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Do antibodies spare the recovered individual from getting the vaccine? Many individuals who recovered from coronavirus ask this question after it has been proven that they have antibodies that protect them from getting infected again, at least in the short term. Does that spare them from getting vaccinated? So far, there is no final answer to this question, especially since vaccination trials today are mostly carried out on those who have not yet been infected with the coronavirus. But some people encourage giving vaccines to this group at a later stage because immunity against the virus diminishes over time as the level of immunity from natural infection is variable, therefore, some people get a very strong immune response, while others have a very weak immune response. At first, the priority remains for those who have not yet been infected, as well as for the frontline workers that work hard to confront the virus. Some experts in this field say that receiving the vaccine in the presence of antibodies will not help increase the immune response

SEROLOGICAL TESTS MEASURE THE AMOUNT OF ANTIBODIES OR PROTEINS PRESENT IN THE BLOOD WHEN THE BODY IS RESPONDING TO A SPECIFIC INFECTION. IT HELPS TO BETTER UNDERSTAND THE VIRUS AND KNOW HOW TO RESPOND TO IT, AND PROVIDES AN OPPORTUNITY TO TRACK THE SPREAD OF THE VIRUS AND DETERMINE ITS EXTENT.


ARTICLE FEATURES . The role of COVID-19 antibody testing

against the coronavirus. The antibodies disappear from the body of the recovered individual and their effectiveness disappears after 8 months, so those who have recovered from the disease must undergo an antibody testing once every three months.

What are antibodies? Antibodies are proteins produced by your immune system in response to an infection. Your immune system — which involves a complex network of cells, organs and tissues — identifies foreign substances in your body and helps fight infections and diseases. After infection with the COVID-19 virus, it can take two to three weeks to develop enough antibodies to be detected in an antibody test, so it's important that you're not tested too soon. Antibodies may be detected in your blood for several months or more after you recover from COVID-19. Although these antibodies probably provide some immunity to the COVID-19 virus, there's currently not enough evidence to know how long the antibodies last

or to what extent past infection with the virus helps protect you from getting another infection. The IgM antibody is assembled first as the body actively fights the infection and the presence of this antibody may indicate a more recent infection. Then the IgG antibody is created, after the acute infection. IgG antibody has the potential to provide long-lasting immunity to a virus. The level of IgM antibody begins to rise after 1 week after the initial infection, while the IgG appears later than IgM (usually in 14 days after infection) and can last for 6 months or even several years, which means that the IgG serves as an indicator of previous infection. Antibodies circulate in your blood, hunting for antigens they recognize. When a familiar antigen is spotted, antibodies can stop it from entering or damaging your cells. Having enough of the right kinds of antibodies can often keep you from getting sick with the same virus more than once. Most people who are infected with COVID-19 develop an immune response within the first few weeks after infection.

RESEARCH IS STILL ONGOING INTO HOW STRONG THAT PROTECTION IS AND HOW LONG IT LASTS. WHO IS ALSO LOOKING INTO WHETHER THE STRENGTH AND LENGTH OF IMMUNE RESPONSE DEPENDS ON THE TYPE OF INFECTION A PERSON HAS: WITHOUT SYMPTOMS, MILD OR SEVERE. EVEN PEOPLE WITHOUT SYMPTOMS SEEM TO DEVELOP AN IMMUNE RESPONSE.

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INTERVIEW

Co-founder and Chairman of Moderna

Noubar Afeyan “I come from an immigrant family, like many innovators. I think immigration and innovation go hand in hand” By Olivier O’Mahony and Zeina Trad for "Hospitals" magazine

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fter having been able to get in touch with his company Flagship Pioneering that founded Moderna, its chairman Noubar Afeyan remembers his career as a biochemical engineer that has pushed him for thirty years to dedicate his life to innovating and transforming inventions into viable businesses. Thus, he created fifty companies and submitted a hundred patents! As early as February, Moderna announced that it had developed a new innovative type of vaccine against Covid-19 that had never been deployed in humans: the messenger RNA (mRNA) vaccine. This technology consists of administering a molecule capable of causing the patient's cells to generate their own medicine.

Is, mRNA-1273 developed by Moderna, the laboratory you co-founded, the miracle vaccine that the whole world is waiting for? It is 94.5% effective and offers long-lasting protection for 120 days, according to a study we just published. It’s a great result. This vaccine is much easier to handle compared to other vaccines. Our vaccine can be kept for one day at room temperature, thirty days in a fridge, and six months in -20 degrees, while Pfizer's vaccine requires a storage temperature of -70 degrees. This vaccine is injected while Pfizer's needs to be diluted, which wastes time and leads to a risk of error.

However, a recent scientific study shows that the severity of side effects (fatigue, headaches, chills) increases with the second injection. Should we be worried? No, this is a common reaction to all vaccines. And out of the 30,000 patients tested, we did not see any severe side effects.

You are one of the creators of this vaccine which was developed in record time. How did you accomplish that? I am a biochemical engineer, and for thirty

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years I have dedicated my life to innovating and transforming inventions into viable businesses. Thus, I created fifty companies and submitted a hundred patents. This experience made me realize that contrary to popular belief, entrepreneurship is not improvisation. There are common points from one project to another and there are also rules to follow. Therefore, I created the investment company Flagship Pioneering, which founded Moderna.

Inventing new concepts, how do you accomplish that? Instead of wondering what can be achieved with existing science, I ask the question: “what if?” (“And if it was possible?”). I rely on imagination. Invention is a process, in which one question leads to another.

What was the idea behind Moderna? It was about coming up with a way to inject a molecule into the human body that causes the patient's cells to generate their own medicine instead of administering a drug or a vaccine that will help them heal. This is a revolutionary approach, which went against the ideas established in the scientific world in 2010, and against my training as a biochemist, whose main mission

INSTEAD OF WONDERING WHAT CAN BE ACHIEVED WITH EXISTING SCIENCE, I ASK THE QUESTION: “WHAT IF?” (“AND IF IT WAS POSSIBLE?”). I RELY ON IMAGINATION. INVENTION IS A PROCESS, IN WHICH ONE QUESTION LEADS TO ANOTHER.


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is to create proteins to heal people. In this case, there is no need to create proteins: it is the human body that makes them, stimulated by mRNA. And the simple fact of asking ourselves if this method was viable led us to ask ourselves several related questions. We thought: “OK, if we want to do this, then we have to inject molecules capable of carrying information.� DNA or messenger RNA fall into this category. DNA, which was already used in gene therapy, with varying degrees of success, was of little interest to us. On the other hand, the messenger RNA has never been used to produce drugs or vaccines, to the best of our knowledge; simply because when injected into a living organism, it is rejected by cells, as if it were a virus. So in 2010-2011, we looked and found a way to overcome the obstacle. We thus established a protocol that allowed us to design the Covid-19 vaccine nine years later.

Has anyone raised this question before you did? No one came to me to put this idea forward. I brought it up to Professor Bob Langer (a biotech expert, Editor's note), with whom I had a lot of discussions. I later learned that Genentech, a very reputable company, had previously tried the experiment and failed. But science has advanced: Derrick Rossi, a professor at Harvard, who worked on stem cells, managed to integrate the messenger RNA into a plate (dish: not sure about the French translation). So I thought to myself that the same could be done in a human body.

When did you discover your mission of becoming an inventor? I have always been interested in science. When I was twelve, I used to dream about America and had heard of MIT, the Massachusetts Institute of Technology, where I ended up doing my PhD. But I come from an immigrant family, like many inventors.

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INTERVIEW I think immigration and innovation go hand in hand. In both cases, the process is the same: getting out of your comfort zone.

How did it become a reality? There was an exile in my family for three generations. My grandparents who are Armenians, had to flee Turkey for Bulgaria, a neighboring country that they knew. My father was born there, but communism emerged, so he had to move to Greece and then to Lebanon, where he had never set foot. He was an architect but had to reinvent himself in the plastic import-export in Beirut where I was born. His business was going well, but he had to flee the civil war. I was thirteen years old and the youngest in a family of three sons. We settled in Montreal and today, I am an American citizen. My wife Anna is Swedish and is also a biochemist.

How did you become an entrepreneur? Totally by chance. When I started my PhD at MIT, after graduating from McGill University in Montreal, I had no idea what I was going to do with my life. Then I thought about becoming a lab employee. But one day in 1985, I went to a conference in Washington about japanese competitiveness, which at the time was thought to be a great threat to America. At lunchtime, a very nice guy sitting next to me told me that in the 1930s he had created one of the first oscilloscopes. Then he told me his name was David Packard. I had no idea he was actually the co-founder of tech giant Hewlett-Packard. We stayed together and talked for an hour after the conference. He told me that as a student, he was part of a new generation of engineers, the “electronics engineers”. I was 23 years old and I was a student in a new engineering specialty, biochemistry, so I ended up asking him how he got started, how he knew which product to start with. “It doesn't matter which product you choose, most importantly is to get started and learn as you move forward,” he replied. As simple as that. I will never forget this piece of advice. After that, I went to see a corporate sociologist, Professor Ed Roberts, at MIT, who warned me, “You don't become an entrepreneur, you either are or you aren't.” I think I was, because

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at the end of my PhD, I followed the example of Hewlett-Packard and created my first company specializing in the creation of tools for engineers in my specialty, biochemistry.

25 years later, you created Moderna, of which you are the Chairman. When you were certain that your approach works? In 2011. We had just injected messenger RNA into a mouse, which by reaction, made exactly the protein we wanted. I was ecstatic when I received the results, my wife still talks to me about it. For me, that was the ultimate proof of the correctness of our approach. That's when I recruited Stéphane Bancel, who is French.

Why him? It was a headhunter who gave me his name when I was looking for an administrator for one of my companies, BG Medicine, which specializes in medical diagnostics. Stéphane was then the head of BioMerieux laboratory, the French laboratory whose headquarters had just been relocated to Cambridge, Massachusetts (the biotech Mecca, Editor's note), right next to our premises. He's a great guy, curious about everything, highly motivated leader and very interested in starting a business. While maintaining his job, he became administrator and then chairman of BG. He's a biochemist like me and one of his teachers was a friend and a classmate. We had a lot in common. I offered him to join me, he was hesitant until I told him about my LS-18 project, Moderna’s code name. LS for Life Science. 18, because it was the eighteenth project of this type that I launched. It was not easy to convince him to leave a well-known established French pharmaceutical company with more than 6,000 employees, for a completely new project with a limited budget of $ 2 million, without a website. Indeed. I still remember it as if it was only yesterday: I called him as he was walking across the Longfellow Bridge, a famous bridge that connects Boston and Cambridge over the Charles River and told him, “I'm working on a crazy project, which can become Apple's equivalent in biotechnology.” Except that I didn't have any specific detail to give him. “It’s never going to work,” he replied, but I could tell he was inter-

THE MRNA TECHNOLOGY IS APPLICABLE TO ANY DISEASE: CANCER, ALZHEIMER'S, HIV...THE RNA MESSENGER IS A MOLECULE THAT CARRIES INFORMATION. IF IT MANAGES TO GET INTO THE HUMAN BODY, NOTHING CAN STOP IT. IF TECHNOLOGY WORKS, THERE REALLY WILL BE A BEFORE AND AFTER IN MEDICINE.


INTERVIEW ested. His wife, Brenda, later told me that when he got home that night, he was very annoyed that I was right. I was firing on all cylinders to convince him. I told him an old saying: “If you don't throw the ball, you can't score”. The mRNA technology is applicable to any disease: cancer, Alzheimer's, HIV...The RNA messenger is a molecule that carries information. If it manages to get into the human body, nothing can stop it. If technology works, there really will be a before and after in medicine. Stéphane felt he would forever blame himself if he missed this opportunity, therefore, he joined me.

Were Moderna's beginnings challenging? I would be lying to you if I told you we were short of money. We initially invested $2 million, which is not a lot, but we knew we could raise it very easily, which we managed to do quickly. Many experts doubted us but we didn’t.

Until today, Moderna has never made a profit or produced any medicine. How does the emergence of Covid-19 change the game for you? When the first alarming news came from Wuhan, China, we were working on other plans. There was a debate within Moderna: some were against the idea of ​​finding a vaccine against Covid-19. But one evening in January, I received an unusual phone call from Stéphane He was then at the Davos forum, where he was harassed with questions on the subject. Stéphane’s calls were always preceded by text messages. When I saw his number displayed on my phone, as I was celebrating my daughter's birthday, it was 3 a.m. in Switzerland where he was and I got worried. In fact, he was very keen on getting into the vaccine race, and wanted to talk to me about it. The mARN technology works in all areas, why not in relation to Covid-19? We agreed: we must get on with that, it will be an opportunity to demonstrate the efficiency and especially the speed of our approach. As of January 11, the day China released the genome of the virus, it only took us a few days to establish the protocol. 42 days later, we suggested a vaccine vial injectable into the human body, which is a world record according to Dr. Anthony Fauci. We have

raised a lot of money from our shareholders, up to $ 1 billion. The American authorities have given us a lot of money as well. Then the tests began. It was stressful and exhilarating at the same time. The teams started with 100 people and then, in the end, tested 30,000 people, which was an achievement. When phase 3 was successful, my wife told me that I was as excited as the day the mouse experiment was successful.

Moderna has been “burnt” by Pfizer’s vaccine where England began it Covid-19 vaccination program a week ago? Do you regret it? Not at all, because the need for vaccines is going to be huge where there will be room for everyone. We opted for diversity, which delayed the testing phase, and we fully accept it. It seemed important to us that all population groups be represented. We have also included a large number of people of color. When we announced it last September, we knew that this choice would cause us to fall behind the competition.

Moderna's vaccine should be approved on December 17 in the United States and then on January 12 in Europe. Are you optimistic? I am always worried: optimism and confidence are not part of my vocabulary. What I know is that we have done everything we can to get these necessary approvals. Now, I cannot prejudge the decision of the supervisory authorities.

If all goes well, you will be credited with saving millions of lives. Is it staggering? No. I'm just doing my job. And there is still a lot to do: upon approval, it will take us two years to grasp and control the introduction of the vaccine to the market: we won’t have time to be staggered.

Have you been vaccinated? Would you vaccinate your children? Not yet, but as soon as possible I will of course. I have three daughters and a son. Everyone is looking forward to it!

I HAVE ALWAYS BEEN INTERESTED IN SCIENCE. WHEN I WAS TWELVE, I USED TO DREAM ABOUT AMERICA AND HAD HEARD OF MIT, THE MASSACHUSETTS INSTITUTE OF TECHNOLOGY, WHERE I ENDED UP DOING MY PHD. BUT I COME FROM AN IMMIGRANT FAMILY, LIKE MANY INVENTORS. I THINK IMMIGRATION AND INNOVATION GO HAND IN HAND. IN BOTH CASES, THE PROCESS IS THE SAME: GETTING OUT OF YOUR COMFORT ZONE.

Paris Match

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Next level IVF treatment: What is in store for the future? Insights by an IVF expert who never says “impossible” A NEW TREATMENT OPTION IS AVAILABLE EVEN FOR MEN WHO HAVE NO MATURE SPERM CELLS – A CONDITION CALLED AZOOSPERMIA THAT WAS PREVIOUSLY ASSOCIATED WITH LITTLE OR NO CHANCE OF SUCCESS IN IVF TREATMENT. AN ADVANCED TECHNIQUE CALLED ROSI HELPS TO ACTIVATE SPERM CELLS WITH ELECTRICAL STIMULATION. Professor Ercan Bastu

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magine a future where human reproductive system can be restarted by stem cells and infertility treatment is aided by artificial intelligence to ensure successful pregnancy for couples failing to conceive naturally. These science-fiction plots are already on the way in some of the best reproductive centers worldwide, says Professor Ercan Bastu, M.D, an infertility specialist at Acibadem Healthcare Group in Istanbul, Turkey. In the modern world, where families tend to postpone parenthood until fulfilling their career or personal goals, medical solutions are being developed to meet their changing needs.

Half of IVF patients are aged 40+ Fertility issues affect an average of 10 to 15% of all couples. It is recommended to see a doctor when they have been regularly trying to conceive a baby for at least one year, in case that the woman is below 35 years of age. If the female partner is above 35, then 6-month attempts are enough before consulting a spe-

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cialist for some tests and evaluation. Recently, patients over 40 years of age become the prevalent group of candidates for in vitro fertilization (IVF). Professor Ercan Baştu explains: “For example, last month half of my patients were over 40. Lots of women postpone their pregnancy and it’s definitely harder for them to succeed because finding the oocytes of good quality and number is not that easy compared to a younger age.”

IVF alone is not enough, new techniques come to light In our changing environment, the best specialists in assisted reproduction are adjusting to the new reality, exploring new treatment options. Technology comes to help with modern devices, such as the embryoscope that allows tracking the development and quality of the embryos. Genetic tests (PGD) let to evaluate the embryos’ genetics and identify any abnormalities that would impede a successful pregnancy. A new treatment option is available even for men who have no mature sperm cells – a condition called azoospermia that was previously associated with little or no chance of success in IVF treatment. An advanced technique called ROSI helps to activate sperm cells with electri-


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cal stimulation, explains Professor Baştu who is among the first to apply the new method at Acibadem. “For women who don’t have enough ovarian reserve, we can use some new treatment modalities to get oocytes of good quality, like platelet-rich plasma (PRP) or stem cells. We are currently working on getting approval from the Health Ministry for stem cells” the fertility expert adds. What about the future? Professor Baştu gives some precious insights: “Artificial intelligence is a very hot topic nowadays, and we have done some research on it, because AI will help us to decide which embryo has an implantation potential, which embryo is of good quality, and it will be very objective and very quick. We will also have some sort of new diagnostic testing for embryos’ chromosome status without touching or harming the embryo. We will take the embryo culture and analyze it. In the future we will learn the crosstalk between the endometrium and the embryo in detail, especially to understand their genetic situation on molecular interaction, and we can help them to establish a good relation between the embryo and endometrium. I think we’ll see it in the future.”

Comprehensive approach to infertility treatment Successful assisted reproduction requires a good understanding of the health conditions impeding the pregnancy. That’s why a comprehensive approach is crucial, states Professor Ercan Baştu, whose career development includes a masterclass in clinical embryology at the University of Leeds, UK; advanced endoscopy masterclass at the University of Surrey in UK, as well as some scientific research at Harvard University in USA. The reason for IVF failures cannot be named in all cases but additional tests and changing the type of treatment might help to improve the outcomes. Sometimes, surgery might be needed to allow conceiving, says the IVF expert who provides complex infertility treatment, including

FERTILITY ISSUES AFFECT AN AVERAGE OF 10 TO 15% OF ALL COUPLES. IT IS RECOMMENDED TO SEE A DOCTOR WHEN THEY HAVE BEEN REGULARLY TRYING TO CONCEIVE A BABY FOR AT LEAST ONE YEAR, IN CASE THAT THE WOMAN IS BELOW 35 YEARS OF AGE.

endoscopic surgeries, to patients from all over the world. Endometriosis, blocked fallopian tubes, myomas and abnormalities of the uterus that need to be corrected with hysteroscopy are some examples of conditions that need a good surgery. With proper treatment, these patients might even be able to conceive naturally, without assisted reproduction. Nowadays, laparoscopic techniques and robot-assisted surgeries make operations safer than ever.

What makes a good IVF clinic? Quality of service and patients’ comfort are the key prerequisites to successful IVF, says Professor Ercan Baştu. “We provide high-quality services, this is the main thing. We are an updated clinic and we have done a lot of research about infertility. We usually have the latest technology in our lab, and the latest developments in medicine; we can use it. Every new thing in Europe or the US,

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we’ve got it and we can use it. Our success rate is similar and maybe higher when compared to other countries. That’s why patients are usually satisfied with their treatment in Acibadem.” The infertility specialist explains that success rates depend on many factors, especially the age. For example, when there is one blastocyst or day 5 embryo with good genetics, there is 60 to 70% chance for pregnancy. However, it would be difficult to have a quality blastocyst above the age 40 and in this case pregnancy rate drops to 30-40% for this age group. And still, what makes the patients satisfied is to have their questions answered in details and feel comfortably even away from home during the treatment. At Acibadem, their jour-

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PROFESSOR ERCAN BASTU HAS HUNDREDS OF HAPPY STORIES IN HIS CAREER BUT ONE OF THEM HE REMEMBERS MOST CLEARLY – HE SAYS IT CHANGED HIS APPROACH TO PATIENTS ONCE AND FOREVER.

ney starts with a detailed conversation – either in English or another native language for the couple, aided by an experienced translator. Then, an ultrasound is performed, test results are evaluated and a road map for treatment is presented and explained to the patients. During the treatment, couples may ask their questions directly to the doctor, who usually shares his phone number for patients’ comfort.

IVF as a happy ending story Professor Ercan Baştu has hundreds of happy stories in his career but one of them he remembers most clearly – he says it changed his approach to patients once and forever. “They came to me so sad, nearly crying, and told me that they wanted a baby. The woman was 46 years old, so I told them: I cannot do an IVF procedure for you, it’s nearly impossible, don’t waste your time and money. Then the woman told me that they had a boy, 19 years old, and they had lost him 2 months ago. He had always wanted a brother or sister and they wanted to try it, even if they didn’t have a chance. I said: okay, if you understand your chances, let’s try it. The woman had just one oocyte and we took it. The same day the man had to give sperm but he couldn’t because after his boy’s death he had started drinking. We needed to freeze the oocyte. The woman came again 2 months later and told me that she wanted to try again. We got 2 oocytes but this time their quality was not good. Two months later she came again, she was 47. She insisted to try again and we tried. This time we had 2 oocytes, and I took the one we had frozen the first time. The man managed to give sperm this time. We had one embryo with an average quality; I did the transfer and she got pregnant. Two months ago she gave birth to a boy. And look at the pictures above my desk – there are no patients’ pictures, just one and that’s him. This is incredible! Now I never say “impossible”: if they say they want to try, I just accompany them. One is one, it can still help.”



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10 important rules for living with a Covid-19 positive patient Attention! It should not be neglected even for a moment!

A PERSON WITH POSITIVE COVID-19 TEST MUST LIVE IN A SEPARATE ROOM FOR A WHILE. DOOR OF THE ROOM SHOULD ALWAYS BE CLOSED AND THE PATIENT SHOULD EAT IN THIS ROOM, RESERVED FOR HIM/HER FOR A WHILE, AWAY FROM OTHER FAMILY MEMBERS.

live in a separate room for a while. Door of the room should always be closed and the patient should eat in this room, reserved for him/her for a while, away from other family members.

A mask should necessarily be worn when getting into the room Nobody should get into the patient’s room unless it's really necessary and the patient should not leave the room except for compelling reasons. If it is necessary to enter the patient’s room, a mask should be worn such that it completely covers the nose and mouth. The rule of wearing mask should not be neglected even for a moment and social distancing should not be ignored.

Bathroom should be cleaned after each use Professor Ahmet Cagri Buke

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here are more Coronavirus cases at homes nowadays! Stating that the Covid-19 infection, which has been increasingly spreading almost every day at global scale, evolves into a state of one infected person in almost every house, Professor of Infectious Diseases and Clinical Microbiology Çağrı Büke, M.D., from Acıbadem Healthcare Group says “Considering the fact that about 80% of the patients diagnosed with Covid-19 through PCR test can be cared at home setting, one should always remember that Covid-19 is mostly contracted in indoor environments. This fact pushes us to review considerations for living together with a Coronavirus-positive case in the same house.” So, what are the considerations that should not be neglected even for a moment while living together with a Coronavirus-positive patient? Professor of Infectious Diseases and Clinical Microbiology Çağrı Büke informs about 10 golden rules and make important advice and warnings.

It is necessary to live in separate rooms A person with positive Covid-19 test must

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If possible, a separate bathroom is reserved for the patient to have toilet and bath needs met. If it is not possible and other family members need to use the same bathroom, then toilet, sink, basin, taps, surfaces and floor should be cleaned with a disinfecting agent after each use.

Laundry and eating utensils should not be shared


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Laundry, cutlery and other items, such as water glasses, used by the coronavirus patient should not be shared. His/her laundry should be washed separately in a washing machine, while eating utensils should be washed in dishwasher or under running water by hand using detergent.

Hands should be washed after contacting the common areas Hands should be washed with soap and water for 20 seconds immediately after contacting any surface at common areas, before and after meal, after bathroom, before and after cooking and after contacting with objects in indoor areas. Hand sanitizers can be used as well for hand hygiene.

Coronavirus patient should wear a mask at home Coronavirus patient should wear a mask, such that it completely covers the mouth and nose, when it is necessary to go to the bathroom or other rooms.

Surfaces should be cleaned frequently Door handles, electric switches and other surfaces that may be touched should be cleaned with disinfecting agent and detergent after each contact.

A separate towel should be used As towels pose high risk of transmission, a separate towel should be used by each family member under normal circumstances. Especially if there is a coronavirus patient at home, towels should never be shared. A separate towel should be allocated or paper towel can be used. Paper towel and toilet paper waste should be kept in a separate bag and disposed after the bag is tightly sealed.

Pillowcases should be changed every day Pillowcases of a coronavirus patient should be changed every day and washed in washing

HANDS SHOULD BE WASHED WITH SOAP AND WATER FOR 20 SECONDS IMMEDIATELY AFTER CONTACTING ANY SURFACE AT COMMON AREAS, BEFORE AND AFTER MEAL, AFTER BATHROOM, BEFORE AND AFTER COOKING AND AFTER CONTACTING WITH OBJECTS IN INDOOR AREAS. HAND SANITIZERS CAN BE USED AS WELL FOR HAND HYGIENE.

machine at minimum 60 degrees Celsius and bed clothes should be changed once every three days and washed at minimum 60 degrees Celsius.

Home should be ventilated regularly Coronavirus patient’s room and all other areas of the home should be ventilated for several minutes on daily basis. Also, Covid-negative family members should never allow ‘get-well’ visits. Because visits pose high risk of spread in indoor areas! Professor of Infectious Diseases and Clinical Microbiology Çağrı Büke adds “Such measures should be maintained for a while after Covid-19 test result become negative; if no test has been done, these measures should be maintained for 48 hours after symptoms disappear completely or approximately for 14 days following onset of the symptoms. However, it should be kept in mind that this virus may, sometimes, be excreted by the body after a longer interval.”

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Why was Hôtel-Dieu de France chosen as the first Lebanese hospital to join the international “Breast Centres Network”?

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he Breast Centres Network, that includes many specialized centers exclusively dedicated to breast cancer diagnosis and treatment, is a joint program between the European School of Oncology and the Senologic International Society. This network aspires to enable all women worldwide to have access to fully equipped, quality-assured, dedicated breast centers or units that provide competent and comprehensive care. It shares the goal of improving breast cancer care throughout the world. Therefore, according to state-of-the-art international standards, some mandatory criteria have been set for giving eligible and qualified centers providing multidisciplinary breast cancer care, full membership to this network.

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BREAST CANCER IS NO LONGER A DISEASE THAT KILLS WOMEN LIKE IT USED TO.


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Accordingly, the Breast Unit at Hôtel-Dieu de France hospital has succeeded in joining this network as a Full Member, since it meets all the required BCN Full Membership criteria, given its comprehensive health services, its multidisciplinary approach and its advanced technologies used for breast cancer diagnosis and treatment at all stages in just one hospital. The Breast Unit at Hôtel-Dieu de France has a Radiology Department, including two dedicated radiologists and breast radiographers. The department performs around 3500 mammograms per year and provides a variety of tests to detect breast cancer. This department is fully equipped, as it has all the necessary breast imaging equipment for diagnosing breast cancer, as well as breast tissue sampling equipment or procedures to perform all kinds of biopsies. As for breast surgery, the Unit performs around 400 cases per year. The hospital has two breast surgeons and a team of dedicated breast nurses. Nearly ten beds are available for breast cancer patients, and ambulatory surgery can be carried out, allowing women to be discharged from the hospital on the same day. Many are the breast surgeries skillfully performed by Hôtel-Dieu's breast surgeons, ensuring high-quality healthcare for women, such as the intraoperative sentinel lymph node, which is a minimally invasive procedure to avoid removing all the lymph nodes in the armpits, immediate breast reconstruction and other reconstructive procedures performed by the plastic surgeon collaborating with the Unit. The Breast Unit also collaborates with the Pathology Department that comprises all the equipment, technology and special techniques for breast cancer detection, the Oncology Department that includes several medical oncologists dedicated to breast cancer cases, and the Radiation Oncology Department that is considered as one of the best departments at the national level and that includes radiation oncologists specialized in providing the best

breast cancer treatment depending on each case. The Breast Unit is also characterized by the nuclear medicine techniques it has, which are often not offered at other hospitals. Doctors have sometimes recourse to the Nuclear Medicine Department to perform scintigraphy, which means placing a nuclear marker in the breast that heads towards the first lymph node that is likely to develop cancer in order to carry out a minimally invasive intraoperative sentinel lymph node, a technique that does not harm a woman's arm and has no post-surgical complications. Women can also benefit from the Leatitia Hatem Rehabilitation Center services at Hôtel-Dieu, a center that ensures post-operation follow-up to help women regain their strength. The hospital also provides genetic counseling to check the history of tumors in the family and advise individuals at risk to detect breast cancer at early stages. For better coordination between the Breast Unit departments, a weekly multidisciplinary meeting for case management is held to discuss every breast cancer case and treatment plans. After fulfilling all the listed requirements, the Breast Unit of Hôtel-Dieu de France was eligible to join the Breast Centres Network. It thus became the first Lebanese member within this international group. It has proved to be a comprehensive unit that provides all the necessary services for breast cancer treatment, starting from detection, diagnosis and therapy, all the way to post-treatment stages.

THE BREAST UNIT AT HÔTEL-DIEU DE FRANCE PERFORMS AROUND 3500 MAMMOGRAMS PER YEAR AND PROVIDES A VARIETY OF TESTS TO DETECT BREAST CANCER. THIS DEPARTMENT IS FULLY EQUIPPED, AS IT HAS ALL THE NECESSARY BREAST IMAGING EQUIPMENT FOR DIAGNOSING BREAST CANCER, AS WELL AS BREAST TISSUE SAMPLING EQUIPMENT OR PROCEDURES TO PERFORM ALL KINDS OF BIOPSIES.

Breast cancer is no longer a disease that kills women like it used to. With recent improvements in treatment, many options and solutions are available to treat this type of cancer that is now being regarded as a chronic disease. The focus has nowadays shifted towards the need to control and prevent this disease through early detection to cure it, guarantee higher survival rates for patients and extend their lives.

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How to treat obesity in children What is the definition of obesity in children? It is an increase in fatty tissue in the child's body in relation to age and height.

What are the methods of measuring obesity in children? 1. Measuring weight and comparing it to standard medical weights tables based on age, height and gender. 2. Measuring the thickness of the skin in special areas of the arms and abdomen and comparing it with special tables in which it is possible to calculate the percentage of the amount of fat in the body. 3. Calculating the body mass index (BMI) by dividing the body weight in kilograms by the square of height in meters. There are tables for children.

Dr. Sura Yasin Noori Al Jawadi Consultant Pediatrician at Al Ahli Hospital

What are the causes of obesity in children?

child feels more hungry. 3. Lack of exercise, which leads to reducing the burning of calories and storing them in the form of fats and fats that are difficult to burn. 4. Using electronic devices for long periods or sitting for a long time in front of the television.

What are the most important methods for treating obesity in children? •

Pathological causes of obesity in children: 1. Diseases of the endocrine glands (thyroid hormone deficiency and excess adrenal gland secretion), which in turn lead to the emergence of hormonal disorders that cause weight gain. 2. Treatment with cortisone drugs in high doses for a long time 3. Hereditary diseases and the genetic predisposition to obesity.

Causes resulting from wrong behaviors: 1. Malnutrition as a result of eating fast and ready meals or as a result of the mother's pressure on the child to eat a lot of foods rich in calories that are incomplete with nutrients or surplus to the child's needs. 2. Neglecting to eat breakfast, which leads to the suppression of the child's metabolism, or giving the child sugary foods that speed up the rise in blood sugar and decrease it again, so that the

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Preventing children from consuming soft drinks and sweetened juice products in abundance, as they contain a lot of sugars that turn into fats. Urging children to drink water a lot, as it is one of the most important nutrients for the child and an essential component for all organs and systems of the body and does not contain any calories, but the body needs it. The family should deal with milk for the child as food, not a drink, and the child must be urged to drink milk and eat dairy products, as they are very necessary as they contain nutrients such as vitamins, minerals, protein and fibers. Urging the child to eat fresh home fruits and juices, especially between meals, as this reduces the child's feeling of hunger and prevents him from pouncing on food and consuming it in a great quantity. It is preferable not to add sugar to the juice. The child should be accustomed to chew food well, so that we can improve the digestion process, and reduce the amount of fats that enter the body. The amount of food must also be determined in both the lunch and dinner meals for children with obesity. It is also recommended to provide the child with plenty of high-fiber foods such as legumes, vegetables and whole grains. Parents are role models for the child, and by gathering family members at


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the dining table naturally, the child will imitate them without exaggerating in issuing orders to eat certain things and avoid eating other things, and it is also worth involving the child in choosing food and meals and informing him of the importance of the benefits of healthy food. A child with obesity should take food at school with him from home with healthy food instead of buying biscuits, soft drinks and potato chips. In order to avoid the child's feeling of boredom from repeated same foods , he must participate in choosing and diversifying food, provided that it conforms to the specifications that help him get rid of the obesity problem. Parents should reduce their taking children to fast food restaurants, and it is preferable to choose restaurants that provide healthy meals for children, such as serving grilled potatoes or corn instead of French fries. The child should be taken to a specialist doctor to study the child's condition closely to help with the aim of finding solutions to get rid of the problem of obesity.

How to prevent obesity in children? •

The child should be breastfed at least till the age of one year, and it is prefer-

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able to continue to two years. Commit to eating breakfast on a daily basis and not to eat late or at least 3 hours before bedtime. Eat fat-reduced dairy products instead of full-fat for children who suffer from obesity after the age of seven. Eat foods rich in fiber to regulate and improve the digestive process. Eat a lot of vegetables and fruits. Doing sports on a daily basis or playing for at least an hour every day, and the parents must be present. Regular examination by the doctor to compare weight and growth. Educating the family on how to deal with an obese child and not focusing too much on the child's eating habits, which leads to adverse results. Stressing that parents not use food as a reward or punishment method to modify the behavior of the child.

MEASURING THE THICKNESS OF THE SKIN IN SPECIAL AREAS OF THE ARMS AND ABDOMEN AND COMPARING IT WITH SPECIAL TABLES IN WHICH IT IS POSSIBLE TO CALCULATE THE PERCENTAGE OF THE AMOUNT OF FAT IN THE BODY.

Each of this advice is no less important than the other, but of course it is not necessary to be strict about applying it all at the same time, so that the child does not consider it as a punishment. We have to make him feel comfortable to understand that there is a problem and we need to solve it without harming his self-esteem. Of course, the opinion of the specialist and following up on the case should not be underestimated at all.

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Al-Ahli Hospital / Doha - Qatar Orthopaedic and Traumatology Center

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A critically-located rare spinal tumor, successfully removed in a 10-year-old child, at Al-Ahli Hospital

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his 10-year-old child presented to Al-Ahli hospital has been complaining of severe upper back pain for 2 months. This was worsening progressively to the extent that it disturbed the child’s sleep and prevented her from going to school. Lately, she started to have difficulty walking due to weakness in her lower limbs.

Dr. El Fatih Bashir Elmalik Consultant Neurosurgeon at Al-Ahli Hospital

Of note was that the child had been taken to several medical centers where she underwent repeated radiological investigations to no avail. The child’s parents stated that she was, indeed, suffering from severe upper back pain which made it hard for her to even breathe. She was eventually seen in the Orthopedic Clinic in Al-Ahli Hospital when a thoracic Spine MRI revealed an abnormality of the second thoracic vertebral body, T2. She was accordingly referred to the Neurosurgery Clinic for further management. As noted in the MRI and CT scans of the spine, the second thoracic vertebral body was collapsed due to tumor invasion. There consequent compression of the spinal cord. The decision of surgical intervention was promptly taken with a view to relieve the child’s pain by removing the pressure from the spinal cord, repair and fixation of the damaged vertebral body and confirmation of the diagnosis by laboratory studies of the tumor material. The

Post-op X-rays showing past of the hardware fixation of the spine

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indications for surgery and goals were explained to the parents. The main challenge in this case is how to safely get access to this tumor. That was because of the anatomical location of this part of the spine directly behind the major blood vessels and the heart. Accordingly, the surgical procedure was planned carefully using the CT-scan and MRI. A team of neurosurgeons and vascular surgeons worked together via an approach in the lower part of the front of the neck was chosen to reach the spine in the upper part of the chest. Using the operating microscope and micro-instruments total resection of the tumor as much as possible with adequate relief of the spinal cord. Repair of the damaged spinal column was achieved by using a special replacement device that was anchored in place by plate and screws under X-ray guidance. Thus, surgery allowed immediate decompression of the spinal cord and restoration of the normal anatomy of the spinal column. The laboratory workup confirmed the benign, yet rare nature of the disease known as Langerhans Cell Histiocytosis – Eosinophilic Granuloma. The child had an uneventful course after surgery. Her disabling pain disappeared promptly and she was fit for discharge 3 days following surgery.

(A) CT-Scan of the Dorsal Spine, (B) MRI of the Dorsal Spine showing the collapsed T2 vertebral body (yellow arrows) and compression of the spinal cord


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Diagnostic Imaging of Acute Abdominal Pain One of the commonest presentations in emergency department

A Dr. Ahmed Nageeb Omer Specialist Diagnostic Radiology at Al-Ahli Hospital

bdominal pain is one of the commonest presentations in emergency department visits. It has many potential underlying causes, ranging from benign, self-limited conditions to life-threatening surgical emergencies.

common cause of left lower quadrant pain in adults. CT has a sensitivity of greater than 95% for detecting diverticulitis, and it can provide information about the extent of the disease and the presence of abscess formation.

The patient history, physical examination, and laboratory test results can narrow the differential diagnosis but imaging is often required for definitive diagnosis and treatment. There are multiple causes of acute abdominal pain, encompassing gastrointestinal, gynecologic, urologic, vascular, and musculoskeletal conditions. The location of the pain is often a helpful starting point. The American College of Radiology (ACR) Appropriateness Criteria for abdominal imaging are based primarily on the location of the pain.

Non-localized Abdominal Pain

Right Upper Quadrant Pain Acute cholecystitis is a primary diagnostic consideration in patients presenting with new-onset right upper quadrant pain. Ultrasonography is more readily available, can identify other potential causes of pain and does not expose the patient to ionizing radiation.

Right Lower Quadrant Pain Acute appendicitis is the most common cause of right lower quadrant pain requiring surgery and is the focus of imaging considerations in this location. CT is the initial imaging test of choice for these patients CT also provides more consistent results than ultrasonography. Routine use of CT for evaluation of appendicitis has reduced the negative-finding appendectomy rate from 24% to 3% and it has been shown to decrease overall costs by preventing unnecessary appendectomies and hospital admissions.

Left Lower Quadrant Pain Acute sigmoid diverticulitis is the most

Diffuse abdominal pain is also a common clinical presentation. CT is typically the imaging modality of choice if there is significant concern for serious pathology or if the diagnosis is unclear from history, physical examination, and laboratory testing.

Reproductive-aged females In females of reproductive age, gynecologic and obstetric causes of abdominal pain (e.g., ectopic pregnancy, ovarian cyst, ovarian torsion, pelvic inflammatory disease) are important considerations in addition to the diagnoses commonly made in the general population. Before ordering diagnostic imaging in premenopausal women, it is important to consider obtaining a beta human chorionic gonadotropin (β-hCG) measurement to narrow the differential diagnosis and to limit the possibility of exposing an embryo or fetus to ionizing radiation. Transvaginal or transabdominal ultrasonography of the pelvis is the recommended imaging study for reproductive-aged females in whom a gynecologic etiology is suspected or a β-hCG test result is positive. In pregnant patients with acute abdominal pain, ultrasonography and MRI are typically the imaging studies of choice because they lack ionizing radiation.

Conclusion Acute abdominal pain is a common presenting symptom in the emergency department and has a wide variety of causes. CT provides rapid and accurate assessment to narrow the differential and aid in the diagnosis of both surgical and non-surgical causes of pain.

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ARTICLE FEATURES . A New Strain of Coronavirus

A New Strain of Coronavirus More infectious but not more deadly

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he new year has begun amid severe fears due to the emergence of a new strain of coronavirus, which has remarkably affected the world over the past year, so many countries have imposed again more stringent precautionary measures in order to limit the rapid spread of this strain, which appears to be more infectious.

Scientists believe that the emergence of the new strain of coronavirus is significantly more contagious than other strains. The United Kingdom is the first to have witnessed the emergence of the new coronavirus strain, urging

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some countries to impose travel restrictions. A new strain of coronavirus identified in the United Kingdom is up to 70% more infectious but it is not thought to be more deadly and vaccines should still be effective. SARS-CoV-2, the virus which causes Covid-19 is evolving and mutating all the time, as do all similar viruses. Such changes are completely to be expected. Just because there has been a small change in the virus’ genetic make-up this does not mean it is any more virulent, nor that vaccines won’t be effective. When a virus replicates or makes copies of itself, it sometimes changes a little bit. These changes are called “mutations.” A virus

SCIENTISTS BELIEVE THAT THE EMERGENCE OF THE NEW STRAIN OF CORONAVIRUS IS SIGNIFICANTLY MORE CONTAGIOUS THAN OTHER STRAINS.


ARTICLE FEATURES . A New Strain of Coronavirus

with one or several new mutations is referred to as a “variant” of the original virus. It’s been snappily named VUI-202012/01 (the first “Variant Under Investigation” in December 2020) and is defined by a set of 17 changes or mutations. One of the most significant is an N501Y mutation in the spike protein that the virus uses to bind to the human ACE2 receptor. Changes in this part of spike protein may, in theory, result in the virus becoming more infectious and spreading more easily between people. There are about 23 genetic changes in this new strain; the mutations in the new strain seem to affect the coronavirus’s spike proteins, which cover the outer coating of the SARSCoV-2 coronavirus and give it its characteristic spiny appearance. These proteins help the virus attach to human cells in the nose and other areas and invade the body, causing COVID-19 illness. But it is not the first time that the coronavirus has mutated, since its first emergence in late 2019, and the virus that was first discovered in the Chinese city of Wuhan is not the same virus that is now spreading around the world. Viruses are always changing. When a virus infects a cell, it begins making copies of its genetic instructions. Most viruses don’t have the necessary tools to proofread each string of RNA for mistakes, so the process is error-prone and differences build up over time. Coronaviruses like SARS-CoV-2, on the other hand, do have a proofreading enzyme — a rarity for RNA viruses. But that doesn’t mean their genomes don’t have errors. Changes still accumulate, just more slowly than in other RNA viruses such as influenza. “Strains,” “variants” or “lineages” are all terms researchers might use to describe viruses that have identical or closely related strings of RNA. WHO Director-General, Dr. Tedros Adhanom Ghebreyesus, explained that there is no evidence that the new strain of the coronavirus causes serious disease or death. The Executive Director of the WHO Health

Emergencies Program, Mike Ryan, confirmed that although the new strain is spreading more quickly than previously known strains, the transmission of infection is not as fast as infection with measles, mumps and smallpox. He also said that the situation is not out of control, but it cannot be allowed to spread, urging countries to implement previously tried and tested health measures. The World Health Organization indicated that every ten people infected with the new strain of the virus can transmit the infection to 15 others on average, while the rate of transmission of infection with the previously known strains in Britain reaches 11 people.

Are symptoms the same? Researchers continue to study the effects of the new strain of coronavirus, but so far studies have proven that the symptoms are the same, as most of the cases recorded so far have the same typical symptoms of nausea, loss of smell, dry cough, fever, body aches and chills. The fast-moving new variant of the virus is 70% more transmissible than existing strains, and appears to be driving a rapid spike in new infections in London and southern England.

THERE ARE ABOUT 23 GENETIC CHANGES Will the new vaccines be effective IN THIS NEW STRAIN; against the new strains of COVID-19? THE MUTATIONS IN As the coronavirus continues to spread THE NEW STRAIN around the world, it will often continue to SEEM TO AFFECT mutate and develop new strains over time, and THE CORONAVIRUS’S therefore it is difficult to predict its future muSPIKE PROTEINS, tations or changes, as it may form strains that WHICH COVER THE won’t be affected by the current vaccines, which OUTER COATING OF THE SARS-COV-2 puts scientists in a situation similar to influenza CORONAVIRUS as the influenza vaccine needs to be develAND GIVE IT ITS oped periodically, and fortunately the current CHARACTERISTIC (Covid-19) vaccines can be easily developed. SPINY APPEARANCE. The aim of the vaccines is to train our immune systems to recognize these viruses or bacteria as “other” and create immune cells against them that will reactivate when we come across them in real life, killing them before they have a chance to make us ill.

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Optimistic Outlook for a Prosperous 2021 By Sheikh Sultan bin Tahnoon Al Nahyan, Chairman of the Board of the Frontline Heroes Office

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ast year has been long and challenging for the vast majority of us and we have seen so many heroes, across different sectors work tirelessly to curb the effects of the pandemic. Looking ahead, 2021 marks the build-up to the UAE’s Golden Jubilee, a moment that marks collective optimism for our shared future whilst maintaining the knowledge that life will never again be quite the same, and nor do we want it to. In the midst of chaos, the pandemic brought with it clarity and a wealth of experience, and what a lost opportunity it would be if we as a nation reverted back to life as we lived it pre-pandemic, and we were to overlook our most invaluable guardians who have put their personal health at risk to protect the lives of citizens and residents of the UAE Throughout 2021 and thereafter, the Frontline Heroes Office will continue to go beyond listening to the concerns of frontline professionals by creating opportunities for us all to celebrate our national heroes to ensure that they will never be unsung again. We invite all government entities, businesses, and social support groups to unite with us to develop new programmes that support and provide for our frontline heroes. The Office will continue its mandate of finding nation-wide solutions to ensure a prosperous and stable future for our frontline heroes.

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WHEN THE FRONTLINE HEROES OFFICE WAS ESTABLISHED IN JULY BY PRESIDENTIAL DECREE UNDER THE CHAIRMANSHIP OF HIS HIGHNESS SHEIKH MOHAMED BIN ZAYED AL NAHYAN, CROWN PRINCE OF ABU DHABI AND DEPUTY SUPREME COMMANDER OF THE UAE ARMED FORCES, TWO CENTRAL IMPERATIVES WERE EVIDENT.

Through various upcoming initiatives, we aim to address essential needs for our heroes and their children across multiple areas such as higher education, mental and psychological wellbeing, housing and healthcare. When the Frontline Heroes Office was established in July by Presidential Decree under the Chairmanship of His Highness Sheikh Mohamed bin Zayed Al Nahyan, Crown Prince of Abu Dhabi and Deputy Supreme Commander of the UAE Armed Forces, two central imperatives were evident. The first is that as a nation we must recognise, celebrate and support our frontline heroes and their families. We need to understand the unique circumstances and challenges they face when asked day in and day out to put their personal safety at risk for the greater societal good. And we need to unite to help alleviate the stresses they endure, to best enable them to deliver the service and protection we ask of them. The second imperative is that we need to continuously invest in, develop, train and maintain a world-class emergency and disaster management network that is always ready to respond and protect us from all types of potential emergency situations. While forming the Frontline Heroes Office, we started by listening and learning. We wanted to hear directly from our frontline professionals about the challenges and stresses they faced and what we could do to help alleviate them. We built the principle of partnerships into the ethos of the Office because we saw a great opportunity to harness the strength and expertise of an incredibly wide range of resources across our government, business community and social services sector to deliver immediate support for our frontline heroes, while investing in a sustainable emergency preparedness and response network. Most recently we launched the new Jaheziya emergency response preparedness and training


NEWS programme. This best-in-class training initiative was developed in partnership with the Sheikha Fatima bint Mubarak Volunteer Programme and a group of prominent US and UK disaster management institutions. It will provide internationally accredited critical care and life-saving certification that will contribute to the UAE’s ability to maintain a sustainable network of highly trained frontline professionals to protect our nation and its people in the face of any future emergency.

Several partnerships have directly addressed the concerns put forward by frontline heroes, for example: •

With Emirates Foundation and the Ministry of Community Development,

we rolled out an innovative new mental health support initiative, addressing one of the highest priorities our frontline heroes told us they need. With the Ministry of Education, we launched Hayyakum to provide scholarships to more than 2,000 children of frontline heroes that extend throughout their education in the UAE. With Daman, we launched an AED 20 million programme to upgrade health insurance plans for the 10,000 lowest earning frontline heroes and their families as well as to provide 2,500 frontline professionals with mental health insurance coverage.

SEHA commences the administration of the COVID-19 vaccine to the UAE community at 40 locations

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bu Dhabi Health Services Company, (SEHA), the UAE’s largest healthcare network, has announced the opening of two COVID-19 Vaccination Centers in the Emirate of Abu Dhabi and one in Dubai, for members of the community who wish to receive the Beijing Institute of Biological Product’s inactivated vaccine. The COVID-19 Vaccination Centers, located in Abu Dhabi Cruise Terminal in Abu Dhabi City and Al Ain Convention Center in Al Ain City, have the collective capacity to administer vaccine shots to 6,000 people daily, and were established in a record time of four days. The centers were established following the UAE Ministry of Health and Prevention’s (MOHAP) announcement of the registration of the vaccine, making the country one of the first in the world to administer a COVID-19 vaccine to the community. In Dubai, the COVID-19 Vaccination Center is located at Dubai Parks & Resorts Field Hospital and has the capacity to accommodate 3,000 people daily. The Sinopharm CNBG COVID-19 vaccine will be also administered within select SEHA facilities, including 35 Ambulatory Health Services (AHS) facilities in Abu Dhabi and Al Ain, 6 hospitals in the Al Dhafrah region, Al Ain and Al Dhafrah, SEHA’s National Screening Center in

UAE NATIONALS AND RESIDENTS WISHING TO RECEIVE THE VACCINE CAN VISIT ANY OF THE CENTERS IN ABU DHABI EVERY DAY OF THE WEEK, FROM 8:00AM TO 8:00PM. THE COVID-19 VACCINATION CENTER IN DUBAI IS OPEN DAILY FROM 8:00AM TO 4:00PM AS WALK-IN OR BY APPOINTMENT THROUGH THE SEHA APP.

Mina Rashid and Khawaneej in Dubai city, and existent screening centers in industrial areas, with an overall capacity of 150,000. The registration of the Sinopharm CNBG COVID-19 vaccine follows the success of the Phase 3 Clinical Trials, which began in Abu Dhabi and was overseen by MOHAP and the DoH, managed by G42 Healthcare, and administered by SEHA. 31,000 volunteers took part in the clinical trials, the analysis of which proved the inactivated vaccine’s 86% efficacy against the COVID-19 virus and was followed by the administration of the vaccine to emergency personnel and frontline healthcare workers. The new centers are each divided into two zones – one for each dose, with every zone including 24 vaccination stations. Visitors to the COVID-19 Vaccination Centers and other SEHA facilities administering the vaccine will first register and then undergo a vital checkup, including blood pressure, height, weight, and temperature. Women will also be required to conduct a pregnancy test. Following the examination, visitors will undergo an assessment to confirm their eligibility and sign a consent form, after which, they will be given the first dose. After receiving the first dose, they will receive their appointment for the second dose, administered three to four weeks after the first dose.

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Bupa Arabia received reputable awards and listing in 2020 Bupa Arabia's distinctive and diverse health insurance programs and product offerings set the company apart from the rest, making it a health insurance leader in the region healthcare services and health insurance products. Bupa Arabia’s products are designed to meet the needs of government institutions, and the private sector, including large-, mediumand small-scale companies, in addition to families and individuals. “Our success is in line with Vision 2030 objectives, which include improving the quality and efficiency of healthcare services along with the company's strategic vision for 2020," Nazer added.

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upa Arabia for Cooperative Insurance continued its exceptional track record of successes in 2020, winning a string of coveted awards at local, regional and international levels. The company has been ranked as the top insurer in the region by Forbes ME’s annual rankings. The leading health insurer is ending 2020 on a high note as it has just been named as the "Health Insurance Company of the Year" by the Middle East Insurance Industry (MEII) Awards; organized by the Middle East Insurance Industry Review and audited by Ernst & Young. The organizers chose Bupa Arabia for its pioneering health insurance programs and diverse insurance products, such as Bupa Munsha'at, which is the first health insurance program offered to medium and small enterprises in the Arab region. Tal Nazer, CEO of Bupa Arabia for Cooperative Insurance and member of the Board of Directors, attributed the achievements to the company’s efforts to be an effective health partner for its clients by providing unique

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OUR ACHIEVEMENTS ARE IN LINE WITH THE HEALTHCARE OBJECTIVES OF VISION 2030 AS WELL AS THE COMPANY'S STRATEGIC VISION FOR 2020.

Earlier this year, Bupa Arabia was ranked No. 1 among the most valuable insurance companies in the region by Forbes Middle East 2020, and listed among the Middle East's top 100 companies in 2020. Brand Finance, a leading and independent global company in the field of rating and evaluation of brands, ranked Bupa Arabia among the 50 most valuable brands in the Kingdom of Saudi Arabia in 2020. Additionally, Bupa Arabia was recognized in two categories by the Business Global Outlook magazine. The first was “Best Healthcare Insurance Service Provider in Saudi Arabia in 2020,” and the second was the “Best Digital Innovation in Insurance Sector.” The winners were chosen after an extensive evaluation by a group of international analysts specializing in the insurance sector. Continuing the honors were the Gulf Sustainability and CSR Awards 2020, which recognized Bupa Arabia as the "Best Workplace" and for its HR practices. The prestigious awards recognize companies in the region with policies that show respect and regard for employees, including policies promoting diversity in the workplace, family-friendly policies, regard for work-life balance, and health and wellness. Finally, Bupa Arabia was named by the International Finance Magazine (IFM) of the UK, as the "Best Health Insurance Company" and "Best Investor Relations Insurance Company" in Saudi Arabia for its implementation of the highest quality standards in the services and products provided to customers.


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Saudi German Hospital Jeddah Successfully Performs Surgery on Patient with Elephantiasis

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audi German Hospital in Jeddah successfully performed surgery on a 55-year-old man suffering from elephantiasis, which included an enlarged testicle weighing over 40 kilograms and swelling in the legs which was affecting his ability lead a normal life for the past four years. The surgery, which used the latest technology and the most advanced medical equipment, was led by Dr. Ihab Saad, Head of Surgery Department at Saudi German Hospital-Jeddah and was supported by a multidisciplinary team from Urology, Plastic Surgery and Anesthesia. The condition includes the enlargement and hardening of limbs or body parts caused by tissue swelling and may also affect the genital area as well. Dr. Saad and his team of surgeons removed the testicle cyst in a ground breaking surgery that lasted for four hours. Post-surgery, the patient spent time in recovery to regain his health and strength, in order to resume normal life. Dr. Ihab Saad said, “We are pleased to announce the success of this very delicate

The Department of General Surgery and Oncology at Saudi German HospitalJeddah performs various advanced surgeries, which include liver transplant surgeries, heated intraperitoneal therapy for peritoneal carcinomatosis, in addition to liver, colon, stomach, pancreatic and biliary cancer surgeries. The department also offers breast cancer, thyroid, endocrine and soft tissue surgeries, aside from various general surgery operations, whether open or laparoscopic.

surgical procedure, especially after several medical institutions and facilities refused to treat the patient's condition due to the high risk posed by surgery. However, we performed the operation using the latest medical technologies available under the supervision of a highly qualified and professional medical team. The success of this procedure is a key addition to the many achievements of Saudi German Hospitals (SGH) Group--reflecting the Group's high-level facilities, advanced medical equipment and worldclass capabilities of its doctors in performing complex surgeries.” “We, at SGH Group, provide the most advanced surgical and therapeutic services across various specialties, backed by medical teams of high-level professionals who are qualified as per the highest international standards, to meet the various health needs of the patients and provide them with comprehensive treatments. We are committed to providing our patients with the latest and most successful treatments that enable them to enjoy a healthy life, while strengthening the Group’s position as a leader in the field of healthcare in the Kingdom of Saudi Arabia.” concluded Dr. Saad.

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People Activation in an Uncertain World

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lthough we saw it coming, COVID-19 spread at such an unprecedented rate it didn’t leave us any time to prepare. Today, COVID-19 continues to strain our health systems. It has forced them to evolve at a faster rate and become a little more robust and readier for future challenges including improved use of virtual care and better disaster planning. Recent news about effective vaccines being released soon is very reassuring and gives us hope of getting out of the COVID-19 tunnel. However, the big question remains: Are we ready for the next “big surprise”? What if the next “big surprise” being unimaginable and highly consequential, is beyond our disaster planning? Or what if the next surprise is a digital virus that breaks down our virtual care systems and obliterates our databases? Oussama Nicolas, Partner, Health Industries at PwC Middle East, said: “There is one element of the healthcare system that we acknowledge the importance of, but we do not invest enough in. It can be considered our first and last line of defense: People Activation. If equipped with knowledge, skills, and confidence, people will be sick less often, and when they do get sick they can take care of themselves (to a certain extent) or receive better care, therefore lowering their cost burden on the health system”. In a survey PwC conducted across the GCC, over 85% of respondents agreed that their lifestyle has a direct impact on their health; however, evidence has shown that over 50% of all years lived with disability are purely attributable to behavioural risk factors.” While the focus of health systems has been mainly on supporting patients and equipping them with the knowledge and skills to manage their health and care (patient activation), PwC stresses the need for People Activation throughout their entire life journey. This requires activating people and their families when they are healthy, when they need acute care, if they have a chronic condition and if they have a disabling

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WHILE THE FOCUS OF HEALTH SYSTEMS HAS BEEN MAINLY ON SUPPORTING PATIENTS AND EQUIPPING THEM WITH THE KNOWLEDGE AND SKILLS TO MANAGE THEIR HEALTH AND CARE (PATIENT ACTIVATION), PWC STRESSES THE NEED FOR PEOPLE ACTIVATION THROUGHOUT THEIR ENTIRE LIFE JOURNEY. THIS REQUIRES ACTIVATING PEOPLE AND THEIR FAMILIES WHEN THEY ARE HEALTHY, WHEN THEY NEED ACUTE CARE, IF THEY HAVE A CHRONIC CONDITION AND IF THEY HAVE A DISABLING CONDITION.

condition. Part 1 of PwC GCC’s paper “People Activation in an Uncertain World” reveals that there is a lot of room for people activation. The paper looks into international studies and evidence to better understand how activation may impact health, care, and value in the GCC given that heart disease, cancer, stroke, respiratory disease, and diabetes are among the leading causes of death in the region. These conditions are influenced by modifiable behaviours and are often preventable.

PwC’s paper proposes a high-level five-pronged framework to guide activation strategies: •

Stratifying the Population to understand the level of activation of the population and the cultural and behavioral implications. Customising Activation Plans in line with the culture and behaviors of your population groups to develop plans that address their health risks and behavioural habits. Empowering people with knowledge, tools, and coaching to build their skills for activation. Addressing the Health System Culture to embrace the fact that medical care accounts for only 10% of health. Healthcare workforce needs to believe in activation and the important role people play in their health. Adjusting Regulation and Funding to drive system change through policy and incentives that hold healthcare players accountable to focusing on activating people and patients.

In conclusion, we need to enable people to care for themselves and their loved ones. This will be crucial for when our health systems are strained. We do not have to re-invent the wheel; a lot has already been done around the world. However, we need to gather the different parts of the wheel within an activation strategy tailored to our culture and needs.


Innovative Patient Care The Multicare® Bed with Automatic Lateral Therapy Precise and Individualized Control of Ventilation Acute respiratory distress syndrome (ARDS) is the most serious manifestation of pulmonary involvement. It has many causes and reaches up to a 30-60% mortality rate with severe lung involvement.(1, 2) In some patients, COVID-19 occurs in the form of very severe ARDS.(3) To assist patients the Multicare® bed with platformbased rotation tilts as far as 30° to help promote ventilation distribution. The Multicare® also has Automatic Lateral Therapy which is programable and allows up to a 30° turn to each side to provide an individualized prevention or treatment plan.

The strength of the unique platform-based lateral tilt assists nurses with turning patients.

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A combination of the open architecture of the Multicare® bed and its features such as lateral tilt and the Ergoframe® allows for the overall management of pressure area care.

30° of rotation 24 hours

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The Early Mobilization with LINET program uses the recommended procedures from the AACN and enhances them by applying the unique Multicare® features.

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(1) ARDS Definition Task Force, Ranieri VM, Rubenfeld GD, Thompson BT, et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA. 2012;307(23):2526-33 (2) Villar J, Blanco J, Kacmarek RM. Current incidence and outcome of the acute respiratory distress syndrome. Curr Opin Crit Care. 2016;22(1):1-6. (3) Ramanathan K, Antognini D, Combes A, et al. Planning and provision of ECMO services for severe ARDS during the) COVID-19 pandemic and other outbreaks of emerging infectious diseases [published online ahead of print, 2020 Mar 20]. Lancet Respir Med. 2020; S2213-2600(20)30121-1. doi:10.1016/S2213-2600(2030121-1

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