HOSPITALS Magazine issue 57 by The Arab Hospital Magazine

Publisher Arab Health Media Communication General Manager Simon Chammas schammas@tahmag.com Creative Department Roula Haddad - Georges Habka Creative Director: Jessy E. Hajj

CORONAVIRUS VACCINATION

A new travel visa

The coronavirus vaccine has actively become a part of our daily life and a crucial decision in our lives and our movements. Since vaccines were proven to be effective, many countries started requiring proof of vaccination as a travel condition, and other countries will also follow in their footsteps. Even within the same country, there are forums, hotels and companies organizing conferences that won’t allow entry of people who haven’t been inoculated. The importance of this is determined by the creation of a herd immunity. Experiments and studies have shown that the presence of non-vaccinated people in society, or the potential carriers of the virus, weakens the war against coronavirus and limits the effectiveness of the vaccination campaign due to its lack of comprehensiveness. One doctor likens this reality to someone who builds a ship and leaves a gap in its wall that will make it sink making all his efforts go to waste. Hence, many countries resorted to adopting vaccination as a condition to allow entry to their territories. Among them is Cyprus, which in December became the first destination to announce plans to allow vaccinated travelers to enter the country, without the need to adhere to quarantine requirements and PCR tests. Some destinations also require that, including: Estonia, Georgia, Iceland, Poland, Romania, and Seychelles. Consequently, Arab and Gulf states, in particular, will begin adopting vaccination as a condition to enter their lands. Denmark is seeking to become the first country to formally introduce COVID-19 vaccination passports. It is the choice of the future, where vaccine means safety. The war against coronavirus has ended, and humanity started picking itself up to start again in a world preserved by health and surrounded by safety. Publisher

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

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

MAR . APR 2021

46 Fighting a Silent Killer: Chronic Kidney Disease

NEWS

8 Al Ain Nursing Department awarded for outstanding quality of care 10 World Kidney Day – 11th March 2021 12 Fakeeh University Hospital in Dubai Digitally Transforms Experiences for Over 700,000 Patients Per Year 18 The Centre for Arab Genomic Studies Organizes Webinar Series 26 Researchers enrolling patients for study to train AI in assisting breast cancer surgery 28 Dubai Blood Donation Center retains AABB accreditation, achieves 100% compliance 30 GE Healthcare & Curea sign first strategic collaboration in Turkey to accelerate AI-based software development in medical imaging 36 Orange Business Services Flexible SD-WAN supports Getinge with increased agility to aid the health industry 40 Boehringer Ingelheim Recognized As Global Top Employer for 2021 90 Arab Health and Medlab Middle East generated over AED 756 million for the Dubai economy in 2020

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92 Healthcare Drive Sees Dubai Science Park Attract Leading Global Companies in 2020 94 Aster DM Healthcare appoints Mr. David Boucher as Global lead for Service Excellence and Patient Experience

INTERVIEWS

56 Dr. Elias Abi Khalil 58 V. Rama Jayanthi 60 Christiana Demetriou

ARTICLES

14 Innovations for In-Bed Patient Care During the Pandemic 16 Glucose stabilisation right from the beginning 32 Employing the Power of AI and Interoperability to Reduce Sepsis Mortality 44 A Cardiopulmonary Rehabilitation Program at HDF for Post COVID-19 Patients 50 Electrophysiological study and catheter ablation procedure 52 The secret enemy of women: Deep endometriosis 84 Upper GI Endoscopy: who should have it, when and why?

‫َ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.

www.hamad.qa

MAR . APR 2021

54 Smart Hospital Beds

85 Al-Ahli Hospital treats the cruciate ligament rupture with the latest surgical techniques 88 A medical achievement by performing a complex surgery for "endometriosis" 89 Al-Ahli Hospital adopts thermal frequency technology to treat legs

FEATURES

46 Fighting a Silent Killer: Chronic Kidney Disease

76 COVID Vaccine Passports

MAR.APR 2021

64 Women's health

54 Smart Hospital Beds Innovative applications for more accurate care 64 Highlighting women’s main health issues 66 Not all breast diseases are cancer 70 Uterine diseases 74 Multisystem Inflammatory Syndrome in Children 76 Will the COVID-19 vaccine passport be adopted? 80 Comprehensive Diabetes Care Centers 96 Infection Control in Coronavirus Departments

80 Diabetes Care Centers

NEWS

Al Ain Nursing Department awarded for outstanding quality of care lation with the best people, talent, and expertise – thus providing the high quality of care and promoting health and wellbeing at all times.” Dr. Ghazala Belal Balhaj, Medical Director, Al Ain Hospital, said, “We are thrilled about the recent recognition of our Nursing Department. The unwavering support of SEHA and its commitment to harnessing talent has been the foundation of our success. By meeting all the requirements laid out by the NDNQI, we are guaranteeing the provision of world-class healthcare across our services, particularly the adult intensive care and pediatric intensive care wards.” “I extend my deepest gratitude to every member of the Al Ain Hospital Nursing Department for their dedication, compassion and hard work – this accomplishment would not have been possible without the efforts of each and every member of the team. I would like to especially thank Sheikha Juma Al Shamsi, Acting Chief Nursing Office of Al Ain Hospital for her inspirational leadership,” continued Dr. Balhaj.

bu Dhabi Health Services Company (SEHA), the UAE’s largest healthcare network, has announced that the Nursing Department in Al Ain Hospital has been recognized by the American Nursing Association for meeting all the requisites set out by the National Database of Nursing Quality Indicators (NDNQI). NDNQI monitors 19 quality indicators in nursing units, encouraging world-class standards and quality, and allowing for hospitals to compare nursing performance in terms of results, patient safety, and staff satisfaction with similar hospitals locally and internationally. Dr. Aysha Al Mahri, Group Chief Nursing Officer, SEHA, said: “Nurses are the cornerstone of every robust healthcare system, and at SEHA, we are fortunate to have empowered the nursing community to be our foundation. Being the largest part of our network’s workforce, SEHA’s nurses dedicatedly embrace compassionate patient-first healthcare values, always strive to fulfill their roles and responsibilities, and continuously pursue opportunities to learn, develop and improve. It is a privilege that Al Ain Hospital’s Nursing Department has been recognized by an esteemed organization such as the American Nursing Association. This strengthens our commitment to providing the nation’s popu-

MAR.APR 2021

THE AWARD, PRESENTED BY THE AMERICAN NURSING ASSOCIATION, ACKNOWLEDGES AL AIN NURSING DEPARTMENT’S SUCCESS IN MEETING ALL OF THE REQUISITES SET OUT BY THE NATIONAL DATABASE OF NURSING QUALITY INDICATORS.

The nursing quality indicators measured at Al Ain Hospital include patient accidents such as falls, turnover of nursing employees, infections associated with delivery of care, ventilator-associated diseases or conditions, nursing hours per patient days, and job satisfaction of resident nurses, among others. As part of NDNQI, medical facilities may participate in as many or as few indicators, according to the eligibility of their units. Shaikha Juma Al Shamsi, Acting Chief Nursing Officer, Al Ain Hospital said, “We are both pleased and humbled by the recent recognition from the American Nurses Association. Being part of Al Ain Hospital and the SEHA network, the Nursing Department is given abundant opportunities to develop, widen our career horizons, work with talented leaders in the field of medicine, and continuously accelerate the advancement of the care we provide to our patients.”

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

World Kidney Day – 11th March 2021

orld Kidney Day may not be as widely acknowledged as other disease awareness campaigns, but it certainly deserves our attention. Kidney disease, is a silent disease in the early stages, meaning diagnosis is often late and can result in life-long complications that require dialysis as a last resort. On March 11th, the global World Kidney Day initiative aims to raise awareness of the importance of our kidneys and keeping them healthy. The organization behind World Kidney Day also aims to raise awareness around preventive behaviors, risk factors, and how to live with kidney disease.

Kidney disease is caused when damage occurs to the kidney’s blood vessels, which affects their ability to function properly. The most common cause of this damage is diabetes, obesity, and hypertension. With such a high prevalence of the comorbidities directly contributing to its prevalence, kidney disease rates are believed to be increasing at an alarming rate in the UAE. The most common type of kidney disease, affecting between 3 and 5%1 of the UAE population, is chronic kidney disease. It is a complex disease that is long-term and doesn’t improve over time. Chronic kidney disease sees the gradual loss of kidney function as a result of damage that can be caused by a number of different conditions, with the most common contributor being diabetes. Managing the disease can be difficult and if the damage gets worse over time, the kidneys can fail completely, leaving the patient dependent on life-long dialysis or requiring a transplant. According to the Emirates Nephrology Society, around 1,600 people in the country undergo regular dialysis, and concerningly, this is increasing year on year. With as many as one in ten adults2 globally suffering from chronic kidney disease, learning to manage such a serious and long-term illness can present a challenge to the patient, and those close to them. Whilst patients can undergo many aspects of normal life without hindrance, treatment pathways of such complex conditions are unique and often, long-term. Patients may need to manage numerous doctor

MAR.APR 2021

visits, nurse follow-ups, and potentially dialysis. Regular tests, assessments and counseling, performed by a range of caregivers at many different facilities, will become a normal part of life and are essential to maintaining kidney function and reducing the risk of disease progression. The theme for World Kidney Day (WKD) in 2021 is ‘living well with kidney disease’, with the organizers turning the focus this year to the effective management of symptoms and enabling patient empowerment. Addressing the impact that living with a chronic disease has on the patient and their quality of life is a priority for the UAE’s leadership and addressing lifestyle-related disease remains a key performance indicator of the UAE National Agenda. An integral part of Abu Dhabi’s commitment to its many patients living with kidney disease is the role of the health information exchange platform, Malaffi. Malaffi is a technology that allows healthcare providers to safely and securely, access and share a patient’s important, up-todate medical record. Previously, the informa-

KIDNEY DISEASE IS CAUSED WHEN DAMAGE OCCURS TO THE KIDNEY’S BLOOD VESSELS, WHICH AFFECTS THEIR ABILITY TO FUNCTION PROPERLY. THE MOST COMMON CAUSE OF THIS DAMAGE IS DIABETES, OBESITY, AND HYPERTENSION.

NEWS

tion and results obtained at each patient visit were not easily shared and had to be physically tracked down and requested, interrupting the care continuum. Continuity of this type of longterm care is extremely important and can have a direct impact on the successful management of the disease and improving the patient’s quality of life. In response to the theme of WKD 2021 – continuity of care really does help patients to ‘live well with kidney disease’. Further explaining the vital role that data sharing has in the management of kidney disease, Dr Maisa Abdalla, General Practitioner, Urgent Care Facility, Kanad Hospital, explains how the health information exchange is critical in patients admitted to hospital with underlying conditions. “If a patient is admitted to hospital, and medical teams aren’t aware of their medical history and underlying conditions such as kidney disease, medication can be given in error and have severe consequences. In particular, patients who suffer from chronic kidney disease often experience severe complications when prescribed relatively common medications, such as antibiotics and anti-inflammatories. This interaction can cause acute kidney injury, also known as acute renal failure, which is a sudden episode of kidney damage as a result of various factors including adverse drug interaction and accounts for around 40% of all acute kidney injuries3 seen within hospitals. “With access to a patient’s important medical history and having detailed information on chronic conditions such as kidney disease and diabetes, medical teams can avoid potentially dangerous interactions. As an example, I recently saw a young patient that complained of abdominal pain, yet she did not report any pre-existing medical conditions. When I checked Malaffi, I saw that she had previously been diagnosed with chronic kidney disease. Having access to this information prevented me from prescribing a pain killer that would have made her condition worse. Instant access to the patient's medical history empowered me to make safe decisions, provide the best possible care to the patient and support the continued, effective management of care for patients with chronic diseases.”

Dr. Siddiq Anwar, Consultant Nephrologist, Abu Dhabi Health Services Company - SEHA Acute Kidney Injury (AKI) in hospitals is common and expensive to manage. In addition, if the elderly and those with cardiovascular risk factors such as diabetes develop AKI, they are at subsequent risk of recurrent AKI and progressive renal failure. The presentation of kidney disease in the UAE is very different compared to the West due to our unique demographics. Hence, local data is needed to design our renal care and to optimize renal healthcare delivery here in UAE. Malaffi, with its big data collated from all Abu Dhabi healthcare providers can help us advance our knowledge in hospital AKI and help us to develop local solutions to local problems. We, at SEHA, look forward to engaging with Malaffi and our regional stakeholders to help the DOH improve healthcare in the Emirate of Abu Dhabi with data-driven decisions.

Dr. Rahul Goyal, Senior Vice President of Clinical Engagement and Adoption, Malaffi At Malaffi we are committed to supporting the Department of Health and tackling the most pressing healthcare needs in our community, including the burden of chronic disease. Malaffi supports our healthcare teams as they work tirelessly to help patients with chronic diseases such as chronic kidney disease to manage their conditions and improve their quality of everyday life. As well as supporting the continuity of management of diseases, Malaffi will assist the Department of Health to perform population health analytics to address the challenge of chronic and lifestyle conditions. As part of the digital transformation of the healthcare system in the Emirate, technology will increasingly have a role in predicting disease patterns, reducing risk factors, improving prevention and ultimately, improving quality of life.”

MALAFFI IS A TECHNOLOGY THAT ALLOWS HEALTHCARE PROVIDERS TO SAFELY AND SECURELY, ACCESS AND SHARE A PATIENT’S IMPORTANT, UP-TO-DATE MEDICAL RECORD. PREVIOUSLY, THE INFORMATION AND RESULTS OBTAINED AT EACH PATIENT VISIT WERE NOT EASILY SHARED AND HAD TO BE PHYSICALLY TRACKED DOWN AND REQUESTED, INTERRUPTING THE CARE CONTINUUM.

1. (PDF) Chronic kidney disease in patients at high risk of cardiovascular disease in the United Arab Emirates: A population-based study (researchgate.net) 2. Global Facts: About Kidney Disease | National Kidney Foundation 3. Hospital-acquired acute kidney injury in medical, surgical, and intensive care unit: A comparative study (nh.gov)

NEWS

Fakeeh University Hospital in Dubai Digitally Transforms Experiences for Over 700,000 Patients Per Year

Dr. Fatih Mehmat Gul

Dr. Fahd Nawwab

akeeh University Hospital, a state-of-theart healthcare facility in Dubai Silicon Oasis announced today that its digital transformation with SAP is set to enhance experiences for more than 700,000 patients per year. Serving communities in the heart of the UAE and the wider region, the 350-bed hospital with medical practitioners across 55 specialties provides primary, secondary, and tertiary care, with an estimated 40,000 admissions and 20,000 surgical operations. Through its integrated healthcare model using smart technologies, Fakeeh University Hospital is well-positioned to make a positive impact on the development of the healthcare sector in the UAE. With an academic and research facility affiliation, Fakeeh University Hospital functions as one of the most advanced smart hospitals in the region, using robust technological systems to facilitate patients’ care and doctors’ efficiency. Through its highly innovative, automated supply chain, the hospital is setting a benchmark in the region by revolutionizing ways in which internal and external hospital systems can be managed. “Committed to excellence through research, education, and clinical care, precise diagnoses and data-assisted decision making is embedded in our culture for better patient outcomes and

MAR.APR 2021

faster recoveries,” said Dr. Fatih Mehmat Gul, Chief Executive Officer of Fakeeh University Hospital. “Our digital transformation with SAP is delivering accountable, compassionate, and innovative healthcare services to enhance the well-being of the community.” To further support healthcare innovation in the region, Fakeeh University Hospital has worked with global technology company SAP to utilize the right tools to support instant decision making, to be future-ready for growth and innovation without limitation. In addition, SAP’s holistic approach to human capital management – ‘from hire to retire’ – has assisted Fakeeh University Hospital to motivate its workforce to perform their best, collaborate and communicate as a family, and grow and upskill through unlimited access to a host of learning materials at any given time. “Fakeeh University Hospital is showing how healthcare providers can embrace best practices to become Intelligent Enterprises that leverage real-time technologies to improve patient outcomes and deliver cost-effective care,” said Dr. Fahd Nawwab, Vice President, SAP Saudi Arabia. “The hospital is delivering a seamless patient and doctor experience and driving innovation that supports value-based care.”

IN LINE WITH ITS VISION TO BE A LEADING REGIONAL ROLE MODEL FOR PATIENT CARE AND MEDICAL EDUCATION, THE HOSPITAL NOW HAS FULL VISIBILITY AND REAL-TIME INSIGHTS ON PATIENT AND DOCTOR CARE AND HISTORY, ASSET MANAGEMENT, MEDICAL BILLING AND INSURANCE PROCESSES. ALL USER INTERFACES ARE MODERN, HIGHLY INTUITIVE, AND SIMPLE TO USE.

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

ARTICLE

Innovations for In-Bed Patient Care During the Pandemic Jitka Stranska, Managing Director LINET MEA

OUR GOAL IS TO INVOLVE THE BEDS IN THE RECOVERY PROCESS AS MUCH AS POSSIBLE AND TO STRENGTHEN THE EFFECTS OF THE THERAPY.

ver the last year, we have witnessed an extreme burden on healthcare professionals and healthcare systems as well as an increased demand for sufficient quality and quantity of medical equipment. As a manufacturer and an innovator, we were pleased to be able to cover the surge in demand for hospital beds and ensure both a temporary and permanent expansion and improvement of the bed capacity throughout our region. Advanced LINET technologies have proven their strength during the current coronavirus pandemic.

Pulmonary Complications Prevention Our invention - bed-framed lateral tilt and especially the Automatic Lateral Therapy smart function, which tilts the bed to the sides automatically (+/- 30°) in predefined cycles, is used to prevent ARDS. The effect of Automatic Lateral Therapy (ALT) on the Multicare bed is through the promotion of ventilation distribution. The safe and radiation-free “Continuous, Individualized Ventilation Care” is based on a combination of frame-based lateral tilt and Electrical Impedance Tomography.

Hands-Free Lateral Tilt Lateral tilt also has many uses in routine nursing tasks that nurses perform many times per shift. Tilting will help the nurse turn the patient sideways without exertion. A simple procedure facilitates hygiene, positioning, and basic examinations. Another great advantage, especially during the increased hygienic demands is the hands-free tilt adjustment. This eliminates unnecessary contact with the surface of the bed and, conversely, the nurse has her hands free for full concentration on nursing procedures. The ability to tilt the mattress platform also enables easier and safer side -mobilization of the patient even in the very early stages of the recovery.

JAN.FEB 2021

ARTICLE

WE HAVE BEEN PROVIDING HEALTH PROFESSIONALS WITH LONG-TERM EDUCATIONAL PROGRAMS AIMED AT MAXIMIZING THE TECHNOLOGICAL ADVANTAGES OF LINET BEDS AND THEIR PRACTICAL APPLICATIONS IN NURSING PROCEDURES AND WE WANT TO SHARE THE DETAILS AND OUR REAL-LIFE EXPERIENCES WITH YOU. Prone Nursing in Combination With ALT A combination of bed-framed lateral tilt positioning options and programmed ALT cycles can be used for ventilated patients to boost the effects of prone nursing. COVID-19 patients with ARDS are often placed in the prone position to improve oxygenation and survival. Prone position, in which the patient lies on his abdomen, allows better blood circulation and ventilation of the dorsal lung regions. Gravity makes it easier to aspirate secretions and permits better gas exchange in both lungs. Rotation in repeated cycles within Automatic Lateral Therapy helps to further increase these effects. Positioning patients in the prone position is very challenging. The main condition is the safety of the intubated patient. At the same time, turning requires great physical demands and therefore the involvement of a large team. With the use of lateral tilt, it is possible to turn the patient safely and gently in just a few steps using fewer members of the treatment team. Our goal is to involve the beds in the recovery process as much as possible and to strength-

en the effects of the therapy. We have been providing health professionals with long-term educational programs aimed at maximizing the technological advantages of LINET beds and their practical applications in nursing procedures and we want to share the details and our real-life experiences with you.

www.linet.ae

Stay with us for innovative solutions and clinical support.

ARTICLE

Glucose stabilisation right from the beginning

ffective glycolysis inhibition for precise determination of the in vivo blood sugar content with the VACUETTE® FC Mix Tube of Greiner Bio-One. The time from collection until separation of plasma and cells, temperature as well as cell count strongly affect glucose levels possibly leading to false low results. Unfortunately, fluoride alone is not able to stabilize the real in-vivo glucose level completely. VACUETTE®

MAR.APR 2021

FC Mix Tubes are citrated and therefore can help to prevent the initial loss of glucose within the first few hours from collection until fluoride shows its effect. Buffered Na2EDTA, citric acid, sodium citrate and sodium fluoride are used to decrease the pH and block the pH dependent enzymes, which would be active in the initial stage of the glycolysis cascade. More information on our website www.gbo.com

THE TUBE IS OPTIMAL FOR THE DIAGNOSIS OF DIABETES MELLITUS AND GESTATIONAL DIABETES.

NEWS

The Centre for Arab Genomic Studies Organizes Webinar Series IT IS WORTH NOTING THAT THE WEBINAR SERIES WILL BE HELD MONTHLY FROM FEBRUARY TO OCTOBER 2021 AND WILL DISCUSS A NUMBER OF TOPICS IN HUMAN GENETICS, INCLUDING POPULATION GENETICS, GENE THERAPY, BIG DATA IN GENOMICS, CLINICAL GENETICS, GENETICS COUNSELLING, AND METABOLIC DISORDERS.

His Excellency Abdullah Bin Souqat

he Centre for Arab Genomic Studies (CAGS), a division of the Sheikh Hamdan Bin Rashid Al Maktoum Award for Medical Sciences, is organizing a series of monthly webinars that will discuss various diverse topics on human genetics and genomics. The series will feature distinguished doctors and researchers in the field of genetics who will share their most recent studies with the participants.

The first webinar in this series will be held on Wednesday, 24th February 2021 and will focus on the topic of “Genomics of Infectious Diseases”. This webinar will feature talks by Dr. Ahmad Abou Tayoun, Director of the Genetics Laboratory at Al Jalila Children's Hospital, and Dr. Youssef Idaghdour, Assistant Professor of Biology at NYU Abu Dhabi. Highlighting the importance of the webinar topic, His Excellency Abdullah Bin Souqat, Executive Director of the Award said, “Discuss-

MAR.APR 2021

Dr. Mahmoud Taleb Al-Ali ing the genomics of infectious diseases is key to better understanding the pathophysiology of such diseases. As we go through the current pandemic, this subject has become more and more relevant. We are glad to be able to provide a platform for participants to gain from learning from some of the experts in this field, while adhering to safety standards in line with the UAE's strategy to maintain social distancing to limit the spread of the novel COVID-19 virus”. Dr. Mahmoud Taleb Al-Ali stated that organizing these webinars is in line with the Centre’s objectives of bringing together expertise and resources in the field of human genetics, and sharing the latest research findings and technical developments. It is worth noting that the webinar series will be held monthly from February to October 2021 and will discuss a number of topics in human genetics, including population genetics, gene therapy, big data in genomics, clinical genetics, genetics counselling, and metabolic disorders.

‫‪20‬‬

‫آذار (مارس) ‪9 l 2021‬‬

‫‪ l 8‬آذار (مارس) ‪2021‬‬

- 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

For more information please call :

+974 44898888 or +974 44898000

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 Health 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.

Tuesday, March 16

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

Researchers enrolling patients for study to train AI in assisting breast cancer surgery providing another layer of real-time information for surgeons during breast cancer surgery.

he vast majority of breast cancer patients will undergo surgery as part of their treatment, and most of those patients will choose a lumpectomy to remove the tumor and conserve the breast. A surgical oncologist at Baylor College of Medicine is enrolling patients in a study that will use a high-resolution imaging system to collect images of breast tumors in order to develop artificial intelligence. The combination of these technologies currently in development shows promise to help surgeons assess if they have successfully removed an entire tumor. “One of the big problems in breast cancer surgery is that in about one in four women on whom we do a lumpectomy to remove cancer, we fail to get clear margins. That in turn leads to a need for reoperation to avoid high recurrence rates. Hence the need for a good, effective and user-friendly tool to help us better identify if we have adequately removed the breast cancer from a woman’s breast, to get it right the first time,” said Dr. Alastair Thompson, professor, section chief of breast surgery and Olga Keith Wiess Chair of Surgery at Baylor College of Medicine. Baylor is partnering with Perimeter Medical Imaging, a medical device company, to use the OTIS™ system, which delivers real-time, ultra-high resolution, sub-surface images of extracted tissues. Perimeter’s AI technology, called ImgAssist, is being developed to overlay OTIS images with areas suspected of containing breast cancer, thus

Perimeter recently received a $7.4 million grant from the Cancer Prevention and Research Institute of Texas (CPRIT) to develop the artificial intelligence algorithm for OTIS using data collected at pathology labs at Baylor College of Medicine, the University of Texas MD Anderson Cancer Center and UT Health San Antonio as part of the ATLAS AI project. Thompson will serve as principal investigator of the study. Enrollment of patients began at Baylor College of Medicine this week. Researchers plan to enroll approximately 400 patients.

“This technique is noninvasive and requires no extra imposition for the patient. OTIS fits into the routine surgical process. The device will examine the tissue sample that is already being extracted,” said Thompson, surgical oncologist at the Dan L Duncan Comprehensive Cancer Center at Baylor St. Luke’s Medical Center and co-director of the Lester and Sue Smith Breast Center at Baylor College of Medicine. “Other imaging technology can be more invasive and may require injections or devices placed in the patient during surgery.” Perimeter will continue the ATLAS AI Project with a second randomized, multi-site study in approximately 600 patients to test the OTIS platform with ImgAssist AI against the current standard of care. Researchers will determine whether the platform lowers the re-operation rate for breast conservation surgery. “This could be a huge improvement for patient care. It could help patients avoid a second surgery and the physical, emotional and financial stress that accompany an additional procedure,” Thompson said. “Our AI technology has the potential to be a powerful tool for ‘real-time’ margin visualization and assessment that we believe will help physicians improve surgical outcomes for breast cancer patients. The patients who enroll in these clinical studies at Baylor are contributing to new technology that we hope will assist surgeons in the future so that they can reduce the likelihood of their patients needing additional surgeries,” said Andrew Berkeley, co-founder of Perimeter Medical Imaging. The Baylor study is only open to patients at the Dan L Duncan Comprehensive Cancer Center at Baylor St. Luke’s Medical Center.

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

MAR.APR 2021

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

Dubai Blood Donation Center retains AABB accreditation, achieves 100% compliance Dr. Hussain Al Samt, Director of Pathology and Genetics Department at the DHA, said, "We are incredibly proud of our team at the DBDC who have maintained the highest level of quality with regard to all aspects of blood collection, processing, testing, storage and distribution. This accreditation highlights the high-level of standards that are followed at the center. International accreditations are important to benchmark ourselves and play an important role in the delivery of safe and high-quality services."

Dr. Hussain Al Samt

he Dubai Health Authority’s Dubai Blood Donation Centre (DBDC) was re-accredited by the American Association of Blood Banks (AABB) after adhering to 100 percent compliance. The center first received its AABB accreditation in 2012 making it the first center in the UAE and one of the few centers in the Middle East region to achieve this accreditation. Since then the center has maintained its accreditation status and has been re-accredited every two years.

The AABB accreditation evaluates all aspects of the blood transfusion chain right from the vein of the donor to the vein of the patient. Al Samt highlighted the fact that the blood donation center is the main blood donation center in Dubai that collects 50 percent of the total blood collected in the country. In 2020, more than 66,000 donors visited the center and 49,500 units of blood were collected. It supplies blood and blood products to all the DHA hospitals as well as 40 private hospitals in Dubai. The DBDC organized 658 mobile blood donation campaigns in 2020. An independent study conducted in 2020 highlighted that customer happiness and trust for the DBDC was 97 percent. Regular blood donation takes 15 minutes, while platelet collection takes 45 minutes to one hour. Thalassemia patients require regular blood transfusions every few weeks.

Platelet collections are also vital and needed by cancer patients undergoing chemotherapy. Since platelets are blood cells critical to stopping bleeding, these are used in life-threatening bleeding situationspost-surgery or after accidents. The center is located on the premises of Latifa Hospital and carries out mobile blood donation drives across the community in Dubai.

Ajman University inaugurates COVID-19 testing, vaccination center

n cooperation with the Ajman Medical Zone and Tamouh Health Care, Ajman University launched a coronavirus vaccination center that also offers PCR and DPI testing services. The center’s launch is part of an academic partnership between Ajman University and Tamouh Healthcare. It is located in the Sheikh Zayed Exhibitions and Conferences Hall and provides free services to all citizens and the university’s students and staff. The center also operates throughout the week 12 hours a day except on Fridays and has separate rooms for men and women and the appropriate equipment required by medical staff for coronavirus tests and vaccinations. People wishing to undergo coronavirus tests or receive the vaccine are required to adhere to relevant precautionary measures, including wearing face masks and ensure social distancing. They must also present their Emirati ID.

MAR.APR 2021

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

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NEWS

GE Healthcare & Curea sign first strategic collaboration in Turkey to accelerate AI-based software development in medical imaging

E Healthcare and Prof. Hakki Muammer Karakas, M.D., Istanbul Provincial Health Directorate Radiology Services Coordinator & Health Sciences University Faculty Member, have announced the country’s first strategic collaboration to accelerate artificial intelligence (AI) development in medical imaging.

Prof. Dr. Karakas will lead the research and development teams comprised of distinguished clinicians, radiologists, scientists from different disciplines, senior data scientists and software developers who have come together under the newly established company CUREA, at TECHNOPOL Istanbul. Using GE Healthcare’s Edison Health Services, the teams will work to develop AI-based applications focused on the detection, categorization and severity grading of COVID-19 to diagnose and treat patients; as well as develop AI-based applications for automatic detection and classification of breast lesions through contrast-enhanced magnetic resonance imaging (CESM). Advances in medical imaging constantly increase our knowledge of diseases and their treatments, creating a surge in the amount of data generated. For each patient to benefit from the promises of personalized medicine, new AI-based tools are needed to aggregate, standardize, and make sense of this data quickly. However, the development of AI applications in medical imaging requires access to large amounts of high-quality annotated data, advanced design visualization capabilities and the ability to trace the development and learnings – which can be a challenge. The collaboration between CUREA and GE Healthcare will leverage large-scale clinical and radiological data from the University of Health Sciences and using the AI-know how and capabilities of the research and development teams led by Prof. Dr. Karakas, work to accelerate the development of AI solutions and help structure an AI healthcare ecosystem in Turkey. Commenting on the collaboration, Prof.

MAR.APR 2021

GE HEALTHCARE AND THE UNIVERSITY OF HEALTH SCIENCES HEALTH TECHNOPOLIS (TECHNOPOL ISTANBUL) BASED CUREA COLLABORATE TO ACCELERATE AI-BASED HEALTH SOFTWARE DEVELOPMENT IN TURKEY.

Edison Health Services is an open, extensible, modern architecture for the development and deployment of digital applications in healthcare. Applications targeting clinical, operational and financial outcomes in healthcare can easily be developed using these tools. Applications developed using Edison Health Services can be quickly and securely deployed in the cloud, on premise (e.g.,via GE Healthcare’s Edison HealthLink appliance), or directly onto smart imaging devices.

Karakas said: “Leveraging the power of GE Healthcare’s Edison Health Services, Turkish clinical scientists, data scientists and software developers will be able to harness our immense datasets to create AI-driven applications that can add significant value to the diagnosis and treatment of diseases in the Turkey. This is an organic tie-up that has the potential not only to establish Istanbul as a global site for AI development in healthcare, but the ability to scale up intelligent clinical analysis and operational management solutions and make them available to radiologists and healthcare professionals around the world.” Nael Dabbagh, General Manager of GE Healthcare in the Middle East, North Africa, Central Asia and Turkey, said: “This is an exciting collaboration that will gradually give Turkish start-ups, researchers and radiologists the opportunity to create AI applications in medical imaging that can dramatically enhance treatment and diagnosis of disease in Turkey and beyond. It is also a significant step forward in establishing an ecosystem for AI development in healthcare for Turkey and the whole region, thanks to the leadership and vision of Prof. Dr. Karakas and his team.” Previous AI collaborations announced in Europe have focused on the management of liver cancer with artificial intelligence characterization tools, the diagnosis and prognosis of lung diseases, and the accuracy and personalization of treatments for brain cancer or patient follow-up through imaging tools and multidisciplinary consultation meetings. Similarly, the recently launched EMEA Edison™ Accelerator is a start-up acceleration & healthcare provider collaboration program in Europe, Middle East & Africa, for the region and the world. It brings together healthcare providers interested in being at the forefront of innovation, and start-ups who want to leverage the GE Healthcare environment and mentoring to enhance their value proposition.

When teams provide care for COVID-19 patients, HAI reduction and efficient workflow are crucial. The Vocera® 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

Employing the Power of AI and Interoperability to Reduce Sepsis Mortality By Dr. Penny Cooper, DHSc, Data Scientist at Augusta Health

ugusta Health is a community hospital nestled in Virginia’s beautiful Shenandoah Valley focused on improving the health and well-being of our community. The statewide sepsis mortality rate in Virginia is 12.7%, while at Augusta Health it is 4.76%. We have been able to achieve a significantly lower sepsis mortality rate by employing the power of artificial intelligence (AI) and communication technology. So far, we have saved over 350 lives that could have been lost to sepsis.

MAR.APR 2021

ARTICLE

Mortality from sepsis increases by as much as 8% for every hour that treatment is delayed. Our nurses are highly trained and are skilled at detecting early symptoms of sepsis based on standard indicators. They are also very busy. Aware of how many patients our nurses care for and the many tasks nurses juggle at once, our leadership team wanted to provide our nurses with additional support. Among the resources provided was a program to identify symptoms of sepsis sooner. We formed a Sepsis Team and Taskforce in 2016 to take advantage of AI and communication capabilities and give our nurses an extra set of eyes to automatically review patient data and alert them as soon as a patient shows signs of being septic. Our goal was to detect and treat sepsis as early as possible and save lives.

Automated Process for Sepsis Risk Detection and Alerts We began by using the four traditional criteria to identify sepsis – a temperature greater than 38°C, heart rate greater than 90, respiratory rate greater than 20, and an abnormal white blood cell count. In addition, we monitored mean arterial pressure and shock index. Our Sepsis Team and Taskforce then began a retrospective study of the data to determine which variables had the highest correlation to Sepsis. We used the results of that study as a benchmark for developing an automated process that analyzes and compiles real-time data from medical systems each hour and assigns each patient a score. If the score is above a specific threshold, a sepsis alert is sent automatically to team members caring for that patient. Team members receive the alert with contextual information on their mobile communication device, which might be a hands-free Vocera Badge or a smartphone running a Vocera app.

System Interoperability Including Real-Time Communication The automated process involves interoperability among three systems:

• • •

Our electronic medical record (EMR), MEDITECH Our predictive analytics tool, which scours critical data in a patient’s record The Vocera clinical workflow and communication system

We considered other sepsis alert tools that flagged potential sepsis cases within patients’ EMRs. However, those tools provide clinicians with sepsis alert flags only when they open the patient’s medical record. By contrast, the system we built alerts the care team immediately on their Vocera Badge or smartphone, without any manual intervention. Sepsis alerts are automatically sent to the right care team to initiate care quickly when early signs of infection are identified. System interoperability has been key to ensuring the right data with situational information gets to the right clinicians at the right time. Upon receiving an alert, the assigned staff member immediately screens the patient for sepsis. If sepsis is identified, they begin early intervention.

SYSTEM INTEROPERABILITY HAS BEEN KEY TO ENSURING THE RIGHT DATA WITH SITUATIONAL INFORMATION GETS TO THE RIGHT CLINICIANS AT THE RIGHT TIME. UPON RECEIVING AN ALERT, THE ASSIGNED STAFF MEMBER IMMEDIATELY SCREENS THE PATIENT FOR SEPSIS. IF SEPSIS IS IDENTIFIED, THEY BEGIN EARLY INTERVENTION.

Saving Time, Saving Lives In the United States, more than 1.7 million people develop sepsis each year, and approximately 270,000 of them die. To decrease mortality rates and increase the likelihood of reversing the damaging outcomes of sepsis, early detection is critical. Hundreds of lives that could have been lost to sepsis have been saved because of our Early Sepsis Alert System; since April 2016, we have been able to save 355 lives. The work done by our teams at Augusta Health to reduce mortality rates from sepsis has been a collaborative effort. Health Quality Innovators (HQI) named our hospital the Health Quality Innovator for Virginia in the category of Data-driven Care in 2018. U.S. News & World Report recognized Augusta Health as a Best Hospital in the Shenandoah Valley for 2019-20. We are very proud of these honors and are happy to have the opportunity to share our work with other facilities around the state so more lives can be saved.

NEWS

Message on International Women’s Day, 2021

Alisha Moopen

s we celebrate this year’s International Women’s Day, I would like to express my sincere gratitude and admiration for all women out there who have been nothing less than warriors. Especially, in the past one year, from managing various roles, like being a mother, sister or a daughter to balancing jobs and careers while working from home, we have come a long way where women are no longer simply accepting roles assigned to them but are

WE ARE AN INSPIRATION FOR ONE ANOTHER.

challenging the status-quo, getting their voices heard and bringing about changes that matter. The COVID – 19 pandemic has disrupted our routine and pushed us out of our comfort zones to do things that we probably did not expect. A lot of us have had to adapt to a new adjusted lifestyle juggling family and work within the four walls of our homes, to learning to use new technologies, to adjusting to situations beyond our expectations. However, this breaking out of the safe spaces leads to an environment of learning and this is the message I would like to communicate to you all. Ladies, do not ever think that you are not ready for a new challenge or there is something out there you cannot do. Instead, think of it in a way that you will soon be ready to take up new challenges and what is it that you can do to be more prepared. Gone are the days where we restricted ourselves within our comfort zones, it is time to move ahead and better ourselves everyday by fearlessly asking for help and support for our own growth and progress. Lastly, I would once again like to thank each one of you for the tremendous roles that you fulfill. We are an inspiration for one another and together we all are an integral part of the growth and development of our society.

Abu Dhabi Airports launches rapid COVID-19 testing

bu Dhabi Airports, in partnership with Pure Health and Tamouh Healthcare, has launched rapid free COVID-19 PCR testing for all arrivals, except those in transit, with results provided in around 90 minutes. The new state-of-the-art RT-PCR lab offers testing within Abu Dhabi International Airport (AUH) to facilitate air travel procedures and support quarantine tracking procedures. Designed to ensure the health, safety, and wellbeing of travelers and staff at Abu Dhabi International Airport, the new Real Time Polymerase Chain Reaction (RT-PCR) testing process is free for arriving passengers and offers results in approximately 90 minutes. The laboratory has the capacity to test more than 20,000 travelers and staff per day. The establishment of the PCR testing laboratory falls in line with the directives and vision of Sheikh Mohammed bin Hamad bin Tahnoun Al Nahyan, Chairman of Abu Dhabi Airports, to contain the spread of COVID-19 while continuing to deliver a smooth and seamless travel experience at Abu Dhabi International Airport. Shareef Hashim Al Hashmi, Chief Executive Officer of Abu Dhabi Airports, said: "Through partnering with Pure Health and Tamouh Healthcare, Abu Dhabi International Airport is now able to offer travellers state-of-the-art rapid testing services delivered by a dedicated laboratory facility. The introduction of the RT-PCR COVID-19 testing is a milestone achievement in our ongoing efforts to facilitate the safe resumption of international air travel and support the recovery of the aviation industry."

MAR.APR 2021

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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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Orange Business Services Flexible SD-WAN supports Getinge with increased agility to aid the health industry

etinge, a leading global supplier of medical technology products and systems, chose Orange Business Services to deploy a software-defined wide area network (SD-WAN). The solution has supported the Sweden-based multinational’s network performance, while increasing security and supporting its cloud-first strategy. The Orange Flexible SD-WAN solution connects more than 100 Getinge sites globally, simplifying the management and operation of its infrastructure. Additionally, the network provides flexibility, scalability and end-to-end visibility, improving both the user and customer experience. Due to the global pandemic, Getinge has adapted parts of its production and support models related to the production of advanced ventilators and associated devices. Flexible SDWAN enabled the company to better support rapid changes in the marketplace and fully support its increasingly distributed workforce. Orange also provides cloud and internet security.

SD-WAN: an essential tool for a cloud-first strategy A cloud-first strategy can impact the net-

MAR.APR 2021

HIGH-SPEED CONNECTIVITY ACCELERATES ITS DIGITAL TRANSFORMATION.

work. Flexible SD-WAN offers secure access to the cloud, enabling traffic to flow to the internet from the closest link. The Orange SD-WAN solution provides Getinge with efficient, secure and fully automated end-to-end network orchestration, from end-users to cloud-based applications at an attractive price-performance ratio. “Flexible SD-WAN from Orange Business Services has helped us build a resilient, secure cloud-based infrastructure that lets us tackle moving business challenges in an unpredictable marketplace. Due to rapidly changing traffic patterns in the network, we needed a future-proof solution that enabled us to effectively support the healthcare industry with devices they are most in need – both during the current pandemic and beyond,” said Ludovic Batal, CIO, Getinge. “Getinge is on a strong transformational path with its SD-WAN infrastructure. We are pleased that the company chose Orange as its partner on this exciting journey in moving its operations to the cloud. Providing efficient, flexible and secure networking services is key to this transformation,” says Fabrice de Windt, Senior Vice President, Europe, Orange Business Services.

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Telehealth: the New Normal

s the healthcare system grapples with COVID-19 pandemic worldwide, telehealth has emerged as a convenient option to implement some of the most reputable healthcare institutions around the world. More patients and physicians have also started to adopt this platform and manage their time through virtual visits that limit health risks and exposure to frontliners. Although COVID-19 was the trigger that further accelerated the adoption of this platform, clinicians and patients are becoming increasingly comfortable with the ‘new normal’. The American University of Beirut Medical Center (AUBMC), and as part of its commitment to the welfare of its community, has recently introduced the telehealth service by means of Video Visits through its MyChart app. The transformational tool creates a remote link between patients and their healthcare providers through a secure internet connection. Today, telehealth has proven to be an effective and sustainable solution for precaution, prevention, and treatment to mitigate the spread of COVID-19, provide support for self-management especially in the cases of chronic diseases, and make healthcare accessible to people residing in rural areas or in other regions of the world, as well as busy individuals that benefit from Video Visits while at work. Its importance lies in leveraging existing telehealth tools to direct people to the right level of healthcare for their medical needs while keeping their safety in mind. After its launch in the recent months at AUBMC, telehealth has seen a large uptake in interest at the Medical Center. Physicians and healthcare providers have been, since then, working relentlessly to ensure the continuation of this platform with a firm belief that it can improve convenience and access to care and lead to better patient outcomes and a more efficient healthcare system. The implementation of AUBMC’s telehealth program offered great flexibility in terms of time and place by reducing unnecessary visits

MAR.APR 2021

NOW, WITH TELEHEALTH, PATIENTS FROM ABROAD CAN EASILY ACCESS THEIR DOCTORS OR GET A SECOND OPINION BY A CLICK, AND THEY CAN REST EASY KNOWING THAT THEIR SESSION IS SECURE AND EFFECTIVE.

As our struggle to contain the spread of the coronavirus continues, TeleHealth is another attestation to AUBMC’s continuous efforts and commitment to providing its patients with the best available care despite all circumstances. The health and wellbeing of AUBMC’s community remain to be the Medical Center’s top priority.

to the Medical Center usually accompanied with waiting time in waiting areas, thus eliminating the need for travel or transportation. Having access to one’s doctor from the comfort of one’s home will also maintain privacy and ease while discussing sensitive health issues. The integration of telehealth into the MyChart app has allowed patients to schedule their appointments with their doctor in various specialties such as Psychiatry, Family Medicine, Cardiology, Endocrinology, Pain Clinic, Surgery, Cardiology, Nephrology, Dermatology, and many others. Another important aspect of telehealth is that it has proven its ability to provide the diaspora in general and AUB alumni community in particular, the advantage of staying in touch with their providers through Video Visits. Telehealth has bridged the gap between people, physicians and healthcare systems, enabling everyone, especially expat patients, to communicate with physicians through virtual channels, which helps them stay connected with the physicians they trust through video visits. Now, with Telehealth, patients from abroad can easily access their doctors or get a second opinion by a click, and they can rest easy knowing that their session is secure and effective.

NEWS

Boehringer Ingelheim Recognized As Global Top Employer for 2021

oehringer Ingelheim, one of the world’s leading pharmaceutical companies, has been recognized for the very first time as a ‘Global Top Employer for 2021’ by the prestigious Top Employers Institute.

This year as a ‘Global Top Employer’, Boehringer Ingelheim joins the ranks of 16 other international organizations to receive this outstanding honor. While the organization has received awards on a country level for the past seven years, and in addition to the global award, the company has been further recognized as a ‘Top Employer’ across 27 country categories, spanning the European, Asia-Pacific, Latin-American and Middle Eastern regions. The independent Top Employers Institute certifies employers worldwide who wish to offer their employees excellent working conditions and support their development. Certification is based on a multi-level program to examine human resources management with detailed final feedback. Boehringer Ingelheim particularly impressed the certification board with its long-term strategic orientation, its modern management culture as well as strong employee communication practices, with its inclusive corporate culture also cited as a highlight. The jury found the organization’s ethical, inclusive approach to corporate decisions and a clear focus on the transfer and application of company values, to be highly commendable. “Receiving such a prestigious award for our efforts, despite the challenges faced in the past year, reflects the company's focus on its employees as its main asset,” said Mohammed Al-Tawil, Country Managing Director and Head of Human Pharma META at Boehringer Ingelheim. “Strengthening our employee experience & capabilities is absolutely critical to our overarching strategy, as we rely on our teams to materialize our mission of creating value through innovation.” A regional highlight coveted by Boehringer Ingelheim in the Middle East Region, was the ‘Top Employer’ recognition for its Saudi

MAR.APR 2021

BOEHRINGER INGELHEIM HAS BEEN RECOGNIZED AS ONE OF THE 16 TOP EMPLOYERS WORLDWIDE BY THE TOP EMPLOYERS INSTITUTE FOR ITS LONG-TERM STRATEGIC ORIENTATION, MODERN MANAGEMENT CULTURE AND STRONG EMPLOYEE COMMUNICATION PRACTICES.

‘TOP EMPLOYER’ RECOGNITION AWARDED TO BOEHRINGER INGELHEIM SAUDI ARABIA FOR ITS STRONG EMPLOYEE CULTURE, DEVELOPMENT AND SUPPORT PROGRAMS.

operation. “We are also delighted to have our Saudi offices recognized as a ‘Top Employer’ within their country division, stemming from the strong leadership, development and growth demonstrated by the team,” Tawil continued. On her part, Birgit Giokalas, Human Resources Director for the region META shares, “We pride ourselves for our employee-centric approach to operations, as we make sure to offer our teams the support, infrastructure and corporate engagement required to succeed in the industry. An example of employee orientation that comes to mind are the areas around agile working methodologies. In this area, that has been in our focus for quite some time before COVID, among other, to ensure that during the pandemic, employees were able to quickly adapt their working styles to align with health protection requirements and to ensure business continuity. We have also worked on the future of work for the time after the pandemic to ensure the learnings and working style will continue and evolve in the years to come. For 135 years, Boehringer Ingelheim has been creating value through innovation for human and animal health, dedicating itself to a better world. It aims to meet this through excellent HR policies and people practices, covering domains such as people strategy, work environment, talent acquisition, learning, well-being, diversity, inclusion and more. The family business invests heavily in individual development opportunities through tailor-made education and training programs for all employees. This serves to enhance its existing progressive workplace culture promoting transparency, open communication and supportive forward-looking campaigns. Boehringer Ingelheim will continue on its journey to implement further employee-focused initiatives, ensuring the growth, development and overarching wellbeing of its teams. More information about Boehringer Ingelheim can be found at www.boehringer-ingelheim.com or in our annual report: http://annualreport.boehringer-ingelheim.com.

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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. © 2021 BD. All rights reserved. 1910004695 (04/20) BD-17226

ARTICLE

A Cardiopulmonary Rehabilitation Program at HDF for Post COVID-19 Patients The program offers 3 to 5 rehabilitation sessions per week for approximately one hour and follows a specific treatment plan divided into three phases. It is also worth noting that the treatment is not about prescribing medications, but is achieved through a training and exercise program performed with specialized equipment.

octors recently noted that around 20% of COVID-19 patients, especially those who were once hospitalized, are experiencing difficulties in regaining their strength and energy and resuming their normal life even after recovery. Following a COVID-19 infection, patients are reporting long-term effects and complications that may last for weeks or even months, such as breathing difficulties, fatigue, heart rate issues... Based on these medical reports, and to complement the measures taken to fight the COVID-19 pandemic, the Hôtel-Dieu de France (HDF) hospital, along with the Department of Pulmonology and Critical Care, has opened the Cardiopulmonary Rehabilitation Unit, whose aim is to provide assistance to post COVID-19 patients and those with chronic heart and respiratory disease, in order to improve their physical and mental health. This Unit adopts a multidisciplinary approach, offers an individualized rehabilitation program tailored to the needs of each patient, and it is equipped with the latest cardiopulmonary rehabilitation and assessment techniques. The team is composed of specialized pulmonologists, physical therapists, respiratory therapists, dieticians, a psychologist and a social worker.

MAR.APR 2021

THE PROGRAM OFFERS 3 TO 5 REHABILITATION SESSIONS PER WEEK FOR APPROXIMATELY ONE HOUR AND FOLLOWS A SPECIFIC TREATMENT PLAN DIVIDED INTO THREE PHASES. IT IS ALSO WORTH NOTING THAT THE TREATMENT IS NOT ABOUT PRESCRIBING MEDICATIONS, BUT IS ACHIEVED THROUGH A TRAINING AND EXERCISE PROGRAM PERFORMED WITH SPECIALIZED EQUIPMENT.

In the first phase, the patient must consult the pulmonologist for a cardiopulmonary and muscular assessment and for deciding on the treatment plan that should be adopted accordingly. In the second phase, the patient can begin the cardiopulmonary rehabilitation sessions that focus on improving their breathing, flexibility, cardiorespiratory endurance and ability to exert effort, through machine exercises, but under medical supervision that includes heart rate, blood pressure, oxygen saturation and all vital signs that can detect medical problems if the exercise is not performed as indicated. Given that the body is still affected by the consequences of the COVID-19 infection, the patient is unable to exercise in a normal way. Therefore, the team follows a gradual progressive rehabilitation program and the patient starts feeling better and reenergized as of the third week. In addition, the patient benefits from educational and counseling sessions with a specialist in smoking cessation, if they are a smoker, a nutritionist or a psychologist. Finally, the third phase marks the end of the program, whereby the pulmonologist assesses and evaluates the patient's progress. The patient will then be able to return to their normal life, along with the needed recommendations to maintain a good quality of life. Thus, thanks to the rehabilitation program, the patient has recovered from COVID-19 long-lasting consequences and returned to a normal life much sooner. For more information and appointments, you can call the Cardiopulmonary Rehabilitation Unit at 01-604000 ext. 8382 between 8 a.m. and 4 p.m.

ARTICLE FEATURES . Kidney Disease

water and low-sugar and low-calorie fluids daily, which reduces the amount of urine to less than 2 liters per day and increases the concentration of some salts and minerals, causing them to build up. Excessive sugary drinks consumption can cause high amounts of calcium in the urine. Doctors stress on the need to drink water frequently throughout the day and not wait to feel thirsty, and to consume water-rich foods, such as fruits and low-salt soups. Also, excessive salt intake (more than 5 g of salt or more than 2 g of sodium daily) may increase the amount of calcium in the urine, which may facilitate the formation of stones. In addition, excessive animal protein intake (more than 150 g of meat, chicken, or fish daily), excessive calcium intake, and excessive vitamin C intake (more than 1 g daily) increase the amount of calcium in the urine. However, calcium should be consumed daily in moderation.

he kidneys are a very important pair of organs in the body. They are primarily responsible for removing excess fluid and filtering the blood free of toxins that may enter the body through food or medicine. They also play a vital role in producing red blood cells, in addition to regulating the levels of minerals in the body, such as calcium, phosphorus, potassium, and sodium.

The kidneys can be affected by a variety of diseases and health problems. Kidney disease is more likely to develop in patients who suffer from diabetes, high blood pressure, and obesity. However, the advanced treatments, the possibility of a kidney transplant, and the success of many operations in this field around the world offer hope in treating many cases of CKD and other diseases. In this regard, early diagnosis is important because kidney disease kills silently and develops with no symptoms or signs, and many people don’t realize they have it until the disease is advanced. The doctor’s goal of advanced-stage treatment is to prevent further progression. The first steps of the diagnostic process are checking the level of creatinine in the blood, measuring the level of protein in the urine, in addition to performing an ultrasound of the kidneys to assess their structure and size.

Kidney Stones Advanced Treatment Options Many factors contribute to the formation of kidney stones, such as frequent urinary tract infections, diabetes, high blood pressure, obesity, a very high or very low urine pH (which may be caused by ureteral disorders), and inflammatory bowel diseases, such as Crohn's disease, ulcerative colitis, and other diseases and surgeries that cause chronic diarrhea. Kidney stones are also caused by gout, high levels of uric acid in the urine, drinking too little

MAR.APR 2021

Lithotripsy

THE FIRST STEPS OF THE DIAGNOSTIC PROCESS ARE CHECKING THE LEVEL OF CREATININE IN THE BLOOD, MEASURING THE LEVEL OF PROTEIN IN THE URINE, IN ADDITION TO PERFORMING AN ULTRASOUND OF THE KIDNEYS TO ASSESS THEIR STRUCTURE AND SIZE.

Kidney stone treatments have become somewhat easy today due to the development in this field, as most of them use a laser to avoid traditional surgeries and their risks. In addition to surgical intervention, the majority of doctors today resort to percutaneous ultrasonic lithotripsy for large stones, especially those in the kidney or the upper part of the ureter. Laser lithotripsy is often used for small stones that can be reached by a cystoscope. Before deciding on the surgery, doctors may resort to conservative treatment for small stones. This includes the use of some dissolving medicines, changing the quality of food, and drinking a lot of water in order to give the patient the chance of getting rid of the stones. However, if this method fails, the alternative solution must be laser lithotripsy or the other techniques, knowing that in some cases, severe symptoms and pain appear late and can only be treated with these techniques.

ARTICLE FEATURES . Kidney Disease

Kidney Failure Excessive Use of Painkillers: One of the Main Risk Factors Kidney failure occurs when the kidneys lose the ability to function properly, and it progresses gradually over time when kidney function declines to 10%, then 30%, until it reaches 100%. There are two types of kidney failure: acute and chronic.

Acute kidney failure is a temporary problem that occurred for some reason and will quickly disappear when the causative factor is gone. This type of kidney failure occurs as a result of a sudden fall in blood pressure (causing a decrease in the blood supply to the kidneys that will stop functioning), bleeding, dehydration,

the presence of serious bacterial infection in the body, or blood poisoning. Taking painkillers for a long time also destroys the kidneys, except for those prescribed by the doctor. Once these factors are removed, the kidneys will recover well.

CKD is considered the most dangerous because it affects the cell tissue itself. The kidney cells begin to die gradually. The disease is categorized into 5 stages that occur gradually over periods of up to 5 years. CKD usually begins at the age of 30 and lasts 6 or 7 years. The patient then starts dialysis. The seriousness of kidney failure is that the symptoms do not usually appear until a lot of damage to the kidney has already happened.

ARTICLE FEATURES . Kidney Disease

Diabetes and Its Impact on Kidneys Difficulty in Maintaining Kidney Function and Controlling Diabetes is a Necessity Diabetes is one of the main causes of chronic kidney disease (CKD) and accounts for more than 50% of the cases, according to the latest international medical studies. High blood sugar levels affect the filtering units of the kidneys. Over the years, the kidney blood vessels become gradually damaged without showing any symptoms. Consequently, the disease does not manifest itself until the late stages, that is, years after being diagnosed with diabetes, which leads to difficulty in maintaining kidney function and thus having CKD. Therefore, it’s important for diabetics to regularly see the doctor and monitor their condition. Diabetes affects the kidneys firstly by limiting their function and reducing their ability to remove urea from the blood. In the late stages, it leads to complete failure of the filtration systems of the kidneys. There is no treatment for diabetic nephropathy or glomerulosclerosis, but there are procedures that help prevent further progression of the disease and delay kidney failure, such as regularly taking diabetes and high blood pressure medicines prescribed by the doctor, maintaining a healthy diet, and abstaining from smoking. A raised level of albumin in the urine is the typical first sign that the kidneys have become damaged by diabetes. Urine samples provide the doctor with the necessary information on kidney function or the presence of a large amount of albumin in the urine. Albuminuria results from damage within the kidneys. People with type 2 diabetes should be tested for microalbuminuria at diagnosis.On the other hand, patients with type 1 diabetes should be tested for microalbuminuria annually five years after diagnosis. Prevention is the best way to protect the kidneys from diabetic neuropathy. The most important step is to maintain a normal blood sugar level by following a diet, exercising or doing any kind of physical activity, and regularly taking medicines as determined by the treating doctor.

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URINE SAMPLES PROVIDE THE DOCTOR WITH THE NECESSARY INFORMATION ON KIDNEY FUNCTION OR THE PRESENCE OF A LARGE AMOUNT OF ALBUMIN IN THE URINE. ALBUMINURIA RESULTS FROM DAMAGE WITHIN THE KIDNEYS.

Controlling blood sugar levels means having a level between 80-120 mg/dl before meals and a level less than 140 mg/dl after eating. People with diabetes should have a blood pressure of no more than 130/85. If it is higher, it will expedite the loss of kidney function.

High Blood Pressure: The First Indicator of Kidney Disease High blood pressure is the first indicator of kidney disease, as it causes damage to blood vessels and over time causes kidneys to not filter blood well. When the arteries become damaged, the nephrons do not receive the essential oxygen and nutrients — and the kidneys lose their ability to filter blood and regulate the fluids, hormones, acids, and salts in the body. Damaged kidneys fail to regulate blood pressure. Kidney damage and uncontrolled high blood pressure each contribute to a negative spiral. As more arteries become blocked and stop functioning, the kidneys eventually fail. Damaged kidneys may produce an amount of renin that raises blood pressure. This is called renal blood pressure and represents 5-10% of blood pressure cases. Regular (non-renal) hypertension affects the function and filters of the kidneys, and albumin may be detected in the urine. This may result in kidney failure. The kidneys affect and are affected by blood pressure. Therefore, patients with high blood pressure must continue treatment and do the necessary tests regularly to monitor the condition of their kidneys. Maintaining a normal rate of blood pressure over long periods carries with it many positive aspects for the patient's health in general, due to the role of moderate blood pressure in the prevention of diseases, especially heart disease. Having a low blood pressure and keeping it with-

ARTICLE FEATURES . Kidney Disease

in normal levels is an ideal opportunity to reduce the risk of developing cardiovascular disease by 32%, coronary artery disease by up to 27%, and having a heart attack by 36%. Maintaining blood pressure also helps in preventing or delaying the progression of CKD and heart failure, relieving the existing symptoms, and reducing recurrence of heart attacks. Doctors advise patients with high blood pressure to lose excess weight and avoid obesity, in addition to eating low-fat foods and unsaturated fats, such as corn oil, sunflower oil, olive oil, and soybean oil. The most important advice is to reduce table salt to 2-3 g per day, equivalent to a teaspoon of salt, and avoid fast foods that contain significant amounts of salt. It is no secret that doing a physical activity that the patient likes is very important, provided that it be done regularly for 20-30 minutes three times a week. Strenuous exercise should be avoided. Abstinence from smoking cigarettes and hookah is also important for patients with high blood pressure.

diabetes and high blood pressure. These health problems have a negative impact on the albumin-to-creatinine ratio, leading eventually to kidney disease, unless care is taken and the extra weight is disposed of in time, that is, before the damage takes place.

Obesity Causes Deteriorating Kidney Function

Some of the obesity-related diseases that affect kidneys are:

Obesity is a major risk factor for CKD, diabetes and high blood pressure. Extra weight forces the kidneys to work harder, filtering above the normal level, to meet the metabolic demands of the increased body weight. This increase in normal function is also associated with a higher risk of developing CKD in the long-term. Studies in this field confirm that excess weight, especially abdominal fat, has been linked to metabolic disturbances that affect the kidneys. It can activate the sympathetic nervous system, which secretes hormones. This increases sodium retention and blood pressure and makes it difficult for the body to get rid of excess sugar in the bloodstream, which leads to diabetes. All of this negatively affects the kidneys. The inflammation associated with obesity and excessive abdominal fat also cause impaired kidney function and sometimes lead to kidney failure. As an indirect cause, obesity increases the risk of the major CKD risk factors – type 2

•

High blood pressure: obesity is associated with increased blood flow, which causes high blood pressure. Uncontrolled blood pressure can cause arteries around the kidneys to narrow, leading to decreased blood flow and thus kidney failure. Diabetes: obesity reduces the insulin’s ability to lower blood glucose levels. Kidneys then have to work harder to filter the blood free of toxins and glucose. This is accompanied by proteinuria, which may cause CKD. High cholesterol levels: the heart’s ability to pump blood is reduced due to the cholesterol buildup along the inside walls of blood vessels. This usually happens when the person has excess weight. The blood supply to the kidneys decreases, making the kidneys unable to function properly and filter blood.

DOCTORS ADVISE PATIENTS WITH HIGH BLOOD PRESSURE TO LOSE EXCESS WEIGHT AND AVOID OBESITY, IN ADDITION TO EATING LOW-FAT FOODS AND UNSATURATED FATS, SUCH AS CORN OIL, SUNFLOWER OIL, OLIVE OIL, AND SOYBEAN OIL.

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Electrophysiological study and catheter ablation procedure NORMAL CONDUCTION AND STIMULATION SYSTEM OF HEART MAY COMPROMISE DUE TO VARIOUS REASONS. SOMETIMES, CONGENITAL ACCESSORY PATHWAYS LEAD TO SHORT CIRCUITS, RESULTING IN ACCELERATED HEART RATE, ALSO KNOWN AS TACHYCARDIA.

What is the heart’s electrical system? Our heart has an electrical conduction system that is similar to power network of a city. In fact, the stimuli signaled from the main center (sinus node), which is located at right atrium, pass an intermediary station (atrioventricular node) between atria and ventricles following a short latent time and ultimately they spread to the ventricles again via specialized conduction

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Why do the disruptions occur in the heart’s electrical system? Normal conduction and stimulation system of heart may compromise due to various reasons. Sometimes, congenital accessory pathways lead to short circuits, resulting in accelerated heart rate, also known as tachycardia. Moreover, extra-nodal stimulations can be emitted, which implies any signal arising out of any region of heart, excluding above specified main stimulation center, and thus, heart rate increases.

What is electrophysiological diagnosis method?

Professor Fatih Duhan Bayran he last two decades have witnessed significant developments in the diagnosis and management of arrhythmias, most people with an abnormal heart rhythm can lead a normal life if it is properly diagnosed. Diagnosing the type of the arrhythmias is the key to the treatment. Today, most of the advance heart centers use Electrophysiology studies (EPS) to test the electrical activity of your heart to find where an arrhythmia (abnormal heartbeat) is coming from. This can help doctors to decide whether patient needs medicine, a pacemaker, ICD, catheter ablation or surgery for arrhythmias. Cardiologist Professor Fatih Duhan Bayran M.D. explains heart’s electrical system and how to find and fix the problems of the rate or rhythm of the heartbeat with advanced methods.

means. Therefore, the electrical stimulation generated in the main center is conducted to all cardiac muscle (myocardial) cells and the heart is contracted.

For patients with complaint of palpitation (in the form of accelerated heart rate), the underlying cause of the complaint, the accelerated beats, is determined by generating stimuli using wires, which are advanced into the cardiac chambers using special methods (number of wires may vary between 2 to 4 wires depending on the aim of the study and type of the rhythm disorder).

This diagnostic method, called electrophysiological study, investigates deviations by recording electrical signals directly on heart and by evaluating them after a catheter, also referred as electrode, is inserted through fine sheaths, which are inserted into the vessel located at inguinal and/or cervical region, to cardiac chamber(s). Thus, it is possible to understand whether main stimulation center of the heart and conduction systems function well. Thus, if short circuit(s) is/are determined, punctuate energy is delivered with radio-waves and palpitation is completely eliminated. Or, if only one focus is responsible for palpitation, radio-waves are delivered and it is eliminated. This procedure is referred as catheter ablation. This method enabled elimination of most palpitations (tachycardia) permanently.

How does the electrophysiological diagnosis method affect the patient and how long does it take? You may feel palpitation when test stimulations are emitted to the intra-cardiac chambers during electrophysiological study. Or, you may have the same feeling when palpitation, the original complaint, is induced with electrical

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stimuli. Sometimes, external electrical shock can be required to correct palpitation, after tachycardia, rhythm is stimulated. You will not feel pain since you will be administered a sedative/ anesthetic agent before the shock is applied. Diagnostic electrophysiological studies last 30-60 minutes. If it is a therapeutic study, the procedure will possibly last 1-4 hour(s).

Is there any risk of electrophysiological diagnosis method? Those procedures are generally associated with low risk. However, it does not mean that it is totally free of problems. The risk of death is very low. Although rare, pericardial effusion (deposition of fluid between layers of pericardium) may develop secondary to the rupture of myocardium. Again, therapeutic procedure may rarely block normal conduction system of the heart, while radio-waves are delivered, since the short circuit, the underlying cause of the palpitation, is located close to the normal conduction system. In this case, permanent placement of pacemaker may be required. Bleeding, subcutaneous hematoma and resultant swelling and pain may develop at puncture site in 2-3% of all cases. However, those complications do not lead to significant problems and they spontaneously resolve.

Are there any alternatives of electrophysiological diagnosis method? Any other diagnostic method may not provide us with data which is obtained with electro-

CATHETER ABLATION IS A TREATMENT FOR RHYTHM DISORDER PERFORMED BY DELIVERING RADIOWAVES. THIS METHOD IS USED FOR TREATMENT OF RHYTHM DISORDER, IF RHYTHM DISORDER CANNOT BE CONTROLLED WITH DRUGS OR IF THE PATIENT DOES NOT WANT TO TAKE DRUGS FOR A LIFETIME. IN SOME CASES, RHYTHM DISORDER MAY BE SEVERE ENOUGH TO THREATEN LIFE.

physiological study. It is usually preferred when other diagnostic methods are insufficient.

What is catheter ablation; when and how is it applied? Catheter ablation is a treatment for rhythm disorder performed by delivering radio-waves. This method is used for treatment of rhythm disorder, if rhythm disorder cannot be controlled with drugs or if the patient does not want to take drugs for lifetime. In some cases, rhythm disorder may be severe enough to threaten life. In such cases, catheter ablation method can be baseline option. The procedure can be carried out under local anesthesia, although some cases require general anesthesia. You will be administered sedative agents in order to feel comfortable during the procedure. You should rest without moving your legs for several hours in order to avoid bleeding.

What is the success rate of catheter ablation method? Success rate of treating rhythm disorders (in the form of accelerated heart rate) with catheter ablation may vary between 70 to 95 percent depending on type of palpitation and localization of short circuit. Success implies lack of recurrence. Rate of recurrence varies depending on the type of rhythm disorder, after palpitation is successfully treated. The rate is around 5-8% for palpitations which are secondary to short circuits in heart.

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The secret enemy of women: Deep endometriosis DEEP ENDOMETRIOSIS ACCOUNTS FOR 10-20% OF ALL ENDOMETRIOSIS CASES AND IT MAY LEAD TO SEVERE DAMAGE IN THE INVOLVED ORGANS ALONG WITH THE SEVERE PAIN; THEREFORE, IT MAY BE NECESSARY TO REMOVE A PART OF THOSE ORGANS SURGICALLY. Professor Mete Güngör

rofessor of Gynecology, Obstetrics and Gynecologic Oncology Mete Güngör warns that the women suffering from severe menstrual pain and painful intercourse should necessarily visit a doctor in order to prevent the damages that can be potentially caused by deep endometriosis. Endometriosis implies growth of the endometrium – the interior lining of the uterine wall – anywhere other than the womb. It is divided into two groups; superficial and deep. The endometrial tissues growing on the peritoneum, the outer surface of the ovaries and the fallopian tubes are referred to as “superficial endometriosis”.

It may cause irreversible damage in organs! The most significant sign of endometriosis is the severe pain that usually occurs during the period and sexual intercourse, it is felt in the abdomen or the groin and impairs the quality of life. The pain may be independent from the menstrual cycle, if it progresses into a chronic form in time. Deep endometriosis accounts for 10-20% of all endometriosis cases and it may lead to

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severe damage in the involved organs along with the severe pain; therefore, it may be necessary to remove a part of those organs surgically.

Colon: It may cause severe pain during defecation, constipation and gas complaints secondary to obstruction in colon. Urinary bladder and ureters: It may cause hematuria (blood in urine) and dysuria (painful voiding associated with feeling of burn). Moreover, it may lead to kidney failure by obstructing the ureters. Ovaries and fallopian tubes: When the ovaries and the fallopian tubes are involved, these organs become totally dysfunctional, resulting in infertility. Nerves: It may, sometimes, lead to extremely severe pain and dysfunction, when the nerves located in pelvic region are involved.

Surgery is a must in deep endometriosis Emphasizing that treatment of the endometriosis varies depending on the severity of the disease, symptoms and future pregnancy plan of the patient, Professor of Gynecology, Obstetrics and Gynecologic Oncology Mete Güngör says “Endometriosis can be managed with medication treatment, surgery or both modalities. However, the patient should be operated on to

“Deep endometriosis” is defined as endometriosis lesions that have penetrated into the peritoneum more than 5 mm, have also involved intestinal and bladder wall, formed painful nodules, invaded the nerves and led to adhesions, resulting in impaired anatomy of the organs in the region.

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eliminate adhesions of organs, obstructions and damages, even if medication treatment may alleviate the pain in endometriosis”.

It may be as difficult as cancer surgery Highlighting that the surgical management of deep endometriosis may, sometimes, be as challenging and complex as the cancer surgery, Professor Mete Güngör adds “Therefore, when surgical treatment is decided, it is very crucial that the surgery is performed with closed techniques by the surgeons, who are experienced in management of this condition, in order to protect the fertility and hormonal functions and reduce the possibility of recurrence”.

Laparoscopic or Robotic-assisted surgeries increase the success Deep endometriosis may cause adhesions between pelvic organs, such as womb, ovaries,

ENDOMETRIOSIS CAN BE MANAGED WITH MEDICATION TREATMENT, SURGERY OR BOTH MODALITIES.

colon, urinary bladder and ureters, and obstruction of the digestive and urinary tracts. In the surgery, it is necessary to ensure patency of these organs without any damage, remove the irreversibly obstructed segments of the digestive or urinary tract and to anastomose them end-to-end. Meanwhile, the nerves should not be injured in order to maintain functions of the organs and the ovaries should be protected; finally, it is necessary to restore this body part such that a potential future pregnancy can be achieved. Professor Mete Güngör specifies that these surgeries should, therefore, be performed with minimally invasive techniques, namely laparoscopic or robotic-assisted surgery, in order to see the anatomy more closely and clearly and adds that those techniques will increase success rates of the surgeries and offer major advantages, such as quicker recovery, milder pain, less bleeding and ability to resume daily life earlier.”

ARTICLE FEATURES . Smart Hospital Beds

Smart Hospital Beds Innovative applications for more accurate care

mart hospital beds are among the most important elements in patient rooms within all kinds of medical facilities given the specifications they provide that contribute to raising the efficiency of medical personnel on the one hand, and facilitating the patient’s movement on the other hand. The manufacturing companies have worked to combine state-of-the-art technology with the medical sector’s requirements and have come up with beds designed according to innovative applications in order for the patient to receive more accurate care. Today, the manufacturing companies provide wireless smart beds that include a device that is directly connected to the nursing department, enabling the nurses to follow up on the patient's condition, monitor his vital functions, and track his condition remotely, but closely,

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SMART BEDS SAVE A GREAT DEAL OF EFFORT IN HOSPITALS THROUGH MONITORING TECHNOLOGIES AND REMOTE SENSORS. THESE BEDS HAVE CONTRIBUTED TO A QUALITATIVE ADDITION TO THE SMART HOSPITALS' COURSE OF ACTION.

taking into account the times of patient rounds, caring for them and having direct communication with them. Smart beds save a great deal of effort in hospitals through monitoring technologies and remote sensors. These beds have contributed to a qualitative addition to the smart hospitals' course of action. The smart beds are designed to facilitate the patient’s movement and help him regain his normal movement faster, with the presence of monitoring systems that alert the nursing staff when the patient moves and leaves the bed with the availability of side rails. Sensors can also monitor the health of the elderly, and other wireless devices can encourage the user to lead a healthy life, such as wearable heart monitors. This type of advanced bed greatly contributes to restoring the patient's wellness, health and activity as it is the main element to achieve this purpose, according to studies that con-

ARTICLE FEATURES . Smart Hospital Beds

firmed that the patient’s movement during his stay in ICU contributes to his speedy recovery and early discharge from hospital. Healthcare providers also benefit from the presence of smart beds as they spare them the trouble of changing the patient’s position from time to time and help reduce the injuries they are exposed to because the bed technology keeps the patient in an optimal position during bed movement, thus helping the medical staff and healthcare providers to perform their tasks to the fullest, which in turn contributed to reducing medical errors in hospitals. Technology in the world of hospital beds has become more sophisticated today than ever before; the smart bed is able to monitor the patient’s vital signs with the presence of sensors that monitor his movement on the bed and when getting out of it. This bed delivers information directly to health care providers, whether the treating physician or the nursing department, via the Internet or through remote sensing and control devices (wirelessly). This bed delivers

TODAY, HOSPITAL BEDS ARE AN INTEGRAL PART OF THE HOSPITAL INFRASTRUCTURE IN GENERAL AND THE PATIENT’S ROOM IN PARTICULAR.

information directly to healthcare providers, whether the treating physician or the nursing department, via the Internet or through remote sensors and control devices (wirelessly). Today, hospital beds are an integral part of the hospital infrastructure in general and the patient’s room in particular. The bed on which the patient lies throughout his hospital stay, greatly contributes to enhancing the healing process, enabling the doctor to monitor the patient’s condition accurately, allowing him to provide the appropriate treatment while making the patient feel comfortable during his stay. In this context, we must talk about the increasing demand for smart beds globally in light of the increased spending on healthcare and the accompanying technological development in light of the transformation of hospitals into smart ones, making them have a greater need to make a qualitative shift in patient care and provide them with comfort. This helps support the work of medical staff, saving time and effort, while maintaining the quality of medical service and patient care.

INTERVIEWS

MD, FACOG – American board-certified Obstetrics and Gynecology/Advanced Pelvic and Endoscopic Surgery - CMC Dubai

Dr. Elias Abi Khalil “We Offer Excellence in Care for Women”

he Center of Endometriosis and Pelvic Surgery at the Woman’s clinic CMC-Dubai offers excellence in care for women with the latest minimally invasive options. ‘Hospitals’ magazine met with Dr. Elias Abi Khalil, MD, FACOG – American board-certified Obstetrics and Gynecology/ Advanced Pelvic and Endoscopic Surgery at CMC Dubai.

Can you brief us about the Center of Endometriosis and Pelvic Surgery- at the Woman’s clinic CMC Dubai? We are a team of endoscopic surgeons offering excellence in care for women with conditions needing advanced gynecologic surgery. We provide comprehensive care for women with conditions including: uterine fibroids, adenomyosis, abnormal uterine bleeding, pelvic pain, endometriosis, pelvic organ prolapse, urinary incontinence, tubal and ovarian cysts – offering the latest minimally invasive options for these conditions. We strive to provide a safer and more effective alternative to traditional open surgery by performing the vast majority of our procedures via robotic surgery, laparoscopy, hysteroscopy and vaginal surgery. We get referrals from other providers for complicated cases that would otherwise be performed via a large abdominal incision. We are leaders in developing innovative minimally invasive procedures that offer our patients faster recovery, less pain, smaller incisions, early return to normal daily activities and shorter hospital stay. We would also like to shed light on the Woman’s Health Clinic as well. At the Woman’s Health Clinic-CMC Dubai, women’s health is our priority. We treat complex gynecological and pregnancy problems and provide women with regular preventive care during annual gynecological visits, screening tests for

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diseases and keeping women healthy through their life cycle. In addition, patients receive education and awareness about disease symptoms, preventive measures and different treatment options. Our physician specialists offer a wide array of services including: Pregnancy Care, Midwifery Care, Maternal-fetal Medicine, General Gynecology, Minimally Invasive Gynecological Surgery, Urogynecology, Sexual Health, Cosmetic Gynecology, IVF, egg freezing.

Uterine diseases are common during women’s life, whether with cancer or any other benign diseases. What are the most common uterine problems? The uterus is often affected by conditions that can affect women’s daily life. Signs of uterine disease could be heavy menstrual bleeding, spotting, severe pelvic and menstrual pain, abnormal discharge, menstrual pain, chronic pelvic pain, pelvic pressure, urinary leakage or incontinence. These can be caused by endometriosis, fibroids, adenomyosis, endometrial hyperplasia, polyps or gynecologic cancers. Diagnosing these conditions can be challenging sometimes and that’s why they need expertise in the field. Endometriosis is a challenging condition that can manifest as pelvic pain, infertility. It affects women throughout their lives and can have a significant effect on their daily life. Diag-

WE ARE LEADERS IN DEVELOPING INNOVATIVE MINIMALLY INVASIVE PROCEDURES THAT OFFER OUR PATIENTS FASTER RECOVERY, LESS PAIN, SMALLER INCISIONS, EARLY RETURN TO NORMAL DAILY ACTIVITIES AND SHORTER HOSPITAL STAY.

INTERVIEWS

nosing and treating this condition is crucial for the improvement in women’s quality of life.

What are the best practices and methods for diagnosing and treating chronic pelvic pain? Chronic pelvic pain is debilitating for many women and can affect their quality of life. We manage refractory cases by finding the reason behind the pain and tailor treatment accordingly. We carry out complex endometriosis surgery for deeply infiltrative and advanced cases of endometriosis using our robotic and laparoscopic platforms. Rectal, bladder and ureteral endometriosis is a common manifestation of the disease that we treat endoscopically in conjunction with our expert general and urologic surgeons.

What are the best practices and methods for diagnosing uterine diseases? Fibroid management depends on many factors including age, desire for fertility and symptoms you are experiencing. Our consultants will guide you formulate a plan of action tailored to your own case. We perform fibroid and uterine surgery for advanced cases with multiple large fibroids using minimally invasive techniques like robotic, laparoscopic and hysteroscopic surgery. We make sure surgeries are done with minimal incisions in the safest way possible.

Do you offer treatment for pelvic organ prolapse, urinary leakage and cosmetic surgery? Our experts in pelvic reconstructive surgery are here to help women with pelvic organ prolapse and urinary incontinence. They are highly trained in the reconstruction of the pelvis using robotic, laparoscopic and vaginal surgery. They also focus on sexual dysfunction, where women can benefit from the latest customized treatments, including pelvic floor stimulators and laser therapy. They bring as well the latest techniques in cosmetic gynecologic surgery including labiaplasty, vaginoplasty, hoodectomy, etc.

What about the latest developments in the diagnosis, treatment and prevention of reproductive health diseases?

We offer the newest technology in diagnostic testing ranging from gynecologic and obstetrics ultrasounds, saline infusion hysterogram, hysterosalpingography, 3D and 4D ultrasounds, office hysteroscopy, etc. Gynecologic cancers are a big burden on women’s health. Screening is crucial for early diagnosis and treatment. Many of these cancers have very effective screening methods like cervical and breast cancers and can be detected early. Cervical cancer is related to a sexually transmitted virus. Patients can protect themselves by getting vaccinated. The recommended age group for vaccination is between 9 and 45 years of age. We can also detect it early by doing a pap smear. Breast cancer is very common affecting 1 in 8 women. We offer the appropriate screening schedule tailored to each patient depending on her lifetime risk and we can detect early changes in the breast. We strive to provide a safer and more effective alternative to traditional open surgery by performing the vast majority of our procedures via robotic surgery, laparoscopy, hysteroscopy and vaginal surgery.

To what extent early detection and yearly check-up can avoid women complications? Yearly check-ups are crucial to early diagnosis and treatment of all diseases affecting women’s health. It is a comprehensive check that includes gynecologic and general health checks. It includes the following: • Clinical gynecologic exam to screen for pelvic pain, sexual dysfunction, heavy bleeding, and many other benign diseases . • Age and risk-based recommendation for ovarian and breast cancer screening • Clinical breast exam for prevention of breast cancer. • Pelvic ultrasound looking for a benign and malignant disease that affects the uterus and ovaries. • Pap test and HPV for prevention of cervical cancer. • Age-based screening recommendations for non-gynecologic diseases that affect women depending on their age.

OUR EXPERTS IN PELVIC RECONSTRUCTIVE SURGERY ARE HERE TO HELP WOMEN WITH PELVIC ORGAN PROLAPSE AND URINARY INCONTINENCE. THEY ARE HIGHLY TRAINED IN THE RECONSTRUCTION OF THE PELVIS USING ROBOTIC, LAPAROSCOPIC AND VAGINAL SURGERY. THEY ALSO FOCUS ON SEXUAL DYSFUNCTION, WHERE WOMEN CAN BENEFIT FROM THE LATEST CUSTOMIZED TREATMENTS, INCLUDING PELVIC FLOOR STIMULATORS AND LASER THERAPY.

INTERVIEW

INNOVATION IN PEDIATRIC UROLOGY: TREATING BLADDER EXSTROPHY AT NATIONWIDE CHILDREN’S HOSPITAL MD, Chief of Urology at Nationwide Children’s Hospital

V. Rama Jayanthi

ationwide Children’s Hospital is one of the largest pediatric hospitals and research institutes in the United States. It is consistently ranked as one of America’s top 10 children’s hospitals by U.S. News & World Report, the recognized authority in United States hospital rankings. V. Rama Jayanthi, MD, leads the Department of Urology, which is also regarded as one of the top programs of its kind in the country. "Hospitals" magazine recently interviewed Dr. Jayanthi about Nationwide Children’s Hospital’s approach to a rare and complicated condition, bladder exstrophy.

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INTERVIEW

What is bladder exstrophy? Bladder exstrophy is a congenital condition, or birth defect, where a child is born with a bladder that is malformed and is sticking through the abdomen – that is, the bladder is exposed outside of the body. The bladder does not function correctly, so children with exstrophy are incontinent. There may also be future issues with the reproductive and other body systems as well. Exstrophy is very rare. Many surgeons can go years without seeing a single case. It’s important that the urology team treating a child with bladder exstrophy has the appropriate training and experience.

How is bladder exstrophy treated? The condition is ideally treated with surgery to close the bladder soon after birth, but most children have one or more additional procedures as they grow. Those are often designed to make children continent or have some control over the way urine is removed from the body, because their bladders likely will never be able to function normally. Boys with exstrophy also need surgery to create a urethra that goes to the end of the penis. The outcomes of these surgeries have a huge impact on a child’s everyday life and on the lives of their family members.

What makes your approach different? The Urology team at Nationwide Children’s Hospital has a crucial focus on our patients’ quality of life. Worldwide, many children undergo a surgical procedure in which the appendix is connected to the bladder and the abdomen. The child then catheterizes him/herself every few hours to remove urine, so their underwear and clothes remain dry. This is a common option and works well, but means patients have to catheterize every few hours for the rest of their lives. We have developed a modified procedure allowing urine to be diverted to the rectum so that it can exit the body that way. Those children can then use the bathroom and do not need to catheterize. For those children and their families, this can be life-changing since their day-to-day routine is relatively “normal”. In our experience, urinary tract infections and other complications that can be a risk with oth-

er procedures have not been as great with our modified procedure. I should also say because there are so few cases of bladder exstrophy, to begin with, we do not have long-term evidence that would allow us to say this approach is definitely better than any other one. We do feel it has advantages for some people, though, and the families who have chosen this approach are quite pleased with the outcome. The procedure is not necessarily appropriate for every child, but it has been a successful option for our patients in recent years.

How have patients and families responded? Families who have children with bladder exstrophy have often done a lot of their own research because they want the best possible outcome. They connect with other families online to learn about their experiences. And they are most often going to find that the typical ways of correcting bladder exstrophy are the only options they have. We offer another option, which may be helpful for some. In our most recent experience, a family who lives far away from our hospital sought us out for this different option, because they knew the way it could positively affect their child and their own lives. Their child has had no infections and is able to go to the bathroom like a “normal” child. It has had a big, beneficial impact on them.

Why is Nationwide Children’s Hospital leading in this area? One of the most important reasons is our desire to collaborate – both inside our institution and outside of it. Inside our hospital, we realize that children with some severe forms of exstrophy will need treatment from multiple surgeons: urologists, colorectal specialists and gynecologists. Through our Center for Colorectal and Pelvic Reconstruction, we bring together those and many other experts so that children can have their medical issues addressed holistically. We also have helped create a consortium of large hospitals, the Pediatric Urology Midwest Alliance, which allows us to learn from each other. That’s especially helpful in developing expertise with rare conditions like bladder exstrophy and in conducting research on those conditions.

WE MAY NOT SEE MANY BLADDER EXSTROPHY CASES INDIVIDUALLY IN A YEAR, BUT TOGETHER, THE ALLIANCE HAS TREATED A SIGNIFICANT PERCENTAGE OF ALL EXSTROPHY CASES IN THE UNITED STATES SINCE 1980. WE BRING THAT KNOWLEDGE TO THE CHILDREN AND FAMILIES WE SERVE.

INTERVIEW

One of those scientists who sees the glass half full in challenging times, opportunity in problems, collectivity when moving forward

Christiana Demetriou “No one should be born in inequality” Interview by Constandinos Tsindas

ot a lab or a control room, but the real Public Health, the one in the street, the one that makes a difference in people’s lives. Her work at the University of Nicosia Medical School, is only but a fraction of her ideas and proposals on building a brighter future.

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INTERVIEW

It's certainly an exciting (although sad) time to be an epidemiologist, and in general terms a scientist in genetics or biology. How do you see the pandemic situation? Are we moving in the right direction and how concerned are you? Definitely an exciting and challenging time. Throughout the past year, we’ve seen how epidemiology has shaped the COVID-19 pandemic; from sounding the alarm following reports of a previously unknown coronavirus causing pneumonia-like symptoms, to modelling the transmissibility of the virus and the impact of control measures, to testing and rolling out several vaccines specific to the new virus, to now predicting the impact of new variants of the virus. In fact, thinking of what the scientific community has achieved in this past year, while navigating unprecedented circumstances, cannot but leave one in awe! Therefore, we are definitely doing many things right and we are moving in the right direction. While discussing with other scientists, I think the consensus is that we have quite a long road ahead of us. The main concerns right now are how to achieve sufficient vaccine coverage, as high percentage of people vaccinated as possible. And of course, while working towards understanding how effective existing vaccines are against new viral strains. We’ve won many a battle, but the war is far from over.

The issue of public health and its effectiveness is highly topical, no less due to the ability of public health systems to manage the pandemic and the challenges it brings, in addition to all the rest that needs attention in this vital field. What are your views and proposals on how to move forward, improve things? Public Health needs to more actively acknowledge and embrace the interconnectedness between human health, animal health and environmental health. You cannot have the one without the other and that’s why this is often referred to as the One Health concept. For years, humans have strived for their wellbeing often disregarding the impact on nature and the environment. This has led to climate change, geologic, hydrologic and meteorological disasters, anti-microbial resistance and, currently, epidemics of emerging zoonotic diseases. If we really want to improve, we need to consider the holistic approach of the One Health concept. Importantly, Public Health needs to pay more attention to health inequalities both between but also within countries. Even in countries with the highest sociodemographic indices, there exist astounding health inequalities between population groups. As a mother, what pains me the most is that children are often born in inequality; with the genetic, lifestyle and socio-economic conditions of their

THE MAIN CONCERNS RIGHT NOW ARE HOW TO ACHIEVE SUFFICIENT VACCINE COVERAGE, AS HIGH PERCENTAGE OF PEOPLE VACCINATED AS POSSIBLE.

INTERVIEW

parents determining their maximum potential in terms of health attainment. In future, I would like to see Public Health addressing these health inequalities by focusing more on the wider determinants of health and their impact on the conditions of future generations.

You’re the Programme Coordinator for the Master in Public Health at the University of Nicosia Medical School. Run us through what the programme entails. The Master of Public Health, MPH for short, is a distance-learning, postgraduate degree offered by the University of Nicosia Medical School. Our vision is to develop a new generation of public health leaders who promote cooperation amongst the human, animal, and environmental health communities, to make a difference in their own communities, both regionally and globally. We offer a core curriculum that supports the development of core and cross-cutting competencies in the three fundamental domains of Public Health Practice, namely Health Protection, Health Promotion, and Healthcare Public Health. We also offer elective courses that provide a holistic approach to Public Health and allow candidates to enhance and expand their learning experiences in relation to their interests in different public health areas. Students have the opportunity to develop applied skills and competence in epidemiology and public health research by carrying out a research project in the field of public health. I truly believe it’s a well thought out programme, balancing all

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essential knowledge, skills and competencies in Public Health, with the flexibility needed to accommodate the personal and professional responsibilities of adult learners.

Do you feel there is a still a long road ahead when it comes to women scientists gaining the same respect in their fields as male colleagues? What else needs to be done? I consider myself fortunate to be working in a country, and more specifically at an Institution, where female scientists are acknowledged, valued and praised. Indeed though, I do think there is a long road ahead. In some countries, respect that to be gained is literal, whereas in other states, it is rather more “practical”, if I may call it that. For one, the gender pay gap needs to be addressed in this decade. Even in the most developed of societies, where equality of opportunity and mutual respect do exist, there is often a gender pay gap. The scientific journal Nature recently published an article on the gender pay gap identified at a few of the most integral science agencies in the United States. I am quite certain the same holds true in scientific organizations throughout the world, especially the ones with little scrutiny regarding such matters. In addition, a study in more than 500 universities and research institutions across the US, Australia and 36 other countries (published in the journal Cell Stem Cell), has found that even though women make up half of the students in life sciences, only one in four are professors, the highest academic rank. This indicates that climb-

AS A MOTHER, WHAT PAINS ME THE MOST IS THAT CHILDREN ARE OFTEN BORN IN INEQUALITY; WITH THE GENETIC, LIFESTYLE AND SOCIO-ECONOMIC CONDITIONS OF THEIR PARENTS DETERMINING THEIR MAXIMUM POTENTIAL IN TERMS OF HEALTH ATTAINMENT.

INTERVIEW

ing the career ladder in science is more difficult and complex, for women. The reasons holding women back need to be further investigated, elicited and addressed so that women scientists can truly gain the same respect as their male counterparts. I do remain hopeful that as more women are given the opportunity of education in the life and other sciences, the paradigms in the scientific community will begin to shift in their favour; I am a firm believer in that it all starts with educating future generations.

Do you actually believe we need to bring the whole public health system down in terms of its approach and build a new one? Or work through this one? I am more in favour of reforming, rather than demolishing and rebuilding! The discipline of Public Health has made tremendous progress in the past few decades. We only need to look at the differences in life expectancies, what 30 to 40 years ago and today to clearly witness the advancements made. Interestingly, most of science happens under controlled conditions, for example in a laboratory, in a petri-dish, in a randomized controlled clinical trial. Unfortunately, when it comes to improving population health, the human factor makes the conditions we have to work with, anything but controlled; anything but ideal! Therefore, we need to learn from the achievements and even some failures of the past to continue tackling the pertinent issues in Public Health. This is actually one of the reasons why I am so proud of my job. We, the MPH programme that is, get to contribute to this reformation and advancement, through the training of the future generation of public health professionals.

Let's talk a little bit about the other part of your expertise. What are you currently working on in terms of epidemiological research and clinical trials? Not surprisingly, most of my current research activity is “consumed” with COVID-19. I am the Principal Investigator of the C-MOR project, coordinated by the University of Nicosia Medical School. It consists of an international consortium of partners who came together with

the aim of creating a reference dataset focused on mortality resulting from COVID-19 (https:// www.unic.ac.cy/coronavirus/mortality/). Currently, the project has more than 50 partners from countries across six continents. Some of our objectives are to investigate excess all-cause mortality during the COVID-19 pandemic, identify the percentage contribution of COVID-19 deaths to the excess mortality, disentangle direct and indirect excess mortality due to COVID-19, and investigate excess mortality in the context of country specific COVID-19 control measures. Our initial results highlight the importance of mortality surveillance in studying the burden of COVID-19, as well as the impact of COVID-19 control measures on the mortality experience of different countries. Perhaps closer to my research background, chronic disease epidemiology, I am currently also involved in a project investigating the epidemiology of cancer in Cyprus. We are looking into temporal trends as well as any inequalities in the stages at which different cancers are diagnosed in different population groups. We also hope that the project will highlight the effectiveness of established and newly implemented cancer screening programmes. This project is in collaboration with the Ministry of Health Cancer Registry.

DEFINITELY OPTIMISTIC AND HOPEFUL! I TAKE PRIDE IN THE ADVANCEMENTS ACHIEVED BY THE DISCIPLINE OF PUBLIC HEALTH, AND THE SCIENTIFIC COMMUNITY, TO DATE. I AM HOPEFUL THAT THE LESSONS LEARNED WILL ENABLE US TO CONTINUE TO TACKLE THE OFTEN WICKED PROBLEMS OF PUBLIC HEALTH.

As a scientist, who goes about things in terms of trials and definitive answers, what do you think about the future? Are you pessimistic, hopeful, in doubt, uncertain? Definitely optimistic and hopeful! I take pride in the advancements achieved by the discipline of Public health, and the scientific community, to date. I am hopeful that the lessons learned will enable us to continue to tackle the often wicked problems of Public Health. Perhaps most importantly, I cannot but be optimistic when I see all our students who have dedicated their studies and professional lives to improving population health! With this kind of woman- and man-power, and ultimately, Human Power, I am certain that we’re in for a bright Public Health future. As Owen Arthur said, “For he who has health has hope; and he who has hope, has everything.”

ARTICLE FEATURES . Women’s Health

Highlighting women’s main health issues A healthy life is the path towards a disease-free body

omen's health is receiving global attention given the importance of its role in society and the family in particular. Protecting the mother’s health also means preserving the health of the child and the family, which prompted hospitals and health facilities to establish comprehensive departments and centers specialized in women and children’s health and provide them with specialized health services in various fields. The aim was to establish medical units that provide integrated healthcare services with the aim of preserving women's health and preventing diseases.

On International Women's Month, we must shed light on women's health issues and concerns, as their health is different from men’s given the changes they go through during their life stages, which start with puberty, then pregnancy and lactation and later menopause without forgetting the menstrual cycle and the hormonal fluctuations women go through, making these stages a factor affecting their health, due to the hormonal changes that experience, which put them at risk of some diseases. The physiological difference between male and female bodies makes them more susceptible to some diseases that do not affect men or make them susceptible to other diseases in a different way due to the different composition between the sexes.

Lifestyle is the gateway to a safe and healthy life Health experts around the world agree on the importance of leading a healthy lifestyle as it is the gateway to long-term health. Food, physical activity and not smoking are all healthy habits that help a woman avoid contracting some diseases that may be life-threatening. Physical activity, even half an hour a day, can prevent overweight or obesity in women, and their accompanying health risks and diseases, including breast cancer, diabetes and heart disease. Obesity has a significant impact on the

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mother’s health during pregnancy, as research indicates that it increases the risk of miscarriage and premature labor while also impacting In Utero conditions, causing serious complications to the fetus’ health. On the other hand, leading an unhealthy lifestyle as well as consuming calorie-dense food with minimal physical activity or exercise are all factors that reduce the speed of the fat-burning process, which leads to its storage in the body. However, this does not mean that a person should skip meals or snacks, as not eating for a long time puts the body in a state of rest, because the body responds to the lack of food by slowing down the metabolism process in an attempt to store calories and surviving, and with the slow metabolism, women quickly gain weight. The best way to speed up the fat-burning process is to exercise and build muscle, provided that it is not associated with overeating.

Obesity is also linked to several types of cancer that women suffer from, including endometrial cancer, uterine cancer, ovarian cancer, cervix and breast cancer, as well as the psychological effects that can affect a woman's quality of life and may cause mental stress, depression, anxiety, etc.

Heart disease in women After menopause, women and men are at equal risk of developing heart disease after the absence of the estrogen hormone that provides them with protection. Also, a woman’s exposure to bouts of stress, anxiety and psychological stress makes her more vulnerable to the broken heart syndrome, which is a temporary heart condition that's often brought on by stressful situations and extreme emotions. The condition can also be triggered by a serious physical illness or surgery. Unlike a heart attack, broken heart syndrome happens when a sudden physical or emotional stress causes a rapid weakening of your heart muscle. Moreover, smoking is considered one of the most dangerous risk factors for a woman's heart, because it damages the blood vessel walls and leads to hypertension. Smoking is considered one of the most dangerous factors for women, not only because of the increased risk of heart disease, but also because smoking removes the protection that the estrogen gives to women to prevent these diseases.

A WOMAN CAN TAKE SOME PREVENTION STEPS BY CHANGING HER LIFESTYLE, EXERCISING REGULARLY, FOLLOWING A HEALTHY DIET AND ABSTAINING FROM SMOKING, IN ADDITION TO DOING REGULAR CHECK-UPS WITH THE DOCTOR AND UNDERGOING THE NECESSARY EXAMINATIONS.

ARTICLE FEATURES . Women’s Health

Not all breast diseases are cancer UNLIKE BREAST CANCER, A FIBROADENOMA DOESN'T CAUSE NIPPLE DISCHARGE, SWELLING, REDNESS, OR SKIN IRRITATION AROUND THE BREAST.

reast tumors, both benign and malignant, are the focus of interest in the health sector and society in all its categories, which is evident through the awareness campaigns that have contributed to breaking the shyness barrier among women. Early detection was a lifeline for many early stage cancer cases. The woman realized that shyness will not benefit her, but might be the cause of losing her life. The earlier the detection, the faster she is freed from the disease. However, breast problems are not always cancer, but there are many benign tumors that are not dangerous, but cause a state of panic in a woman until the doctor diagnoses it.

Benign Breast Tumors Most breast lumps are benign, which means they're not cancer. Benign breast lumps usually have smooth edges and can be moved slightly when you push against them. They are often found in both breasts. There are several common causes, including normal changes in breast tissue, breast infections, or injury. Fibroadenomas are the most common benign lumps. If you push on them, they are solid, round, rubbery lumps that move freely.

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ARTICLE FEATURES . Women’s Health

They’re usually painless but may be painful before a period. The majority of women with benign breast disease don’t develop breast cancer. If you have a disease type that increases cancer risk, your healthcare provider may recommend more frequent cancer screenings. Certain breast diseases can make you more prone to developing lumps. You should notify your healthcare provider anytime you notice changes in how your breasts look or feel. Perhaps the hormonal fluctuations and disorders in a woman’s life stages are one of the risk factors of benign breast disease, in addition to taking birth control pills, weight gain, aging and menopause. Unlike breast cancer, a fibroadenoma doesn't cause nipple discharge, swelling, redness, or skin irritation around the breast. Doctors don’t know what causes them. They may be related to changing levels of hormones, since they often appear during puberty or pregnancy and go away after menopause. These lumps develop as a result of changes in the estrogen levels in the body. The breasts are made of “lobules” that are the milk-producing glands, as well as milk ducts that carry milk to the nipple. A benign breast tumor begins to form in one of the milk lobules, so the tissues and milk ducts enlarge, eventually forming a soft, cohesive mass, and this is what they call an adenoma. Breast self-exam, or regularly examining your breasts on your own, can be an important way to find a breast cancer early, when it’s more likely to be treated successfully. While no single test can detect all breast cancers early, it is believed that performing breast self-exam in combination with other screening methods can increase the odds of early detection. The second stage of the examination takes place in the doctor's office, and here the woman should not neglect the regular visit to the specialist doctor, especially if there is a family history of benign lumps or even breast tumors. She must visit her doctor annually after the age of forty. Your risk for benign breast disease increas-

EARLY DETECTION IS IMPORTANT WITH THE AIM OF DETECTING MALIGNANT CELLS IN ITS EARLY STAGES, WHICH INCREASES THE EFFECTIVENESS OF TREATMENT. AFTER THE AGE OF FORTY, EVERY WOMAN MUST GO TO CENTERS OR HOSPITALS THAT PERFORM A MAMMOGRAM TO DETECT THE PRESENCE OF LUMPS THAT BEGIN TO FORM INSIDE THE BREAST WITHOUT FEELING THEM.

es if you have a family history of breast cancer or benign breast disease, use hormone replacement therapy or have a hormonal imbalance. You may notice breast changes or a lump while doing a breast-self exam, showering or getting dressed. Sometimes a mammogram detects these changes. Besides a breast lump, other signs of benign breast disease include breast pain, nipple discharge, change in breast size, shape or contour, inverted, creased or scaly nipple and dimpled, puckered or scaly breasts. In some cases, the doctor may need to take a sample of breast lumps for reassurance (biopsy). Dealing with this type of benign tumor starts by monitoring it to see the extent of its development and growth, especially if it is small and does not seem to grow with time, which means that keeping it does not cause any problem. Breast lump removal is surgery to remove a lump that may be breast cancer. Tissue around the lump is also removed. This surgery is called an excisional breast biopsy, or lumpectomy. When a noncancerous tumor such as a fibroadenoma of the breast is removed, this is also called an excisional breast biopsy, or a lumpectomy. It is done under local or general anesthesia. Image-guided vacuum-assisted excision biopsy is a non-surgical procedure that can be used to remove benign (non-cancerous) lumps in the breast. A vacuum-assisted excision (VAE) of a breast lesion involves a small cut being made in your breast and the lesion (area of swelling or a lump) being removed using a needle attached to a vacuum/suction device. This lesion will then be analyzed in the laboratory to see what it is. Cryoablation, also referred to as cryotherapy, is a minimally invasive procedure that uses extremely cold temperatures to destroy diseased tissue. In certain clinical situations, it can be preferred over other techniques and has a faster recovery time. For internal tumors, cryotherapy is carried out by using a cryoprobe, a thin wand-like device with a handle or trigger or a series of small needles, attached via tubing to a source of nitrogen or argon, which super-cools the probe tip.

ARTICLE FEATURES . Women’s Health

Breast Cancer Breast cancer is the most common type of cancer worldwide. According to the United Nations Health Agency, there were 2.3 million new breast cancer cases in 2020, representing almost 12 percent of all cancer cases. It is also the leading cause of death from cancer among women worldwide. Awareness campaigns have always focused on early detection because it is the way to detect the disease early and protect the patient from spreading the cancer beyond the breast area. This step greatly contributed to avoiding the complete excision process while only removing the cancerous tumor, with the patient undergoing a number of chemotherapy and radiology sessions before and after the operation, according to the appropriate treatment protocol for her disease. Early detection is important with the aim

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UTERINE DISEASES MAY INCLUDE BENIGN FIBROIDS THAT MAY BECOME MALIGNANT. THERE ARE DISEASES THAT MAY BE A CAUSE OF INFERTILITY, SUCH AS ENDOMETRIOSIS OR ABNORMAL UTERINE BLEEDING, AND MORE SERIOUS DISEASES SUCH AS CANCER.

of detecting malignant cells in its early stages, which increases the effectiveness of treatment. After the age of forty, every woman must go to centers or hospitals that perform a mammogram to detect the presence of lumps that begin to form inside the breast without feeling them. Awareness campaigns always focus on the need to do a mammogram to be on the safe side because when symptoms appear it means that the disease has already started. The types of breast cancer differ according to the ability of the disease to spread and respond to each type of treatment. In researching the type of cancer, the oncologist focuses on the characteristics of the breast cancer through histological examination and biopsy, to see if it is slow, moderate, or fast-growing. They also look into the type and amount of proteins present in this malignancy on or inside the cell wall, in addition to examining the estrogen,

ARTICLE FEATURES . Women’s Health

progesterone and HER 2 protein receptors. In terms of treatments, the doctor determines the appropriate treatment for each patient, taking into account several factors, namely, the size of the malignant tumor and where it has spread. In some cases, a tumor excision is required only while preserving the breast, provided that the operation is followed by radiotherapy, while for other cases where the disease has spread, the breast must be completely removed then chemotherapy and radiotherapy sessions should be done in addition to hormone therapy afterwards. In some cases, the doctor decides to combine surgery, radiation, chemotherapy and hormonal therapy, in order to prevent complications and control the disease. Sometimes surgery is postponed until they see a response to chemotherapy, and other times surgery is ruled out in the elderly and is replaced with radiation and hormonal therapy only. Breast cancer surgeries have also witnessed a remarkable development, as it is now possible

YOU WON'T NEED TREATMENT FOR CERVICITIS CAUSED BY AN ALLERGIC REACTION TO PRODUCTS SUCH AS SPERMICIDE OR FEMININE HYGIENE PRODUCTS. IF YOU HAVE CERVICITIS CAUSED BY A SEXUALLY TRANSMITTED INFECTION (STI), BOTH YOU AND YOUR PARTNER WILL NEED TREATMENT, OFTEN WITH AN ANTIBIOTIC MEDICATION.

to remove the first node only to be examined, and if it was healthy, the remaining nodes are not removed and this method is called Central Lymph Node Biopsy. Medical studies and research also concluded that the preventive hormonal therapy tamoxifen should be taken for ten years instead of five given its importance in reducing the risk of disease recurrence. Breast reconstruction surgery takes place during or soon after mastectomy, and in some cases, lumpectomy. It can also be done many months or even years after mastectomy or lumpectomy. During reconstruction, a plastic surgeon creates a breast shape using an artificial implant (implant reconstruction), a flap of tissue from another place on your body (autologous reconstruction), or both. Surgeons today are doing their best to avoid performing radical mastectomy. However, in the end, the size of the tumor, the extent of its spread, its type, and the extent of skin injury are all factors that the doctor considers in order to determine the type of the surgery.

ARTICLE FEATURES . Women’s Health

Uterine diseases The severity of symptoms determines the treatment and regular examination is the way to survive

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ARTICLE FEATURES . Women’s Health

here are numerous uterine diseases and problems, and the reason for this is the physiological differences that a woman experiences in her life stages, starting with her period and the hormonal changes that this stage witnesses every month then pregnancy and childbirth in addition to menopause and its accompanying disorders. Uterine diseases may include benign fibroids that may become malignant. There are diseases that may be a cause of infertility, such as endometriosis or abnormal uterine bleeding, and more serious diseases such as cancer.

Uterine fibroids Fibroids are growths made of smooth muscle cells and fibrous connective tissue. These growths develop in the uterus and appear alone or in groups. They range in size, from as small as a grain of rice to as big as a melon. In some cases, fibroids can grow into the uterine cavity or outward from the uterus on stalks. An estimated 20% to 50% of women of reproductive age currently have fibroids, and up to 77% of women will develop fibroids sometime during their childbearing years. Only about one-third of these fibroids are large enough to be detected by a health care provider during a physical exam, so they are often undiagnosed. In more than 99% of fibroid cases, the tumors are not cancerous and do not increase the risk for uterine cancer. It is common that women who have fibroids do not experience any noticeable symptoms. Other women with fibroids experience severe symptoms that interfere with their daily lives. Since the growth of most fibroids slows as you approach menopause, your healthcare provider may simply suggest “watchful waiting” if your symptoms are tolerable. With this approach, the healthcare provider closely monitors your symptoms with frequent follow-up visits and ultrasounds to make sure there are no significant changes in your condition. Treatment may be necessary if your fibroids cause significant symptoms. Treatment options include medicinal and surgical approaches. Your doctor will recommend treatment based on your symptoms, location and size of the fibroids,

your age and medical history, and your health goals such as a desire for pregnancy. Hormonal treatment can include gonadotropin-releasing hormone agonists (GnRH agonists). This treatment lowers your estrogen level and triggers a temporary “medical menopause.” GnRH agonists are used to shrink the fibroid(s). They are also used to stop your period in preparation for surgery or to improve your blood count. Doctors will not typically administer this medication for longer than a year — and the medication’s effects are reversed once it leaves your system. Oral contraceptive pills (or a patch or vaginal ring) can help reduce bleeding associated with fibroids and progesterone-containing agents — pills, implant, injection or intrauterine device (IUD) — may also control bleeding. During a hysterectomy, the entire uterus is removed. Because a hysterectomy is a major surgery, it is only recommended to treat fibroid cases for women who are not interested in preserving their fertility. It is the most effective method of fibroid treatment because it eliminates the possibility of recurrence.

Uterine infections

Common fibroid symptoms include heavy or prolonged periods, bleeding between periods, abdominal discomfort and/or fullness, pelvic pain, lower back pain, bladder symptoms, such as frequent urination or difficulty emptying the bladder and bowel symptoms, such as constipation or excessive straining with bowel movements. Women with fibroids can also experience infertility, complications during pregnancy and pain during intercourse.

Gynecological and uterine infections are common diseases among women, and they may cause many problems. They may affect fertility, unless treated early. There are many causes that can lead to infections, whether cervicitis or endometriosis. Possible causes of cervicitis include sexually transmitted infections. Most often, the bacterial and viral infections that cause cervicitis are transmitted by sexual contact. Cervicitis can result from common sexually transmitted infections (STIs). An allergy, either to contraceptive spermicides or to latex in condoms, may lead to cervicitis. A reaction to feminine hygiene products, such as douches or feminine deodorants, also can cause cervicitis. An overgrowth of some of the bacteria that are normally present in the vagina (bacterial vaginosis) can lead to cervicitis. Most often, cervicitis causes no signs and symptoms, and you may only learn you have the condition after a pelvic exam performed by your doctor for another reason. If you do have signs

ARTICLE FEATURES . Women’s Health

and symptoms, they may include large amounts of unusual vaginal discharge, frequent, painful urination, pain during sex, bleeding between menstrual periods and vaginal bleeding after sex, not associated with a menstrual period. Your cervix acts as a barrier to keep bacteria and viruses from entering your uterus. When the cervix is infected, there's an increased risk that the infection will travel into your uterus. Cervicitis that's caused by gonorrhea or chlamydia can spread to the uterine lining and the fallopian tubes, resulting in pelvic inflammatory disease (PID), an infection of the female reproductive organs that can cause fertility problems if left untreated. Cervicitis can also increase the risk of getting HIV from an infected sexual partner. You won't need treatment for cervicitis caused by an allergic reaction to products such as spermicide or feminine hygiene products. If you have cervicitis caused by a sexually transmitted infection (STI), both you and your partner will need treatment, often with an antibiotic medication. Antibiotics are prescribed for STIs such as gonorrhea, chlamydia or bacterial infections, including bacterial vaginosis. Your doctor may offer antiviral medication if you have genital herpes, which helps decrease the amount of time you have cervicitis symptoms. However, there is no cure for herpes. Herpes is a chronic condition that may be passed to your sexual partner at any time. To avoid passing a bacterial infection along to your partner, wait to have sex until you're finished with the treatment recommended by your doctor.

Cervical Cancer The World Health Organization recently stated that cervical cancer is the fourth most common cancer in women worldwide. This report came on the occasion of World Cancer Day, where the WHO’s Global Strategy for the Elimination of Cervical Cancer a Public Health Problem provided a roadmap, through the following 90-70-90 targets for 2030: 90% of girls fully vaccinated with the HPV vaccine by age 15, 70% of women are screened with a high-performance test by 35 and 45 years of age and 90% of women identified with cervical disease receive treatment. Successful implementation

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of all three could reduce more than 40% of new cases of the disease and 5 million related deaths by 2050. Human papillomavirus (HPV) is a group of viruses that are extremely common worldwide. There are more than 100 types of HPV, of which at least 14 are cancer-causing (also known as high risk type). HPV is mainly transmitted through sexual contact and most people are infected with HPV shortly after the onset of sexual activity. Two HPV types (16 and 18) cause 70% of cervical cancers and pre-cancerous cervical lesions. There is also evidence linking HPV with cancers of the anus, vulva, vagina, penis and oropharynx. Primary prevention begins with HPV vaccination of girls and boys aged 11-12 years, before they become sexually active and before exposure to HPV. Once infection occurs, the vaccine may lose its effectiveness. If they are not fully vaccinated at the age of 11 to 12 years, the Centers for Disease Control and Prevention (CDC) recommends to give the vaccine to girls and women at age 26, and boys and men at age 21.

HUMAN PAPILLOMAVIRUS (HPV) IS A GROUP OF VIRUSES THAT ARE EXTREMELY COMMON WORLDWIDE. THERE ARE MORE THAN 100 TYPES OF HPV, OF WHICH AT LEAST 14 ARE CANCERCAUSING (ALSO KNOWN AS HIGH RISK TYPE).

Pap Smear and its role in early diagnosis A Pap smear is a procedure to test for cervical cancer in women. It involves collecting cells from your cervix — the lower, narrow end of your uterus that's at the top of your vagina. Detecting cervical cancer early with a Pap smear gives you a greater chance at a cure. Your doctor will gently insert an instrument called a speculum into your vagina. The speculum holds the walls of your vagina apart so that your doctor can easily see your cervix. Inserting the speculum may cause a sensation of pressure in your pelvic area. Then your doctor will take samples of your cervical cells using a soft brush and a flat scraping device called a spatula. A Pap smear can alert your doctor to the presence of suspicious cells that need further testing. If your Pap smear is abnormal, your doctor may perform a procedure called colposcopy using a special magnifying instrument (colposcope) to examine the tissues of the cervix, vagina and vulva. Your doctor also may take a tissue sample (biopsy) from any areas that appear abnormal. The tissue sample is then sent to a laboratory for analysis and a definitive diagnosis.

A Pap smear can also detect changes in your cervical cells that suggest cancer may develop in the future. Detecting these abnormal cells early with a Pap smear is your first step in halting the possible development of cervical cancer.

5th Consecutive JCI Accreditation Against All Odds

2020 has been a challenging year filled with obstacles. Despite all, CMC is honored to announce that it has been accredited for the 5th consecutive time by the Joint Commission International (JCI)-7th edition with distinction for the highest standards of healthcare quality and patient safety.

ARTICLE FEATURES . Multisystem Inflammatory Syndrome in Children

Widespread inflammation and acute complications

Multisystem Inflammatory Syndrome in Children

ith the coronavirus outbreak, studies indicated that the effect of this virus is less harmful on children, and the symptoms are often mild in this age group. However, some children later developed a rare but serious medical condition, Multisystem Inflammatory Syndrome (MIS-C) associated with COVID-19, after many countries reported this condition after recovering from the virus.

What is Multisystem Inflammatory Syndrome in children? What are its symptoms? Why does it appear weeks after recovering from the coronavirus? Multisystem inflammatory syndrome in children (MIS-C) is a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. Children with MIS-C may have a fever and various symptoms, including abdominal (gut) pain, vomiting, diarrhea, neck pain, rash, bloodshot eyes, or feeling extra tired. We do not yet know what causes MIS-C. However, many children with MIS-C had the virus that causes COVID-19, or had been around someone with COVID-19. In such a situation, the child needs emergency medical intervention to obtain the necessary medical care because the condition is dangerous and the consequences may be severe. Scientists have found that most children who contract the coronavirus show mild or no symptoms, and rarely develop serious complications from the disease. However, some of them may end up developing severe complications from an abnormal immune system reaction but after recovering from the virus. The cause of MIS-C is not yet fully understood. Some researchers suspect that MIS-C is caused by a delayed immune response to the coronavirus causing inflammation that damages organs. It’s also possible that the antibodies children make to the virus are creating the immune reaction. Since only a small number of

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IN CHILDREN WHO DEVELOP MIS-C, SOME ORGANS AND TISSUES — SUCH AS THE HEART, LUNGS, BLOOD VESSELS, KIDNEYS, DIGESTIVE SYSTEM, BRAIN, SKIN OR EYES — BECOME SEVERELY INFLAMED.

children develop MIS-C, it is possible that there are genetic factors that make some children susceptible. It is important to remember that overall, children fare very well with COVID-19 as compared to adults. Only a small number of children seem to develop signs and symptoms of MIS-C, and most have recovered quickly.

Symptoms and Treatment Signs and symptoms of multisystem inflammatory syndrome in children (MIS-C) may include fever that lasts 24 hours or longer, vomiting, diarrhea, stomach pain, skin rash, feeling unusually tired, fast heartbeat, rapid breathing, red eyes, redness or swelling of the lips and tongue, redness or swelling of the hands or feet, headache, dizziness or lightheadedness and enlarged lymph nodes. These symptoms may include, but are not limited to, an elevated CRP, ESR, fibrinogen, procalcitonin. Most affected children will need to be admitted to hospital, and some may require to stay in the ICU. The treatment of this syndrome aims to reduce the inflammatory symptoms, and based on the child's condition, he will receive anti-inflammatory drugs to alleviate these symptoms and protect the affected internal organs from any damage or permanent harm.

ARTICLE FEATURES . Multisystem Inflammatory Syndrome in Children

ARTICLE FEATURES . Will the COVID-19 vaccine passport be adopted?

Will the COVID-19 vaccine passport be adopted? COVID-19 Vaccine Passport...The Travel Gateway

ith the launch of vaccination campaigns against the coronavirus, which has exhausted the world and paralyzed global travel, some believe that the vaccine is the only way to return to normal life and resume travel. A year after the pandemic outbreak and staying in home quarantine for months, many people hope to return to their normal lives, which will be under the condition to get vaccinated, which will be the travel gateway. Today, the COVID-19 vaccine became the only hope for returning to normal life, as it does not seem that the world will get rid of this cross-border virus except with the vaccine, which put forward the idea of a “COVID-19 vaccine passport”, allowing whoever gets the vaccine to travel again freely. Some governments around the world, airlines, as well as vaccine manufacturers are working on that as research

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THE COMMON COVID-19 CERTIFICATE SYSTEM, WHICH IS EXPECTED TO BE OPERATIONAL AS EARLY AS JUNE, AIMS AT PROVIDING “PROOF THAT A PERSON HAS BEEN VACCINATED, RESULTS OF TESTS FOR THOSE WHO COULDN’T GET A VACCINE YET AND INFO ON COVID-19 RECOVERY.”

is being made about the possibility of using “the COVID-19 vaccine passports” as a way for economic and tourism recovery by identifying those who are protected from the coronavirus. It isn’t just governments that are suggesting vaccine passports. In fact, some Arab countries will participate in a trial of IATA Travel Pass to help pave the way for the re-establishment of global connectivity while managing the risks of COVID-19. It will help passengers manage their travel plans and provide airlines and governments documentation that they have been vaccinated or tested for COVID-19. The European Commission will propose an EU law on COVID-19 vaccine certificates. The common COVID-19 certificate system, which is expected to be operational as early as June, aims at providing “proof that a person has been vaccinated, results of tests for those who couldn’t get a vaccine yet and info on COVID-19 recovery.”

ARTICLE FEATURES . Will the COVID-19 vaccine passport be adopted?

A unified GCC health passport The GCC countries would soon discuss the issue of a unified Gulf health passport, in addition to travel and movement between GCC countries. Soon, those wishing to travel will be required to present a certificate proving that they have obtained the coronavirus vaccine, as it is a prerequisite for travel from one country to another. Many international airlines tend to impose that travelers obtain a certificate of receiving the COVID-19 vaccine, a prerequisite for travel in the coming period, and it is expected that many countries will require travelers to provide vaccine certificates to enter their borders, so that the vaccine certificate becomes a new travel rule in the world. Qatar Airways Group CEO believes that everyone will have to present a certificate of vaccination in order for them to board the plane, indicating that this will be the new standard, and every person must present a certificate of vaccination onboard the plane and not just to board the plane. Many countries require that you be vaccinated before you travel to them. The major efforts made by the national carrier in Qatar during the coronavirus period made it the first global airline to obtain a 5-star rating for “auditing safety measures for coronavirus at the airline level” from Skytrax. This announcement follows a careful review conducted by the Skytrax team last December, in which it evaluated the effectiveness and strictness of the safety and sterilization standards and procedures related to the coronavirus applied by the Qatari carrier, from the check-in point at the airport to the passengers’ experience onboard. Etihad Aviation Group and Emirates Airlines announced their cooperation with the International Air Transport Association (IATA) to use a mobile application that helps download and share information about coronavirus tests and vaccines. The app is a health “digital passport” that allows travelers to share their data with travel companies and relevant authorities in order to facilitate their travel and movement between countries and with airlines. It also allows them to verify that their pre-travel test for the

MANY INTERNATIONAL AIRLINES TEND TO IMPOSE THAT TRAVELERS OBTAIN A CERTIFICATE OF RECEIVING THE COVID-19 VACCINE, A PREREQUISITE FOR TRAVEL IN THE COMING PERIOD, AND IT IS EXPECTED THAT MANY COUNTRIES WILL REQUIRE TRAVELERS TO PROVIDE VACCINE CERTIFICATES TO ENTER THEIR BORDERS, SO THAT THE VACCINE CERTIFICATE BECOMES A NEW TRAVEL RULE IN THE WORLD.

coronavirus or vaccination meets the requirements of their destinations. Saudi Arabia’s Minister of Health, Dr. Tawfiq al-Rabiah, announced the launch of an online “Health Passport” for those who completed the two doses of the COVID-19 vaccine. The “Health Passport” is developed by the Kingdom’s Ministry of Health, in cooperation with the Saudi Authority for Data and Artificial Intelligence (SDAIA). “Tawakkalna,” developed by SDAIA, is the official application approved by the Ministry of Health of Saudi Arabia to limit the spread of the coronavirus. The minister of health said the “Health Passport” will help the authorities identify those who received the vaccine. In addition, the Kingdom of Bahrain launched a “digital passport” for those who received the protective vaccine against COVID-19, thus becoming one of the first countries to take this step. A Bahraini government mobile application allows people to digitally register the status of their immunity to COVID-19 after receiving the vaccine. The BeAware Bahrain app offers a coronavirus vaccination certificate that enables users to receive the certificate stating that they are vaccinated against the virus. To receive the certificate, people must receive two doses of the vaccine 21 days apart and then wait two weeks after the second dose for antibodies to develop, according to the app. Vaccines against COVID-19 typically require two doses to be fully effective.

ARTICLE FEATURES . Will the COVID-19 vaccine passport be adopted?

Authorities can verify the validity of the certificate by scanning a QR code linking to the national vaccine register. Bahrain’s ‘BeAware’ app displays a green shield alongside an official certificate detailing the person’s name, date of birth, nationality and which vaccine was received. Users must have received two doses of a vaccine, separated by 21 days, and then wait for two weeks for antibodies to develop. Authorities can verify its validity by scanning a QR code linking to the national vaccine register. Also, in the State of Kuwait, Minister of Health, Sheikh Dr. Basil Al-Sabbah said that a special certificate of vaccination will be given to those who got vaccinated. It will contain information confirming receipt of the vaccine for those who receive the second dose, confirming that it will be used as a passport at the airports that request it.

IATA Travel Pass In this context, the International Air Transport Association (IATA) is preparing to launch a new mobile application “the IATA Travel Pass” allowing travelers store and manage certifications for COVID-19 tests or vaccines. The Association hopes that the free mobile application will be the key to reopening borders and bringing the world back to normal travel again, without the need for a quarantine. The information provided through the IATA Travel Pass can be used by governments requiring testing or vaccination proofs as a condition of international travel during and after the COVID-19 pandemic. A critical aspect is the fact that the information supplied is verified. It is a secure means to manage health requirements, much more efficient than paper processes.

The IATA Travel Pass will help people travel at ease while meeting any government requirements for COVID-19 tests or vaccines. It will encompass: Global registry of health requirements – to find accurate information on travel, testing and vaccine requirements for journeys Global registry of testing/vaccination centers – to identify testing centers and labs at departure location which meet the standards

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for testing and vaccination requirements of the destination Lab app – to locate authorized labs and test centers to securely share test and vaccination certificates Digital passport module - to enable passengers to create a ‘digital passport’, receive test and vaccination certificates and verify that they are sufficient for their itinerary, and share testing or vaccination certificates with airlines and authorities to facilitate travel. This app can also be used by travelers to manage travel documentation digitally and seamlessly throughout their journey, improving the travel experience. IATA is calling for systematic COVID-19 testing of all international travelers and the information flow infrastructure needed to enable this must support governments with the means to verify the authenticity of tests and the identity of those presenting the test certificates, airlines with the ability to provide accurate information to their passengers on test requirements and verify that a passenger meets the requirements for travel, laboratories with the means to issue digital certificates to passengers that will be recognized by governments, and travelers with accurate information on test requirements, where they can get tested or vaccinated, and the means to securely convey test information to airlines and border authorities.

It is not a new idea The idea of requiring vaccination for entry into some countries or some places is not limited to COVID-19 vaccines. Many countries require a yellow fever vaccine to enter their territories either for all expatriates, as is the case in French Guiana, or for those from Africa and South America where this disease is prevalent. Vaccination centers issue certificates officially called "an international certificate for vaccination and preventive medicine," which is a yellow notebook recognized by the World Health Organization. Supporters of the vaccine passport, who are many in the tourism and entertainment sectors, see it as a way to “return to life before” COVID -19, as it allows safe entry to theaters, restaurants and football fields.

THE INTERNATIONAL AIR TRANSPORT ASSOCIATION (IATA) IS PREPARING TO LAUNCH A NEW MOBILE APPLICATION “THE IATA TRAVEL PASS” ALLOWING TRAVELERS STORE AND MANAGE CERTIFICATIONS FOR COVID-19 TESTS OR VACCINES.

ARTICLE FEATURES . Comprehensive Diabetes Care Centers

Comprehensive Diabetes Care Centers Diagnosis, treatment, prevention and education… Comprehensive services in one place

he diabetic patient needs comprehensive care for his entire body due to the damage that this disease causes. Hence the need to establish specialized centers that provide comprehensive care to the patient, so that he can obtain all medical services in one place without the need to change doctors. Today, medical facilities and specialized centers are available according to the highest international standards. They follow up on diabetic patients with the most accurate details and give them the necessary guidance and advice when needed, from diagnosis to appropriate treatment protocols, with the necessary advice and guidance and close follow-up. The Gulf countries and the Middle East region abound with this type of medical centers that have had a great impact in diagnosing and closely following up on diabetes cases while helping the patient avoid serious complications, as he undergoes the most important treatment protocols as well as prevention plans and pro-

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THESE CENTERS PROVIDE EDUCATIONAL MEETINGS WITH SPECIALISTS THAT GIVE THE PATIENT THE NECESSARY INFORMATION ABOUT HOW TO COPE WITH THE DISEASE FOR HIS SAKE AND HIS FAMILY, WHETHER THROUGH INDIVIDUAL MEETINGS OR LECTURES THAT COME AS PART OF EDUCATING THE DIABETIC PATIENT..

grams with the aim of providing comprehensive care for diabetic patients. In these comprehensive centers, the diabetic patient finds clinics specialized in examining the retina, limbs, small blood vessels and arteries, kidney examination, treatment of endocrine diseases, diabetes, foot care, nutritionist advice, and other issues that a diabetic patient needs on a regular basis.

Educating the Diabetic Patient Educating the diabetic patients comes at the core of the comprehensive care centers' concerns because this disease will accompany him throughout his life and he needs a comprehensive briefing in which the patient knows about the type of this disease, its complications, how to take care of himself and his diet, and control his blood sugar level. These centers provide educational meetings with specialists that give the patient the necessary information about how to cope with the disease for his sake and his family, whether through individual meetings or lectures that

ARTICLE FEATURES . Comprehensive Diabetes Care Centers

come as part of educating the diabetic patient. Health education is a fundamental step for the success of all treatment elements and guarantees the implementation of the treatment program while adhering to it as a daily routine. When diagnosing diabetes for the first time, the patient will be afraid and lost; he will also have many questions about how to live with this disease, and here comes the role of patient education, as these centers provide psychological and cultural support, in order for him to feel that he is not the only one affected by diabetes, but there are millions of people suffering from it, and most of them lead a normal life. Educating type 2 diabetes patients is based on the importance of losing weight, increasing exercise, and learning various ways to achieve this. As for type 1 diabetes patients, education means that the patient learns about diabetes, its causes, how to live with treatments for this type of disease and integrate them with his daily life and regular activities, in addition to having the skills to face the possible emergency complications such as hypoglycemia. Diabetics need a lot of education and awareness in order to be able to adapt to all aspects of life. Diabetes is a chronic disease that will stick to the patient throughout his life, which may affect the health, psychological, social and economic aspects of the individual.

But, what are the most important medical services that diabetics need? Endocrinology and Diabetes Diabetes is a disease affecting the endocrine system that secretes hormones, controls growth and reproduction, and regulates the work of every organ in the body. Diabetes occurs when the pancreas does not produce enough insulin or cells become insulin-resistant and unable to convert carbohydrates into usable fuel. The role of the endocrinologist and diabetes specialist is to diagnose this condition and give the patient the appropriate treatment after determining the type of diabetes and its associated diseases. Endocrinologists treat diabetes with drugs that reduce blood sugar levels, along with diets that are complementary

DIABETICS NEED A LOT OF EDUCATION AND AWARENESS IN ORDER TO BE ABLE TO ADAPT TO ALL ASPECTS OF LIFE. DIABETES IS A CHRONIC DISEASE THAT WILL STICK TO THE PATIENT THROUGHOUT HIS LIFE, WHICH MAY AFFECT THE HEALTH, PSYCHOLOGICAL, SOCIAL AND ECONOMIC ASPECTS OF THE INDIVIDUAL.

to drug treatments, to contribute over time to controlling the disease. At the Comprehensive Diabetes Centers, patients receive high-quality patient care that includes food services and medical nutrition therapy.

Retina Examination The retina is probably the most affected organ by diabetes, as diabetes complications are among the major causes of blindness in this group of patients. Hence, doctors focus on the necessity of periodic retina examination, as this plays an essential role in the early detection and follow-up on any defect so that it does not worsen with age. In such comprehensive centers, the patient does not need to wait or search for a suitable ophthalmologist; the follow-up team will quickly refer him to the appropriate doctor. We should emphasize that even if the patient does not have any visual disturbances and his glucose levels are within normal limits, the damage may have started without the patient realizing because the effects of diabetes begin silently to cause severe damage to the retina over time. Patients who suffer from type 2 diabetes and do not have retina problems, must undergo an initial preventive examination upon diagnosis of the disease, followed by annual examinations to assess the condition. As for patients with type 1 diabetes, initial examinations must begin five years after the diagnosis, and must be done annually after that. If there are any retina problems, the ophthalmologist recommends further visits to monitor the problem and treat it.

Foot Care Diabetic neuropathy is a type of nerve damage that can occur if you have diabetes. High blood sugar can injure nerves throughout your body. Diabetic neuropathy most often damages nerves in your legs and feet. Depending on the affected nerves, diabetic neuropathy symptoms can range from pain and numbness in your legs and feet to problems with your digestive system, urinary tract, blood vessels and heart. Some people have mild symptoms. But for others, diabetic neuropathy can be quite painful and disabling.

ARTICLE FEATURES . Comprehensive Diabetes Care Centers

ing regularly, which contributes to lowering blood pressure and help control blood sugar level, in addition to quitting smoking, as these steps have an effective effect on treatment success and long-term control of the disease. The doctor prepares a treatment plan that suits the patient's condition, who in turn remains in constant contact with his doctor.

Cholesterol and Heart Disease

Nerve damage can make you lose feeling in your feet, so even minor cuts can turn into sores or ulcers without your realizing it. In severe cases, an infection can spread to the bone or lead to tissue death. Removal (amputation) of a toe, foot or even the lower leg may be necessary. Comprehensive care centers provide specialized doctors to examine the foot and the arteries of the legs to see if there is a risk that wounds may form in the foot before they occur and the possibility of performing surgeries to widen the arteries or even implanting and connecting arteries to the affected part of the body while taking drugs to help improve blood circulation inside the blood vessels.

Diabetes and Hypertension There is a close relationship between diabetes and kidney disease, as research indicates that about 50-60% of diabetics develop hypertension. High blood pressure and type 2 diabetes both occur for the same reasons, and include obesity and cardiovascular disease. Comprehensive Diabetes Care Centers provide the necessary advice and guidance to control hypertension and diabetes through drug treatments in the first place, and then urge the patient to make lifestyle adjustments and consume the right healthy food while exercis-

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Diabetics are advised to undergo daily checkups and look for new cuts or sores, especially on the feet as well as between and under the toes. The patient must also remove the excess tissue that often occurs with diabetic wounds, because it is a cause of bacteria accumulation and increase of wound infection, and the doctor can help in the removal process.

Diabetes is one of the main causes of heart disease, especially coronary artery disease. The ability of the body to secrete enough insulin decreases in diabetic patients, or the insulin that is produced is not utilized. Since the cells cannot enter glucose, it accumulates in the bloodstream and damages the small blood vessels in the kidneys, heart, eyes, or nervous system. The problem with diabetes is that with time, it impedes the work of the large blood vessels that irrigate the heart, neck or legs, as fat accumulates on the artery walls and this worsens with high blood pressure, smoking or consuming a fatty-rich diet. It worsens with time, and the patient develops hardening of the arteries or clots. The causes of heart disease among diabetics are that it raises the level of cholesterol in the blood and increases fat accumulation of fat in the heart vessels and arteries, which leads to the development of atherosclerosis causing heart attacks and strokes. Diabetes also causes insufficient blood supply to the heart, which causes the heart to be unable to perform its normal functions. Specialists provide comprehensive healthcare services so that the patient’s vital functions and organs are closely monitoring.

Diabetes and Obesity Obesity is one of the factors that cause type 2 diabetes, and statistics indicate that 85% of people with diabetes suffer from excess weight. Excessive food intake means giving the body more calories and fats that cannot be processed simultaneously, which signals insulin receptors not to respond to it. This leads to a rapid release of sugar in the blood, which leads to an increase in the blood sugar level and over time the insulin inside the body won’t be able to maintain the blood sugar

ARTICLE FEATURES . Comprehensive Diabetes Care Centers

level, so insulin resistance occurs and cannot perform its role efficiently, which reduces glucose absorption and thus, increasing the blood sugar level. Prevention is highly possible once you get rid of excess weight, through physical activity and a healthy diet that limits weight gain. The goal of this type of specialized centers is not limited to treating obesity and weight loss, but also includes developing the health aspect and reducing the risks that threaten the overweight patient. Therefore, it is necessary to focus on weight management by providing patients with comprehensive, multidisciplinary, long-term healthcare, as this plays a role in controlling blood sugar level and keeping it within normal levels.

Nutrition Experts A special diet for each diabetic patient 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 kilograms and overcome obesity and thus successfully control diabetes. The experts stress the need to follow an appropriate healthy diet and not follow a crash diet that leads to rapid weight loss. Fast food must be avoided and should be replaced with healthy foods such as fruits, vegetables, whole grains, legumes, lean meats, dairy products, fish and poultry. You should also choose nutrient-dense food instead of calorie-rich food, and avoid trans fats, sugary foods, soft drinks and processed foods. Nutritionists recommend exercising as much as possible to make the diet more efficient. Sport is an essential part of controlling diabetes and fighting obesity, in addition to drug treatment under the supervision of a specialist.

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Upper GI Endoscopy: who should have it, when and why? By Dr. Siddiq Mohamed Osman Elmalik, Consultant Gastroenterologist at Al-Ahli Hospital / Qatar there is evidence of recent onset of dyspepsia, reflux or abdominal pain. 2. Those who are less than 50 years old should have the endoscopy if they present with one of the following symptoms: a. Upper and lower GI bleeding. b. Persistent vomiting. c. Dysphagia. d. Anemia. e. Unintentional weight loss. f. Abdominal mass.

Why Do We Do It? 1. To check for gastroesophageal reflux, if it is only acid or bile. 2. To assess the degree of esophagitis. 3. To check if there is hiatal hernia or not. 4. To assess the stomach and check for Helicobacter pylori. 5. To assess the duodenum and take biopsies to rule out inflammation, parasitic infestations, or Celiac disease.

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. The gastroscope is a plastic tube where on top of it, there is a camera which is inserted through the mouth after sedating the patient to the esophagus, stomach and duodenum. All the patient needs to do before to prepare for the endoscopy is fasting for 8 hours from food and even water. There is no need to admit the patient to the hospital. The gastroscopy is done as a day case where they will stay in the Endoscopy Unit for 4 to 5 hours.

Who Should Have It? 1. Those patients above the age of 50. They should have done it directly if

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When the equipment and facilities are available and there is good expertise, the OGD is the ideal test for Upper GI diseases, non-cardiac chest pain and recurrent unexplained ENT problems.

THE GASTROSCOPE IS A PLASTIC TUBE WHERE ON TOP OF IT, THERE IS A CAMERA WHICH IS INSERTED THROUGH THE MOUTH AFTER SEDATING THE PATIENT TO THE ESOPHAGUS, STOMACH AND DUODENUM.

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Al-Ahli Hospital treats the cruciate ligament rupture with the latest surgical techniques By Dr. Maher Youssef, Consultant Orthopedic Surgeon and Specialist of Artificial Joint Replacement and Sports Knee Injuries at Al-Ahli Hospital / Qatar

l-Ahli Hospital in Doha performed a number of successful cruciate ligament surgeries, which restores the normal functions of knee with very high success rate, as most patients can do their sports and jobs after the surgery. The cruciate ligament surgery is performed a lot, which gives physicians practical experience to be distinguished in such type of sensitive surgeries. Dr. Maher Youssef, Consultant Orthopedic Surgeon and Specialist of Artificial Joint Replacement and Sports Knee Injuries, said that the cruciate ligament surgery is performed by knee endoscope with no need to open the knee, which helps patients to get well soon and re-practice their activities within a short time and reduces the pains during the surgery, where a small aperture is made in the tibia and another in the femur and the new ligament patch is passed through both apertures and fixed to both apertures by self-dissolving nails so that the patch acts as the new anterior cruciate ligament. Moreover, metal fixatives are used to fix the patch and often there are other injuries to the knee, such as the rupture of semilunar cartilages, which are treated during the same surgery. He added that the rebuilding of anterior cruciate ligament is made as one bundle and such surgery is the most common one as its results are excellent and most researches support its use. In this surgery, two femoral tendons are stitched together and then folded to form a bundle of four tendons.The bundle is fixed through aperture in the tibia and another in the femur. Regarding the causes of cruciate ligament rupture, Dr. Maher said that the cruciate ligament rupture often affects the anterior ligament, and the sports injuries are always the most common cause of rupture, such as knee sprain during exercises or collision during football play-

ing. Upon cruciate ligament rupture, the knee joint suffers from severe swelling and pain. In many cases, the cruciate ligament rupture causes rupture sound in the knee joint and the patient cannot move his knee a full motion. Dr. Maher advises those with injuries not to be late for consulting their physician for making early diagnosis because, unfortunately, the cruciate ligament rupture is often diagnosed after several years as many patients think that it is just a minor injury. If the femoral muscles are strong, sometimes the cruciate ligament injury is not clinically confirmed and the injury is treated without the treatment of cruciate ligament rupture. Unfortunately, over time, the patient feels increasing discomfort in the knee and may then have gonitis because the cartilage would have been damaged due to injury. The problems often appear many years later and the patient then begins to feel uncomfortable on turning, walking on uneven ground for example, or in normal motion. The result is permanent pains in the knee.

IN THIS SURGERY, TWO FEMORAL TENDONS ARE STITCHED TOGETHER AND THEN FOLDED TO FORM A BUNDLE OF FOUR TENDONS. THE BUNDLE IS FIXED THROUGH APERTURE IN THE TIBIA AND ANOTHER IN THE FEMUR.

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Conducted by a specialized medical team at Al-Ahli Hospital

A medical achievement by performing a complex surgery for "endometriosis" By Dr. Mazen Bashtawi, Specialist and Head of the Department of Obstetrics and Gynecology at Al-Ahli Hospital / Qatar

r. Mazen Bashtawi, a Specialist and Head of the Department of Obstetrics and Gynecology at Al-Ahli Hospital, confirmed that the department succeeded in treating a 37-year-old American woman who suffers from severe and continuous pains at the lower abdominal area resulting from "endometriosis". Initially, her sufferings from these pains were coinciding with the menstrual cycle pains.

However, its condition worsened to suffer from continuous and prolonged pains for whole days, and in all the positions she takes, whether sitting or sleeping, etc… This greatly affected her daily life and working conditions, which made her being absent from work as a result of these severe pains which she frequently suffers. Dr. Bashtawi added, "As soon as the initial examination of the patient was carried out by means of abdomen laproscopy, it was found that she is in a very advanced state of adhesions within the pelvis and adhesions between the intestine and the uterus on the one hand, and between the intestine and the ovaries on the other hand, to the extent that they blocked the possibility of good vision and examination of the uterus and ovaries due to the large and numerous adhesions. The examining medical team was unable at the beginning to intervene or find feasible solutions for her condition. She was advised to go to a hospital in America for treatment. Finally, she decided to go to the Obstetrics and Gynecology Department at Al-Ahli Hospital. After required examination and diagnosis, it is found that she complains the same conditions of a case which we frequently dealt with, and we achieved many successes with it,

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THE HOSPITAL HAS ADVANCED CAPABILITIES WHICH ENABLE IT TO DEAL WITH THE MOST COMPLEX CASES.

due to the scientific and technical capabilities we possess in terms of advanced devices and high-resolution endoscopes which match those found in the best hospitals in the world. Dr. Al-Bishtawi added: "We were able to perform this operation laparoscopically and its results were good and surprising to the patient. She felt the first results once she recovered from the operation to discover that she no longer suffers any pains and that she finally got rid of such pains which remained with her for a long time and affected her lifestyle. He continued: "Thanks to God, we managed, during the operation, to loosen adhesions and remove the endometriosis. The patient returned to her normal life. This disease is one of the common diseases that around 15% of women suffer from. Unfortunately, the diagnosis of this disease may delay from 5 to 7 years because at the beginning it concurs with the pains of the menstrual cycle. Most women do not pay attention to these pains, believing that they are the usual pains which accompany the menstrual cycle, until their condition develops later and the disease is discovered at late and advanced stages.

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It is an immediate success and gives stable results over time

Al-Ahli Hospital adopts thermal frequency technology to treat legs By Dr. Atef bin Youssef, Open Heart and Vascular Surgery Consultant at Al-Ahli Hospital / Qatar

l-Ahli Hospital has recently adopted the technique of thermal frequency for treating varicose veins in less than an hour by treating the perforating veins, via sending radio frequencies that heat the affected perforating vein in order to be closed, after being examined by a simple prick through which the catheter or the dedicated tube is inserted. Ultrasound is used for examining the affected area. The material placed inside the catheter clearly shows the affected area.

frequencies, including an increase in the immediate success rate and achievement of stable results over time. It also enables the treated patients to resume their normal life activity on the next day. From an aesthetic perspective, the patient does not need any wounds to be made in the patient’s skin by the doctor; hence, it does not leave any traces. In his speech, Dr. Ben Youssef pointed out how this type of operation is specifically performed. It begins with a prick through which a small metal probe (catheter) is inserted into a vein with electrodes. It then provides heat energy for the radio frequencies which cause the vein walls to retract. Under the influence of temperature, the vein narrows and dries up without causing damage to the surrounding tissues. This results in significant disappearance of varicose veins after three months. This surgery is made under local anesthesia in less than an hour. So, the patient can go back home on the same day. He noted that there are two types of blood vessels: arteries and veins. Varicose veins appear under the surface of the skin as a result of a defect in one of the main superficial vein valves with the perforating veins, which results in reflux of the blood and the appearance of varicose veins. Varicose veins also appear when a blood pool occurs resulting in enlargement of veins. Venous ulcers rarely occur.

In this context, Dr. Atef bin Youssef, an open heart and vascular surgery consultant, explained that this type of treatment depends on the extraction of thermal frequency from the radio frequency, in order to benefit from the effect of heat on the affected area varicose veins. He also confirmed that this technology is used while the patient is under local anesthesia, with the possibility of simple hypnosis. Dr. Ben Youssef stated that there are many benefits for treating varicose veins with thermal

Dr. Atef bin Yusef, a consultant, added: The symptoms of varicose veins differ from one person to another. They distort the aesthetic form of the legs, as blood veins appear near the surface of the skin. They also cause pain and heaviness in the legs, especially with standing for long periods, and swelling in the feet and ankles. All these symptoms are accompanied with skin discoloration and venous ulcers which are among the most dangerous symptoms and problems resulting from varicose veins.

THIS TECHNOLOGY AIMS AT USING HEAT IN THE TREATMENT OF VARICOSE VEINS IN THE AFFECTED AREA. THIS SURGERY IS PERFORMED UNDER LOCAL ANESTHESIA IN LESS THAN AN HOUR.

NEWS

Arab Health and Medlab Middle East generated over AED 756 million for the Dubai economy in 2020

rab Health and Medlab Middle East, the largest exhibitions for the healthcare and laboratory industry in the MENA region, generated more than AED 3.7 billion worth of business during the 2020 edition of the show, a year-on-year increase of 3.7%. The exhibitions also contributed over AED 389 million to the Dubai economy through direct and indirect spending from visitors and exhibitors. Furthermore, according to recent research by Informa Markets, 85% of healthcare and laboratory key visitors surveyed stated they would like to attend live events again. This underscores the pent-up demand to attend and support the local economy when visiting Arab Health and Medlab Middle East on its return to the Dubai World Trade Centre, 21-24 June, which this year will be under the show theme of ‘United by Business’. Wouter Molman, Executive Vice President for Informa Markets, said: “Our survey results clearly indicate an appetite to return to a physical event format, with face-to-face networking at the forefront of what our key audiences are looking for. The message from our participants has been unequivocal. They want to be present at the event and feel safe doing so, thanks to the UAE's measures. “Based on our research, we can safely expect both events to attract 61,000 visitors, roughly half of which will attend the in-person event, with the other half attending the event online. Having seen the successes of events recently run in Dubai, we are confident in delivering a strong and successful live, in-person event, with good MENA representation. “The UAE government’s commitment to vaccinating the population and facilitating a safe environment for people to come together while adhering to all safety protocols has been a defining factor in the confidence to get back to business. We are in one of the few countries in the world where this is possible as a result of the incredible government work.”

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Wouter Molman As part of Informa Markets' commitment to providing the highest hygiene levels at all events by ensuring attendees and staff safety, the company has launched Informa AllSecure. The enhanced measures include 35 guidelines covering all aspects of cleaning and hygiene, social distancing measures, and the use of PPE, screening, and a track and trace in conjunction with local authorities. “We created Informa AllSecure for two reasons. The first was to boost confidence within the events industry, while the second was to ensure that everyone attending one of our physical events can connect, learn, and safely do business,” said Molman. "Our exhibitions are not only conducive to generating deals amongst participants; they also have a huge impact on the local economy and support industries such as tourism and hospitality, F&B, and aviation. We are all truly ‘United by Business’”, he added.

IN ADDITION TO THE DIRECT AND INDIRECT SPENDING IN THE LOCAL ECONOMY, BOTH SHOWS COMBINED GENERATED OVER AED 3.7 BILLION WORTH OF BUSINESS, A 3.7% INCREASE Y-ON-Y.

NEWS A host of government initiatives since the onset of COVID-19 has fast tracked the countries recovery and permitted the opening of hotels and exhibitions before elsewhere in the world. As such, the latest STR data revealed the Middle East’s hotel sector was a top performer globally during 2020, with an average occupancy of 45.9%. One of the best performing countries was the UAE, with an average occupancy of 51.7% and an average daily rate (ADR) of over AED 418. Although these figures were 29.3% & 16.5% down year-on-year, the return of physical exhibitions will help buoy optimism among hoteliers. Issam Kazim, CEO of Dubai Corporation for Tourism and Commerce Marketing (DTCM), said: “It has been vital that we have the best policies in place and that we engage with stakeholders internationally and locally to ensure all visitors feel safe and can travel confidently to and from Dubai. We have been working closely with our partners including Informa Markets and Dubai World Trade Centre, implementing the latest guidelines and best practices to create safe environments for their events and put Dubai at the forefront of the recovery of the business events sector globally.” Both events take place from 21-24 June at the Dubai World Trade Centre and will feature a range of keynote speeches and roundtable discussions, industry briefings, product demos and networking opportunities, as well as a series of pre-arranged one-to-one meetings, with an emphasis on creating lasting relationships and doing business.

Issam Kazim to allow participants to find the correct contacts to meet and do business, with a showcase of the latest products and technological advancements, and a host of focused informative sessions drawing in medical and healthcare trade professionals from the region and beyond. The online event platforms for Arab Health and Medlab Middle East will launch on 23 May 2021 and will remain available to participants until 22 July 2021. The online platform, while supporting visitors at the live show with scheduling qualified meetings in advance, will also offer visitors who cannot attend the event in-person, the opportunity to connect with valuable contacts and build target audiences through AI-powered matchmaking and video conferencing technology.

RESEARCH BY INFORMA MARKET’S HEALTHCARE DIVISION HAS REVEALED 85% OF HEALTHCARE TRADE AND NON-TRADE VISITORS EAGER TO RETURN TO LIVE AND IN-PERSON EVENTS.

“Arab Health and Medlab Middle East are part of the very fabric of UAE business and trade; the return of physical events are an important sign of the renewed confidence and commitment in the UAE as an important trade corridor. Now, more than ever, it is important for the healthcare industry to come together, to network, to discuss the future of the industry, and to do business,” concluded Molman. In the month preceding the live event in Dubai, both Arab Health and Medlab Middle East will host a series of dedicated online focus days

NEWS

Healthcare Drive Sees Dubai Science Park Attract Leading Global Companies in 2020

ore than 400 companies and 4,000 professionals are based in Dubai Science Park today, after a global push to bolster healthcare systems served as a catalyst for biotechnology, pharmaceutical and life sciences leaders to join the business district. Top global companies joined Dubai Science Park, the region’s leading science and healthcare-focused business district, last year as the importance of science, technology and medical innovation came to the fore. Many existing business partners also expanded their presence, opening new offices and innovation centres to develop new products as Dubai reinforced its position as an attractive destination for healthcare-focused companies. New businesses at Dubai’s top science district include New York Stock Exchange-listed biotechnology multinational Biogen, which makes neurological disease treatments; Dubai-based

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DGrade, the first bottle-to-yarn manufacturing company to make clothes out of plastic waste; and Indian’s largest biopharmaceutical company, Biocon, which has a presence in more than 120 countries, employs over 12,000 staff, and develops medicine to treat diabetes, cancer and autoimmune diseases.

Dubai: A Hub for Scientific Talent In addition to a raft of new companies, existing business partners including Germany’s life sciences leader Bayer expanded its presence by opening a new regional headquarters in Dubai Science Park. Bayer’s office design incorporates new ways of working founded on what it dubs an ‘activity-based-work set-up’. This underlying conceptual approach aims to set new benchmarks in workplace organisation, productivity, efficiency, and wellbeing. Meanwhile, US-based IFF opened earlier this year a new creation, application and innovation

THE NEW LAB IS SUPPORTING BOTH THE CREATION AND APPLICATION NEEDS OF ALL KEY CATEGORIES, INCLUDING SNACKS, BEVERAGES, SAVOURY, SWEET AND DAIRY.

NEWS

centre for its Taste, Food & Beverage division in Dubai Science Park, to drive further growth in Africa, Middle East, Turkey, and India (AMETI). The state-of-the-art 1,400m2 creative facility services companies within the AMETI region by offering innovative flavours, savoury solutions, juice-based compounds, inclusions, colours, and food protection solutions. The new lab is supporting both the creation and application needs of all key categories, including snacks, beverages, savoury, sweet and dairy. The creative centre also includes a sensory facility, as well as an analytical lab. In line with the company’s focus on sustainability, the facility is GOLD LEED certified. With IFF’s investment in the Dubai Creative Center, the company is reaching a key milestone in bringing a stronger emphasis on these exciting markets and providing enhanced and locally relevant support for the customers and to better meet their present and future needs. In addition to many local and regional players, more than 60 leading global biotechnology, healthcare, life sciences, pharmaceutical and light manufacturing companies established a presence in Dubai Science Park last year, increasing the total number of business partners to more than 400. Marwan Abdulaziz Janahi, Managing Director of Dubai Science Park, said: “The remarkable international response to this extraordinarily challenging year has reminded all of us that science matters. It took less than a year to vaccinate the first person after the virus’ genetic sequence was made public, and this will go down as a historic moment for pharmaceutical innovation. In Dubai Science Park, our business partners have been at the heart of the region’s response to the pandemic, providing cutting-edge testing and disinfection services. We have continued to take great strides forward in our scientific achievements and I am delighted to be home to more than 400 leading companies and 4,000 professionals.” He added: “With a renewed sense of hope as the region shifts its focus to growth, scientific innovation will play an increasingly critical role in the UAE’s knowledge-based economy. By providing a business-friendly environment

Marwan Abdulaziz Janahi with state-of-the-art infrastructure, sustainable laboratories, light industrial units and favourable rules and regulations, we have created a holistic ecosystem to support startups, entrepreneurs and multinational corporations operating across the sciences, environmental and energy sectors. Inspired by the UAE’s visionary leadership, we are optimistic this year.”

Boosting the UAE’s Response and Recovery Established in 2005, Dubai Science Park is a vibrant business district home to leading local and international institutions including the UAE Ministry of Health and Prevention, Pfizer, Medtronic, Olympus and Mettler Toledo. Many of these companies played a critical role in the UAE’s efforts to mitigate the impact of COVID-19, with companies such as Alliance Global supplying hundreds of thousands of PCR test kits across Africa, the Middle East, and Central Asia. As part of its commitment to supporting the community last year, Dubai Science Park continued to host a regular series of panel discussions and talks on topics ranging from mental health and wellbeing, clinical research, COVID-19.

WITH IFF’S INVESTMENT IN THE DUBAI CREATIVE CENTER, THE COMPANY IS REACHING A KEY MILESTONE IN BRINGING A STRONGER EMPHASIS ON THESE EXCITING MARKETS AND PROVIDING ENHANCED AND LOCALLY RELEVANT SUPPORT FOR THE CUSTOMERS AND TO BETTER MEET THEIR PRESENT AND FUTURE NEEDS.

NEWS

Aster DM Healthcare appoints Mr. David Boucher as Global lead for Service Excellence and Patient Experience his unique perspectives of leading healthcare systems that saw 150 nationalities being served as patients, personalizing and creating a haven for care and recovery for people who travel for access to quality care. As the group head of Service Excellence, we hope to build on our combined strengths further to become one amongst the most distinguished brands in healthcare built on the cornerstone of trust.”

Mr. David Boucher, Group Chief of Service Excellence at Aster DM Healthcare

ster DM Healthcare has announced the appointment of Mr. David Boucher, a global leader in healthcare service excellence and medical value tourism, in an effort to strengthen its patient and customer service offering and enable wider access to its quality healthcare services to patients across the world. Working closely with the strategic leadership team of the organization, he would be responsible for fostering and driving a culture of patient/ customer centricity, while improving patient experience across markets. The appointment is in alignment with Aster’s long-term vision to make its quality healthcare services accessible to patients across the world. Commenting on the appointment Ms. Alisha Moopen, Deputy Managing Director of Aster DM Healthcare said, “The 3 S of healthcare - safety, service and savings propel people to go searching for healthcare services. At Aster, we are committed and passionate about complementing the highest levels of clinical expertise with best pricing and unparalleled seamless service. We aim to combine the three elements to ensure patient wellbeing and care for them with grace and compassion. Mr. David brings

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“A leading healthcare provider in India and GCC and soon to be a local player in Cayman Islands, Aster DM Healthcare is on the verge of an exciting journey and I am thrilled to join the organization at this point. With a core-focus on the voice of the customer or patient and enabling solutions that would support them in the best possible way, the organization has tremendous potential to emerge as a global leader,” said Mr. David Boucher, Group Chief of Service Excellence at Aster DM Healthcare. With more than four decades of experience in the area of patient excellence and business transformation, Mr. David has provided both operational and strategic leadership at various roles with healthcare organizations across the world. He last served as Chief Business Transformation Officer at Bumrungrad International Hospital in Bangkok, Thailand. Prior to that he served as President and COO of UCI Medical Affiliates, Columbia, USA and held several leadership roles with various healthcare organizations like BlueCross BlueShield of South Carolina, Columbia, Companion Global Healthcare among others. David has been quoted in over 250 newspapers and journals including The Wall Street Journal, New York Times, The Economist, U.S. News & World Reports. He has been interviewed on NBC Nightly News and Fox Business News. He has also delivered lectures on disruptive innovation in healthcare at Harvard Business School, Yale School of Management and Harvard Medical School.

WITH MORE THAN FOUR DECADES OF EXPERIENCE IN THE AREA OF PATIENT EXCELLENCE AND BUSINESS TRANSFORMATION, MR. DAVID HAS PROVIDED BOTH OPERATIONAL AND STRATEGIC LEADERSHIP AT VARIOUS ROLES WITH HEALTHCARE ORGANIZATIONS ACROSS THE WORLD. HE LAST SERVED AS CHIEF BUSINESS TRANSFORMATION OFFICER AT BUMRUNGRAD INTERNATIONAL HOSPITAL IN BANGKOK, THAILAND.

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ARTICLE FEATURES . Infection Control in Coronavirus Departments

Precautionary measures to protect the medical staff

Infection Control in Coronavirus Departments

he medical staff working in the coronavirus departments are at the highest risk for getting COVID-19, especially after the number of infections among doctors, nurses, and other teams working in those departments has spiked. They are like soldiers in a battle fighting this deadly and rapidly spreading virus.

There are infection control programs and international protocols in place that require the application of precautionary measures to limit the spread of infection within the hospital. The focus on these programs has increased recently in the coronavirus departments, especially since respiratory infection is the second most common hospital infection and the first most common infection within ICUs.

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THE IMPORTANCE OF HAND HYGIENE URGED THE WORLD HEALTH ORGANIZATION TO CELEBRATE HAND HYGIENE DAY GIVEN ITS ROLE IN PREVENTING THE TRANSMISSION OF INFECTIONS

To prevent infection, standard precautions are the minimum infection prevention practices that apply to all patient care, regardless of suspected or confirmed infection status of the patient, in any setting where healthcare is delivered. These practices are designed to both protect DHCP and prevent DHCP from spreading infections among patients. Standard Precautions include hand hygiene, use of personal protective equipment (e.g., gloves, masks, eyewear), respiratory hygiene / cough etiquette, sharps safety (engineering and work practice controls), safe injection practices (i.e., aseptic technique for parenteral medications), sterile instruments and devices as well as clean and disinfected environmental surfaces. The hospital environment, whether rooms

ARTICLE FEATURES . Infection Control in Coronavirus Departments

or corridors, should be sterilized to prevent virus transmission, and here we must emphasize the need to sterilize doorknobs, elevator buttons and office surfaces because they are the primary driver for infection.

Handwashing is the first step Infection control programs focus primarily on the hands, as they are the primary source of transmission of infection and germs, which requires washing them in the best way recommended by the World Health Organization. Cleaning, sterilizing and disinfecting hands before and after dealing with the patient, especially when taking samples, is the first procedure to stop and prevent the risk of cross-infection, and it is crucial for everyone working in the health facility to follow it, as it has been shown that washing hands contributes to reducing infection cases in hospitals by up to 50 percent. The importance of hand hygiene urged the World Health Organization to celebrate Hand Hygiene Day given its role in preventing the transmission of infections. Hand hygiene is one of the most important measures that prevent the spread of infection in hospitals, and it is a general term that includes washing hands with soap and water, using disinfectants by rubbing them with alcohol and disinfecting them in preparation for surgical procedures. Medical teams and healthcare providers follow the seven handwashing steps in order not to neglect any area during handwashing and ensure that their hands have been thoroughly cleaned and sterilized. But handwashing in hospitals must be done in a specific technique that guarantees getting rid of germs, and this technique is as follows: 1. Wet hands with water and apply single shot of soap 2. Rub hands palm to palm 3. Rub back of each hand with the palm of other the hand with fingers interlaced 4. Rub palm to palm with fingers interlaced 5. Rub with backs of fingers to opposing palms with fingers interlocked 6. Rub each thumb clasped in opposite hand using rotational movement

THE HOSPITAL ENVIRONMENT, WHETHER ROOMS OR CORRIDORS, SHOULD BE STERILIZED TO PREVENT VIRUS TRANSMISSION, AND HERE WE MUST EMPHASIZE THE NEED TO STERILIZE DOORKNOBS, ELEVATOR BUTTONS AND OFFICE SURFACES BECAUSE THEY ARE THE PRIMARY DRIVER FOR INFECTION.

7. Rub tips of fingers in the opposite palm in a circular motion 8. Rub each wrist with the opposite hand 9. Rinse hands with water and dry thoroughly

Healthcare workers must follow a stricter handwashing process as recommended by WHO: • Before touching a patient, • Before clean/aseptic procedures, • After body fluid exposure/risk, • After touching a patient, and • After touching the patient surroundings Knowing how to wash your hands properly is an important step in preventing the spread of infections in the workplace, home or schools. Also important is knowing when to wash your hands.

Here are the key times when handwashing should be conducted: • • • • •

At the end of each work/school period Before each break Before eating or preparing food After going to the restroom Whenever hands are dirty or contaminated

Medical waste The COVID-19 outbreak has increased medical waste all across the world and it has also led to a huge amount of face masks and medical waste. In particular, another aspect of the spread of COVID-19 is improper solid waste management. If waste is not managed properly, it may lead to the spread of the virus. Consequently, the number of confirmed cases has rapidly increased and the amount of medical waste associated with COVID-19 has also significantly increased. According to the World Health Organization (WHO), infectious waste is defined as waste contaminated with blood and other bodily fluids, cultures and stocks of infectious agents from laboratory work, or waste from patients with infections. But WHO interim guidelines suggest all healthcare waste produced during patient care, including those with confirmed COVID-19 infection, is considered as infectious medical waste, but the waste generated in waiting areas of healthcare facilities can be classified as

NEWS

Doctors urge intensive lifestyle change to fight obesity in UAE teens Cleveland Clinic Abu Dhabi’s Obesity Program sees an increase in young patients with BMI of 50

asy access to high-calorie fast food and fewer physical activity hours are contributing factors to the disturbing rise of overweight and obesity levels among young people in the UAE, say experts at Cleveland Clinic Abu Dhabi, an integral part of Mubadala Health.

Dr. Rahat Ghazanfar Staff physician in the General Medicine Department in the Medical Subspecialties Institute at Cleveland Clinic Abu Dhabi

Patients with a Body Mass Index (BMI) above 25, and with risk factors for chronic diseases, such as diabetes, cardiovascular disease and cancer, are considered for the Obesity Program at Cleveland Clinic Abu Dhabi. Doctors saw an increase in the number of patients seeking medical and surgical treatments for weight loss last year and performed 450 bariatric surgeries in 2020. The program’s youngest patients have been between 14 and 18 years of age. “There’s plenty of evidence to suggest that the rates of overweight and obesity in the UAE remain stubbornly high. What is worrying is that these numbers seem to be increasing among young adults,” says Dr. Javed Raza, a staff physician and surgeon in the Digestive Disease Institute at Cleveland Clinic Abu Dhabi. “While the rise in the number of patients is a sign of awareness that they need to get their health back on track, it is also an indication of the scale of the problem, which needs to be addressed through more community education,” he says.

Dr. Javed Raza Staff physician and surgeon in the Digestive Disease Institute at Cleveland Clinic Abu Dhabi

According to the Ministry of Health and Prevention, the prevalence of obesity amongst children between the ages of five and 17 in the UAE was 14.45 percent in 2018. “2020 added the challenge of homeschooling, fewer opportunities for outdoor activities and the convenience of food being delivered at the click of a button. The pandemic may not have caused the high obesity levels, but it did contribute to an unhealthy lifestyle in young people,” says Dr. Raza.

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Dr. Rahat Ghazanfar, a staff physician in the General Medicine Department in the Medical Subspecialties Institute at Cleveland Clinic Abu Dhabi, says she typically recommends a lifestyle-altering approach for young patients before suggesting a medical or surgical route. “There are ways to reverse and manage this chronic disease through a good diet and exercise plan. Even if a patient opts for a medical or surgical approach, a complete overhaul of their lifestyle is imperative to make any treatment effective and successful,” she says. Patients of the Obesity Program are cared for by a multidisciplinary team of endocrinologists, metabolic surgeons, nurses, dieticians and patient educators. As part of the program, they are evaluated for comorbidities, hormonal problems associated with obesity, complications and nutritional deficiencies. They are then given a lifestyle, medical, surgical, or a combination plan based on their history, screening and preferences. Dr. Ghazanfar explains that the care for patients seeking weight loss looks at all aspects of their wellbeing. “The unique aspect of our program is that we look at all dimensions of health that can be affected by their weight. That includes pulmonology for sleep apnea, cardiology, psychiatry, advanced endoscopy and gastroenterology to deal with post bariatric problems.” Dr. Raza adds that they’ve enhanced convenience for patients from across the country during the pandemic with more access to ongoing support. At the same time, patients who have had bariatric surgery will be seen even without an appointment at the clinic if they have concerns or questions during the first month of their recovery.

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.

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

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

(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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HOSPITALS Magazine issue 57

Articles inside

Healthcare Drive Sees Dubai Science Park Attract

Arab Health and Medlab Middle East generated over

A medical achievement by performing a complex

Comprehensive Diabetes Care Centers

Multisystem Inflammatory Syndrome in Children

Uterine diseases

Not all breast diseases are cancer

Christiana Demetriou

Highlighting women’s main health issues

Smart Hospital Beds

Electrophysiological study and catheter ablation

The Centre for Arab Genomic Studies Organizes Webinar

Employing the Power of AI and Interoperability to

A Cardiopulmonary Rehabilitation Program at HDF for

Boehringer Ingelheim Recognized As Global Top

Dubai Blood Donation Center retains AABB

Al Ain Nursing Department awarded for outstanding

Glucose stabilisation right from the beginning

Researchers enrolling patients for study to train AI in