HOSPITALS Magazine issue 59 by The Arab Hospital Magazine

Issue 59/ 178 JULY-AUG 2021

THE ARAB HOSPITAL APPLICATION IS AVAILABLE

Hospital Hotel Services How can #hospotel improve patient outcomes?

More than a hospital bed The concept combines comfort, convenience and multifunctionality Living idea The healing environment enables a faster recovery

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

FIGHTING AGAINST THE DELTA VARIANT WITH VACCINATION NOT FEAR

Copy Editor Jessica Achkar

After the outbreak of the novel coronavirus, fast-spreading mutated strains of varying severity began to emerge. Hence, the “Delta” variant increased fear as it is the most fast-spreading coronavirus variant at the present time. It is 50 percent more transmissible than the “Alpha” variant. According to the World Health Organization, the “Delta” variant will quickly become the dominant strain of the virus in the world within a few months. According to experts, countries that did not make great strides in vaccinating their residents against Covid-19 will be at higher risk. The biggest fear is the return of travel restrictions between a number of countries, while the tourism sector was starting to recover from the recession period, especially the medical tourism, which was affected by the travel bans more than other sectors. The different characteristics of the coronavirus variants prompted the World Health Organization to develop two basic classifications to identify the variants, namely, the “Variants of Interest” and “Variants of Concern”. The latter includes four types so far: Alpha, which appeared in Britain, Beta, which was identified in South Africa, Gamma, which was discovered in Brazil, and Delta, which originated in India and is now present in more than 120 countries. But the core of the issue is our greater interest in vaccination, as experts doubt that “Delta” can escape from the antibodies produced by the body, whether through previous infection and recovery from the coronavirus, or by taking the vaccine. Therefore, fighting against this variant is through vaccination, not fear and this is what the Gulf countries and a number of countries in the world are successfully doing.

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 Elie Yammine 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

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44 How can #hospotel improve patient outcomes? Sponsored by LINET MEA

NEWS

10 New Zealand Government’s response to COVID-19 puts the laboratory in the spotlight at Medlab Middle East 12 Thumbay Group inks partnership with PayBy to power the cashless ecosystem at ambitious Thumbay Medicity 14 Healthcare industry leader Faisal Juma Belhoul to lead Valiant Clinic & Hospital as Executive Chairman 16 Australian Nobel Laureate Professor Marshall and Pankaj Savara partner to set up Tri-Med’s UAE office 18 Malaffi receives its first regional award -The ZIMAMElsevier Digital Health Transformation Project of the Year 2020-2021 24 Qatar International Geriatrics and Gerontology Conference Transforming Older Persons’ Care in Qatar Virtual conference 26 Unilabs launches innovative health App allowing customers to schedule appointments and receive Covid-19 results 28 Orthopaedic Clinics opened in two Abu Dhabi healthcare centers 30 AstraZeneca praises UAE for vaccination rollout and testing strategy 36 Cleveland Clinic Abu Dhabi passes 150 organ transplant milestone

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42 19Labs & Doctory partner to bring Gale eClinics to the Middle East

ARTICLES

20 Sysmex Middle Eeat: Immunochemistry testing contributes to fighting the COVID-19 34 ExpressMed Laboratories - Bahrain: The Importance of Thyroid Molecular Testing in Management of Thyroid Nodules 54 Vocera: Effective Communication: Foundation for Nurse Safety 70 Al-Ahli Hospital / Qatar: Smoking and Pregnancy 72 Baylor St. Luke’s Medical Center: Double lung transplant for 17-year-old patient, one of the Youngest COVID Transplants in The World 82 Acibadem University 88 Al-Ahli Hospital / Qatar: Scoliosis 90 LINET MEA: It shouldn't hurt to be a nurse 92 Acibadem International: Scoliosis Awareness Month... What a parent needs to know? 100 Biophilic Life 102 Becton Dickinson; Streamlining for Safety: Barcode Medication Administration for Intravenous Medications

NEWS

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64 Cervical Cancer 106 Al-Ahli Hospital / Qatar: Acute pyelonephritis 108 Al-Ahli Hospital / Qatar: Carpal tunnel syndrome

INTERIVEWS

50 Maher Elhassan, Vice President & General Manager, BD Middle East, North Africa & Turkey 50 Jihad Hussami, Business Director – BD Medication Management Solutions, Eastern Europe, Middle East & Africa 56 Mr. Alaa Adel, Managing Director for Cerner in the Middle East and Africa 60 Elie Chaillot, President & CEO, Services, Europe, Middle East & Africa (EMEA), at GE Healthcare

78 Medical Colleges

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74 Robots in Healthcare 68 Dr. Toufic Eid MD (MBBS) FRCOG, Obstetrician and gynaecologist Consultant at Clemenceau Medical Center in Dubai 86 Carlo Di Lorenzo, MD, Chief of Gastroenterology, Hepatology and Nutrition at Nationwide Children’s Hospital

FEATURES

44 How can #hospotel improve patient outcomes? Sponsored by Linet MEA 64 Cervical Cancer 74 Robots in the Healthcare Sector 78 Medical Colleges after the COVID-19 pandemic 96 Endoscopic Spine Surgeries

96 Endoscopic Spine Surgeries

NEWS

New Zealand Government’s response to COVID-19 puts the laboratory in the spotlight at Medlab Middle East changing space. There is also the need to provide an interface with clinicians around appropriate testing and explaining uncertainties, and to be realistic about testing capacity based on consumables supply,” Dr Sally A. Roberts said. “High performing leaders are your best asset during a pandemic, and great teams are resilient, and they work to improve the process. They problem-solve, they anticipate, and they make sure that the task gets done. Most importantly, they look after each other,” she added.

he 20th edition of Medlab Middle East, the MENA region's most prominent medical laboratory exhibition and congress, which concludes, has shone the spotlight on laboratory leadership during the COVID-19 pandemic with a focus on the New Zealand Government’s response to the pandemic. During the Laboratory Management Conference, attendees heard from keynote speaker Dr Sally A. Roberts, Acting Clinical Director, LabPlus, Clinical Microbiologist and Infectious Diseases Physician, Microbiology Department, LabPlus, Auckland Hospital, Auckland, New Zealand, about New Zealand’s elimination strategy for COVID-19. She explained that by reducing transmissibility, contact rate and duration of infectivity, the Government aims to get the reproduction number (R) to less than 1 and reduce ongoing community transmission. During the 18 months of the pandemic, Dr Roberts explained that New Zealand learnt that it is critical to have multiple platforms for testing for COVID-19 and establish referral pathways to manage the surge. Also, to develop contingency plans for reagent/consumable shortages or equipment failure. “The role of clinical leadership in the laboratory during the pandemic is to keep the ship steady and try to keep pace with a rapidly

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New Zealand’s first case was identified on 28 February 2020, and the borders were closed on 19 March. A four-tier alert system was introduced on 21 March, and the country moved to level four alert just a few days later, on 23 March. Up until 9 June 2021, New Zealand’s national testing volumes stood at 2,175,651 PCR tests, just under 4,000 tests per day. To date, New Zealand has had 2,723 confirmed and probable cases of COVID-19 with a Case Fatality Rate (CFR) of 0.96%, according to the New Zealand Ministry of Health. During the pandemic, the existing New Zealand Microbiology Laboratory Network took on the role of promoting best practice through collegiality, collaborating with Public Health and providing advice to the Minister of Health and Medical Officers of Health. Meanwhile, the new National COVID-19 Laboratory Group was established to coordinate the delivery of testing across the country, mainly focusing on supply chain issues, agreed testing strategies and support for validation of assays. Rejoy Penacerrada, Conference Director for Informa Markets, said: “The global pandemic has presented major challenges for clinical laboratories, and many lab specialists and technologists are working selflessly and standing on the forefront of the battle against COVID-19. Conferences such as this play an important role in strengthening care in medical laboratories and improving the role of pathologists and technicians amidst the pandemic.”

Rejoy Penacerrada

DURING THE PANDEMIC, THE EXISTING NEW ZEALAND MICROBIOLOGY LABORATORY NETWORK TOOK ON THE ROLE OF PROMOTING BEST PRACTICE THROUGH COLLEGIALITY, COLLABORATING WITH PUBLIC HEALTH AND PROVIDING ADVICE TO THE MINISTER OF HEALTH AND MEDICAL OFFICERS OF HEALTH.

NEWS

Thumbay Group inks partnership with PayBy to power the cashless ecosystem at ambitious Thumbay Medicity

n a milestone moment on the UAE’s journey toward becoming a cashless society, leading business conglomerate Thumbay Group has signed an agreement with PayBy, the innovative fintech start-up. Under the agreement, PayBy will support Thumbay Group’s digital transformation with its mobile payment-based projects, to build a cashless and smart community with enhanced experiences for all stakeholders. The agreement with PayBy was signed by Dr. Thumbay Moideen, Founder President, Thumbay Group. Also present at the occasion were Akram Moideen Thumbay, Director, Thumbay Technologies, Akbar Moideen Thumbay, Vice President, Healthcare division, Thumbay Group, and Prof Hossam Hamdy, Chancellor of Gulf Medical University. Always at the forefront of adopting new technologies, Thumbay Group started its digital transformation journey to enhance customer experiences for patients and students, and protect public health with safe, cashless and contactless transactions. Dr. Thumbay Moideen, Founder President, Thumbay Group, said: “The partnership between the Thumbay Group and PayBy is a key pivot in the group’s digital transformation journey, showcasing the benefits of a cashless society in a self-contained community such as Thumbay Medicity. The collaborative model is a win-win proposition for all: customers, business, employees and the larger community. It reflects the kind of imagination and innovation made possible by the UAE’s digital-first business ecosystem.” With customer experience being the prime competitive differentiator for the post-pandemic landscape, a frictionless customer journey will build loyalty and grow revenues. The PayBy contactless, cashless ecosystem, being introduced exclusively for Thumbay Group, will thus deliver positive impact at scale. It is sure to disrupt every aspect of payments and customer experience. Highlight of the partnership is to develop

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a cashless community in Thumbay Medicity, which includes a tailored PayBy loyalty program for Thumbay clients and partners, a payment wallet for Thumbay Smart University students, customised solutions for Thumbay Smart Hospital, and many other exciting, innovative lifestyle and convenience products, such as booking appointments, navigating in the hospital. Through this partnership, various activities and transactions at Thumbay Medicity will be contactless: be it making a hospital appointment, booking a COVID-19 test, buying coffee, getting a discount voucher for the gym, or even renting a shared bike or a power bank. The solutions are agile, flexible, contactless, and use QR Codes or biometric technologies to authorize payments – offering first-mover advantage for Thumbay Group. Thumbay Medicity, Ajman, plays a key role in the advancement of medical education, healthcare, and research. It houses the Gulf Medical University – the region’s leading private medical university, Thumbay University Hospital – the largest private academic hospital in the region, Thumbay Dental Hospital – the first private dental hospital in the country and the largest academic dental hospital in the Middle East region’s private sector, and Thumbay Physical Therapy and Rehabilitation Hospital – the biggest state-of-the-art rehabilitation hospital in the country.

Thumbay Medicity also has outlets of Thumbay Pharmacy – including the biggest robotic pharmacy, in addition to the central lab of Thumbay Labs – the biggest CAPaccredited private diagnostic facilities in the region. It also has leisure and hospitality amenities, such as Body & Soul Health Club and Spa, Thumbay Food Court with diverse food brands and cuisines, The Terrace Restaurant, Blends & Brews Coffee Shoppe, as well as the Thumbay Housing Project to accommodate 2500 staff and students, coming up soon. With its state-of-the-art facilities and superior amenities, Thumbay Medicity is expected to attract 15,000 visitors daily.

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

NEWS

Healthcare industry leader Faisal Juma Belhoul to lead Valiant Clinic & Hospital as Executive Chairman Business named him as one of the Top 100 Executives in the Gulf region.

Faisal Juma Belhoul

s part of its goal to strengthen its position as a first-class multi-specialty hospital in Dubai, Valiant Clinic & Hospital has announced that Faisal Juma Belhoul is now the Executive Chairman of its board. Leveraging on his many years of experience in various leadership positions, Belhoul will lead Valiant towards achieving its goals of providing world-class healthcare services and a preferred healthcare destination. Belhoul is well known in the UAE healthcare industry for his leadership and entrepreneurial insight. He is the Founder of Amanat Holdings PJSC, a publicly listed healthcare and education investment company, where he served as Chairman. He was also Chairman of the Board of UAE Private Hospitals Council and of the Pharmaceutical and Healthcare Equipment Business Group of the Dubai Chamber of Commerce and Industry (DCCI). Belhoul also led the successful listing of Al Noor Hospitals, an FTSE 250 company listed on the London Stock Exchange (LSE). He is also a member of the Young Presidents Organization (YPO), and in 2007, Arabian

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Ahmed Belhoul, Chief Executive Officer, Valiant Clinic & Hospital, said: "We are truly pleased to welcome Faisal Juma Belhoul at the helm of our board. His vast wealth of knowledge in the healthcare industry and proven track record in decision-making will certainly empower our management to come up with the most timely and relevant decisions. With Belhoul as the Executive Chairman, Valiant Clinic & Hospital is positioned to further accelerate its growth and add value to the entire UAE healthcare industry." Commenting on his appointment, Belhoul said: “Valiant Clinic & Hospital is a premier multi-specialty boutique hospital that provides its patients with world-class diagnostic and wellness services, and I see a lot of expansion opportunities given the fact that many people have recognized their overall health and wellness as a priority. I am honored for this appointment, and I am looking forward to many milestones that we will achieve together.” Aside from his affiliation with healthcare companies and organizations, Belhoul has also taken leadership roles in other industries. Currently, he serves as Chairman and Founder of Ithmar Capital Partners, as well as Chairman of the Board at the UAE Private School Council.

BELHOUL IS WELL KNOWN IN THE UAE HEALTHCARE INDUSTRY FOR HIS LEADERSHIP AND ENTREPRENEURIAL INSIGHT. HE IS THE FOUNDER OF AMANAT HOLDINGS PJSC, A PUBLICLY LISTED HEALTHCARE AND EDUCATION INVESTMENT COMPANY, WHERE HE SERVED AS CHAIRMAN.

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

Australian Nobel Laureate Professor Marshall and Pankaj Savara partner to set up Tri-Med’s UAE office Professor Barry Marshall to speak at Arab Health, the world’s second-biggest health event, held in Dubai in June this year

ustralia based Tri-Med, a leading healthcare brand has chosen UAE as its regional headquarters in partnership with Former Western Australian Trade Commissioner, Pankaj Savara for Asia, and Africa region. Tri-Med is a Perth-based organisation founded in 1996 by Nobel Laureate Professor Barry Marshall to satisfy a need for the design, development, and distribution of a safe, reliable diagnostic test to detect 'Heliobacter Pylori', commonly known as H. pylori bacteria. In the ‘spirit of Aussie entrepreneurship’, Professor Marshall famously ingested H.pylori to prove the link between the bacteria and its role in gastritis and peptic ulcer disease. This single act of bravery has resulted in a cure for stomach ulcers which has helped millions of people around the world. It also resulted in a Nobel Prize for Professor Barry Marshall and Dr. Robin Warren. Professor Marshall was also invited to speak at Arab Health, one of the world’s largest healthcare events, held in Dubai in June this year. H.E. Ian Halliday, Australian Consul General in Dubai, and General Manager, Australian Trade and Investment Commission for the Middle East, Africa and Turkey stated that “We applaud Professor Marshall’s achievements in the health sector and are delighted to learn of Tri-Med’s expansion plans of setting up a regional hub office in the UAE. Healthcare has become an increasingly important service sector globally, and we are pleased to introduce Australian capabilities and best practices in healthcare to this region,”. Tri-Med’s Founder and Nobel Laureate Professor Marshall was excited to announce the appointment, “The UAE offers a perfect hub for Tri-Med for its expansion plans in The Middle East and Asia. Tri-Med has been exporting into the region since 2008 and coincidentally Pankaj

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Professor Barry Marshall

Pankaj Savara

Savara was instrumental in helping us to connect to markets in the United Arab Emirates and Saudi Arabia back then”. “We are very happy to have Pankaj on board as a regional partner to help consolidate our presence in this marketplace. Pankaj brings a wealth of experience to our business, after having spent 18 years as a Trade Commissioner in Dubai. Our investment demonstrates a deep commitment to continuing to grow our international markets and improve the service to our existing clients”, added Professor Marshall. Tri-Med has expanded both its product base and international footprint and now markets PYtest, CLOtest, Scintillation and Collection Fluids, and associated Therapeutics throughout Australia and to a worldwide market including over 30 export destinations. When asked what attracted him to the role, Pankaj responded “I have watched Tri-Med grow its presence in the region for many years. I believe that Tri-Med will add tremendous value to the region and has excellent potential to grow and capitalize on the brand’s prominence as an Ulcer Diagnostic. I also feel a connection to the purpose of the business, which is the global detection and treatment of Helicobacter Pylori. I look forward to further strengthening the organisation’s position in the global market”.

AUSTRALIA HAS BEEN ONE OF THE COUNTRIES TO SUCCESSFULLY CONTAIN THE COVID-19 PANDEMIC AND ONE OF THE OBJECTIVES OF THIS PARTNERSHIP IS TO SHARE AUSTRALIAN BEST HEALTH PRACTICES AND SERVICES WITH THE REST OF THE WORLD WITH THE PURPOSE OF RESOLVING HEALTH-RELATED CHALLENGES.

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NEWS

Malaffi receives its first regional award -The ZIMAM-Elsevier Digital Health Transformation Project of the Year 2020-2021

alaffi was recognised with its first award – The ZIMAM-Elsevier ‘Digital Health Transformation Project of the Year 2020-2021’, an initiative of the GCC Taskforce on Workplace Development in Digital Healthcare Conference. The ZIMAM Award, in collaboration with Elsevier, aims to recognise and honour the best players in digital health. The Award is given to organisations that demonstrate the highest quality in eHealth and as a result, have achieved transformations within the region’s healthcare sector – an ambition that resonates closely with the one of Malaffi, which makes receiving such an award so important.

Malaffi received the accolade in recognition of multiple success criteria, including: •

•

The successful journey demonstrated in connecting of 98% of the Emirate’s hospitals and 94% of all patient episodes in less than two years since the first go-live High clinician’s satisfaction rates with proven benefits to the healthcare system

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THE ZIMAM AWARD, IN COLLABORATION WITH ELSEVIER, AIMS TO RECOGNISE AND HONOUR THE BEST PLAYERS IN DIGITAL HEALTH. • • •

Added value to the efforts of handling COVID19 International awards and recognitions on data privacy and security High caliber eHealth workforce

This year, with an emphasis on digital health workforce development, the event organisers were particularly focused on highlighting excellence within the healthcare ecosystem that has effectively deployed information technology to improve clinical, administrative, financial, and organisational performance. This award stands as another testament to the leadership of the Department of HealthAbu Dhabi and Malaffi in the digital health domain in the GCC region and a great motivation for the team to keep working tirelessly to improve healthcare in Abu Dhabi.

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ARTICLE

Immunochemistry testing contributes to fighting the COVID-19 pandemic

mmunochemistry, the medical discipline that studies the immune system’s chemistry, plays an important role in the testing strategy to control this COVID-19 pandemic. Mass testing has become essential across most countries. Besides large testing capacities, results are needed fast, and they must be reliable. While molecular tests are accurate, they require highly skilled personnel throughout the testing process, sophisticated laboratory facilities and a longer time to deliver results. On the other hand, rapid tests have a lower reliability and do not achieve the large capacities required. A high-throughput SARS-CoV-2 antigen laboratory test that yields accurate and reliable results in a very short time would be the solution for laboratories to cope with the challenging workload.

What Sysmex does – our strengths in laboratory diagnostics For more than 50 years Sysmex has been

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A HIGHTHROUGHPUT SARS-COV-2 ANTIGEN LABORATORY TEST THAT YIELDS ACCURATE AND RELIABLE RESULTS IN A VERY SHORT TIME WOULD BE THE SOLUTION FOR LABORATORIES TO COPE WITH THE CHALLENGING WORKLOAD.

helping clinical laboratories across the globe with reliable and efficient diagnostics solutions, for example in areas such as haematology, haemostasis, and urinalysis. The increase in productivity and the clinical value provided by our products and their results support the laboratories, but equally benefit the clinicians and, ultimately, the patients involved.

How Sysmex can support you in immunochemistry testing with the HISCL-5000 Now, Sysmex extends its offering to the immunochemistry laboratory. By providing a solution that meets their needs in the evolving pandemic, we can support laboratories, clinicians, and patients with results you can have confidence in, based on a technology you can trust. So you can be ready to welcome the challenges. www.sysmex-mea.com/n/products/diagnostics/ immunochemistry

NEWS

Thumbay Hospital Ajman crosses 4 Million patient visits from 175 Nationalities, serving the community since 2002

humbay Hospital – Ajman, the first academic hospital established by Thumbay Group under its Healthcare Division, celebrated with joy of crossing Treatment of 4 Million patient visits from 175 nationalities, Dr. Thumbay Moideen – Founder President Said “It was a great achievement by our team of healthcare professionals who have put all their efforts to serve the community. We are grateful to Almighty and Thank the Government and Rulers of Ajman for all the support given.

Thumbay Hospital – Ajman was inaugurated on 17th October 2002 by His Highness Sheikh Humaid Bin Rashid Al Nuaimi, Member of the Supreme Council, UAE and Ruler of Ajman. It is part of the Gulf Medical University Academic Health System (GMUAHS), the first private academic health system in the region, and provides clinical training to the students of Gulf Medical University. Its inception marked the beginning of Thumbay Group’s foray into healthcare, with many more academic hospitals, family clinics and day care hospitals later added to the group’s healthcare division. Today, Thumbay Hospitals constitute the biggest network of private academic hospitals in the region, and the largest group of JCI-Accredited private academic hospitals in the region. Thumbay Hospital Ajman was built, primarily with the purpose of providing adequate training facilities to the students of Gulf Medical University, Ajman. What started with this hospital has now grown into the Thumbay Hos-

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pital network with presence throughout the UAE and in India. With the opening Thumbay Medicity in Ajman, with three world-class hospitals – the Thumbay University Hospital, Thumbay Physical Therapy & Rehabilitation Hospital and Thumbay Dental hospital – Thumbay Group has achieved a landmark in our persistent pursuit of excellence in healthcare, medical education and research.” Mr. Akbar Moideen Thumbay, Vice President of Thumbay Group’s Healthcare Division said, “I thank everyone who has supported the hospital’s journey in the last 19 years and also we appreciate the dedicated efforts of our team in fighting the pandemic and continuing to do so. Dr. Mohammed Faizal Pervez– Chief Operating Officer of Thumbay Hospital, said that we make sure quality healthcare is delivered to all our patients and we deliver complete care to your family committed to our brand promise being “Your family hospital providing quality care at affordable prices.” Thumbay Hospital – Ajman has a capacity of 250 beds, and is the first JCI accredited hospital in Ajman. The hospital offers services across all major medical specialty’s ICU, Dialysis, Advanced Radiology, Lab Services, Minimal Invasive Surgeries, Women Wellness and Super Specialty Dental Center. The hospital also offers special antenatal packages, state-of-the-art equipment, 24-hours emergency and in-patient services.

THUMBAY HOSPITAL AJMAN WAS BUILT, PRIMARILY WITH THE PURPOSE OF PROVIDING ADEQUATE TRAINING FACILITIES TO THE STUDENTS OF GULF MEDICAL UNIVERSITY, AJMAN. WHAT STARTED WITH THIS HOSPITAL HAS NOW GROWN INTO THE THUMBAY HOSPITAL NETWORK WITH PRESENCE THROUGHOUT THE UAE AND IN INDIA

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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.

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NEWS

Qatar International Geriatrics and Gerontology Conference Transforming Older Persons’ Care in Qatar - Virtual conference

he Qatar International Geriatrics and Gerontology conference will once again be hosted by Hamad Medical Corporation in Qatar. In compliance with the COVID-19 safety measures, this year’s event will be held online from 30 September to 2 October 2021, using a professional online conference platform. This conference will cover core areas of interest to all clinicians and allied health professionals responsible for the healthcare of older people. It will also provide general knowledge for any healthcare professionals from other disciplines who have older patients as part of their patient population, or who are interested in this population group. Under the theme of ‘Transforming Older Person’s Care in Qatar’ the 3-day educational event will feature local and international experts in the field of gerontology and geriatric care to accommodate the significant interest from a wide range of healthcare professionals in the care of older persons. The geriatrics tracks will look at the healthcare delivery and services for older people; and the gerontology tracks will review research on ageing and the impact this has on populations. The COVID-19 pandemic and ongoing challenges has brought greater global awareness about the geriatric population and their experiences and specific risks arising from the pandemic. More evidence is emerging on the predisposition and severe outcomes of COVID-19 infections which enhance the risks for elderly people, which needs to be incorporated in geriatric care developments and policy changes. The conference encompasses a blend of local, regional and world perspectives on the comprehensive care of older patients during the COVID-19 pandemic. Renowned international speakers from the World Health Organization (WHO) and Gulf Cooperation Council (GCC) countries will speak on their pandemic response systems, focusing on their approach to maintaining the Integrated

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The variety of topics and speakers ensures there is something of interest for all healthcare professionals, including doctors, nurses and allied healthcare professionals who care for adults and older adults.

For more information, please visit hamad.qa/ QIGGVC-2021

Care for Older People (ICOPE) strategy of excellent healthcare during these challenging times. The conference features lectures, interactive sessions and workshops, including panel discussions with delegates proactively taking part in the discussion. Hands-on workshops will be pre-recorded videos which will be displayed in real time with interactive engagement with the faculty. Delegates will be actively encouraged to be fully engaged to meet the requirement outlined by the QCHP for virtual CPD events. The conference covers a broad range of topics, including frailty, polypharmacy and deprescribing and the effects of multidrug resistant organisms (MDRO) on older patients. The importance of quality and performance indicators, research and statistics, falls and bone health, neurocognitive disorders as well as dementia risk reduction are also among the important subjects covered.

‫َر ْبط الصحة‬ ‫والتعليم‬ ‫والبحوث‬ Linking health, education and research

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

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NEWS

Unilabs launches innovative health App allowing customers to schedule appointments and receive Covid-19 results

nilabs, the leading European diagnostic group, has announced the launch of its innovative and pioneering new health App "Unilabs ME". The mobile app providing a new experience for the customer, increasing convenience, security, and simplifying and streamlining the entire covid-19 testing process and results delivery. The partnership with Cristiano Ronaldo's digital agency is part of Unilabs's expansion plans as a premium brand and represents a strong impetus to the international efforts being made to counter the Covid-19 pandemic. The app will allow customers to schedule and make an appointment for Covid-19 testing in Unilabs units. This new process will reduce waiting times in the testing process, as customers will have access to a check-in QRcode that the clinic will use to quickly admit the patient, avoiding the hassle of bureaucratic processes and unnecessary contacts. Within a maximum period of 6 hours, customers will receive their test results in the new Unilabs ME App, by email and SMS. Commenting on the launch of the Unilabs ME App, Mohamed Daoud, CEO of Unilabs UAE said: "We are extremely proud of our partnership with the digital agency of the legend player Cristiano Ronaldo, which is part of ongoing endeavors to improve customer experience and provide better service and convenience.

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THE UNILABS ME APP WAS DEVELOPED IN PARTNERSHIP WITH 7EGEND, CRISTIANO RONALDO´S AGENCY, THAT IS A REFERENCE IN DIGITAL TRANSFORMATION, WITH BRANDS IN THEIR PORTFOLIO SUCH AS UNILABS, CR7, FNAC, ASER VENTURES, VALENCIA CF, PORTUGUESE FOOTBALL FEDERATION, LEVI´S, MCDONALD´S, FC PORTO, ALTICE OR FOOTLAB.

Daoud affirmed that the newly launched app is another milestone of our business to consumer strategy, with many other digital and technological initiatives already on the roadmap, pursuing innovation always with a customer-centric approach, most notably the agreement with the International Air Transport Association (IATA) to incorporate Unilabs’ worldwide COVID-19 testing network into IATA Travel Pass, making the process seamless, secure, and easy. "We are eager to hold more partnerships with the most popular public figures, as this will make our projects and initiatives more holistic and successful. Meanwhile, we work tirelessly to support the UAE's strenuous efforts to expand the scope of Covid-19 tests, under the supervision of health authorities on the quality and efficiency of laboratory testing services, and the use of digital and medical technology innovations in accordance with international best practices to ensure that medical tests are being conducted in an effective and high-quality environment," he concluded. For his part, Luis Parafita CEO of 7egend, said: “It is with great pleasure that a 7egend joined Unilabs UAE in this journey for the digital transformation of the brand in the region. Sharing the strategic vision, working across the board with teams and adding value to the entire ecosystem, we all work with a common goal at the top of the priorities, a customer-centric approach". “This first phase culminates with the launch of the first version of the native mobile app, developed for iOS and Android, and designed to provide customers with a top-notch experience, a reference in the healthcare industry. This first and very important milestone in the brand's digital transformation strategy, increases the efficiency, provides more comfort and convenience, innovates, and delivers better service to customers. The future is bright, the ambition is high and 7egend will walk side by side with Unilabs on this path,” Parafita added.

NEWS

Orthopaedic Clinics opened in two Abu Dhabi healthcare centers

he Abu Dhabi Health Services Company (SEHA) has unveiled new orthopaedic clinics in Abu Dhabi’s Baniyas and Al Bahia Healthcare centers. The new clinics are managed by the Ambulatory Healthcare Services (AHS), in line with the network’s drive towards streamlining access for specialized services. Dr. Ahmed Al Shamary, orthopaedic specialist, Oud-Al-Touba Diagnostic & Screening Center, said: “Orthopaedic challenges and pain in the bone, muscle, or joints have a significant impact on a person’s overall quality of life, which is why early diagnosis and rapid treatment is extremely important “. “To ensure early diagnosis, we utilize the latest diagnostic tools available, such as the DEXA scan, which is a quick and painless procedure that measure bone density and is often used to diagnose or assess the risk of osteoporosis. In addition, treating orthopaedic ailments is not limited to the orthopaedic department, patients often require referral to rheumatology or endocrinology or physiotherapy sessions, to support overall treatment. Therefore, we ensure that we put a comprehensive treatment plan in coordination with the patient’s family physician and the relevant specialist, in order to provide a holistic treatment plan that improves the patient’s quality of life.” Recently, a 59-year-old patient visited Al Zafaranah Diagnostic & Screening Center suffering from multiple co-morbidities including

THE TEAM DEVELOPED A TREATMENT PLAN THAT INCLUDES PAIN RELIEF AND ANTIINFLAMMATORY INJECTIONS FOR BOTH KNEES WITH A TWO-WEEK GAP BETWEEN EACH.

obesity, end-stage kidney disease, and hypertension. She came in using a wheelchair as she had extreme pain in both knees. X-rays and Ultrasounds carried out by the team showed signs of osteoarthritis (the most common form of arthritis) of both knees, with the DEXA scan also revealing osteoporosis. The injections helped relieve the pain in her knees and she soon began walking with the support of a walking stick instead of a wheelchair. Dr. Dilshad Elahee Ansari, Orthopaedic Specialist, Al Zafaranah Diagnostic & Screening Center, said: “Since the patient was suffering from multiple illnesses and was undergoing frequent dialysis, and with the help of the DEXA scan and other exploratory tests and images, we developed a precise and cautious treatment plan to counter her pain and knee swelling. We opted to proceed with local injections as opposed to oral medications since she is already on robust medication plans to treat her other conditions. The patient is responding well and has already shown remarkable improvement.” The orthopaedics clinics, which have a combined daily capacity of 120 patients, are available in Abu Dhabi at Al Zafaranah Diagnostic & Screening Center, in addition to the newly opened clinics in Baniyas and Al Bahia. And in Al Ain, the clinic is available at Oud Al Touba Diagnostic & Screening Center, Al Yahar, Al Hili and Al Quaa healthcare centers.

Saudi Arabia’s Health Ministry 50% of population had been vaccinated

audi Arabia’s Health Ministry said 50 % of the population had been immunized with the first dose of the COVID-19 vaccine, stressing the need to take the second jab to give greater immunity, and to protect against coronavirus mutations. The ministry announced the resumption of inoculating people of all age groups with the second dose of the vaccine, according to the national plan. Those seeking to take the second jab should book an appointment through ‘Sehaty’ (My Health) application, the ministry said. Saudi Arabia recorded 1,244 COVID-19 new infections, bringing the tally to 502,439, while active cases decreased slightly to 10,510, including 1,434 critical and in intensive care units. The ministry said 1,523 cases recovered, bringing the total recoveries to 483,937, while the deaths rose by 16 to 7,992. It warned against complacency in applying precautionary measures, and stressed the importance of adhering to preventive measures, such as wearing masks, social distancing, sterilizing hands and not shaking hands, to limit the spread of the coronavirus.

JULY.AUG 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

AstraZeneca praises UAE for vaccination rollout and testing strategy “Specifically, the UAE ranks among the best in the world in terms of the speed of its vaccination programme. This is attributed to strong efforts from key senior stakeholders who worked collaboratively with health authorities to deliver impactful campaigns that are aimed at increasing the trust in the safety of vaccines available in the country, and uptake from the local population,” added Al Manaseer. The comments were made ahead of the inaugural Pharma and Drug Discovery Conference were held on the opening day of Arab Health, which took place from 21-24 2021 June at the Dubai World Trade Centre. During the conference, Mr Al Manaseer presented the session Oxford University and AstraZeneca partnership towards broad and equitable access to COVID-19 Vaccine.

To date, over 12.1 million vaccination doses have been administered in the UAE with a vaccine distribution rate of over 124 doses per 100 people, with approximately 70,000 doses of the vaccine administered daily. In terms of population vaccinated, the UAE is currently fourth after the Seychelles, Maldives and Israel.

"From the start of the pandemic, AstraZeneca's approach has focused on partnering with scientists, governments, multilateral organisations and manufacturers to establish agreements for the development and supply of our vaccine, and to fight the pandemic, together,” said Al Manaseer. “At AstraZeneca, we were proud to be the first global pharmaceutical company to join COVAX in June 2020. Through the initiative, we are partnering with CEPI, Gavi, the WhO, UNICEF and PAHO and our subscribing partner, the Serum Institue of India, to enable equitable and global access to our vaccine. Together, we have already delivered 37 million doses of our vaccine, including critical deliveries to countries in the Middle East. It is only through effective partnerships that reaching these milestones was made possible," he added.

Qutaiba Al Manaseer, Government Affairs Director, Middle East and Africa, AstraZeneca, said: Middle East countries have been successful in their efforts to make vaccines available as soon as possible. Health authorities across the region have developed agile regulatory systems and adapted rolling review strategies to ensure a fast but thorough regulatory process.

Among the experts presenting at the Pharma & Drug Discovery Conference, are Dr Yang Xiaoming, Chairman of the China National Biotech Group (CNBG), Prof Graham Ball, Professor of Bioinformatics, Nottingham and Trent University, UK, and Prof Mirza Baig, Professor and Chairman of Clinical Pharmacy and Pharmacotherapeutics, Dubai Pharmacy College for Girls.

Qutaiba Al Manaseer

Government Affairs Director from AstraZeneca, the developer of one of the leading COVID-19 vaccines in partnership with Oxford University, has praised the UAE’s vaccine rollout program by highlighting the work done by health authorities in the region to make vaccines available as soon as possible.

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ASTRAZENECA HAS APPLAUDED THE UAE’S IMPACTFUL VACCINATION CAMPAIGNS WHICH HAS CREATED INCREASED TRUST AND EARLY UPTAKE RESULTING IN OVER 12.1 MILLION DOSES IN THE UAE TO DATE.

TO DATE, OVER 12.1 MILLION VACCINATION DOSES HAVE BEEN ADMINISTERED IN THE UAE WITH A VACCINE DISTRIBUTION RATE OF OVER 124 DOSES PER 100 PEOPLE, WITH APPROXIMATELY 70,000 DOSES OF THE VACCINE ADMINISTERED DAILY.

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NEWS

CAGS Conducts Webinar on Big Data

he Centre for Arab Genomic Studies (CAGS) conducted the fourth webinar in its monthly webinar series. Yesterday’s program focused on Big Data in Genomics, and was attended by more than 450 participants from all over the world. The webinar began with a talk by Dr. Julia Baptista, Clinical Scientist at the Exeter Genomics Laboratory, in which she discussed genomic testing for acutely ill children with rare disease and the UK national rapid exome sequencing service. Dr. Shareef Nahas, Senior Director at the Rady Children’s Institute for Genomic Medicine discussed a system for delivery of rapid genome sequencing-enabled management of childhood genetic diseases. Lastly, Dr. Andreas Henschel, Associate Professor at the Khalifa University discussed genotype-phenotype predictions using genomic data science: Enabling machine learning for understudied populations. The webinar was moderated by Dr. Aashish Jha, Assistant Professor, NYUAD. Dr. Mahmoud Taleb Al Ali, Director of CAGS said, "Just as important as the generation of big data, is the sharing of this data with other researchers in the field via public databases. CAGS is proud to have been one of the first

CAGS IS PROUD TO HAVE BEEN ONE OF THE FIRST ORGANIZATIONS IN THE ARAB WORLD TO RECOGNIZE THE IMPORTANCE OF GENETIC DATA AND TO ESTABLISH A PUBLIC DATABASE TO MAINTAIN THE DATA.

organizations in the Arab World to recognize the importance of genetic data and to establish a public database to maintain the data. I take this opportunity to invite genetic researchers in the region to contribute their data into the CTGA Database, for the benefit of the community." Choosing this topic for this webinar comes within the framework of the UAE’s strategy in addressing genetic diseases. Especially through projects such as the Emirati Genome Program, which aims to develop a genetic map for individuals and integrate it with health data in order to provide distinguished healthcare to citizens based on the results of the genetic sequence examination.

Saudis approve Moderna as 4th COVID-19 vaccine

audi Arabia has authorized the use of the Moderna vaccine against COVID-19, making it the fourth vaccine approved by the kingdom to fight the highly contagious disease. The Saudi Food and Drug Authority (SFDA) said it had approved Moderna after the manufacturing company of the vaccine had applied for its registration. The SDFA approval was based on the data provided by the US-based company. The SDFA said that based on its approval, health authori-

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SAUDI ARABIA HAS ALREADY GRANTED AUTHORIZATION FOR THE USE OF THE PFIZER-BIONTECH, ASTRAZENCA, AND JOHNSON & JOHNSON VACCINES.

ties in the Kingdom will embark on procedures for importing the Moderna jabs. Consequently, the SDFA will analyze samples from each shipment before allowing its use to ensure quality. Saudi Arabia has already granted authorization for the use of the Pfizer-BioNTech, AstraZenca, and Johnson & Johnson vaccines. In mid-December, the Kingdom kicked off mass vaccinations against COVID-19. Over 19 million doses have since been administered through 587 inoculation centers across the country, according to the latest figures from the Health Ministry.

ARTICLE

The Importance of Thyroid Molecular Testing in Management of Thyroid Nodules By Dr. Mohamed Hani, Medical Products Specialist at ExpressMed Laboratories - Bahrain

hyroid nodules, a common endocrine disorder where the numbers of these cases are showing an upward trend over the last several decades. These occur in women more than men, the risk in both increases by age; where a majority of the nodules are benign and only 4-6% are malignant. Fine needle aspiration (FNA) is a critical method used in the early stages to evaluate and triage patients with thyroid nodules, 70–75% of cases can be definitively diagnosed by FNA cytology. However, a group of indeterminate lesions (Bethesda III, IV) that accounts for 20% of cases offers a challenge in interpretation and clinical management, which is usually carried out with a cloudy view for the treatment plan. Because of this challenge, many patients may undergo unnecessary surgery leading to the loss of a functioning organ. Molecular testing platforms are highly recognized as an option by the American Thyroid Association (ATA) Guidelines since the year 2015, and it can help identify benignity and establish the diagnosis of cancer in thyroid nodules with high accuracy as well as predict how aggressive the cancer is likely to be, based on the genetic expression in the nodule. ATA developed evidence-based recommendations to inform clinical decision-making in the management of thyroid nodules and differentiated thyroid cancer. They represent, in our opinion, contemporary optimal care for patients with these disorders. Academic and Clinical Studies of validating the accuracy of a Next Generation Sequencing assay called ThyroSeq v3 Genomic Classifier, was done by using an extensive series of thyroid samples representing all significant types of thyroid cancers, which also includes Hurthle cell (oncocytic) cancer, like Hurthle cell carcinomas, Hurthle cell adenomas, and hyperplastic nodules with Hurthle cell predominance.

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DON'T UNDERGO SURGERY WITHOUT ALL THE INFORMATION… DR. MOHAMED HANI

ThyroSeq V3 GC Showed that all types of alterations could be detected preoperatively with a sensitivity of 94%, specificity of 82%, NPV of 97% and PPV of 66% among Bethesda III and IV nodules. It can Interrogates 112 genes for five different classes of molecular alterations: single nucleotide point mutations, insertions/deletion (indels), gene fusions, copy number alterations, and abnormal gene expression. Along with accepting a number of sample options for molecular testing, such as Thyroid FFPE tissue specimens, FNA cell block, or FNA cytology smear slides; the surprising part is that it is not required to re-FNA if previous FNA smear slide is available! This enables better management of the diagnosis by applying ThyroSeq V3 GC test in practice. Surely, today we can rely on the results from ThyroSeq V3 GC and provide relief to many patients from undergoing unnecessary surgeries, to provide recommendations for doctors and to determine the most informed treatment decisions for patients with cancer.

MOLECULAR TESTING PLATFORMS ARE HIGHLY RECOGNIZED AS AN OPTION BY THE AMERICAN THYROID ASSOCIATION GUIDELINES SINCE THE YEAR 2015.

ExpressMed Laboratories, A multi-specialized lab in the Kingdom of Bahrain, in partnership with University of Pittsburgh Medical Center presents

A molecular test for cytologically indeterminate thyroid nodules, empowering individualized patient management.

ThyroSeq reports comprehensive detailed molecular proﬁle with cancer risk assessment and treatment recommendation.

94%

82%

97%

66%

Sensitivity

Speciﬁcity

Negative Predictive Value

Positive Predictive Value

RELIABLE DETECTION OF ALL TYPES OF THYROID TUMORS CUTTING-EDGE NEXT-GENERATION SEQUENCING TECHNOLOGY MOST RIGOROUSLY VALIDATED TEST IN THE MARKET HIGHEST REDUCTION IN NUMBER OF DIAGNOSTIC SURGERIES

FOR THYROSEQ TESTING, CONTACT:

Kingdom of Bahrain Tel: +973 38000796, +973 77298888 Fax: +973 17911531 35 Email: mhani@expressmedlabs.com www.expressmedlabs.com

NEWS

Cleveland Clinic Abu Dhabi passes 150 organ transplant milestone

leveland Clinic Abu Dhabi, an integral part of Mubadala Health, has reached a milestone of performing more than 150 transplants since the introduction of its multi-organ transplant program in 2017. The UAE’s sole multi-organ transplant center, Cleveland Clinic Abu Dhabi performed the UAE’s first heart, liver, lung and pancreas transplants. In addition, the hospital’s transplant center recently began performing complex dual transplant surgeries, the first in the UAE. Cleveland Clinic Abu Dhabi has now performed 82 kidney transplants, 52 liver transplants, 10 heart transplants, 6 lung transplants, 3 combined pancreas and kidney transplants and a combined kidney and liver transplant. “It is humbling to see the life-changing impact our transplant program has had on patients and their families across the UAE. That we have reached this 150 transplant milestone during Cleveland Clinic’s centennial year is a fantastic acknowledgement of the legacy of innovation and patient-centered care we are continuing here in Abu Dhabi. When we opened our doors just five years ago, we couldn’t have imagined our transplant program would have touched so many lives this quickly,” says Dr. Bashir Sankari, Director of Cleveland Clinic Abu Dhabi’s transplant program. Despite growing numbers of registered organ donors, demand continues to outpace

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supply and there remains a long waiting list of patients who require a transplant. In order to mitigate the impact of this and offer a fresh lifeline to patients waiting for a new liver, the hospital’s multidisciplinary transplant team worked with their colleagues at Cleveland Clinic in the United States to introduce complex living related liver transplants that enable relatives to donate part of their liver to family members in need. The introduction of living related liver donation has meant that 22 patients have been able to access life-saving transplants without needing to wait for a compatible donor organ to become available. The impact of this introduction has spread beyond the UAE, with patients travelling from abroad to access living related transplant services. Recently, a 14-year-old patient travelled to Abu Dhabi from Sudan so that he could receive part of his brother’s liver. “The introduction of living-related liver donation has been a huge boost to some of the country’s sickest patients. We are building on that success with the introduction of combined organ transplants that see patients receive two new organs in a single surgery. We are very proud to be among just a handful of centers in the world able to offer this highly complex level of care that has the ability to completely transform a patient’s life, particularly when a pancreas transplant frees a patient from the need for daily insulin injections,” says Dr. Luis Campos, director of the liver transplant program and head of hepatobiliary surgery at Cleveland Clinic Abu Dhabi. Surgeons at Cleveland Clinic Abu Dhabi performed the UAE’s first pancreas transplant in a combined operation that also saw a young woman receive a new kidney. Following the successful surgery, the patient is no longer reliant on insulin injections to control her blood sugar and has effectively been cured of her diabetes. Since her operation, two more patients have received combined kidney and pancreas transplants. Surgeons at the hospital also performed the nation’s first combined liver and kidney transplant.

“Caregivers from across Cleveland Clinic Abu Dhabi come together to form the backbone of our multidisciplinary transplant program. Their and our donors’ contributions to the health and future of our community cannot be overstated. Each successful operation is another person who can return home to his or her life and family, and I am so proud of every caregiver who helps to make that happen,” concludes Dr. Sankari.

THE INTRODUCTION OF LIVING-RELATED LIVER DONATION HAS MEANT THAT 22 PATIENTS HAVE BEEN ABLE TO ACCESS LIFE-SAVING TRANSPLANTS WITHOUT NEEDING TO WAIT FOR A COMPATIBLE DONOR ORGAN TO BECOME AVAILABLE.

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

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NEWS

19Labs & Doctory partner to bring GALE eClinics to the Middle East Bringing hospital-at-home to pharmacies, schools, and rural communities in the Gulf

he hospital-at-home trend is rapidly changing the healthcare industry globally and throughout the Gulf countries. Healthcare companies are now moving quickly to provide full care in patients’ homes, rural communities, schools, and pharmacies using the latest diagnostic devices combined with telehealth. 19Labs and Doctory have entered into a partnership that will bring GALE eClinics to Gulf countries and the Middle East. GALE eClinics are next generation point-of-care platforms that seamlessly integrate leading mobile and healthcare technologies into cost-effective and smart solutions such as telehealth carts, healthcare kiosks, or portable telehealth kits. The two companies are working together to customize and localize GALE; introducing important features such as support for national ID cards, localized server hosting, custom health & wellness applications, full arabic translation of front-end & back-end systems, right-to-left user experience, and local customer support & sales. “19Labs is flexible, listens to local needs, and works together with us to make healthcare accessible in the Middle East in the best possible way,” said Samer ChamsiPasha, Doctory CEO. “GALE allows customers to deploy full eClinics equipped with the world’s most advanced diagnostic devices such as 12L ECG, ultrasound, remote exam cameras, blood testing, vital signs, pulse oximeters, spirometers, and blood pressure monitoring. It also brings together Zoom, Amwell, remote patient monitoring, and more into a cost-effective and easy-to-deploy solution that’s designed to be used by non-healthcare professionals.” "Doctory's insights on the local market have been tremendous from a business, product, and technology perspective,” said Ram Fish, 19Labs CEO & Founder. “They are a great partner: smart,

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tech-savvy, healthcare-centric, and well-connected. Doctory truly cares about making a real difference in the Middle East with GALE eClinics."

Doctory Doctory, based in the UAE and with offices throughout the Gulf, is an advanced enhanced telehealth and medical device company with a mission to contribute to advancing quality of care in the region. For more information, please visit www.doctory.me.

19LABS 19Labs is the creator of GALE, Next Generation Point-of-Care platform for pharmacies, schools, and rural communities. GALE brings together “best of breed” diagnostic technologies from industry leaders like Zoom, Elo, Amwell, Eko, Samsung Mobile, MIR, Omron, Viasat, and many others in one smart, efficient, and cost-effective platform. It was designed from the ground up to be operated by non-healthcare professionals, in locations with limited infrastructure and optimized for low bandwidth and intermittent connectivity. To learn more about GALE, please visit www.19labs.com/platform

BRINING THE CLINIC TO YOU The smart tele-health platform for remote care in patients homes, employers and rural communities.

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ARTICLE FEATURES . Hospotel

How can #hospotel improve patient outcomes?

ith the development of the concept of medicine in the world, researchers and stakeholders have tested the importance of a high-end hospital stay and its role in helping the patient recover or even accept a long hospital stay without experiencing negative complications. Modern luxury hospitals, or what is known as “Hospotels”, have been considered a sophisticated alternative to hospital stays, given their advantage of improving patient outcomes and recovery period and the ability to provide the appropriate atmosphere and services for that. The future of this type of healthcare looks promising, as healthcare competencies are gained through advanced technologies and a

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renewed focus on the patient, as well as medical operations. These hybrid facilities combine constant access to premium medical care with on-demand amenities of luxury hotels. The hospitalization cost is not an obstacle for those seeking both treatment and well-being, because it is studied according to the ability and request of each patient and what is provided to him. The flow of data stimulates the rethinking of how healthcare is delivered to maximize patient benefit across all income levels. In an unprecedented development where the rich rather than the poor are the targets of this advanced hospitalization approach, hospotels provide the ideal testing ground for new healthcare models, technologies and medical procedures.

FROM SPECIALIST MEDICINE TO ROBOTICS AND 3D MEDICAL IMAGING, THEORY BECOMES A MATTER OF PRACTICE, ESPECIALLY SINCE MOST OF THESE HOSPOTEL ENVIRONMENTS ARE RICH IN EFFICIENT RESOURCES.

ARTICLE FEATURES . Hospotel

Models from the world These hospotels began to spread, especially in elite countries. They also started occupying a large part of the medical sector around the world. The Scandinavian countries have significantly led the way to this new concept in the hospital sector. Lund University Hospital in Sweden opened a hospotel in 1988 as a way to free up more hospital beds for patients arriving for treatment. According to a specialized report, the Swedish hospital is considered the first large-scale integrated hospotel. In 2015, a specialized care hospital was opened in Denmark. It includes long-term care patients, and medical tourism patients who are looking for high-quality care and treatments not available in their home countries. It is worth noting that hospotel accommodations in some countries can be booked by anyone: the patient, a patient’s relative, a business traveler, or a tourist. These hospotels are a medical facility but with a different concept of luxury and care. Design considerations impose themselves, from luxurious accommodation, distinguished service and complete comfort. Surfaces, for example, should be easy to clean and sterilize. The bathroom design should take into account the functional work rather than the architectural type features. Also, communications between guests and employees need to be ubiquitous, as well as easy and quick access to the staff room is essential in case of an emergency. The accommodations are more like the characteristics of a traditional hotel. They usually feature a restaurant inside the building, lounges, free Wi-Fi and more.

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Gatehouse Capital, for instance, is an example of an American company that owns and invests in hospotels, which is known as a medical hospitality company. In 2017, Gatehouse opened Home2 Suites in collaboration with the Hilton Hotel on Dallas campus at Baylor University Medical Center. It is well known that medical hospitality in the United States is more than just a term for hospotels. US hospitals tend to integrate amenities and hospitality to earn higher patient satisfaction scores. This focus on hospotels comes after noticing the high demand for them. “We found that patients demand significantly more amenities along with the quality of care,” says Dr. John Rumley, Professor and Researcher at the Leonard D. Schaeffer for Health Policy and Economics at the University of California. This means that hospitals can improve their reputation by focusing more on hospitality.”

#Hospotel Care While some see hospotels as a theoretical or superficial matter, however, they have proven to be efficient and successful in providing better service to patients. Healthcare-associated infections are on the rise and are often resistant to antibiotics, making them difficult to treat. Hence, the hospotel can prevent these gaps, given the high care that is available throughout. According to a report from the Office of Disease Prevention and Health Promotion in the United States, about one in 25 patients have an infection related to hospital care. These infections cost tens of thousands of lives and cost the healthcare system billions of dollars each year.

THESE HOSPOTELS ARE A MEDICAL FACILITY BUT WITH A DIFFERENT CONCEPT OF LUXURY & CARE. DESIGN CONSIDERATIONS IMPOSE THEMSELVES, FROM LUXURIOUS ACCOMMODATION, DISTINGUISHED SERVICE & COMPLETE COMFORT.

ARTICLE FEATURES . Hospotel

These adverse events in hospital settings are universally common. A recent report from the World Health Organization (WHO) on patient safety estimates that up to one in 10 patients are harmed while receiving hospital care, even in high-income countries. Approximately 50 percent of these accidents are preventable. In low- and middle-income countries, the adverse event rate in hospitals is 8 percent, of which 83 percent are considered preventable, and 30 percent are potentially fatal. Hospital-acquired infections and procedural complications are the cause of most deaths, according to the WHO report. The organization adds, “There is increasing concern that the stressful hospital environment may lead to post-hospitalization syndrome - a pathophysiologic syndrome of weakness and increased stress that may leave patients vulnerable to clinical adverse events.” From here comes the importance of hospotel services, given their contribution to protecting the patient from catching viruses on the one hand and avoiding psychological and non-psychological complications of staying in a regular hospital on the other hand. Considering such problems, the emergence of an alternative to stressful hospital environments aimed at improving patient outcomes is inevitable. Moreover, the common negative conditions of hospitals are not sustainable in saving money and securing profit. Hospitals may at some point follow a well-established path to increasing revenue and decreasing risk: focusing on core competencies and outsourcing other jobs, as well as increasing adoption rates for machine learning, robotics, and automation. Even the budgets of entire countries suffer from problems associated with negative events in the hospital. For example, in Canada, at least $1 out of every $7 was spent “addressing the effects of patient harm in hospital care.” Hence, hospotels seem to be more capable of affording the latest medical technologies in the market.

Better service at a lower cost? After the success and expansion of this sector, and due to its need for specific expertise in the field of healthcare hospitality, schools and

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institutes started teaching this type of competence. Two theories also emerged regarding whether it is better to develop and provide hotel service in hospitals through partnership with hotels that build hospotels on their campuses, or by increasing hospital services with hotel amenities across the hotel. In the first scenario, the hospital prepares patient services and provide them to another business entity, which can be wholly or partly owned by the hospital. This approach allows the primary hospital entity to focus precisely on acute, emergency and surgical care while receiving new flows of cases from the other entity. In the second scenario, the hospital can quickly raise patient satisfaction and thus speed up insurance reimbursements to improve cash flow. However, focusing on comfort around the quality of care can eventually arrange other repayments, with consequences such as hospital-acquired infections and high pain rates. But in both cases, the availability of hospotel services and advanced medical technologies have positive implications for long-term medical developments. Experience has proven that, in addition to the patient receiving better services, the bill considered high for this type of hospitalization is in the end less than the normal hospital bill, because this method of hospitalization does not include many follow-ups and there are no side complications that in turn require a cost if added to the normal hospitalization cost. Also, the strategic use of a range of techniques can improve patient outcomes and provide relief. There are mobile applications, for example, that provide healthcare by following up on X-rays and other medical images, in addition to many laboratory results directly on the mobile phone. Digitizing this information also provides faster patient care results and reduced waiting times. These apps can even suggest diagnosis and treatment. Patient applications can also facilitate telemedicine sessions, resulting in reduced costs and waiting times, as well as patient comfort and medical hospitality concepts. Medical hospitality can also bring advanced technologies to a wider range of patients.

EXPERIENCE HAS PROVEN THAT, IN ADDITION TO THE PATIENT RECEIVING BETTER SERVICES, THE BILL CONSIDERED HIGH FOR THIS TYPE OF HOSPITALIZATION IS IN THE END LESS THAN THE NORMAL HOSPITAL BILL, BECAUSE THIS METHOD OF HOSPITALIZATION DOES NOT INCLUDE MANY FOLLOW-UPS & THERE ARE NO SIDE COMPLICATIONS THAT IN TURN REQUIRE A COST IF ADDED TO THE NORMAL HOSPITALIZATION COST.

INTERVIEWS

“Leading with Innovation and Empathy”

Maher Elhassan

Jihad Hussami

Vice President & General Manager, BD Middle East, North Africa & Turkey

Business Director – BD Medication Management Solutions, Eastern Europe, Middle East & Africa

D is a global medical technology company that is advancing the world of health by improving medical discovery, diagnostics and the delivery of care. “Hospitals” magazine had the privilege to meet with Maher Elhassan, Vice President & General Manager, BD Middle East, North Africa & Turkey and Jihad Hussami, Business Director – BD Medication Management Solutions, Eastern Europe, Middle East & Africa. Below is the full interview:

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INTERVIEWS

How was BD impacted in 2020? Reports say that due to work from home (WFH) and added work pressure, the mental health of the employees has been affected; has BD introduced any initiatives for its employees on this front? In 2020, our role as one of the largest global medical technology companies in the world became that of a first responder to the first responders. We have deployed our capabilities, expertise, and scale to address the critical health needs of the patients – through our diagnostic offerings to identify infections, to real-time informatics and electronic surveillance technology, to essential medical devices, products and solutions to support patient care. Our rapid response strategy in addressing the crisis by quickly mobilizing and working with urgency and purpose to react to the critical needs of the healthcare sector has also been recognized in Fortune’s Change World list in 2020. Our foremost priority has been to ensure the health and safety of our people, their families, our customers and partners. We have always been a people-centric organization, but the last year has further strengthened our commitment to them. Not only are people today grappling to get accustomed to the forlorn environment but also to make sense of the newness of the workfrom-home culture that has to a large extent dwindled the scales of work and life. Taking this into account we have introduced a series of initiatives that have fostered a winning culture that is conducive not only for the growth of the company but also for employees. Some of our key initiatives include flexible and hybrid work from home policies to ensure work-life balance, as well as regular engagement sessions with our employees to safeguard their mental health and well-being and avoid burnout and stress. Added to that is a wealth of resources on mental wellbeing and a 24/7 Employee Assistance Program providing our associates and their families counselling for emotional and psychological support as well as practical guidance

on legal, financial, family and work matters. We will continue to stand by our people to safeguard them and to take care of their needs. Our mission to advance the world of health is only achieved through our people – who remain at the centre of everything we do.

What has been the impact on the medical device industry in 2020? Are there any specific hurdles that the companies will have to overcome? Catastrophes always bring to the forefront both challenges and opportunities. In testing times, it is imperative to put our people and customers at the core of everything we do. The medical technology industry plays a vital role in any crisis. The industry is at a vantage point due to the surge in demand and increased awareness about health, the present situation also highlights the fact that medical technology needs to be trusted, it should be effective and affordable. We believe these are some of the challenges that the medical sector will have to resolve while making sure that the wellbeing and safety of healthcare workers and patients is not compromised at any point. That’s one of the many areas that we’re focused on. At BD, we strive to sustain a culture of safety, promoting patient and healthcare workers safety across the entire journey, implementing safe, innovative, and optimized technology. Moreover, we’re also bringing innovation to the market to drive automation and efficiency, thus helping to reduce medication errors and to enhance the productivity of caregivers.

In your opinion, what are the key trends that are complementing the growth story of the healthcare industry in the UAE? Market research projects that the UAE’s healthcare sector will experience growth of around 10% on a compounded annual basis during the 2019-2023 period. The government’s healthcare strategy coupled with increased awareness are confirmed growth drivers for the industry. The country is also investing extensively in upgrading the healthcare system to match world-class standards. This signifies an improve-

BD MMS (MEDICATION MANAGEMENT SYSTEM) PRIMARILY ADDRESSES INFUSION & DISPENSING, WHICH ARE COMPLEX AND ERROR-PRONE PROCESSES. GAPS IN COMMUNICATION, AND LACK OF VISIBILITY BETWEEN STEPS, CAN CONTRIBUTE TO HIGHER RISKS FOR MEDICATION ERRORS, AND CAN LEAD TO INCREASINGLY HIGHER COSTS IN UNREPORTED DIVERSION, AND ANNUAL WASTES.

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ment in the quality of patient care leading to a resilient medical ecosystem in the country. The emergence of technologies like artificial intelligence (AI), cloud and internet of things (IoT) is giving birth to new trends in the healthcare sector leading to high optimization of the digital infrastructure. With an increased focus on digitalization, the regulators are leaving no stone unturned to encourage private sector companies to expand and upgrade their infrastructure to be able to elevate the quality of services offered. Medical device companies and Medtech, in general, have a vital role in this journey. According to forecasts by Statista, the market for medical devices in the UAE will grow to a value of AED 4.9 billion by the end of 2021. BD’s strategy and vision for increasing medication safety and facilitating an error-free experience to patients and medical professionals are in line with the government’s plan for the healthcare industry and will certainly make a difference in enhancing the healthcare landscape in the country.

How do you think will the new normal shape businesses in the future? Today, companies are left with not much choice but to adapt to the changing trends in the business. On the other hand, the year 2020 has witnessed the birth of various business-enabling opportunities that will scale up in the months to come, and will eventually thrive and benefit the economy. This decade is going to see a boom in the healthcare sector with increased demand and accessibility. Medical technology will play a crucial role in building the healthcare sector’s resilience and new strategies. Businesses will not only need to continue to work in tandem to be sustainable, but will also have to transform digitally. The old ”one-size-fits-all” approach may not work anymore. Agile, personalized, and individualized product propositions will gain momentum and factors like empathy and compassion will set the growth tone for a company.

How is BD planning to establish a

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culture of safety via medication management solutions? The global medication management system (MMS) market size is expected to reach USD 5.97 billion by 2025 at a CAGR of 20.5%. There has been a rise in the volume of medical transactions, the number of prescriptions generated, processes and more; all accommodated by the short-staffed medical professionals. The situation underlines the fact that there is no room for error and an alarming need for technological innovations. BD is known to be at the forefront in adopting advanced technology to be able to deliver better patient and medical professional experience. BD MMS offers a variety of solutions, some prominent ones would include Infusion and IV therapy systems, software, infusion pumps, bi-directional interoperability, and automated solutions from the hospital pharmacy to the patient’s bed. BD developed technology that communicates IV infusion data to the Health Information System (HIS) partners and the Electronic Medical Record (EMR) vendors allowing the innovative IV pump modules to offer expanded future capabilities to ensure the system is consistently kept up-to-date, through wireless connectivity. Thanks to the consolidated workflows offered by BD, the inventory of medicines is managed efficiently providing immense support to patient care ensuring medicines are avail-

BD MMS OFFERS A VARIETY OF SOLUTIONS, SOME PROMINENT ONES WOULD INCLUDE INFUSION AND IV THERAPY SYSTEMS, SOFTWARE, INFUSION PUMPS, BI-DIRECTIONAL INTEROPERABILITY, AND AUTOMATED SOLUTIONS FROM THE HOSPITAL PHARMACY TO THE PATIENT’S BED.

INTERVIEWS

able when they are needed. A central view of inventory, orders and usage across the health organization helps to effectively manage medication availability. Optimizing inventory for pharmacy, improving nurse productivity, and increase in the time for patient care together help achieve better clinical, technical and operational benefits.

How is BD’s medication management system going to impact the healthcare sector? BD MMS (Medication Management System) primarily addresses Infusion & Dispensing, which are complex and error-prone processes. Gaps in communication, and lack of visibility between steps, can contribute to higher risks for medication errors, and can lead to increasingly higher costs in unreported diversion, and annual waste. We intend to: • Support our customers in their journey to unify medical records across all healthcare sectors so that data can be used and made available whenever required • Standardize electronic medical records including information from pharmacy and labs, making data easily accessible • Promote the adoption of regulations to mandate reporting of medication errors and infections, including antimicrobial usage

We are keen to know how BD responded to the evolving critical needs of the healthcare systems and patients last year? How were resources and efforts optimized to match the same? We observed that last year our capabilities were tested as well as enhanced, we extended our expertise and scale to address the critical health needs of the patients. A few of our initiatives are as follows: • Due to rapid change in the healthcare landscape, there was a need for upskilling and re-skilling on infection control practices. BD equipped the medical staff involved in direct patient care including physicians, nurses, pharmacists,

•

and laboratory technicians with digital learning tools and training in infection prevention. BD improved its inventory management system to ensure the availability and safe administration of medicines. As researchers moved into clinical trials, we developed a full suite of medication delivery devices to meet the needs of each potential drug. We also increased the supply of systems such as medication management, infusion pumps and sets, IV access, IV Care and maintenance, Foley Catheters, as well as surveillance and analytics to support patient management. We have stepped up the response to the needs of communities through our philanthropic and volunteering activities. BD and the BD Foundation have issued nearly $2.5 million in philanthropic grants and product donations to non-profit organizations that are working to protect the most vulnerable communities and individuals from the pandemic’s spread and negative impacts. A recent example is our donation of products worth $900,000 via the NGO, Anera, to support the disaster response in Beirut, Lebanon, following the tragic explosion that took place last year.

BD’S STRATEGY AND VISION FOR INCREASING MEDICATION SAFETY AND FACILITATING AN ERROR-FREE EXPERIENCE TO PATIENTS AND MEDICAL PROFESSIONALS ARE IN LINE WITH THE GOVERNMENT’S PLAN FOR THE HEALTHCARE INDUSTRY AND WILL CERTAINLY MAKE A DIFFERENCE IN ENHANCING THE HEALTHCARE LANDSCAPE IN THE COUNTRY.

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Effective Communication: Foundation for Nurse Safety By Rhonda Collins, DNP, RN, FAAN, Chief Nursing Officer, Vocera

ver the past year, as we’ve all seen how nurses impact the health and healing of our world, we’ve also seen them embrace the mantra “Never Again” and leave the profession at an unprecedented rate. The need for change is clear. We must heed the call from all corners to listen to, support, and protect nurses.1 We must envision new ways of staffing and new ways of communicating and engaging, and focus on changing complex work environments and workflows – the source of most workplace fatigue and burnout. I have been researching, writing, and speaking on the topic of nurses’ cognitive burden for more than two years. I continue to be invited to talk about the cognitive burden and how it affects nurse safety. At every CNO roundtable, I attend, I meet nurse leaders who are perplexed and frustrated over how to fix what’s wrong. They are experiencing everything their staff

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is suffering and more, and they are asking for workable solutions. Often, nurse leaders focus primarily on building nurse resiliency. While resiliency is important, we also need to address the mental fatigue and moral injury this pandemic has wrought on our healthcare workers. It’s helpful to give people a safe place to go or a dedicated expert to talk to. There is nothing wrong with offering nurses space to meditate or listen to a mindfulness recording. But if nurses take five minutes every hour to go collect themselves and they come out of that space and the work environment is still chaotic, newfound serenity can’t be sustained. It’s not the nurse that needs to change. It’s the work environment. Nurses need tools to minimize the stress and make it easier to do their job. To this end, there are tangible actions nurse leaders can take to improve the work environment and strengthen nurse safety.

COMMUNICATION IS THE UNDERPINNING OF EVERYTHING THAT HAPPENS IN A HOSPITAL, AND EFFECTIVE COMMUNICATION IS THE PRIMARY FOUNDATION OF A SAFE AND EFFECTIVE WORK ENVIRONMENT.

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Six Solutions for Strengthening Nurse Safety Communication is the underpinning of everything that happens in a hospital, and effective communication is the primary foundation of a safe and effective work environment. In my 2021 CNO Perspective report, “Protect the Nurse, Protect the Practice,” I propose six solutions to help nurse leaders create a safe and effective work environment, all rooted in strengthening communication.

These solutions factor in lessons learned from the COVID-19 pandemic and include: • • • • • •

Keeping nurses protected and safe Empowering nurses with control over patient-family communication Reducing the stress of crisis care Enabling smooth movement from novice to expert and back Protecting nurses from workplace violence Measuring and solving for communication task load

The NASA Task Load Index (TLX) measures on 6 dimensions: • • • • • •

How mentally demanding was the task? How physically demanding was the task? How hurried or rushed was the pace of the task? How successful were you in accomplishing what you set out to do? How hard did you have to work? How insecure, discouraged, stressed, or annoyed were you?

The more we listen to nurses’ voices, the better we can support and protect them, and the better we can engage the creative thought process of nurse leaders. Join me in this conversation. Work with me as we ask the questions and look for answers to improve communication, facilitate nurse safety, and ease the work of nurses caring for patients and families.

I INVITE NURSE LEADERS TO MAKE THEIR NURSES’ VOICES HEARD AS PART OF AN UNPRECEDENTED STUDY THAT AIMS TO MEASURE HOW THE EFFORT INVOLVED IN COMMUNICATING AFFECTS NURSES MENTALLY, PHYSICALLY, AND EMOTIONALLY.

I invite nurse leaders to make their nurses’ voices heard as part of an unprecedented study that aims to measure how the effort involved in communicating affects nurses mentally, physically, and emotionally. The study will provide insight and a body of knowledge to solve for the task burden of communicating more effectively going forward.

Let’s Partner to Measure and Solve for Communication My plan is to measure nurse communication in hospitals using the NASA Task Load Index (TLX). The NASA TLX has been used to measure the task load of workers in high-intensity jobs, such as pilots and air traffic controllers. It’s been used to measure the task load of ICU nurses2– and this is the first time it will be used to measure the task load involved in clinical communication. Nurses will be able to anonymously answer seven questions while thinking about a clinical communication task or effort during their most recent 12-hour shift. For example, trying to reach a physician or obtain a lab result.

www.vocera.com/me Citations 1. Brown, Theresa, and Rushton, Cynda. Frontline Nurses WikiWisdom Forum. https://nurses.wikiwisdomforum.com/ 2. Hoonakker, Peter, et al. “Measuring Workload of ICU Nurses With a Questionnaire Survey: The Nasa Task Load Index (TLX).” PMC, 12 Oct. 2011. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3388621/

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Mr. Alaa Adel Managing Director for Cerner in the Middle East and Africa

“Digitalization shapes the future of our industry and allows our clients to secure better performance in providing healthcare services”

hirty years since the birth of Cerner in the Middle East, the company has contributed to many innovative changes in healthcare delivery. It has around 300 employees and serves healthcare organizations in seven different countries in the region. On that occasion, ‘Hospitals’ magazine met with Alaa Adel, Managing Director for Cerner in the Middle East and Africa for his valuable insights about leadership attributes and driving innovation in the industry in fair weather or foul.

Can you brief us about your career? I have been working in the healthcare field for the past 15 years. I joined Cerner in 2009 and I’ve held various roles within the company starting in the Middle East, then relocated to our head office in Kansas City for five years where I was part of the first healthcare information and management system society. I am currently the Managing Director for Cerner in the Middle East and Africa working with an amazing team to support our clients and partners in the region.

In your opinion, what are the qualities of a good leader? In my opinion, the most important quality of a good leader is empathy with a wide contextual perspective. Leadership is about inspiring people to do things they never thought they could

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OUR SUCCESS IS THE SUCCESS OF OUR CLIENTS AND PARTNERS.

do. Being people-oriented, building trust among your people and the power of delegation are crucial to a leader’s core responsibilities. I also believe effective leadership and communication are intertwined. You need to be able to communicate in a variety of ways, from transmitting information to coaching your people. The quality and effectiveness of communication across your organization directly affect the success of your business strategy, too.

Congratulations for Cerner’s 30th anniversary in the region, can you tell us about the reforms or improvements that Cerner has brought to the healthcare sector over the years? We are extremely honored to have been present in the region for 30 years and would not

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have been successful without visionary country leaders, clients and partners who trust and work closely with us. Our core belief is building a seamless and connected world where everyone thrives. Cerner started in the Kingdom of Saudi Arabia with one client and four employees. Today we are proud to have around 300 employees and a presence in seven countries: UAE, Saudi Arabia, Qatar, Egypt, Kuwait, Jordan and Oman. Thirty years might seem like a long time, but it has flown by quite quickly for us. Our aim is to support healthcare facilities throughout their digital transformation journeys; focusing on leveraging health information technologies (HIT) to enhance the experience of patients and healthcare workforce, all while improving the health of the population and reducing the mounting costs of healthcare.. Our success is the success of our clients and partners.

Over the past two years, the world has faced an unprecedented pandemic. What can you tell us about Cerner’s role during this unprecedented time? The past two years have been challenging. Everything has changed and COVID-19 affected everyone and everything. However, the pandemic has fast-forwarded and accelerated our vision realization and implemented in a few months what was planned for years. Cerner has been working closely with clients in the region optimize our clients’ electronic health record (EHR) systems with the most recent and applicable developments from across the globe. This includes operational readiness, screening, testing, treating, monitoring, public health surveillance and other clinical activities to help our clients respond to the pandemic.. Moreover, we have implemented end-to-end Cerner solutions to help clinicians monitor, track and discharge patients. We’ve always known the power of data and interoperability to transform healthcare, however during these extraordinary times, accessing data to support and execute real-time evidence-based clinical decisions on small and large scales has never been more critical. Cerner has created various dashboards and data analytics

to inform quick decision making and operational management aspects.

What are some of the challenges faced during these difficult times and what was the strategy you followed? One of the most difficult challenges was to change our mindsets and adapt to the situation with a different approach. The pandemic has been a defining moment for the healthcare industry. We had to find ways to optimize our technology to be able to collect and document data at a faster pace. We now know that one of the main strategies to be resilient in similar situations is agility and fast adoption. Embracing new digital health technologies has accelerated and is becoming a priority of every healthcare player in the market.

What is the role of artificial intelligence (AI) in the war against COVID-19? Can you imagine this pandemic in the 80s? It would have been a catastrophe. The pandemic has made us realize the importance of AI is managing the health of communities with several healthcare and research organizations in the Middle East contributing to the development of AI models. AI offers several advantages over traditional analytics and clinical decision-making techniques. Machine learning algorithms can become more precise and accurate, allowing caregivers to gain unprecedented insights into diagnostics,

LEADERSHIP IS ABOUT INSPIRING PEOPLE TO DO THINGS THEY NEVER THOUGHT THEY COULD DO. BEING PEOPLEORIENTED, BUILDING TRUST AMONG YOUR PEOPLE AND THE POWER OF DELEGATION ARE CRUCIAL TO A LEADER’S CORE RESPONSIBILITIES.

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care processes and personalized treatment. I believe AI has played an important role in managing the crisis. Identifying healthcare issues and developing relevant AI models to help support the delivery of better clinical and health outcomes, as well as improved patient and caregiver experiences, will be an important component of advancing a healthcare organization’s digital transformation journey. We are starting to see various innovative projects that use AI to answer important questions raised by the pandemic. From machine learning models that can predict the probability of a COVID-19 patient requiring intensive care admission to models that stratify the population into priority groups for vaccination – even to models that try to predict the possible upcoming waves of the infection in certain cities or districts; the experiments are surfacing from many countries around the globe and in the region.

What have we learnt and what would be the impact of the pandemic on the future of healthcare? Agility, in addition to the speed of healthcare delivery and decision making among others are key fundamentals of what we’ve learnt from this crisis; and we are still learning. We salute the visionary country leaders and all healthcare frontline staff for their efforts urging us to move with higher pace to find better ways provide better outcomes for patients. A few years from now, we will look back and see a clear distinction between the pre- and post-COVID eras when it comes to modernization of the healthcare delivery. The pandemic has pushed us to come together and rethink healthcare delivery, which will create new opportunities to improve healthcare and accelerate the next era of transformation. I believe the pandemic has truly opened new doors for us. Now, healthcare is ripe for change.

OUR CORE BELIEF IS BUILDING A SEAMLESS AND CONNECTED WORLD WHERE EVERYONE THRIVES. CERNER STARTED IN THE KINGDOM OF SAUDI ARABIA WITH ONE CLIENT AND FOUR EMPLOYEES. TODAY WE ARE PROUD TO HAVE AROUND 300 EMPLOYEES AND A PRESENCE IN SEVEN COUNTRIES: UAE, SAUDI ARABIA, QATAR, EGYPT, KUWAIT, JORDAN AND OMAN.

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Elie Chaillot President & CEO, Services, Europe, Middle East & Africa (EMEA), at GE Healthcare

“Artificial Intelligence (AI) has the potential to drive real breakthroughs across the care continuum”

t the outset of the crisis, GE Healthcare ramped up production of critical spare parts for the ventilators, X-ray machines and MR scanners that would be so important in treating COVID-19 patients. "Hospitals" magazine recently interviewed Mr. Elie Chaillot, President & CEO, Services, Europe, Middle East & Africa (EMEA), at GE Healthcare, about the projects undertaken by GE Healthcare during the pandemic.

What developments have been achieved through the use of AI and analytics in the healthcare sector? Healthcare has never been more accessible, intelligent or dynamic. Health systems, however, face increasing pressures – with the growth and aging of global populations, rising levels of chronic disease coupled with escalating costs, growing complexity and inadequate infrastructure – forcing a fundamental rethinking of

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WITH THE RIGHT TECHNOLOGIES, WE NOW HAVE THE ABILITY TO UNLOCK THIS DATA & UNLEASH INTELLIGENCE ACROSS THE HEALTHCARE INDUSTRY.

every aspect of healthcare. The increased use of advanced data analytics, connected devices, genomics and Artificial Intelligence (AI) have the potential to drive real breakthroughs in patient outcomes and operational efficiencies across the care continuum. Health systems have never been better at generating data – but most goes unused. With the right technologies, we now have the ability to unlock this data and unleash intelligence across the healthcare industry.

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We are seeing health systems using AI and analytics to gain access to real-time data that illustrates hospital and resource capacity, and this will only become more central to how health systems operate. Our Command Center technology – essentially an AI toolkit to improve outcomes and efficiency in hospital operations – is used by more than 200 hospitals around the world. AI is also built directly onto medical devices. Critical care suite, for example, was the first FDA-cleared AI algorithms embedded on mobile X-ray devices to prioritize pneumothorax. There are also AI applications like Thoracic Care Suite, a suite of AI apps to help identify chest X-ray abnormalities, including pneumonia caused by COVID-19 and tuberculosis. The possibilities are endless: Our customers are also asking us to work with them to make their machines more productive and help them build tools to interface with patients using innovative technology. But the technology must be simple; clinicians need it to be intuitive, embedded in their existing workflows and easy to use.

How has the pandemic shifted the focus of healthcare systems going forward? COVID-19 continues to be the primary focus of health systems globally, and with the pandemic I believe we have seen a glimpse of the future. We’ve learned a lot in the past few year about both the disease and the potential consequences of holding off on treatment of pre-existing conditions. As we see health systems start to recover, patients still have some fear of going back into the hospital for care. We are helping our customers look at recovery in a way that is holistic and balanced between managing new COVID-19 cases but also ensures patients understand how new policies will protect them and will limit transmission. Managing that recovery means health systems need better line of sight to all available resources, including staff. And that’s only possible through greater access to data.

How do we build a sustainable intelligence-based healthcare system? Building the intelligence-based health system requires a complete modernization of the

WE ARE SEEING HEALTH SYSTEMS USING AI AND ANALYTICS TO GAIN ACCESS TO REAL-TIME DATA THAT ILLUSTRATES HOSPITAL AND RESOURCE CAPACITY, AND THIS WILL ONLY BECOME MORE CENTRAL TO HOW HEALTH SYSTEMS OPERATE.

current infrastructure to enable virtual hospitals, enable greater access to care and ultimately lower the cost of care delivery. Moreover, 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. We know that by changing the underlying technology infrastructure, we can deploy applications that will make a huge difference in the lives of both clinicians and patients. No one company can solve this alone, which is why we are bringing together the ecosystem, leveraging the strengths of clinicians, technology & academic partners, and others to advance healthcare together. Just over a month ago in Turkey, we finalized an agreement with TECHNOPOL-based CUREA, led by Chairman of Radiology in Istanbul Province, Prof. Dr. Muammer Hakkı Karakaş, Turkey’s first strategic collaboration to accelerate AI development in medical imaging. The collaboration will see Prof. Karakas and his team of distinguished radiologists, data scientists and software developers use GE Healthcare’s Edison Health Services to develop AI-based applications focused on the detection, categorization, and severity grading of COVID-19 to diagnose and treat patients, as well as auto-detection and categorization of breast lesions through contrast-enhanced spectral mammography (CESM). 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.

Could you please tell us about the projects undertaken by GE Healthcare during the pandemic? At the outset of the crisis, GE Healthcare ramped up production of critical spare parts

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for the ventilators, x-ray machines and MR scanners that would be so important in treating COVID-19 patients. These were housed at GE Healthcare’s three regional supply centers in Turkey, Saudi Arabia and the UAE, allowing faster support for hospitals across the region. We also innovated quickly. Our CT-in-a-Box solution, a modular machine that captures the same robust imagery of traditional CT scanner, was installed at many institutions around the world—including Turkey, the UAE, and Kuwait in this region. Another step GE Healthcare took to increase the regional supply of ventilators is to work with its customers to identify and return their old, unused or non-working ventilators to be repaired at our Repair Centers in Turkey and Saudi Arabia. While the number of refurbished ventilators by no means meets demand, every ventilator we’re able to put back in use means another patient can be treated. When governments around the region took decisive action to commission emergency field hospitals, we quickly mobilized to deliver equipment. The task before us was to manufacture, ship, deliver and commission a range of equipment, including MRI’s, CT’s, and patient monitors, all during a time where most planes around the world were grounded because of the pandemic. Through collaboration with our partners and suppliers, and the support of governments who helped us prioritize custom clearance, we were able to do it.

It has been nearly one year since your appointment to lead Services for GE Healthcare in EMEA. What are the services at GE Healthcare, and how do they fit in the context of healthcare delivery? I have always believed that at our core, we are a services company. Our customers are our north star and services are integral to their experience with us. Service has come a long way from the traditional break-fix model. The ongoing pandemic has put an enormous strain – both financial and operational – on healthcare systems across the world, intensifying a trend that was already

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AT THE OUTSET OF THE CRISIS, GE HEALTHCARE RAMPED UP PRODUCTION OF CRITICAL SPARE PARTS FOR THE VENTILATORS, X-RAY MACHINES AND MR SCANNERS THAT WOULD BE SO IMPORTANT IN TREATING COVID-19 PATIENTS.

being felt pre-pandemic by both private medical systems and health ministries. As a result, across Europe, the Middle East and Africa, and indeed the world, healthcare providers have been looking for opportunities to better manage costs and improve care to patients. This includes both private healthcare systems looking to deliver returns to shareholders and ministries of health looking to contain rising healthcare spending and improve patient outcomes. Our customers manage thousands of assets—all types of healthcare equipment, big and small—complexity that creates additional costs required to stay on top of each piece of equipment’s performance, maintenance, repair status, and location. So we work with our partners to introduce Healthcare Technology Management (HTM) programs, which provide a unified, simplified and cost-effective tool to address the equipment challenge. In other words, we provide a total asset management solution with multi-vendor coverage and a single point of contact for all equipment issues for healthcare providers, taking on responsibility for managing all equipment. Productivity is the name of the game and GE has been innovating and leading this charge.

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 . Cervical Cancer

Cervical Cancer The easiest to prevent

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ARTICLE FEATURES . Cervical Cancer

ervical cancer is the type of cancer that develops in the cervix of women, and almost the majority of cases are caused by the human papillomavirus (HPV). Fortunately, there is a vaccine for this virus that prevents infection provided that it is given at a specific age. On the other hand, regular gynecological check-ups and pap smears contribute to early detection as well as determining the risk of disease even if there are no signs of cancer, which led to a recent decrease in the mortality rate. The World Health Organization had launched a strategy aimed at eliminating cervical cancer, as it is a disease that can be prevented, and can be cured if detected early and treated appropriately, but it is the fourth most common type of cancer among women in the world. This strategy aims to vaccinate 90% of girls by the age of 15 against HPV, which causes cervical cancer. If these measures are successfully taken by 2030, the number of new infections could fall by more than 40%, and the number of deaths from this disease by five million by 2050. Almost all cases of cervical cancer are attributed to permanent HPV infection, which is transmitted through sex and is one of the most common sexually transmitted diseases that affects both men and women. There are more than 100 strains of the virus, but the strains 16 and 18 in particular are responsible for about 70 percent of all cervical cancer cases. This virus has several types, some of which are less serious and cause genital warts, and some are very dangerous and are responsible for changes in the cervical cells. Other cervical cancer risk factors are HIV, immunodeficiency, changes in cervical cells (pre-malignant changes), lack of early gynecological examination, smoking, and direct or indirect contact with people who carry this virus. Many women recover from the virus automatically, but chronic infection leads to abnormal changes in the cervical cells, which is a pre-cancerous stage that silently develops unless treated and turns into cancer 15 to 20 years later. Since it takes years to develop, the possibility of detecting it early through a gynecological examination is possible, which

THE HPV VACCINE IS ROUTINELY RECOMMENDED FOR GIRLS AND BOYS AGES 11 OR 12, ALTHOUGH IT CAN BE GIVEN AS EARLY AS AGE 9.

increases the chances of successful treatment and survival, because this disease is completely treatable, especially if detected early.

What does the woman feel? Symptoms of cervical cancer may be signs of other problems and diseases, but regular checkups remain the best way for prevention because it may not cause any symptoms or they may not be obvious. Early-stage cervical cancer generally produces no signs or symptoms. Signs and symptoms of more-advanced cervical cancer include vaginal bleeding after intercourse, between periods or after menopause, watery, bloody vaginal discharge that may be heavy and have a foul odor, pelvic pain or pain during intercourse.

Tips to reduce the risk of cervical cancer: HPV Vaccine The HPV vaccine is routinely recommended for girls and boys ages 11 or 12, although it can be given as early as age 9. It's ideal for girls and boys to receive the vaccine before they have sexual contact and are exposed to HPV. Research has shown that receiving the vaccine at a young age isn't linked to an earlier start of sexual activity. Once someone is infected with HPV, the vaccine might not be as effective or might not work at all. Also, response to the vaccine is better at younger ages than it is at older ages.

ARTICLE FEATURES . Cervical Cancer

The Centers for Disease Control and Prevention (CDC) now recommends that all 11- and 12-year-olds receive two doses of HPV vaccine at least six months apart, instead of the previously recommended three-dose schedule. Younger adolescents ages 9 and 10 and teens ages 13 and 14 also are able to receive vaccination on the updated two-dose schedule. Research has shown that the two-dose schedule is effective for children under 15. The CDC now recommends catch-up HPV vaccinations for all people through age 26 who aren't adequately vaccinated. Unlike other cancers, cervical cancer is caused by human papillomavirus (HPV), which can be passed from one person to another through sexual contact. 70 percent of women are considered to be exposed to HPV during their lifetime. There are many types of HPV, and many do not cause problems.

Pap smears A Pap smear is a screening procedure for cervical cancer. It tests for the presence of precancerous or cancerous cells on your cervix, which is the opening of the uterus. If the test results are abnormal, this doesn’t mean you have cancer. It simply means that there are abnormal cells on your cervix, some of which could be precancerous. Pap tests are very accurate. Regular Pap screenings reduce cervical cancer rates and mortality by at least 80 percent. It can be uncomfortable, but the brief discomfort can help protect your health.

Quitting smoking Smoking interferes with incidence and prevalence of HPV infection and is associated with cervical intraepithelial neoplasia and invasive CC. Multiple factors seem to intervene on cervical carcinogenesis related with tobacco, especially by direct local carcinogenic effect and local immunosuppression.

Healthy lifestyle Proper nutrition, regular exercise, avoiding stress, drinking plenty of water, and adequate sleep are important steps in our daily life to prevent not only cervical cancer but many other diseases.

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HPV INFECTIONS USUALLY CLEAR UP WITHOUT ANY INTERVENTION WITHIN A FEW MONTHS AFTER ACQUISITION, AND ABOUT 90% CLEAR WITHIN 2 YEARS. A SMALL PROPORTION OF INFECTIONS WITH CERTAIN TYPES OF HPV CAN PERSIST AND PROGRESS TO CERVICAL CANCER.

Advanced Treatments Treatments have developed over the years along with technological advances in the medical field, and today it is possible to treat early precancerous lesions and preserve fertility. Cervical cancer is a treatable condition, and there is an excellent chance of cure if the cancer is found and treated in the early stages. Treatment for cervical cancer depends on several factors, such as the stage of the cancer, other health problems you may have and your preferences. Surgery, radiation, chemotherapy or a combination of the three may be used. Early-stage cervical cancer is typically treated with surgery. Which operation is best for you will depend on the size of your cancer, its stage and whether you would like to consider becoming pregnant in the future. Early-stage cervical cancer might be treated with a radical trachelectomy procedure, which removes the cervix and some surrounding tissue. The uterus remains after this procedure, so it may be possible to become pregnant, if you choose. Most early-stage cervical cancers are treated with a radical hysterectomy operation, which involves removing the cervix, uterus, part of the vagina and nearby lymph nodes. A hysterectomy can cure early-stage cervical cancer and prevent recurrence. But removing the uterus makes it impossible to become pregnant.

INTERVIEWS

Dr. Toufic Eid MD (MBBS) FRCOG Obstetrician and gynaecologist Consultant at Clemenceau Medical Center in Dubai

“Advanced methods of early detection can avoid cervical cancer” JULY.AUG 2021

INTERVIEWS

lthough cervical cancer is the fourth most common cancer in the female population worldwide, but women are lucky as there are advanced tools of early diagnosis through periodic screening tests, cervical smears, and HPV vaccine. ‘Hospitals’ magazine recently interviewed Dr. Toufic Eid, MD (MBBS) FRCOG Obstetrician and gynaecologist Consultant at Clemenceau Medical Center in Dubai to highlight the advanced tools of diagnosis and treatment at CMC Dubai.

How common is cervical cancer? What are the recent key facts about this disease? Cervical cancer is the fourth most common cancer in the female population. In 2018, an estimated six hundred thousand women were diagnosed with cervical cancer worldwide and about half of them died from the disease. The Pap smear test was originally invented by George Nicholas Papanicolaou in the 1920s. He was a Greek physician and a pioneer in cytopathology. Pap smears allowed us to detect the very early cellular changes in the cervix that may become cancer in the future. This secondary prevention method has significantly reduced cervical cancer over the years and it was a major breakthrough in fighting this terrible disease. Recently, it was found that almost 99% of cervical cancer is due to an infection with highrisk HPV strains. Vaccines have been produced to combat the most common types of these viruses. It is estimated that global vaccination for HPV will reduce the risk of cervical cancer by more than 90%. Hence, primary prevention of cervical cancer is available by administering the vaccines. The current secondary prevention, a combination of cervical cell liquid cytology and HPV testing, has replaced the classic pap smear with much greater accuracy. With early detection and effective management cervical cancer is preventable and curable. Recently, the World Health Organization (WHO) has launched the “cervical cancer elimination initiative” through the widespread use of primary and secondary prevention worldwide. The objective is to abolish cervical cancer by 2030.

Who is at risk? ALMOST 99% OF CERVICAL CANCER IS DUE TO AN INFECTION WITH HIGH-RISK HPV STRAINS.

It has been established that HPV infection is the main vector for cervical cancer, which is sexually transmitted. Other factors that are associated with it is having aids or reduced immunity, smoking, women who use birth control pills for many years, and having given birth to three or more children and having several sexual partners.

How can women prevent or lower the risk of cervical cancer? Women can take steps to prevent cervical cancer by taking the HPV vaccine, practicing safe sex and quitting smoking. In our practice, advanced stages of cervical cancer patients are very rare. We believe it is because the primary and the secondary prevention for cervical cancer are applied.

How is cervical cancer diagnosed and treated?

PATIENTS THAT GET TO THE CERVICAL CANCER STAGE, THE BEST TREATMENT FOR THEM IS SURGERY AND THIS WILL BE USUALLY IN THE FORM OF RADICAL HYSTERECTOMY, REMOVING THE UTERUS AND THE CERVIX AND THE LYMPH NODES.

Women that develop abnormal cervical smear or have HPV high-risk positive results undergo colposcopy, which is an examination via a microscope that actually looks at the cervical cells. We can identify the abnormal areas in the cervix and treat them by freezing, cautery or resection. This is the treatment when we have abnormalities in the early pre-cancer stages. Patients that get to the cervical cancer stage, the preferred treatment is surgery and this will be usually in the form of radical hysterectomy, removing the uterus, cervix and the lymph nodes. There are other adjuvant therapies like radiation and chemotherapy that may also be incorporated.

What are the advanced treatments at Clemenceau Medical Center in Dubai? Surgery was classically done as open surgery; but nowadays it's done more and more laparoscopically. At Clemenceau Medical Center in Dubai, we use robot-assisted laparoscopic surgery to perform more precise resection and achieve better outcomes.

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Smoking and Pregnancy By Dr Dalila Znimi, Specialist Obstetrics and Gynecology at AlAhli Hospital / Qatar

moking and Chicha became social habits in the Middle East and especially in women. During pregnancy, some of them will continue smoking and to have a healthy newborn, it is very important to encourage decreasing tobacco consumption.

The prevalence of smoking during pregnancy in the world is estimated around 1, 7% (up to 20% in some western countries). The need of smoking is higher during pregnancy as the metabolic and renal clearance of the nicotine is increasing due to the changes in the physiology of the body. Therefore, the failure of weaning is predictable if no counselling and no supervision were done. Some risk factors are recognized such confinement at home, environment of smokers, depression… Antenatal visits and preconception visit are considered as the best time to stop smoking. As health professionals, we have to identify the smoker pregnant women as soon as possible. The Carbon Monoxide (CO) concentration measure in the expired air is an non-invasive and simple test used to identify smokers during pregnancy and post-partum. Some question tests as FTCD (Fagerstrom Test for Cigarette Dependence) and HSI (Heaviness of Smoking Index) are the most used for evaluation to nicotine exposure. The addiction to tobacco is evaluated by diagnostic criteria of DSM-V (Diagnostic and Statistical Manual of mental disorders version) The active smoking during pregnancy especially if heavy will increase risks of miscarriage,

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THE CARBON MONOXIDE (CO) CONCENTRATION MEASURE IN THE EXPIRED AIR IS AN NON-INVASIVE AND SIMPLE TEST USED TO IDENTIFY SMOKERS DURING PREGNANCY AND POST-PARTUM.

ectopic pregnancy, congenital abnormalities, placenta abruption, placenta praevia, intrauterine growth restriction and intrauterine fetal death. An increased number of cesarean and deep venous thrombosis during post-partum are even noticed. The passive smoking is responsible for increasing risk of preterm labor and there is an effect on the dose- dependency. There has been a decreased rate of preterm births since the restriction of smoking in public spaces. It is also associated with a high risk of stillbirth and intrauterine growth restriction < 2, 5 kg at birth. The consequences of smoking on the newborn and childhood life are multiple like infant sudden death, lower respiratory tract infection, asthma especially if combined with the environmental pollution, cognitive deficiency, hyperactivity & attention deficit and decreased school performance. A recent Irish study published that babies of mothers vaping (using E cigarettes exclusively) have the same birth weight compared to those not smoking. Vaping could be an alternative solution to those not able to stop smoking during pregnancy. Other products of vaping ( like Chicha or

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warm tobacco ) are not advisable as there is no clear data about their effects in pregnancy. However, the use of nicotine substitutive therapy (pastilles, gums or patches) during pregnancy and breastfeeding are allowed as long as it is under control of a health professional. It is reducing smoke exposure and no bad effects on the baby have been reported yet. Bupropion

( ZYBAN ) and other non nicotine substitutive therapy are definitely not recommended. In conclusion, the safest way is to not smoke or vape. If smoking cessation is impossible, vaping without nicotine would be the best option. However, vaping with nicotine could be if the withdrawal is still too difficult. The worst is to continue smoking even a few cigarettes.

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Baylor St. Luke’s Medical Center: Double lung transplant for 17-yearold patient, one of the Youngest COVID Transplants in The World younger patient, and No. 2, the patient neither died from COVID, and he didn’t recover either,” Loor said. “He was somewhere in between.

Dr. Gabriel Loor

ehind round, wire-rimmed glasses, Jose Chavez’s eyes flicked between his mother and his hands on his lap. He took shallow breaths with his new lungs as he spoke about his experience battling COVID-19, which he contracted in September 2020. He was 16 then, and only a few days back in virtual high school. Now 17, Jose underwent a double lung transplant in January 2021, making him one of the youngest “COVID transplants” in the world, according to his surgeon, Dr. Gabriel Loor, surgical director of lung transplantation at Baylor St. Luke’s Medical Center. “The doctors were saying that his lungs were like rocks,” said his mother, Ana, who was diagnosed with COVID-19 at the same time as her son. She was never hospitalized for her infection. A year into the coronavirus pandemic, COVID transplants are becoming more common for patients who get over the initial infection but can’t breathe without the help of a ventilator or extracorporeal membrane oxygenation machine (ECMO), Dr. Gabriel Loor said. But lung transplants, even for COVID-19, are exceedingly rare for 17-year-old boys. Much about Jose’s case is rare, said Loor. “No. 1, he’s a

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A YEAR INTO THE CORONAVIRUS PANDEMIC, COVID TRANSPLANTS ARE BECOMING MORE COMMON FOR PATIENTS WHO GET OVER THE INITIAL INFECTION BUT CAN’T BREATHE WITHOUT THE HELP OF A VENTILATOR OR EXTRACORPOREAL MEMBRANE OXYGENATION MACHINE (ECMO). DR. GABRIEL LOOR

COVID-19 hit four out of five members of the Chavez family last fall. Though they’re not sure where it originated, Jose’s father was the first to feel sick and test positive. From there, Jose, his mother, and his younger brother felt symptoms and took numerous COVID tests. Compared to Jose, the rest of his family had mild cases. But he ran a 105-degree fever for several days — Tylenol and fluids did nothing to help, his mother said. About eight days after his positive COVID test, the Brownsville teen was admitted to a hospital. And while he was moved to hospitals in three different cities — Harlingen, San Antonio, and Houston — one thing remained constant for the following five months: He lived in a hospital bed. He lost his ability to discern place and time, his mother said. On the rare occasions when he opened his eyes, Jose would groggily ask where he was. The answer always came: In the hospital. But he didn’t understand why. “Because you got very sick. The COVID never went away,” his mother would reply, adding that the condition of his lungs had only worsened. Even as the infection abated, Jose didn’t get better, much to his doctors’ confusion. Jose was an active teenager, playing tenor saxophone in his high school’s marching band — an activity that requires lung fitness. As a young child, he had mild asthma but never required an inhaler. Within the first few weeks in a hospital, Jose was intubated and placed on a ventilator that breathed for him. After his transfer to San Antonio, he was placed on ECMO support, which meant he breathed through an artificial lung. By early 2021, the COVID staff at Baylor St. Luke’s in Houston had begun developing its own practices for the 100 to 150 long-term patients on ECMO support.

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When the process works right, ECMO patients recover slowly, until they’re removed from that machine. Typically, they remain on the ventilator for a while longer. Once they’re removed from the ventilator, they are slowly weaned off additional oxygen, Loor said. But Chavez’s case was a “stalemate,” Loor said. Though his health wasn’t improving, the boy was well enough to be placed on a lung transplant list. And more evidence pointed toward his need for new lungs. Though the virus was no longer in his body, it “wreaked so much havoc” that the aftermath on Jose’s lungs would lead to irreversible lung damage and chronic lung disease, Loor said. Without the transplants, it was likely Jose would be connected to an ECMO machine to stay alive, Loor added. Loor began reaching out to transplant programs across the country to learn how they handled similar patients. While there is no official COVID transplant registry yet, everything Loor learned from the small network of transplantation surgeons worldwide leads him to believe Jose could be the nation’s youngest double-lung transplant. Jose’s young age has been a “silver lining” in terms of his transplant surgery and recovery, Loor said. “He has more reserve than the average person that has suffered from a chronic respiratory illness for many years,” Loor said. “If he happened to be older, undergoing transplant surgery stresses the body. Younger patients are up and out of bed in a day or two. ”Jose’s age and activity levels before he was sick helped him take deeper breaths and move quickly,'' Loor said. His younger body will likely respond better to immunosuppression medications he will need to take for the rest of his life. About three weeks after his surgery, Jose was finally discharged to live in a Houston rental house with his family for 95 days. He follows up with his doctor every two weeks and practices physical therapy for his newfound balance issues.

Loor believes that younger patients who receive transplants use good judgment and understand the risks of taking immunosuppression medicine, such as having a lower immune response. “They can even go parachuting, on expeditions or hikes,” Loor said. “He can really go about living a normal life, which is what we really want if he is cautious and takes his immunosuppression medicine.” At times, the last seven months have felt unreal to Jose — from the long hospital stay to living in Houston to taking new medications that work to keep his body from rejecting his new lungs.He’s ready to return to the Valley and attend his senior year virtually, he said.

BY EARLY 2021, THE COVID STAFF AT BAYLOR ST. LUKE’S IN HOUSTON HAD BEGUN DEVELOPING ITS OWN PRACTICES FOR THE 100 TO 150 LONG-TERM PATIENTS ON ECMO SUPPORT.

His mother is hesitant to let any of her three sons return to in-person school after Jose’s ordeal. From his cellphone, Jose shows off pictures of his transplant surgery proudly. He was interested in the medical field before his experience with COVID, and his surgery has solidified that goal. “I want to be a surgeon,” he said.

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

ARTICLE FEATURES . Robots in the Healthcare Sector

Robots in the Healthcare Sector They help healthcare providers complete the assigned tasks more quickly

here are many tasks performed by robots in health facilities and institutions, and in addition to the surgical robot in the operating room, there are robots that help the nursing staff perform most of the routine tasks that do not require direct communication with patients, in order for the nurse to spend more time caring for them. The need for this type of robots in hospitals has emerged during the spread of the coronavirus pandemic, which has exhausted the health personnel’s energy due to the enormous pressure and the hospitals filled with coronavirus patients, and the most important thing is to reduce human contact between the nurse and the patient, which prevents transmission of infection. The use of robots in the healthcare sector reflects the role of technology and artificial intelligence, which opened up broad horizons for increasing the role of robots and taking the pressure off caregivers for several reasons such as the emergence of pandemics and infectious viruses in addition to the growing population, increase in life expectancy and high healthcare costs. Robots can help healthcare providers complete tasks more quickly, with fewer errors. There is a surgical robot that has arms that can reach places where the human hand can't. Today, the demand for these robots is high in the field of laparoscopic, orthopedic and endoscopic surgery.

What can a robot do in a hospital? There is a wide range of functions that robots can perform in hospitals and health institutions in order to help doctors, surgeons, nursing staff as well as technicians with their daily routine tasks. Robots have greatly helped in facing the spread of coronavirus, as they can be used in disinfection, providing medicines and food to patients inside and outside quarantine, measur-

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ONE OF THE TASKS ASSIGNED TO ROBOTS IS TO PROVIDE FOOD AND MEDICINE TO PATIENTS IN HOSPITALS, ESPECIALLY IN CORONAVIRUS DEPARTMENTS. THEY ARE STERILIZED AGAIN BEFORE HELPING OTHER PATIENTS, TO REDUCE THE CHANCES OF CROSSCONTAMINATION.

ing vital signs, and preparing medical reports necessary to follow up on health conditions.

Sterilization There are robots dedicated to sterilization and disinfection by UV disinfection devices that use ultraviolet light to kill harmful microorganisms. These robots are used in places where infection can be spread such as coronavirus departments, which poses a threat to the lives of personnel, especially the ones responsible for the sterilization process, as these robots use ultraviolet rays to sterilize places within a few minutes. Robots can also be used to disinfect surfaces with built-in UV. It is known that coronaviruses live on hard surfaces for a specific time, which increases the possibility of transmission upon contact. Sterilization with these devices has proven to be highly effective in hospitals instead of manual disinfection, which requires large numbers of cleaners and puts them at risk of catching infection.

Measurement of vital signs Robots can also be used to measure vital signs and identify healthy patients. This robot enters the patient's room, digitally fills the required documents, monitors the patient's general condition, and takes vital signs such as blood pressure, temperature, and heart rate, thus reducing the risk of infection. One of the tasks assigned to robots is to provide food and medicine to patients in hospitals, especially in coronavirus departments. They are sterilized again before helping other patients, to reduce the chances of cross-contamination. This technology can be used in hospitals and linked with a facial recognition database to alert and warn patients and add any necessary information that may benefit their health and limit the spread of disease in the future.

ARTICLE FEATURES . Robots in the Healthcare Sector

Medicine Distribution In addition, robots in the hospital distribute, store and re-stock medicines automatically, while handling laboratory samples, disinfecting and sterilizing devices and equipment, reminding patients to take medicines, serving food at meal times, and making sure that medicines are taken correctly, which contributes to saving expenses and performing medical tasks accurately, reducing errors and allowing time for healthcare professionals to focus on patient care.

Rehabilitation Rehabilitation robots are available today to help people with certain disabilities after an accident or after a stroke who need physical therapy and rehabilitation sessions. These robots help increase their mobility and strength as they are programmed to suit the needs of each patient. These robots used in gait rehabilitation and mobility rehabilitation are used for various stages of rehabilitation where motor skills can

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REHABILITATION ROBOTS PROVIDE A NUMBER OF REPETITIVE MOVEMENTS BASED ON THE PATIENT'S NEED, AND THEY CAN ALSO BE USED TO CONTROL THE CHANGE OF THE VARIOUS EXECUTED MOVEMENTS WITHIN CERTAIN LIMITS.

be practiced safely and repetitively, and they reduce the effort exerted by physical therapists. These robots provide a number of repetitive movements based on the patient's need, and they can also be used to control the change of the various executed movements within certain limits. These steps help obtain successful training and learning to perform the required motor tasks and complete the process of balanced and safe walking.

Surgeon's Assistant Robot As for the operating rooms, the surgeon’s assistant robot has been significantly developed so that more complex and less invasive operations can be performed through the robotic arms, their mechanism of action and their ability to reach places that the surgeon’s hand cannot reach. Most importantly is the experience of the surgeon who controls these arms, as he can see what is happening inside the patient's body through high-resolution 3D imaging technology.

ARTICLE FEATURES . Medical Colleges

Medical Colleges after the Covid-19 Pandemic New majors and programs that simulate the future

any researchers and stakeholders have talked about many changes that the world will witness after the coronavirus subsides. Among these changes are the emergence of new specializations that are expected to receive great demand after the pandemic subsides, amid expectations that the crisis will lead to millions of unemployed people in the world. It is expected that there will be high demand for crisis management consultants and financial consultants. Experts expect that a large number of companies will work remotely, so the demand for programmers and time management specialists will increase. After the spread of the coronavirus crisis, medicine has proven that it has regained its position as the most important science for humans, as the status of doctors in the whole world has risen after medicine became the first and last hope in discovering the treatment that would save the world. The world no longer cares about any of the other sectors. Flights, factories and events have stopped, but the concern was that a hospital would not stop providing service to an infected person. Therefore, according to the opinion of many experts in the medical and educational fields, the study of medicine will move to a higher position, and specializations that were not known before become essential with the great transformations caused by the pandemic. After the expected demand for medical specialties, universities are expected to expand their medical faculties of all kinds, and it will become important to develop medical sciences and the institutions that teach them in order to keep pace with this increasing demand. Also, institutions that teach medicine will put the issue of saving the world from pandemics as their top priority given what we have seen in the past months, which will affect the curricula and their development, and increase the attempt to focus on instilling medical values in medical students.

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The coronavirus crisis has proven the urgent need for personnel specialized in Emergency Medical Sciences, Respiratory Care Sciences, Medical Laboratory Analysis and Laboratory Research, Health Management and Disease Outbreak Control, medical assistance and support experts and biotechnology.

Post-pandemic transformations Many specialists assert that epidemiology has increased in importance after the emergence of the coronavirus crisis, and it is a science specialized in the study of epidemics and the analysis of their data and their impact on societies and the world. After the Covid-19 crisis and its major repercussions, this science related to medicine will be greatly activated. It is expected that the interest to study and research it, learn about its details and dive into it, will increase. Epidemiology has become one of the most important sciences affected by the coronavirus crisis, especially after it became widespread in all countries of the world. University hospitals have always played a major role in containing the medical isolation for coronavirus in all countries affected by the pandemic. This has led universities to significantly increase investment in these hospitals, which will enhance the medical education process everywhere. It is also expected that grants in this field will increase in various universities around the world, whether to fill the gaps in dealing with the virus, or to meet the increasing demand in medical specialties, especially new ones. Universities started announcing new Master’s programs related to medical sciences, which were launched in line with the Covid-19 outbreak, such as Master of Science in Adult Critical Care Nursing in the Health Sciences Faculties, Master of Science in Environmental Health, Master of Science in Environmental Engineering in Colleges of Engineering in a number of well-known universities. In addition to doctorate programs in pharmacy that are compatible

THE CORONAVIRUS CRISIS HAS PROVEN THE URGENT NEED FOR PERSONNEL SPECIALIZED IN EMERGENCY MEDICAL SCIENCES, RESPIRATORY CARE SCIENCES, MEDICAL LABORATORY ANALYSIS AND LABORATORY RESEARCH, HEALTH MANAGEMENT AND DISEASE OUTBREAK CONTROL, MEDICAL ASSISTANCE AND SUPPORT EXPERTS AND BIOTECHNOLOGY.

University hospitals have always played a major role in containing the medical isolation for coronavirus in all countries affected by the pandemic. This has led universities to significantly increase investment in these hospitals, which will enhance the medical education process everywhere.

ARTICLE FEATURES . Medical Colleges

with the updates and developments imposed by the pandemic, in terms of new medicines or the development of the relationship between the pharmacy and the patient. Multiple disciplines have emerged, representing technology as the common factor among them, developing programs that focus on applied work and not only theory, developing curricula for supportive healthcare disciplines, strategic planning and crisis management to deal with non-traditional developments, where the traditional framework of curricula and teaching methods is no longer effective. University and medical institutes officers consider that there is no alternative to finding radical changes in educational outcomes and evaluation mechanisms and the use of many methods that combine the virtual and the conventional. This requires special teaching skills and the use of educational, technical and behavioral resources and sources. Universities say that they are in the process of updating and developing all their current specializations in the medical, administrative and information fields, especially those related to crises and disasters, in addition to preparing educational programs that take into account the economic and digital transformation, reliance on artificial intelligence, and programs on future foresight through big data analysis.

New Colleges and Majors The Medical College recently started introducing new programs that fit with the new medical reality after the Covid-19 experience, including a Bachelor of Science in Respiratory Care and a Bachelor of Science in Emergency Medical Services with the aim of diversifying medical programs in the specialties required locally and internationally while focusing on preparing specialized personnel in medical fields due to the urgent need for specialization within the medical sector. Medical college officials in the Gulf region believe that the medical sciences and technology majors will witness an increasing demand due to their proven importance, and the human need for them during the coming period locally and globally, in addition to the great need for

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specialized personnel in times of crises and disasters. They point out that the most important disciplines that will be introduced and will witness an increase and momentum are digital crisis management, crisis logistics, biotechnology, artificial intelligence and decision-making, in addition to bioengineering, medical laboratory analysis sciences, viral and laboratory research and supportive medical services in its various branches. They state that most of these majors exist on a global level and some of them are the result of recent developments, expecting that introducing these programs in the region will increase soon during the next two years with a new perspective focusing on the global experience of the coronavirus pandemic and with advanced technical educational methods. This aims to prepare specialized staff to benefit from their capabilities during crises, including a Bachelor of Science in Molecular and Cellular Biology, a minor in cybersecurity and artificial intelligence in computer engineering and computer science, as well as a minor in mechatronics. Some universities have included in the programs new materials in various scientific disciplines related to crisis management, first aid and emergency handling, because of their great role in supporting students to be active within their current specializations. Managers and university professors suggested merging disciplines to graduate multi-skilled generations, constantly studying market needs, and focusing on specializing in digital crisis management.

The Gulf and Keeping Pace with Modernization The fight against the coronavirus in the world showed the urgent need for every student to arm themselves with the knowledge related to crises of all kinds in order for them to possess the necessary skills to be more resilient in the future. This is what universities around the world have been working on vigorously, including, of course, universities in the Arab world in general and the Gulf in particular. Among the main disciplines are new programs in Health Science colleges related to medical analysis, molecular genetics, molecu-

SOME UNIVERSITIES HAVE INCLUDED IN THE PROGRAMS NEW MATERIALS IN VARIOUS SCIENTIFIC DISCIPLINES RELATED TO CRISIS MANAGEMENT, FIRST AID AND EMERGENCY HANDLING, BECAUSE OF THEIR GREAT ROLE IN SUPPORTING STUDENTS TO BE ACTIVE WITHIN THEIR CURRENT SPECIALIZATIONS.

In the Gulf, many universities have introduced new majors and courses for students, including what came due to the repercussions of the global health crisis “Covid-19” and the experiences of the countries of the world, and others that keep pace with the timing of the pandemic based on the labor market needs.

ARTICLE FEATURES . Medical Colleges

lar and cellular biology, specializations in crisis management, future foresight through big data analysis, a postgraduate diploma in ultrasound technology applications in the College of Medicine and a minor in mechatronics as well as cybersecurity and artificial intelligence, a master’s degree in digital transformation and information systems, as well as in healthcare management, in addition to updating and developing current specializations in the medical, administrative and information fields, especially those related to crises and disasters. Prestigious universities launched new programs in Faculties of Health Sciences, namely medical laboratory analysis, molecular and medical genetics, nutrition and diets, in order to keep pace with the current needs in light of the present health crisis as well as the future one associated with the labor market, indicating that they focused their attention on the opening of these faculties in line with the expectations of an increase in the local universities’ interest to introduce scientific, medical and technical specializations and crisis management. New colleges of engineering and health sciences programs meet the needs in the engineering and technological fields, including biomedical engineering, cybersecurity engineering and industrial engineering, all of which are very

important programs with great demand. The aforementioned universities confirmed that new specializations are expected to open later, indicating that the market needs are continuously studied within a meticulous plan to develop and approve new programs in cooperation with the Ministries of Education in the GCC countries, seeking to ensure the introduction of programs that meet the needs and aspirations and attract students to study them. In this context, introductory seminars are held constantly to introduce the currently available programs in the disciplines that are in an urgent situation, either now or in the future. A Master's degree in counseling and psychology was introduced, in response to addressing the major psychological repercussions caused by the coronavirus pandemic in societies. Some of them intend to reintroduce the Master's program in healthcare management soon. New Master's programs are currently being prepared and are expected to be launched in the academic year 2021-2022. According to doctors and academics, over time, practice may show the need for other specializations, and universities will not hesitate to include them in their programs to meet the demand and improve the medical and hospital level in the region.

NEW COLLEGES OF ENGINEERING AND HEALTH SCIENCES PROGRAMS MEET THE NEEDS IN THE ENGINEERING AND TECHNOLOGICAL FIELDS, INCLUDING BIOMEDICAL ENGINEERING, CYBERSECURITY ENGINEERING AND INDUSTRIAL ENGINEERING, ALL OF WHICH ARE VERY IMPORTANT PROGRAMS WITH GREAT DEMAND.

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Acibadem University

cıbadem University, founded in 2007 by Acıbadem Health and Education Foundation, focuses on excellence in the field of health sciences. There are two main goals that stimulate the establishment and development of the University: the first one is the desire to transfer the experience and knowledge gained while providing high-quality health services in Acıbadem Healthcare Group to future generations; the second is the enthusiasm in working with Turkey's leading academics both within the group and in the University to contribute to developments in the health sciences with their student training and research. The University pursues its goals with the vision of pioneering innovations in education, research and services in health, life and social sciences as well as becoming one of the best universities in Turkey and one of the world's leading universities. The university provides education with 14 departments in 5 faculties, 18 programs in 2 vocational schools with associate degree educa-

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THE UNIVERSITY PROVIDES EDUCATION WITH 14 DEPARTMENTS IN 5 FACULTIES, 18 PROGRAMS IN 2 VOCATIONAL SCHOOLS WITH ASSOCIATE DEGREE EDUCATION, AND 37 GRADUATE PROGRAMS IN 4 INSTITUTES.

tion, and 37 graduate programs in 4 institutes. These are as follows: Faculty of Arts and Sciences, Faculty of Engineering, Faculty of Health Sciences, Faculty of Pharmacy, School of Medicine, Vocational Schools, Institute of Health Sciences, Institute of Natural and Applied Sciences, Institute of Senology Research and Institute of Social Sciences. The university has approximately 5,000 students in the academic year of 2020-2021 and over 6,000 graduates.

The medium of instruction in the following departments and faculties is English: •

• •

Faculty of Arts and Sciences: Departments of Psychology and Molecular Biology and Genetics. Faculty of Engineering. Faculty of Health Sciences: Departments of Nursing and Nutrition and Dietetics. Faculty of Pharmacy. School of Medicine.

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Acıbadem University has 2 affiliated hospitals: Acıbadem Mehmet Ali Aydınlar University Atakent and Maslak Hospitals, both of which are accredited by the Joint Commission International (JCI) for clinical applications and field training. The University has 12 centres for carrying out research, application and training activities. In addition to research-practice activities, inter-unit multidisciplinary studies are also carried out in the centres. Within the scope of University-industry cooperation, joint projects are created with national and international institutions and organizations.

The Campus That Generates Its Own Energy The University’s Kerem Aydınlar campus, an area of 100,000 square meters located on the Anatolian side of Istanbul, was built with sustainability criteria in mind and has achieved LEED Gold (Leadership in Energy and Environmental

ACIBADEM UNIVERSITY HAS 2 AFFILIATED HOSPITALS: ACIBADEM MEHMET ALI AYDINLAR UNIVERSITY ATAKENT AND MASLAK HOSPITALS, BOTH OF WHICH ARE ACCREDITED BY THE JOINT COMMISSION INTERNATIONAL (JCI) FOR CLINICAL APPLICATIONS AND FIELD TRAINING.

Design) certification. The buildings in the campus are designed with an environmental-friendly approach based on energy efficiency and savings. On campus, clean energy is produced with renewable energy plants such as solar panels and wind turbines.

The Most Comprehensive Simulation Centre in the World; ACU CASE Kerem Aydınlar Campus is replete with high-technology equipment and offers students a privileged university life. Clinical Simulation and Advanced Endoscopic - Robotic Surgery Training Centre (CASE), is one of the two medical simulation centres in the world to receive the “Centre of Excellence” award from the CAE Healthcare Academy. Pre and post-graduate training programs are carried out at the centre, where an innovative education model is applied with simulated patients, virtual / mixed reality-based training laboratory and skill lab-

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oratories and advanced technological medical simulators. The Centre consists of two departments: the Clinical Simulation Training Centre and the Advanced Level Endoscopic - Robotic Surgery Training Centre. The Clinical Simulation Training Centre uses a blended training methodology for students with electronic learning, simulated patients and simulation applications. Medical simulation training is used in conjunction with training modules in the virtual reality laboratory. In the Clinical Simulation Training Centre, designed as a virtual hospital, students are prepared for internships in clinical training by implementing different crisis scenarios. Postgraduate specialist training is carried out at the Advanced Endoscopic - Robotic Surgery Training Centre, established to develop the skills of specialist surgeons in the field of endoscopy and robotic surgery. Over 100,000 participants have been

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CASE IS ACCREDITED BY THE NETWORK OF ACCREDITED CLINICAL SKILLS CENTRES OF EUROPE (NASCE) AND THE SOCIETY FOR SIMULATION IN HEALTHCARE (SSH). CASE ALSO HAS THE TITLE “GLOBAL TRAINING CENTRE” IN THE FIELD OF ROBOTIC SURGERY.

trained so far in the centre, established in 2013. CASE is accredited by the Network of Accredited Clinical Skills Centres of Europe (NASCE) and the Society for Simulation in Healthcare (SSH). In addition to these, the centre is also one of the few centres in the world accredited by SSIH in the field of "Simulation Research." CASE also has the title “Global Training Centre” in the field of robotic surgery.

“Research-oriented University” One of the main fields of activity in Acıbadem University is research. Neuroscience, Biotechnology, Cancer Research, Rare Diseases, Biomedicine, Health Policy and Basic Sciences are the priority areas, which are supported by laboratories equipped with advanced technological infrastructure and devices to enrich the programs. The Biomaterials and Nanotechnology centres are also highly valued platforms that

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contribute to the multidisciplinary approach in science at the University. The Acıbadem University Nano Biotechnology Centre has the Molecular Modeling Laboratory, Advanced Bioanalysis Laboratory, Biomimetics Laboratory, Sensors and Functional Materials Laboratory, Mammalian and Bacterial Cell Culture laboratories, Brain-Mind Laboratory, Biomechanics Laboratory, Data Analytics Laboratory and Central Research Laboratory. The centre is fully supported with high-tech equipment, from high-resolution digital PCR systems that allow preoperative diagnosis of cancer diseases to a peptide synthesis device used in the synthesis of biotechnological drug molecules inspired by nature. The Acıbadem University Biomaterials Centre is a laboratory equipped with basic and hightech devices required for biomaterials studies. The Centre exists with the mission of catalysing research and development on biomaterials, tissue engineering and regenerative medicine and ensuring their application in the field of health.

“Acıbadem University Incubation Centre Supports innovative and entrepreneurial ideas” Being a university in the heart of the health ecosystem, Acibadem University founded the

KEREM AYDINLAR CAMPUS IS REPLETE WITH HIGH-TECHNOLOGY EQUIPMENT.

Incubation Centre, in 2017, in order to transfer its wealth of knowledge and energy to new business ventures. New business ideas in the health field and their subsequent transformation to production distinguish the Acibadem University Incubation Centre among incubation centres specific to health. The Acıbadem University Incubation centre focuses on supporting new companies that will shape the future of the health sector, pursuing an international reputation as an institution where entrepreneurs can create innovative solutions to complex problems and issues of great interest to patients, healthcare professionals and the community. The centre aims to facilitate entrepreneurs’ learning, application, and work-planning processes by providing access to the expertise of academics at the University and the University’s technical infrastructure and labs as well as the companies and partner institutions affiliated with the University. Beyond the start-up level, the companies which are at different steps of installation can also be featured in funding and commercialization opportunities. The Centre is currently supporting more than 180 projects.

INTERVIEWS

Chief of Gastroenterology, Hepatology and Nutrition at Nationwide Children’s Hospital

Carlo Di Lorenzo, MD “Our faculty has visited Arab countries and I have personally participated in clinical activities in Dubai. We routinely discuss patients and provide consultations with several of our colleagues in South America and Europe”

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. Carlo Di Lorenzo, MD, is chief of the Division of Pediatric Gastroenterology, Hepatology and Nutrition, and is widely regarded as one of the world’s top experts in diagnosing and treating functional neurogastrointestinal and motility disorders in children. "Hospitals" magazine recently interviewed Dr. Di Lorenzo about his work at Nationwide Children’s Hospital.

What are some uncommon or particularly challenging conditions treated in the motility center at Nationwide Children’s Hospital? The Motility Center at Nationwide Children’s Hospital evaluates and treats children and adolescents with any type of motility or functional gastrointestinal disorder. Some of the most challenging diseases for which the Motility Center has developed unique and innovative expertise include: Pediatric intestinal pseudo-obstruction (PIPO): This is a condition in which the gastrointestinal tract has such poor motility that the child is often not able to eat by mouth and needs tube feeding or parenteral nutrition. Testing in our center helps determine what areas of the intestine are affected by the disease, if there is a nerve or a muscle disease, and how to direct medical and surgical treatment.

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PATIENTS FROM 12 DIFFERENT COUNTRIES HAVE BEEN REFERRED TO OUR CENTER AND HAVE BEEN EVALUATED BY OUR TEAM.

Gastroparesis: Children with gastroparesis often have severe nausea, vomiting and early satiety. Our Motility Center offers innovative treatments for this condition such as gastric electrical stimulation, injection of botulinum toxin and pylorus and pyloric dilatation Rumination syndrome: This is a disorder which is being recognized with increased frequency in children of any age. The Motility Center offers the only multidisciplinary treatment to this condition in both the outpatient and in-hospital setting Post-surgical defecation disorders: Patients who have had surgery for Hirschsprung disease or anorectal malformations often continue to struggle with symptoms even after surgery. The Motility Center is part of the Center for Colorectal and Pelvic Reconstruction and collaborates with several other specialists to diagnose and treat, with innovative technologies, the anatomical or physiological problems that are responsible for the child’s symptoms.

INTERVIEWS

What are the different disciplines involved in diagnosing and treating motility disorders in children? We have a diverse team of experts representing the key disciplines. These include pediatric and adult gastroenterologists, colorectal and general surgeons, urologists, interventional radiologists, otorhinolaryngologists, dietitians, psychologists, psychiatrists, occupational and speech therapists. They are all part of the Motility Center. We meet weekly to discuss those patients referred to the center and determine our best approach to treatment.

What are some of the latest advancements in treating children with motility disorders? Several new medications with the potential of improving motility and sensory function of the gastrointestinal tract have been developed in the past 10 years. We have also discovered that some medications which were initially used to treat different diseases (infections, myasthenia gravis, acromegaly, spasticity, etc.) have a beneficial effect on gastrointestinal motility. Neurostimulation of different areas of the intestine has also shown great promise in improving symptoms of children with nausea, abdominal pain and constipation. Surgical interventions, albeit a last-resort treatment, are

now being tailored to each patient based on the radiological and manometric tests that we use to determine how a patient’s gastrointestinal tract is functioning.

How have you been involved with international outreach over the past few years? Our faculty has visited Arab countries and I have personally participated in clinical activities in Dubai. We routinely discuss patients and provide consultations with several of our colleagues in South America and Europe. Patients from 12 different countries have been referred to our center and have been evaluated by our team.

WE HAVE A LONGSTANDING AND VERY FRUITFUL COLLABORATION WITH EMMA CHILDREN'S HOSPITAL, IN AMSTERDAM, THE NETHERLANDS, WITH EXCHANGE OF VISITING SCHOLARS, WHICH HAS PRODUCED MORE THAN 40 PEER-REVIEW PUBLICATIONS IN THE PAST 15 YEARS.

Do you or members of your faculty take part in international research collaborations? We have a long-standing and very fruitful collaboration with Emma Children's Hospital, in Amsterdam, the Netherlands, with exchange of visiting scholars, which has produced more than 40 peer-review publications in the past 15 years. Currently we have ongoing research collaborations with researchers in Italy, the Netherlands, United Kingdom, Australia, Argentina and several other countries. We value those relationships and hope to expand them in the coming years.

To learn more about Nationwide Children’s Hospital and Dr. Di Lorenzo, visit NationwideChildrens.org/GI

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Scoliosis By Dr. Ahmed Tayeh, Specialist Pediatrician Al-Ahli Hospital / Qatar

coliosis is a deformity of the backbone (spine). It’s when the spine has a side-to-side curve. The curve of the spine measures 10 degrees or more. A normal spine appears straight when looked at from behind. But a child with scoliosis has a spine with an S or C shape. The child may look like he or she is leaning to one side. The curve can happen on the right or left side of the spin. Or it can happen on both sides in different sections. Both the middle (thoracic) and lower (lumbar) spine may be affected.

Causes In most cases, the cause of scoliosis is not known. A child may be born with it. Or he or she can develop it later in life. It’s most often seen in children between the ages of 10 and 18. It tends to affect more girls than boys.

Possible causes of scoliosis include: • • • • • •

Nervous system problems like cerebral palsy or muscular dystrophy Inherited conditions that tend to run in families Differences in leg lengths Injury Infection Tumors

Symptoms The following are the most common symptoms of scoliosis. Symptoms can occur a bit differently in each child. They can include: • Difference in shoulder height. • The head not centered with the rest of the body. • Difference in hip height or position • Difference in shoulder blade height or position. • Difference in the way the arms hang beside the body when the child stands straight. • Difference in the height of the sides of the back when the child bends forward.

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FINDING SCOLIOSIS EARLY IS IMPORTANT FOR TREATMENT. IF LEFT UNTREATED, SCOLIOSIS CAN CAUSE PROBLEMS WITH HEART AND LUNG FUNCTION.

These symptoms may seem like other back problems. Or they may be a result of an injury or infection. Make sure your child sees his or her healthcare provider for a diagnosis.

Diagnosis Your child’s healthcare provider can diagnose scoliosis with a complete health history of your child and a physical exam. Your child may also need these tests: X-rays. This test makes images of bones. It is the primary tool for diagnosing scoliosis. It measures the degree of spinal curvature. MRI. This test uses a combination of large magnets and a computer to make detailed images of organs and structures within the body. CT scan. This test uses X-rays and a computer to make detailed images of the body. Finding scoliosis early is important for treatment. If left untreated, scoliosis can cause problems with heart and lung function. Healthcare providers, and even some school programs, routinely look for signs of scoliosis in children.

Treatment Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. The goal of treatment is to stop the curve from getting worse and prevent deformity. Treatment may include:

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Observation and repeated exams. Your child will need to see his or her healthcare provider often to check on the curve of his or her spine. Whether the curve gets worse depends on the amount of skeletal growth, or how skeletally mature your child is. Curving

• •

of the spine often slows down or stops after a child reaches puberty. Bracing. If your child is still growing, he or she may need a brace for some time. Surgery. Your child may need surgery when the curve measures 45 degrees or more on an X-ray.

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It shouldn't hurt to be a nurse

orking in the healthcare service is very strenuous and sometimes also stressful, especially for nurses, considering that 90 percent of nurses are women. Occasionally, the nursing staff has to lift up to 1,8 tons during one shift. Koen De Doncker, ergonomist and product manager, helps nurses with ergonomic moving and handling patients. His goal is to share tips and instructions for ergonomic execution of daily nursing routines. “Many nursing activities have a common problem. They are carried out in a posture when the nurse is bent forward. This unfavorable angle places excessive physical strain on the body and often leads to back pain and other musculoskeletal complications. When the body is in the normal, neutral and recommended position, even larger loads can be moved,” explains Koen de Doncker.

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The right bed can make a difference Notably for activities during basic care, nurses often have to lean forward, for example to be able to wash the patient's legs or feet. Patients with high weight often need to be moved and the body reacts to unfavorable working angles in the medium and long term

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ELECTRICALLY ADJUSTABLE BEDS GIVE NURSES A NUMBER OF OPTIONS TO SUPPORT ERGONOMIC MOVING & HANDLING OF THE PATIENT.

with symptoms and injuries – a consequence of excessive and one-sided loads during lifting and repositioning. Electrically adjustable beds give nurses a number of options to support ergonomic moving and handling of the patient. Especially medical beds with the lateral tilt feature can significantly reduce the physical strain of caregivers and give the patient more comfort during turning.

Some of the basic principles to reduce strain on the body • • • • • • • • • • •

Use as many tools as possible, such as a height-adjustable bed or a sliding mat. Ensure sufficient (movement) space. Always set the bed to a comfortable working height for you. Keep your back straight. Always lift from your legs. Find a stable posture (e. g. legs standing sideways or offset). Make movements by shifting your body weight in the same direction. Work as much as possible with your arms outstretched. Hold your palms down to minimize strain on your arms and back. Avoid back pain by using a firm and stable stance. If necessary ask a collegue for help.

LINET Academy – 15 years of training experience To learn more about the best practice of moving and handling techniques, contact the LINET MEA team for made-to-measure trainings by LINET Academy. This training centre with more than 15 years of training experience provides specialised courses and hands-on workshops for caregivers, focused on training for real-life situations in daily nursing practice and elimination of harmful stereotypes for in-bed patient care. Almost 1.000 nurses from the region were already trained by LINET Academy. Join LINET Academy and improve patient positioning and in-bed patient care with the effective usage of medical beds in daily nursing practice.

Experience LINET Academy with Koen de Doncker, Ergonomist & Product Manager https://www.youtube. com/watch?v=N_ 0jp293Xv8

Follow @linetmea on LinkedIn & Instagram

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Scoliosis Awareness Month... What a parent needs to know?

Professor Ahmet Alanay

ssala Benamara was diagnosed with congenital scoliosis when she was only four months old. By the age of 7, the condition progressed enough to cause neurological injury and made her unable to walk or feel her legs and control her bowel and bladder function. Despite the treatment in her home country, Algeria, severe kyphoscoliosis threatened the young girl to spend her life in a wheelchair. Scoliosis is a spinal deformity that affects around 3% of adolescents. It looks like a sideward curve of the spine. When combined with an outward curvature, it forms kyphoscoliosis. While mild cases might not need any treatment, severe spinal curves that progress over time can be a disabling and life-threatening condition. If left untreated, they cause chronic pain, respiratory

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MOST PEOPLE THINK THAT SCOLIOSIS IS A RARE CONDITION AND THE AFFECTED PEOPLE ARE VISIBLY HUNCHED OVER. ON THE CONTRARY, SCOLIOSIS IS THE MOST COMMON SPINAL DEFORMITY DETECTED IN CHILDHOOD.

and cardiac problems, poor quality of life and reduced lifespan. Early detection is the key to successful and less invasive treatment, warns Professor Ahmet Alanay, an eminent specialist in orthopaedics and traumatology at Acibadem Maslak Comprehensive Spine Center. The leading institution for spine care in Turkey is committed to early detection, prevention, and advanced treatment of scoliosis. Every year in June, Acibadem marks Scoliosis Awareness Month, organizing events and providing useful information about the condition. The purpose is to increase public awareness and help parents and medical providers to understand better and recognize faster spinal deformities in children.

Scoliosis facts and myths Most people think that scoliosis is a rare condition and the affected people are visibly

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hunched over. On the contrary, scoliosis is the most common spinal deformity detected in childhood. The onset is usually between 10 and 15 years of age. However, it may show up earlier or later in life. In some children, scoliosis might be inborn or related to other neurological or muscular disorders, such as cerebral palsy. In nearly 8 out of every 10 cases, the cause of scoliosis is unknown. This is usually called idiopathic scoliosis. Risk of scoliosis becomes 10 times higher for girls during puberty, says Prof. Dr Alanay. A spine deformity of 0 to 20 degrees is not noticeable from the outside, and between 20 and 40 degrees it can be noticed only on a naked body. Unlike the common belief, a straight posture is not a guarantee against scoliosis.

Home screening takes minutes but can change lives A parent is often the first to notice when a child has one shoulder higher than the other, or see uneven waist or hips. All of these may be warning signs of scoliosis. A regular home screening can help in early detection and intervention. The home exam involves evaluation in standing and forward bend position: the child bends at the waist until the spine gets parallel to the floor. Parents should watch out for any asymmetrical parts of the lower or upper back,

EARLY DETECTION IS THE KEY TO SUCCESSFUL AND LESS INVASIVE TREATMENT.

shoulder blades, hips, waist, or a rounded back. In a straight position with arms down, a bigger gap between one arm and the torso compared to the other side or tilted body might also be alarming. If you spot any of these symptoms, refer to a specialist as soon as possible, says Professor Alanay. Mild scoliosis cases need only medical observation, while moderate curves can be corrected through the right exercises and bracing. Without proper early measures, the risk of progression increases, and the treatment becomes more difficult.

Advanced surgical options for severe scoliosis When the curvature develops over time and exceeds 45 degrees, it reduces the space within the chest, making it difficult for the lungs and heart to function properly. For severe scoliosis, the standard treatment is surgery involving spinal fusion. The procedure stabilizes the spine with screws and rods, and it is highly effective. Nowadays, high-tech equipment helps to improve safety and eliminates the risk of injury during spine surgery. At Acibadem, spinal navigation and neuromonitoring enhance the safety and success rates of spinal operations. For a specific group of scoliosis patients, an innovative surgery called Vertebral Body

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Tethering (VBT) can be an alternative to spinal fusion. This is a highly advanced procedure performed by a handful of medical teams worldwide. Preserved spinal flexibility while the spine keeps growing and a shorter recovery period are strong advantages of VBT. After the minimally invasive procedure, the child can go back to school within a week or two and engage in all types of sports 3 months later. The spinal deformity is partially corrected during the surgery, and spontaneous correction continues over time, with the patient’s growth. The Acibadem Maslak Comprehensive Spine Center was the first one to apply the new method outside of the USA, where it was first invented. During the last 7 years, more than 100 patients have been successfully treated with Vertebral Body Tethering at Acibadem, which makes it one of the most experienced centres around the world.

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HIGH-TECH EQUIPMENT HELPS TO IMPROVE SAFETY AND ELIMINATES THE RISK OF INJURY DURING SPINE SURGERY.

Amazing results and a better future for scoliosis patients 7-year-old Assala, who was about to stay immobile due to severe kyphoscoliosis and had exhausted the treatment options in her home country, was brought to Acibadem Hospitals in Turkey by her family. “I researched the advantages of the Acibadem hospital on the social media sites, on the internet, but when I came here and I had my first-hand experience with the hospital, I was very surprised by the warm welcome and the expert medical care this hospital offers to patients from all over the world,” says Assala’s father, Fodel Benamara, who is a primary education teacher. Actually, Assala had two serious problems at the same time: severe spinal deformities and significant loss of neurological functions. “We had to react quickly and do a surgery to decom-

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press her spinal cord and relieve it, which might hopefully end up with recovery in her neurological function and make her able to walk again,” explains the spinal surgeon Professor Ahmet Alanay. The medical team experienced in complex cases planned a high-risk surgery in two stages. As a first step, three deformed vertebrae were removed to ease the pressure on the spinal cord and replaced by a cage. Three days later, the surgery was completed by full correction of the deformity. After the operation, Assala had a quick recovery of neurological functions: she could feel her body again and was able to move the fingers, knees and hips of her legs. “Having all these functions back in a very short period gave us big hope about her future. We believe that with good rehabilitation, she will be able to walk again,” Prof. Alanay commented. In order to preserve the fixation, the girl will have to wear a halo brace for a period of 3 to 6 months. After 6 weeks of the surgery, Assala came walking to her follow-up control.

A STRAIGHT POSTURE IS NOT A GUARANTEE AGAINST SCOLIOSIS.

Assala’s father, Fodel Benamara, is now optimistic about the future: “Assala’s condition has improved and, in fact, I am amazed by the result. There is an improvement and all doctors agree that we’ll see bigger improvement as the rehabilitation continues and with daily exercise for some time. God willing, the future will be better, better than now.

ARTICLE FEATURES . Endoscopic Spine Surgeries

Endoscopic Spine Surgeries Minimal surgical intervention, fewer complications, less pain and high success rates

ndoscopic spine surgery is one of the breakthroughs of modern medicine that reflects the technological progress, as the operation is carried out effectively and safely through small incisions with minimal complications and less pain under local anesthesia.

It is like a revolution in the world of spine surgery, and it receives great attention by doctors because they know its benefits on patients, such as mild pain, short hospital stay, speed of recovery, and less risk of infections, as well as avoiding vertebral fixation operations, making them safer. During the operation, the surgeon determines the place through which the endoscope will be inserted, which is a device in the form of a cylinder with a diameter of less than 1 cm, at the end of which is a very small lens that allows a clear view of the inside of the patient's back on the computer screen as it is magnified several times, increasing the accuracy, efficiency and safety of the operation. This type of operation is often done from the side of the spine and not from the back, and from an opening of about half a centimeter, it is performed under local anesthesia. In addition to some medications that the patient takes intravenously, the patient can walk and leave the hospital on the same day. Endoscopic spine surgery allows the successful treatment of many cases, and one of which is when the cartilage is pressing on the nerves, or when the patient suffers from a narrowing in the nerve cavity or as it is known as the bone pressure on the nerves. These operations are performed with minimally invasive spine surgery, which led to a change in the prevailing perception of risks and complications that may occur during or after spine surgeries, such as paralysis, excruciating pain, or a large wound. Through small incisions that do not exceed one or two centimeters, disc operations, spinal canal expansion (laminaplasty) and spinal fibro-

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ENDOSCOPIC SPINE SURGERY ALLOWS THE SUCCESSFUL TREATMENT OF MANY CASES, AND ONE OF WHICH IS WHEN THE CARTILAGE IS PRESSING ON THE NERVES, OR WHEN THE PATIENT SUFFERS FROM A NARROWING IN THE NERVE CAVITY OR AS IT IS KNOWN AS THE BONE PRESSURE ON THE NERVES.

sis operations can be performed, in addition to operations to remove spinal tumors or back pain resulting from spinal stenosis. Endoscopic spine surgeries are mostly performed under local anesthesia, which means that the patient can leave the hospital on the same day with minimal complications, unlike large traditional surgery that requires a longer hospital stay, as well as the risk of wound infection and bleeding, especially if the patient is an elderly or suffers from chronic diseases.

Endoscopic Discectomy It is one of the modern surgeries that orthopedic surgeons resort to in 70% of cases. Under anesthesia, a small metal tube is inserted to the spine for direct visualization. This tube serves as a passage for the surgical tools so that the patient’s muscles do not have to be torn or cut. Then, the annular tear, bulging disc, or herniated disc can be found easily under direct visualization looking through the tube. Under the guidance of the x-ray fluoroscopy and direct visualization, a piece of the herniated disc is pulled out with a grasper. A small disc bulge or annular tear can be treated with a laser, which vaporizes disc material, kills pain nerves inside the disc, and hardens the disc to prevent further leakage of disc material to the surrounding nerves. Finally, the tube is removed and the incision is closed with a stitch or two. Endoscopic Discectomy is a true minimally invasive spine surgery that include the following advantages: minimally invasive, short recovery, high success rate, preservation of spinal mobility, local anesthesia, minimal blood loss, sameday surgery with no hospitalization (outpatient procedure), small incision and minimal scar tissue formation.

Spinal Stenosis One of the advantages of endoscopic spinal stenosis operations is that it achieves the desired goal, as the spinal canal is effectively

ARTICLE FEATURES . Endoscopic Spine Surgeries

expanded while preserving tissues, ligaments and bones without the need to remove these tissues, unlike in traditional surgeries that need to stabilize the vertebrae. This condition affects people after the age of 50, and is caused by enlargement of tissues and ligaments in addition to calcifications. This type of operation is easily and effectively carried out today through a 1 cm incision, and the patient is usually able to leave the hospital on the same day. These operations have lower inflammation rates and higher accuracy, in addition to the easy access of the endoscope to all areas and from both sides.

Recurrent Disc Herniation Recurrent disc herniation is the return of the disc after 6 months or two years of treatment, and the reason behind this is the removal of the large mass that is pressing on the nerve and not the entire cartilage, which can lead to vertebral erosion and chronic pain. 10% of patients suffer from such condition, which

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ENDOSCOPIC SURGERY IN SUCH CASES AVOIDS ADHESIONS AND FIBROSIS THAT CAN OCCUR AROUND THE NERVE, WHICH MAKES THE OPERATION EASY AND SAFE.

does not mean that the first operation failed, but has achieved what was required, which is to relieve the patient's pain and preserve most of the disc material necessary for the spine at the same time. Endoscopic surgery in such cases avoids adhesions and fibrosis that can occur around the nerve, which makes the operation easy and safe.

Cervical Neck Surgery One of the main benefits of the endoscopic cervical neck surgery is to avoid vertebral fixation and placing metal plates, as is known in the cervical neck operations. The operation is carried out through a small incision that does not exceed half a centimeter from the back. As with the rest of endoscopic surgeries, it is performed with a high safety rate and effectiveness, as the patient can be discharged from hospital on the same day. It should be noted that not all cases of cervical discs are possible with this technique, but the surgeon determines this according to patient’s condition.

Shaping the industry, keeping the patient first.

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Biophilic Life “...Sometimes, I find it very stupid when I fill my lungs with oxygen and breathe. We could do much better. We could be flying or be a frequency in the air....” having a mobile connection), paraesthesia & pain in the hands as a result of nerve entrapment. On the other hand, the news of Mark Zuckerberg who increased his property to 1,300 hectares in Hawaii by purchasing additional 600 hectares land with a sea view. What is changed? Butterfly Effect in the Chaos Theory of the mathematician Edward Lorenz basically states that: a small change on the initial conditions of a system can result in large differences in a later state. So, far too many changes are occurring by the effect of an un-flattering bat in China region recently…

Biophilic Hospital

Aylin Altuntaş Istanbul/London/Dubai Founder @AA Executive Consulting / Board Member @Future Healthcare Conference, Istanbul

hese lines are from a British science fiction-dystopic TV series, Years & Years when two teenage girls are chatting about their desire to transfer their brain to computer and become Trans-Humans to be immortal. The film was shot in 2019 and Covid-19 was not in our life yet. Therefore, to be able breathe by filling the lungs with oxygen might have seemed rather “stupid”. Today, there is the news of new diseases resulting from the excessive use of mobile phones and social media such as photolurking (spending hours by glancing at other people’s photos), cyberchondria (over-anxiety about one’s health by using internet search for medical information), nomophobia (the fear and anxiety caused by not

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The new lifestyle is spreading by word of mouth, inspired from the Hanging Gardens of Babylon which is said to have been built in the ancient city of Babylon, near present–day Hillah, Babil province in Iraq. The Hanging Gardens were built by the Neo-Babylonian King Nebuchadnezzar (who ruled between 605 and 562 BC) for his depressed Median wife Queen Amytis, who was homesick of the green hills and valleys of her homeland. The gardens were described as a remarkable feat of engineering with an ascending series of tiered gardens in the shape of a pyramid. The building itself was not seen because of the terraces containing a wide variety of trees, shrubs and vines, which looked like they were hanging in the air. The boats were floating in the cannels that was formed by the water carried from the Danube River… Biophilic life aims to restore the lost connection of mankind with the nature. A natural living space is built for the humans as a form of biological organism in the eco-system. Indoor and outdoor colourful plants, self-sufficient buildings constructed by the sustainable materials, refreshing weather, natural lighting, provinces lost in greenery... Singapour after a fast urbanisation, came to

THE RESEARCHES SHOW THAT, THE SPACES THAT REDUCE CARBON DIOXIDE HAVE A POSITIVE EFFECT ON THE MEMORY AND HAPPINESS. THE HIGH AMOUNT OF GREEN AREAS INCREASES THE STAFF SATISFACTION AND THEREFORE THE PRODUCTIVITY.

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the edge of losing its natural resources such as water and later, became a pioneer at transforming into a biophilic life. Singapur Khoo Teck Puat Hospital is the first to win the Yale University Prof. Stephen R. Kellert Biophilic Design Award in 2017. The blocks are designed for air transfer and reach of sun light for each Hospital building. There are spaces like small forests or lakes enabling birds and butterflies to fly with inside and outside greenery, reaching to the patients’ beds. Greenery used in the vertical and horizontal architecture equals to almost four times of the land that the buildings stand on...Total 700 different plants grow in the Hospital. There is a farm at the roof garden, where 100 different fruit trees, 50 dif-

ferent vegetables and 50 kinds of medical herbs grow. The organic food cooked and served in the Hospital is provided from this roof farm. The researches show that, the spaces that reduce carbon dioxide have a positive effect on the memory and the happiness. The high amount of green areas increases the staff satisfaction and therefore productivity. The time spent at open spaces reduces stress; and increases the mental focus and concentration. In a research in 2008, it shows that the patients with reach of plants have less blood pressure, pain, anxiety and fatigue complaints. In another research in 1984, the patients with a view of nature recover more rapidly. Premature born babies grow faster if they have a reach of natural sunlight…

CHANGE: SOMETIMES FOR THE BAD, SOMETIMES FOR THE GOOD...

References: International Living Future Institute: www. living-future.org Effects of Flowering and Foliage Plants in Hospital Rooms on Patients Recovering from Abdominal Surgery SeongHyun Park1 and Richard H. Mattson, 2008 View through a window may influence recovery from sergery, R.S.Ulrich, 1984, National Library of Medicine

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Streamlining for Safety: Barcode Medication Administration for Intravenous Medications James Waterson. RN, M.Med.Ed. Medication Safety Manager, Medical Affairs. Becton Dickinson. Eastern Europe, Middle East and Africa. James.waterson@bd.com Radwa Elsawah. RPh. Product Manager. Medication Management Solutions. Becton Dickinson. Eastern Europe, Middle East and Africa. Larry Neal. Regional Marketing Manager, Medication Management Solutions.Becton Dickinson. Eastern Europe, Middle East and Africa.

otential errors of Wrong Patient, Wrong Medication, Wrong Dose, Wrong Documentation, and Wrong Time can all take place at the bedside, and among all the stages of the medication chain -from prescription to administration- medication errors which occur at the point of administration are the most prevalent at 68% of all IV medication errors. And with only a 2% chance of detection of error, in terms of Failure Mode Effect Analysis (FMEA) the IV administration process consistently scores as a high-risk activity by virtue of this difficulty of detection, with a Detectability Score of 10 (0 = Minimum Harm Risk – 10 = Maximum Harm Risk) commonly being applied by organizations utilizing FMEA. This is the dangerous ‘gap’ that Connected Compounding Solutions and Interoperability Capable Infusion Pumps can close, as they effectively loop back IV medication administration directly to the original prescription and ensure completion of the documentation of administration. This can be achieved by bidirectional-interoperability capable IV pumps through direct communication with the patient’s Electronic Medical Record (EMR):

The barcode on the IV medication bag or syringe triggers this communication during a

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process of scanning the Patient’s ID band, scanning the medication to be given, and scanning the barcoded unique identifier of the IV pump. The pump is then triggered to communicate with the EMR and the confirmation with the Computerized Provider Ordering Entry system allows for auto-population of the pump with an order string that carries the correct dose, duration or rate, correct volume of the IV bag and the patient ID. This is truly streamlined safety as it can also reduce the time spent programming the pump by over 80%, and healthcare needs streamlining badly. Up to 38% of a nurse’s time is spent on non-value added activities and these non-value costs can take millions of dollars per year out of an organization’s budget. The hospital pharmacy is central to the above workflow as it is here where the order

WITH INTEGRATION, PHYSICIAN PRESCRIPTIONS CAN BE RECEIVED ELECTRONICALLY INTO THE PHARMACY FOR VERIFICATION, AND IF APPROVED, FOR PUSHCOMMUNICATION TO THE COMPOUNDING UNIT.

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is electronically received from the CPOE, the medication is compounded and the individual and unique barcode with an order string is created from the CPOE, and the individual patient ID is created. It is possible to manage this process manually, but many of the critical steps involved in compounding carry potential error rates as high as 49%, and it is far better to have integration between the CPOE and the compounding software to avoid breaks in the medication chain, and to reduce the risk of transcription errors. Prescribing software should also include ‘Hard Stops’ for dosing and automation of calculations for Area Under the Curve (AUC) dosing. Ideally, the CPOE gives prescribers access to computer-based standardized protocols, which reduce non-standard regimen creation, can make for a faster regimen build, and automatically calculate doses and create preparation guidance. With integration, physician prescriptions can be received electronically into the pharmacy for verification, and if approved, for push-communication to the compounding unit. Interoperability between the EMR and IV Pumps is an ideal solution for the whole hospital medication safety, as it requires an investment in communication engines to link pumps to the EMR and an organization-wide network capable of carrying these messages, ideally via secure wireless communication. Modern smart pumps can make this a highly protected connection via Advanced Encryption Standard (AES) 128-bit key encryption using Cipher Block Chaining (CBC). This encryption applies to a vast number of connections with modern smart pump servers being able to manage up to 18,000 pump channels with full, and secure, bidirectional interoperability across hospital campuses with multiple sites. As mentioned above, efficient compounding software is a central part of any EMR interoperability solution for IV medications, as every prescription must pass through the pharmacy for reconstitution and application of the unique patient-medication matched barcodes. The pharmacy compounding unit is truly the engine house of IV medication production and of

IV medication safety. A compounding workflow software solution can undertake both preparation and documentation assistance and checks. A software suite should support initial pharmacist verification of the order, gravimetric checks, and incorporate a monitor inside the work area with a minimal interaction interface with stepby-step instructions. The software can propose a list of items that includes the minimum medication vials, diluents and consumables required to prepare the dose. Scanning of individual components ensures a recipe match for all items including the final IV administration bag. The system must also carry ‘Hard Stops’ for dosing out of tolerance (usually ±4% tolerance is accepted by most institutions). The compounding system should only deliver a patient-medication label after all the steps of compounding are successfully complete, which makes it ideal for building into an FMEA process, as the steps involving risk are all before the final verification checks and issuing of the label with a unique preparation and patient identification number. The software must be capable of recording all cancelled mixes, tolerance limit breaches, incorrect item scans, and the resolutions of alerts by the user. Date-time stamps are automatically applied to all these alerts and actions by modern compounding solutions. This data is ideally stored locally on an MS-SQL database inside the hospital firewall. Documentation in the central pharmacy of compounding statistics for each preparation can be aggregated and this assists with forecasting. Viewers and dashboards of the entire IV medication management process from prescription to administration help senior pharmacy managers to identify bottlenecks in the pharmacy fulfilment process. Compounding units can also view infusion status in all nursing units, allowing for just-in-time resupply of critical medications and prioritizing of activity and queuing of compounding requests. New medication dose requests are easily identifiable in such an arrangement, and such systems are extendable into inventory control and forecasting functions. Compounding software can also

INTEROPERABILITY BETWEEN THE EMR AND IV PUMPS IS AN IDEAL SOLUTION FOR THE WHOLE HOSPITAL MEDICATION SAFETY, AS IT REQUIRES AN INVESTMENT IN COMMUNICATION ENGINES TO LINK PUMPS TO THE EMR AND AN ORGANIZATIONWIDE NETWORK CAPABLE OF CARRYING THESE MESSAGES, IDEALLY VIA SECURE WIRELESS COMMUNICATION.

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be used to extend medication safety beyond the pharmacy and into the nursing unit. This solution is a ‘lighter touch’ than full EMR bidirectional interoperability, though hybrid solutions with all the advantages of compounding software to smooth the workflow of production, married to barcode right patient-right medication verification via EMR-interoperability capable IV pumps, are also feasible. Medication safety should always be an ongoing journey to zero patient harm and scalability and adaptability of solutions, so called ‘futureproofing’ is a vital consideration for organizations when building their IV medication risk management strategies. The ‘light touch’ solution requires less infrastructure and complexity as it can stand outside of the EMR or have touchpoint integration only, with access to Admission Discharge and Transfer (ADT) data from the EMR for example. The below workflow shows how bedside BCMA scanning by nursing staff to support right patient-right medication verification at the bedside is supported by the compounding solution: (image on the right) This requires the deployment of wireless connected handheld barcode scanners to the nursing unit. As the patient ID band and the patient-medication barcode label on each compounded product are scanned, this potential ‘match’ is transmitted to a ‘listening post’ interface and through to the compounding solution server, where the match is tested and if it is correct for patient, medication, dose, volume and regimen appropriateness (oncology regimens, of course, contain multiple medications and are timed and scheduled as per the CPOE order) the nurse gets a green light, and can proceed with administration. This workflow achieves several things. It replaces a large amount of manual activity by nursing staff, and should reduce the risk of medication errors as it undertakes positive patient ID and matching of the compounded product to the patient. It also means this activity takes place directly at the bedside, avoiding the risk of checks being made at the nursing station

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and then a mix up occurring due to distraction or other error in the ‘last few metres’ to the patient. The two-nurse or ‘four-eyes’ check is also not required as the barcode acts to verify fully, and of course there are many reports of the ineffectiveness, dangers of positive reinforcement of error, and of time-wasting that occurs when verification is undertaken manually by two clinicians. Printed pages for regimens, which can be mislaid or placed in the wrong patient record, are also eliminated in this approach. As discussed above, safety systems can also streamline practice. In a recent study in a high turnover oncology unit with 16,000 patient visits and over 14,000 compounded medications per annum the introduction of a compounding software solution with BCMA labelling saw a 35% reduction in the time required to compound each product. The introduction of handheld barcode scanners for patient-medication verification led to patient verification time falling from ≈ 6 minutes to a mean average of only 41 seconds within two weeks of its introduction. When calculated against the checking of 14,000 medications this gives a saving of nursing time equivalent to 0.43 fulltime nurses per year. The savings for a 1,000-bed hospital compounding 40,000 oncology medications per year would be 1.21 full time nurses. Technology cannot do everything that healthcare staff can do, but what it can do is release our most valuable asset, our highly skilled staff, to undertake patient work of real value and to allow them to work in an environment that supports them in keeping patients safe.

MODERN SMART PUMPS CAN MAKE THIS A HIGHLY PROTECTED CONNECTION VIA ADVANCED ENCRYPTION STANDARD (AES) 128BIT KEY ENCRYPTION USING CIPHER BLOCK CHAINING (CBC).

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

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Acute pyelonephritis

cute pyelonephritis (APN) is an infection involving the kidney and renal pelvis. It represents a more severe form of infection than acute cystitis. The main features that define this syndrome include the triad of high fever, flank pain and tenderness. 80 % of cases may present with storage lower urinary tract symptoms such as burning, frequency and urgency. The causative uropathogen is isolated by urinalysis and culture and the most common bacteria isolated is E. coli and other gram-negative bacilli. APN may be mild or severe resulting in sepsis and shock. The severity is dependent on host factors e.g. presence of comorbidities, immune status, presence of obstruction and elderly patients (> 65 years).

Epidemiology APN is a common disease. The estimated global annual incidence is 10.5 to 25.9 million cases. It is common among females. Percentage of hospitalized patients is higher among children and elderly than among healthy- young women. APN is a major cause of mortality. This is largely due to associated sepsis and septic shock. It is estimated that APN accounts for 10% of septicemia cases. The total estimated cost is very high, however, recent introduction of observation units and change in practice have resulted in significant drop in rates of admission.

DIAGNOSIS OF APN IS DEPENDENT ON CLINICAL EVALUATION, URINE CULTURE AND SUPPORTIVE IMAGING MODALITIES. IT DEPENDS LARGELY ON ISOLATION OF BACTERIA BY URINE CULTURE. IMAGING IS, INITIALLY, RECOMMENDED IN PATIENTS WITH SEPSIS OR SEPTIC SHOCK, KNOWN OR SUSPECTED UROLITHIASIS, OR A NEW DECREASE IN THE GLOMERULAR FILTRATION RATE.

or no improvement by 24 to 48 hours arouses concern for potential complications that may warrant urgent intervention. These complications may include obstruction (e.g. stones), abscess formation, severe gas-forming infection (especially in diabetics), acute kidney injury (usually transient), advanced renal failure and recurrent pyelonephritis (rate of < 10%).

Diagnosis Diagnosis of APN is dependent on clinical evaluation, urine culture and supportive imaging modalities. It depends largely on isolation of bacteria by urine culture. Imaging is, initially, recommended in patients with sepsis or septic shock, known or suspected urolithiasis, or a new decrease in the glomerular filtration rate. Subsequent imaging is indicated in patients whose condition worsens or does not improve after 24 to 48 hours of therapy. Differential diagnosis for flank pain or tenderness, with or without fever, include: 1. Acute cholecystitis, 2. Appendicitis, 3. Urolithiasis, 4. Paraspinous muscle disorders, 5. Renal-vein thrombosis 6. Pelvic inflammatory disease.

Pathogens •

Risk factors APN occurs in around 3% of cases of cystitis and asymptomatic bacteriuria. It also complicates cases of urinary tract obstruction e.g. pregnancy, stones. Others include genetic predisposition, high bacterial load and virulence and presence of comorbid conditions e.g. diabetes.

Natural history APN occurs when enteric bacteria enter the bladder and ascend to the kidneys. Rarely, organisms such as Staphylococcus aureus or candida seed the kidneys hematogenously. With appropriate care, clinical manifestations usually decrease progressively. However, resolution may require up to 5 days. Worsening

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Among young healthy women, E. coli

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Dr. Yousef Matani, Consultant Urologist at Al-Ahli Hospital / Qatar

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account for more than 90% of pyelonephritis cases. In contrast, among men, elderly women, and urologically compromised or institutionalized patients, other organisms are involved in addition to E. coli strains. Emerging antimicrobial resistance is growing due to antibiotic abuse and bacterial virulence.

Management The three pillars of pyelonephritis management are: Supportive care • Fluid resuscitation • Medications to control symptoms, such as analgesics, antipyretics Antimicrobial therapy • Must be started promptly without waiting for the urine culture result. • Type and duration of empirical antibiotics, route of administration and necessity for admission are dictated by many factors including, but unlimited to, microbial resistance, severity of infection and host-related risk factors. • Duration of antibiotic treatment ranges between 1 to 4 weeks. • Monitoring the effectiveness of ther-

APN IS A COMMON DISEASE. THE ESTIMATED GLOBAL ANNUAL INCIDENCE IS 10.5 TO 25.9 MILLION CASES. IT IS COMMON AMONG FEMALES. PERCENTAGE OF HOSPITALIZED PATIENTS IS HIGHER AMONG CHILDREN AND ELDERLY THAN AMONG HEALTHY- YOUNG WOMEN. APN IS A MAJOR CAUSE OF MORTALITY. THIS IS LARGELY DUE TO ASSOCIATED SEPSIS AND SEPTIC SHOCK.

Dr. Hassan Sabbagh, Specialist Urologist at Al-Ahli Hospital / Qatar apy is essential. Clinical worsening or lack of any improvement after 1 to 2 days of antibiotic therapy mandates repeat urine culture and imaging to identify an underlying cause and/or abscess formation. Source control • Indications for initial and subsequent imaging (i.e., baseline risk factors and clinical worsening or lack of improvement after 24 to 48 hours of therapy) to assess obstruction, abscess, or necrotizing infection. • Ultrasonography is more sensitive than computed tomography (CT) for the diagnosis of hydronephrosis, less expensive and available at the bedside. • Unenhanced CT is the preferred initial method for management of acute flank pain or tenderness. • Contrast enhanced CT is more sensitive for the diagnosis of abscesses, inflammation, and gas formation. Special Populations • Pyelonephritis during pregnancy can progress rapidly, causing life-threatening complications in both the mother and the fetus. It requires hospitalization. • Febrile UTI in children is usually associated with underlying congenital anomalies.

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Carpal tunnel syndrome

Dr. Stanley Jones, Consultant Orthopedic Surgeon - Head of Department at Al-Ahli Hospital / Qatar

Dr. Mohammed Mansur Ali, Specialist Orthopedics at Al-Ahli Hospital / Qatar

arpal tunnel syndrome is a condition where the median nerve becomes compressed or squeezed at the wrist. The median nerve provides sensation to the palm side of the thumb, index, middle and part of the ring finger and also controls some of the thumb muscles. The median nerve passes from the forearm to the palm of the hand through the carpal tunnel which is a narrow passageway of ligaments and bones at the base of the hand. The median nerve and the tendons which help in flexing / bending the fingers pass through this tunnel. The median nerve can be compressed or squeezed due to thickening of the tendon sheaths or due to other swellings which narrow the tunnel.

What are the symptoms? •

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Numbness, tingling, burning sensation, pain – mainly in the thumb, index, middle fingers. Occasional shock-like sensations to the

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IN MOST PEOPLE, THE SYMPTOMS BEGIN GRADUALLY, COME, & GO AT FIRST. HOWEVER, AS THE CONDITION WORSENS, THE SYMPTOMS OCCUR MORE FREQUENTLY AND MAY PERSIST FOR A LONGER TIME...

Dr. Ahmed Kamhawy, GP Orthopedic at Al-Ahli Hospital / Qatar

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thumb, index and middle fingers. May feel pain or tingling travel up the forearm toward the shoulder. Weakness or clumsiness in the hand and may have difficulty in doing fine movements like buttoning clothes. Dropping things due to weakness or numbness.

The symptoms are more common during the night, because many people sleep with their wrists bent, and may be awakened by the symptoms. During the day, the symptoms often occur when holding objects for a prolonged period of time with the wrist bent forwards or backwards, such as when using a phone, driving or reading a book. Many patients find that moving or shaking their hands help relieve their symptoms.

What are the causes and risk factors? • • •

Women are more likely to be affected Repetitive hand use Hand and wrist position - doing activities

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• • •

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with extreme flexion or extension of hand and wrist for prolonged periods of time can increase pressure on the nerve. Pregnancy – Hormonal changes during pregnancy can cause swelling. Wrist fractures or sprains Other health conditions like diabetes, thyroid hormonal disturbances, rheumatoid arthritis. Cysts or tumors within the carpal tunnel can put pressure on the median nerve.

Surgical treatment • If your symptoms are severe or if non-surgical treatment does not relieve your symptoms surgery may be recommended. • Surgery involves cutting the ligament which forms the roof of the carpal tunnel which would relieve pressure on the median nerve.

Recover

How to diagnose carpal tunnel syndrome?

After the surgery you will be encouraged to elevate your hand and move your fingers to help reduce swelling and prevent stiffness. There will be some pain, swelling and stiffness after the procedure . You may have to wear a splint /brace for a few weeks after the surgery. Driving and self-care activities may be permitted soon after surgery. Minor soreness in your palm may last for a few weeks to several months. Grip and pinch strength usually returns by about 2 to 3 months after surgery . However, if the condition of your median nerve was poor before the surgery, grip and pinch strength may not improve for 6 to 12 months .

Your doctor can examine and check for the sensitivity in the fingers, check for any atrophy or wasting of the muscles and perform physical tests to assess the median nerve. Diagnosis may be confirmed by doing Electrophysiological tests to assess whether there is too much pressure on the nerve and how well your median nerve is working and those tests may include: • Neve conductions studies - which can detect how well the nerve is conducting signals. • Electromyogram (EMG)- which measures electrical activity in the muscle

Complications It can include bleeding, infection and nerve injury.

X Rays – may be required if you had any injury or occasionally to see if you have any arthritis. Ultrasound and MRI may be required if there is any suspicion of cysts or tumors.

How is carpal tunnel syndrome treated? Non-surgical treatments • Splints /Braces – helps keep your wrist in a straight or neutral position and reduce pressure on the median nerve. • Non-steroidal anti-inflammatory medications can help relieve pain and inflammation. • Activity changes • Steroid injections- corticosteroid is injected into the carpal tunnel and can help reduce inflammation and relieve pain or help to calm a flare up of symptoms. The effect is sometimes only temporary.

OCCASIONALLY, CARPAL TUNNEL SYNDROME CAN RECUR, ALTHOUGH THIS IS RARE. IF THIS HAPPENS, YOU MAY NEED ADDITIONAL TREATMENT OR SURGERY.

Outcomes For most patients, surgery will improve the symptoms due to carpal tunnel syndrome. Recovery, however, may be gradual and complete recovery may take up to a year. You may require physiotherapy to help recovery. If you have another condition that causes pain or stiffness in your hand or wrist, such as arthritis or tendonitis, it may slow your overall recovery. In long-standing cases of carpal tunnel syndrome with severe loss of feeling and/or muscle wasting around the base of the thumb, recovery will also be slower. For these patients, a complete recovery may not be possible.

References: https://orthoinfo.aaos.org https://www.ninds.nih.gov https://www.nhs.uk

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A simple shift in chemistry one of the reasons why the UK COVID-19 variant has become so problematic, says virology expert at Arab Health overview of COVID-19 vaccines and variants across the globe. “In the United States, the predominant B.1.1.7 variant (known as the UK variant) has higher transmissibility, higher morbidity and mortality, and is affecting many young adults and adolescents. It is a simple shift in chemistry because of higher interactions of the spike protein of the virus with the receptor; that is one of the reasons why the B.1.1.7 variant has become so problematic,” Professor Peter Hotez explained.

Professor Peter Hotez

ith 150 million cases and more than 3.5 million deaths, the global effects of the COVID-19 virus have been devastating, particularly for the G20 countries where it has had such a huge impact on the global economy. According to Peter Hotez, Director, Texas Children’s Center for Vaccine Development (CVD), Dean, National School of Tropical Medicine, Professor of Paediatrics and Molecular Virology & Microbiology, Baylor College of Medicine, Houston, Texas, USA, low-income neighbourhoods, especially in the G20 countries, have been particularly hard hit. Also, because of all the social disruptions caused by the pandemic, there has been an overall decline in global paediatric vaccinations, which could result in the return of vaccine-preventable diseases. Addressing the audience during the Pharma & Drug Discovery Conference at the live and in-person Arab Health event at the Dubai World Trade Centre, Professor Hotez gave an

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Although the virus-neutralising antibodies induced by the two mRNA vaccines in the US (Pfizer-BioNTech and Johnson & Johnson’s Janssen) do a good job of neutralising the B.1.1.7 variant spike protein, he warns of the implications of the second mutation in the US, the B.1.351 ZA or South Africa variant and the Brazil variant (P.1.), as the virus-neutralising antibodies are lower against this variant induced by the current vaccines. “The implications of this is that the vaccines do not work quite as well, and it will also

B.1.1.7 VARIANT (KNOWN AS THE UK VARIANT) HAS HIGHER TRANSMISSIBILITY, HIGHER MORBIDITY AND MORTALITY, AND IS AFFECTING A LOT OF YOUNG ADULTS AND ADOLESCENTS

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not be surprising to start seeing booster shots later in the year in the US for a third dose of the Pfizer-NioNTech or a second dose of the J&J vaccines, which will give you higher levels of virus-neutralising antibodies and more durable protection, and help us against some of the variants,” Professor Hotez said. The Houston Methodist Hospital recently reported that the B.1.1.7 variant in Houston, in some places, is picking up a second mutation, which is making the variant look like the South African or the Brazil variants. “This is going to be a trouble area for us down the road in the US and globally,” Professor Hotez added. The good news for the US is that since the vaccines work well against B.1.1.7, and the US is hitting about 60% vaccination rates across the country, cases will continue to trend downward. The hope is that if the country can hit the 7075% benchmark by July and August, then the transmission is going to decrease dramatically. However, Professor Hotez underlined tremendous vulnerability in the rest of the world including, Africa, India, many parts of Southeast Asia and Latin America, and even parts of the Middle East, where vaccination rates are low, highlighting the urgency to do something soon. The Indian Maharashtra strain (B.1.617) that grows out of the Mumbai area is also a variant that is partially resistant to vaccination. Since the growth of the B.1.617 in India, which is now also affecting Pakistan, Nepal, Bangladesh, elsewhere in South Asia, three sub-lineages have been found in 44 countries. We are starting to see these sub-variants rise quickly, for example, in the United Kingdom, where the B.1.617.2 is spreading faster than other imported variants.

look like for all of these new variants.” Arab Health has been developed under the show theme of 'United by Business, driving the industry forward, with the live, in-person event expected to welcome 1,500 exhibiting companies and over 20,000 attendees expected during the Live, in-person event. In addition, more than 300 speakers came together for the Arab Health Congress to improve medical practice and ultimately improve patient outcomes. A total of 12 medical conferences took place between 21-24 June, nine of which were Continuing Medical Education (CME) accredited.

SUB-VARIANTS OF THE INDIAN MAHARASHTRA STRAIN (B.1.617) ARE RISING QUICKLY, FOR EXAMPLE, IN THE UNITED KINGDOM WHERE THE B.1.617.2 IS SPREADING FASTER THAN OTHER IMPORTED VARIANTS.

“It will be important to collect as much evidence as we can on vaccine protection against this variant,” he said. “However, the overall good news is there's a lot of convergence in these mutations. They don't seem to be random, and they seem to be converging towards one or the other. But as we make booster shots, I think we are going to have to think about what this consensus sequence will

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Arab Health and Medlab Middle East generated over AED767 million of deals during the four-day live, in-person event

rab Health and Medlab Middle East, the leading exhibitions for the healthcare and laboratory industries in the MENA region, generated AED767.7 million of new business deals during the live, in-person element of the show last month. Maktoum, Chairman of Dubai Civil Aviation Authority and Chairman and Chief Executive of Emirates Airline and Group, the exhibitions welcomed 22,800 visitors from 172 countries who connected with 1,700 exhibitors. A total of 61 countries were represented by exhibitors, which included 30 international pavilions. Wouter Molman, Executive Vice President for Informa Markets, said: “Arab Health and Medlab Middle East have been a resounding success this year and underscored the importance, and perhaps, more importantly, the demand, to host live and in-person events once again. Our overarching goal was to create a platform that was conducive to facilitating business deals by providing an opportunity to make connections, network and ultimately to support global healthcare recovery.” Deals completed during the event included a collaboration between American Hospital Dubai and Etisalat Digital to enhance the patient experience by utilising multiple digital technologies. The Ministry of Health and Prevention, the EHSE, the DHA and DoH also signed a bulk purchase agreement for medicines and medical supplies. Al Jalila Children’s Specialty Hospital (AJCSH) announced a high-profile agreement with Illumina Netherlands BV, the world’s leader in next-generation sequencing, to provide technical expertise, reagents and analysis tools and training to the group. Elsewhere on the show floor, Gulf Medical University signed an MOU with GEOTAR-Med LLC, a leading company

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in Russia providing complex turnkey solutions for medical education, to develop, produce and advance exciting simulation equipment for education in healthcare professions. At Medlab Middle East, a series of deals were completed, including G42 Healthcare who announced a partnership with Seegene, a global biotechnology company specialising in molecular diagnostics, to offer fully equipped mobile diagnostics and testing laboratories across the Mena region. Further announcements included Unilabs new diagnostic solutions deal with Roche Diagnostics. Vincenzo Ventricelli, CEO, Philips Middle East, Turkey & Africa, said: “We’ve been very pleased with the positive feedback we’ve received during the show. Not only have customers been willing to come to the event, but they are also happy to engage, discuss, and make decisions in a face-to-face environment. This means business is being done faster and better.”

THE TWO-MONTH ONLINE SHOWCASE ATTRACTED 19,699 ATTENDEES AND FACILITATED 46,300 UNIQUE CONNECTIONS.

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As part of the online element of the show, 19,699 visitors attended from countries including Chile, Congo, Mauritius, Zambia, Bolivia, Costa Rica & Dominican Republic, totaling over 31 countries who were only represented online thanks to the virtual aspect of the exhibitions. A survey of online participants revealed that 47% of online attendees had never attended either show in the past. “These results underscore the importance of our online event by providing an opportunity for an even greater audience to participate. While the physical events remain a strong and impactful platform, which resulted in millions of dirhams worth of business generated at the in-person shows, the online element has so far facilitated over 46,300 unique connections from around the world," added Molman. The events, which took place under the theme of 'United by business, driving the industry forward’, was supported by the Ministry of Health and Prevention (MoHAP), Dubai Healthcare City Authority, Dubai Health Authority, and the Dubai Government. As part of Informa Markets' commitment to providing the highest hygiene levels at all events by ensuring attendees and staff safety, the event took place with protocols introduced via the company’s Informa AllSecure health

and safety mandate. 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. The 2022 edition of the show, which returns as a co-located event for the healthcare and laboratory industries, will take place from 24 – 27 January at the Dubai World Trade Centre.

22,800 VISITORS FROM 172 COUNTRIES ATTENDED THE HEALTHCARE AND LABORATORY EXHIBITIONS. 1,700 EXHIBITORS FROM 61 COUNTRIES REPRESENTED.

“As an organiser, the learnings from hosting a live, in-person event concurrently with the online edition have been invaluable. The results have exceeded our expectations. As with our show theme this year, now is the time to drive the industry forward and prepare for 2022, where we look forward to replicating this year’s successes," concluded Molman.

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Organon UAE Launches with a Focus on Women’s Health, creating over 400 job opportunities across MENAT

omen’s health is being transformed and further prioritized with the launch of Organon (NYSE: OGN), the only global company of its size focused on women’s health. With a vision to create a better and healthier every day for every woman by putting women at the center of everything Organon does. The majority of Organon’s leadership board is comprised of women. Their unique approach and new treatments for women healthcare will directly create new employment opportunities, result in cost-savings for healthcare institutions, as well as increase diversity in the healthcare industry of UAE. Managing Director Ramy Koussa of MENAT (Middle East, North Africa, and Turkey) in Orga-

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non highlights the vision of the company, “As the MENAT region continues to grow and is expected to expand further in the coming years, we recognize the need to focus on women-specific health conditions and treatments that impact the everyday life of women. This launch will not only transform women’s healthcare, but will also create over 400 job opportunities across MENAT. With our expertise, products, and technology in women-related conditions, we want to influence change in the region and empower women to take charge of their health to live better lives.” The Organon executive leadership team rang the opening bell at the New York Stock Exchange (NYSE) to mark the first day of active trading. Recognizing the need to listen to and

Ramy Koussa

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act on women’s experiences to address the challenges in women’s health, Organon gathered voices from around the world to create the “Wall of Voices,” a multimedia installation outside of the NYSE sharing powerful perspectives, voices and images. Dr. Sawsan Al Madhi (MD, Msc), Director General of Friends of Cancer Patients UAE stated, “The core starting point for tackling healthcare challenges for women has to be empowerment, and I don’t just mean giving power to women, but by reigniting and remembering our inner true essence and strength, of which we have forgotten over decades, centuries and millennia because of cultural and social stereotyping, believes and labels. Remembering is crucial before we can even think about starting to speak about: Rights, Equality, Equity and Justice. That is the true journey that no one can give us nor can take away, remember who you have always been, remember the power within and change will follow”. Women everywhere are invited to take the “microphone” to add their voice to the digital “Wall of Voices” at www.HereForHerHealth.com.

set of products and trusted brands are critical drivers of Organon’s growth that will enable us to invest in new opportunities. Organon has an international footprint that serves people in more than 140 markets, with nearly 80% of its approximately $6.5 billion in annual revenue generated outside the U.S. Organon believes it is well positioned for organic low-to-mid-single digit growth from its 2021 base of business. Their approach to innovation is led by patient needs and the use of extensive global capabilities in clinical development and patient safety with the greatest potential to impact women’s health. Sandy Milligan, Head of Organon Research & Development stated “Women have been told to accept and normalize their conditions as a part of life, Organon’s mission is to change this. We believe this approach will be very successful — we hope to discover the ability to identify diseases earlier, the ability to modify the course of diseases or healthcare conditions and to ultimately, improve the quality of life for women at all stages.”

Dr. Sawsan Al Madhi

Razan Gharaibeh

Organon UAE’s Lead, Razan Gharaibeh , stated, “The influence that Organon will have on the UAE community would directly impact the quality of health services and medicines available to women in the region as well as provide more employment opportunities. We are fully committed to delivering impactful solutions for a healthier woman, every day.” The three core pillars that lead Organon’s offerings in UAE include: • Biosimilars: Actively building a strong foundation by broadening the reach of offerings into new geographies while expanding through new collaborations and into new disease areas. • Women’s Health: With more than 140 therapies that are being investigated by multiple companies across the women’s health industry, our goal is to add value by identifying and advancing the most promising opportunities for women. • Established Brands: Our portfolio of over 60 medicines span several areas including cardiovascular disease, respiratory conditions, non-opioid pain management and dermatology. This diverse

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RANKED AMONGST TOP 100 WORLDWIDE HIGHEST RANKED HOSPITAL IN THE MIDDLE EAST ONLY HOSPITAL RANKED IN LEBANON

HOSPITALS Magazine issue 59

Articles inside

Al-Ahli Hospital / Qatar: Acute pyelonephritis

Becton Dickinson; Streamlining for Safety: Barcode Medication Administration for

Biophilic Life

Endoscopic Spine Surgeries

Acibadem International: Scoliosis Awareness Month

Carlo Di Lorenzo, MD, Chief of Gastroenterology Hepatology and Nutrition at Nationwide Children’s Hospital

LINET MEA: It shouldn't hurt to be a nurse

Al-Ahli Hospital / Qatar: Scoliosis

Acibadem University

Medical Colleges after the COVID-19 pandemic

Robots in the Healthcare Sector

Baylor St. Luke’s Medical Center: Double lung

Al-Ahli Hospital / Qatar: Smoking and Pregnancy

Dr. Toufic Eid MD (MBBS) FRCOG, Obstetrician and

Elie Chaillot, President & CEO, Services, Europe, Middle East & Africa (EMEA), at GE Healthcare

Cervical Cancer

Mr. Alaa Adel, Managing Director for Cerner in the Middle East and Africa

How can #hospotel improve patient outcomes?

Vocera: Effective Communication: Foundation for Nurse Safety

19Labs & Doctory partner to bring Gale eClinics to the

AstraZeneca praises UAE for vaccination rollout and

Cleveland Clinic Abu Dhabi passes 150 organ transplant milestone

Orthopaedic Clinics opened in two Abu Dhabi healthcare centers

Australian Nobel Laureate Professor Marshall and

Unilabs launches innovative health App allowing

Healthcare industry leader Faisal Juma Belhoul to lead Valiant Clinic & Hospital as Executive Chairman

Qatar International Geriatrics and Gerontology Conference Transforming Older Persons’ Care in Qatar -

Malaffi receives its first regional award -The ZIMAM

New Zealand Government’s response to COVID-19

Thumbay Group inks partnership with PayBy to power

JULY.AUG 2021