HOSPITALS Magazine issue 65 by The Arab Hospital Magazine

Issue 65 / 190 - July/AUG 2022

NEWS NEWS

Publisher Arab Health Media Communication President Simon Chammas schammas@tahmag.com

SPORTS AND HEALTH

Let's achieve the ultimate goal Since technology entered the world of medicine and health, it has made a qualitative leap in the diagnosis and treatment process, all while providing top-notch screening techniques for medical institutions and ensuring optimal comfort for patients. Then, we gradually started seeing smart products expand. Even mobile phones have applications that monitor the phone holder’s blood pressure, heart rate, etc., by simply touching the phone in the right spot. On the other hand, the technological revolution has decreased the movement of individuals, as it has started providing many of their daily life requirements and imposing a different work pattern. On the other hand, it has opened up new horizons for entertainment, exchanging information and sharing it with others. According to all the studies conducted on the importance of body movement, this has urged people to adopt a sedentary lifestyle while making them more prone to inactivity and increasing screen time. In turn, the amenities and means of transportation achieved by the industrial and technological advancement have reduced sports and exercise for many; for instance, a person used to walk from one place to another, which is an important and simple type of physical activity that helps the person stay active and healthy. Today, we need to bring back sports events and practices, and encourage governments, guidance centers and media outlets to restore what was lost. “Hospitals” magazine also took the initiative and devoted a large section to highlight the importance of sports and encourage it. This is all for the sake of achieving the ultimate goal, which is better health for all! Publisher

Executive Vice President Mirna Khairallah mirna@tahmag.com Senior Editor Elham Najem editorial@tahmag.com Content Executive Jessica Achkar editorial@tahmag.com Editors Aline Debes, Mark Steven, Don Karn, Andrew Weichert, Colette Semaan, Abbas Moussa Content Marketing Manager Jessie Chlela jessie@tahmag.com Creative Director Rania Khalil rania@tahmag.com Business Development Manager Wadih Chammas wadih@tahmag.com IT Manager Elie Yammine elie@tahmag.com Photographer Hanna Nehme Advertising advertising@thearabhospital.com

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Distribution KSA - UAE - OMAN - TURKEY LEBANON - JORDAN - KUWAIT BAHRAIN - QATAR - EGYPT All images from shutterstock© unless provided by clients . All rights reserved by the HOSPITALS magazine. No part of this publication can be reproduced in any form without prior permission in writting from the publisher.

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34 Choosing the right hospital

NEWS

8 Emirates Health Services Discusses Committee Recommendations, Showcases Strategic Projects at 3rd Board Meeting of 2022 10 Al Qassimi Hospital in Sharjah Performs Rare Surgery to Remove Tumor from the Skull of a 40-Year-Old 12 NYU Abu Dhabi Researchers Develop New Tool That Brings Missing Sense of Touch to Minimally Invasive Surgery Procedures 16 Cleveland Clinic Children’s Ranked Among the Best Children’s Hospitals by U.S. News & World Report 18 Geltec Healthcare FZE officially rebrands as Bioventure Healthcare FZE to reflect strengthened position in supplements and pharmaceuticals manufacturing 20 Transasia unveils a range of IVD solutions with enhanced user experience at Medical Fair 2022 22 Emirates Health Services Signs MoU with Johnson & Johnson to Strengthen Healthcare Sector 26 Multidisciplinary team at SSMC successfully

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reconstructs neck of UAE patient 28 The 25th Annual Congress of the Lebanese Society of Endocrinology, Diabetes and Lipids (LSEDL) 30 Dubai Health Authority electronic medical record initiative to further bolster the health sector 78 Sheikh Shakhbout Medical City launches new interventional neuroradiology service to treat stroke 80 WCM-Q training program provides a boost for budding local researchers 84 Cleveland Clinic Performs First-In-World Full Multi-Organ Transplant to Treat Rare Appendix Cancer 92 Success stories written by MEDICA – how a small developer team with a prototype in their pocket became one of the biggest exhibitors

INTERVIEWS

40 Dr. Sohaila Cheema, Assistant Dean for the Institute for Population Health, Associate Professor of Clinical Population Health Sciences

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40 Institute for Population Health MEDICAL INSTITUTIONS

66 ACIBADEM IVF Centers: New horizons in

to Administration and Beyond

62 Our results are equivalent to the international records, if not better

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72 Physiotherapy and Rehabilitation Department at Marble Medical Center; Unique Programs with The Best Medical Equipment

ARTICLES

63 Healthy ways to overcome stress at work 64 Al-Ahli hospital saves the life of a Qatari whose heart suddenly stopped

70 WCM-Q’s Intersection of Law and Medicine series highlights legal, ethical perspectives in healthcare

32 A win-win strategy for patient transportation Putting Caregivers First with Advanced Motorized Stretchers By Dounia Benjelloun-Hack, Regional Sales Director LINET MEA 44 Wissam Daoud: A Visionary Leader Catalyzing Transformation in the Diagnostic Space 46 Reimagining Nursing for the Future: 6 Ways to Improve Communication for Nurses 48 Closed-Loop Oncology from Medication Compounding

46 Vocera Communications

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44 Sysmex Middle East FZ-LLC

FEATURES

34 Choosing The Right Hospital 54 How does expenditure turn into health? The Gulf raised budgets and achieved outcomes 60 What’s the difference between heat stroke and heat exhaustion? 74 Tendon Injuries and Treatments 88 Monkeypox

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NEWS

Emirates Health Services Discusses Committee Recommendations, Showcases Strategic Projects at 3rd Board Meeting of 2022

he Board of Directors at Emirates Health Services (EHS) held its third meeting of 2022 at the EHS headquarters in Dubai, headed by His Excellency Dr Mohammad Salim Al Olama, Chairman of the EHS Board of Directors, and attended by H.E. Dr Yousif Mohammed Al-Serkal, Director-General of EHS, and the members of the Board. The meeting discussed several topics including EHS’ training policy and the services provided by the Training and Development Centre, which include clinical training and medical education. The Board also explored ways to increase support for the development of services that keep pace with the future of health insurance, before looking over EHS’ transformational projects and the new approach to government work. Members went on to discuss the decisions of the previous meeting, as well as the recommendations of the Policies and Strategies Committee meeting and the inclusive planning project. “We take pride in the achievements brought by the Board’s decisions and recommendations, which aim to upgrade and develop the healthcare sector in the UAE,” said H.E. Dr Mohammad Salim Al Olama. “The next step will be to build on what has been achieved so far and to continue to develop and strengthen the work environment in a bid to cement the UAE health services sector’s leadership status at the local and global levels.” “This meeting is a continuation of the discussions we previously had on how to enhance the quality and efficiency of business, improve performance indicators, and continue to provide quality health services that assert EHS’ leadership in the sector, ultimately boosting the competitiveness of the UAE’s health sector in the region and around the world, and fulfilling the visions and directives of our wise leadership and its ambitions to implement the national strategy for the next 50 years, and drive sustainability in the national healthcare sector,” H.E. added.

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For his part, H.E. Dr Yousif Mohammed Al-Serkal asserted that: “The common purpose and collective efforts made by our teams at Emirates Health Services and all affiliated healthcare facilities have led to a series of remarkable achievements. This was largely driven by the efficient performance of employees and EHS’ commitment to empowering talented professionals, honing their skills, and enabling them to gain more experience.” “The Board meeting discussed a series of decisions and recommendations, in line with our strategy at EHS, which aims to provide holistic and integrated healthcare in innovative and sustainable ways to protect the community from diseases, implement international standards in managing infrastructure at health facilities, and establish top-quality for treatment, medical, and health services,” H.E. Al-Serkal explained. “The strategy also strives to provide administrative services in accordance with standards of quality, efficiency, and transparency, in addition to promoting a culture of innovation in the work environment to build on existing achievements.”

The meeting was the third in a series of periodic Board meetings, held to follow up on the implementation of the recommendations and decisions made in previous sessions, as well as to assess their impact on promoting and developing the health services sector. Members aim to evaluate the impact that administrative decisions have on the efficiency of performance, in an effort to establish an ideal, supportive, and transparent work environment that champions innovation as a core part of the sector’s operations.

Nurses are heroes. Nurses are professionals. Nurses are mentors. Nurses are changemakers. Nurses are leaders. Nurses are therapists. On International Nurses Day, BD and the Saudi Nurses Association salute the unwavering commitment of Nurses from around the Kingdom and the invaluable contributions they make to the health and wellbeing of our communities and the Kingdom’s healthcare system. We are thankful to your heroism and professionalism and commit to offer you leading skilling programs, best practices and cutting-edge innovations to help secure your safety while enhancing patient safety and treatment outcomes.

Learn more: sna.org.sa | bd.com

NEWS

Al Qassimi Hospital in Sharjah Performs Rare Surgery to Remove Tumor from the Skull of a 40-Year-Old

he ear, nose, and throat (ENT) surgery team at Al Qassimi Hospital – an affiliate of Emirates Health Services (EHS) – successfully performed a rare, complex, and precise surgery to remove a tumor from the skull base of a forty-year-old patient – the first such procedure to be performed in the UAE. The tumor had caused complete loss of hearing in the left ear, as well as total paralysis of the seventh cranial nerve (also known as the facial nerve) on the same side. The landmark surgery was conducted in collaboration with Dr Hassan Diab, Head of Otology Department at the National Medical Research Centre for Otorhinolaryngology in Moscow, Russia. Dr Diab is part of the Visiting Doctors Program, implemented by EHS to promote the exchange of experiences with doctors in various specialties. The surgical team successfully removed the tumor, keeping the facial nerve and cerebral arteries intact, and the patient has shown promising signs of recovery in the post-operative phase. He is currently undergoing facial nerve rehabilitation treatment, which will continue until the recovery phase is completed. Dr. Issam Howayer Al Zarouni, Director of the Hospitals Administration Department at EHS, asserted that Emirates Health Services is committed to implementing the latest advanced technology across various medical fields and specialties, in an effort to equip its health facilities around the UAE with innovative smart medical services, as well as to supply hospitals and healthcare centres with highly qualified and skilled medical and nursing professionals. “The medical achievements we have made reflect our efforts and strategies, which were designed to build and empower our human capital,” he added. “This set the stage for the series of accomplishments we have made, including rare and sophisticated surgeries, which we carried out using the latest AI-powered medical technologies and devices. We also have the

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teams of highly accomplished doctors to thank; their efforts help advance the UAE’s reputation in the healthcare sector and its position on the global healthcare map.” For her part, Dr. Iman Al-Hawai, Head of the Ear, Nose, and Throat Department at Al Qassimi Hospital, said that the surgical dissection of the tumor revealed that it had reached the base of the skull and caused erosion of the bones lined with the meningeal membranes of the brain. It had also reached the internal carotid artery in the brain and completely enveloped the facial nerve, she explained. “The unlimited support Emirates Health Services offers us at Al Qassimi Hospital is what allows us to treat such cases, now and in the future,” Dr Al Hawai added, noting EHS’ specialised programs and the role they play in training highly qualified medical staff and bringing in rare and professional expertise to serve patients. The Visiting Doctors Programme is a leading initiative aimed at improving health services, raising the efficiency of staff working in various medical specialties, and keeping up with global practices in patient care, the latest innovations, modern technologies, and proven treatments. All hospitals under the EHS umbrella have obtained international accreditations and ISO certificates, establishing themselves as a destination of first choice for complex surgeries using hi-tech equipment, and registering a series of successes and accomplishments in that regard.

Dr. Issam Howayer Al Zarouni

THE OPERATION WAS CARRIED OUT WITH THE SUPPORT OF EMIRATES HEALTH SERVICES (EHS) AND ITS PROGRAM FOR VISITING DOCTORS.

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NEWS

NYU Abu Dhabi Researchers Develop New Tool That Brings Missing Sense of Touch to Minimally Invasive Surgery Procedures

team of researchers from the NYU Abu Dhabi (NYUAD) Advanced Microfluidics and Microdevices Laboratory (AMMLab) have developed a simple, yet effective approach for on-demand tactile sensing in minimally invasive surgery, overcoming a key limitation – the inability of surgeons to “feel” tissues during an operation. The researchers successfully tested the efficacy of their new tool, which uses offthe-shelf sensors integrated into a laparoscopic grasper, with the assistance of surgeons from Cleveland Clinic Abu Dhabi (CCAD). minimally invasive surgery (MIS), also known as "keyhole surgery", has many advantages. Using specialized surgical instruments with thin, long tube-like shafts associated with endoscopes and surgical graspers, needles, and shears, MIS allows visualization and surgical access to target organs through small incisions. It requires shorter recovery times than “open surgery” and often involves less pain and scarring. Nonetheless, it offers surgeons limited field of vision and no ability to “feel” relative differences and stiffness of tissues during operation. Therefore, MIS operations are associated with the “lost sense of touch” dilemma for surgeons. In a new study titled Stiffness Assessment and Lump Detection in Minimally Invasive Surgery Using In-House Developed Smart Laparoscopic Forceps in the IEEE Journal of Translational Engineering in Health and Medicine, the researchers, led by NYUAD Associate Professor of Mechanical Engineering and Bioengineering Mohammad Qasaimeh, describe how they incorporated a

system of commercially available sensors into common laparoscopic instruments to develop their Smart Laparoscopic Forceps (SLF), a system that measures in real-time the grasping force and angle of the grasped tissue using a force sensor on the grasping jaw and an angle sensor at the handle. The data is analyzed using a microcontroller, and the grasping feedback is displayed on a monitor. Based on the deformation parameters captured by the two sensors, this smart tool gives the surgeon a relative stiffness index of the tissue on top of the applied force magnitude to help with decision-making throughout the surgery. Using this approach, conventional surgical tools can be made smart with tactile feedback features, on-demand, and in plug-and-play configuration. “The basic idea of this work is very simple, and we teach the concept of Hooke's law to our students early on, in fundamental solid mechanics. Yet, this work shows how basic engineering concepts can be powerful in translational engineering in medicine,” said Mohammed Qasaimeh. “During open surgeries, surgeons use their fingers to interact with internal tissues and organs, giving them tactile information that informs real-time surgical decisions,” said Wael Othman, a PhD candidate in Mechanical Engineering and the first author of the study. “But open surgeries come with costs, including the need for major incisions and potential serious consequences, including pain, risk of infection and lengthy recovery times. Our approach is exciting because it gives surgeons similar tactile information that, until now, has been missing during minimally invasive surgery.” “While the current prototype serves as a proof of concept, our future work will focus on developing even more precise ability to mechanically discern subtle differences in tissue stiffness and texture, and in collaboration with our colleagues from the CCAD, we plan to perform experiments with samples that represent better human organs,” said Qasaimeh.

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Mohammed Qasaimeh

The prototype was tested in the lab with the help of MIS CCAD surgeons using different soft and hard tissues, including home-fabricated samples with known stiffness, raw and cooked chicken meat samples, as well as sheep samples from digestive organs including stomach and bowel. Results showed that the developed tool significantly helped them in accurately sort the different samples based on their stiffness. Further, the developed tool was able to identify hidden embedded lumps within these samples, demonstrating the capability to offer surgeons tactile feedback information including grasping forces, organ stiffness, and the presence of embedded lumps.

NEWS

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NEWS

Cleveland Clinic Children’s Ranked Among the Best Children’s Hospitals by U.S. News & World Report

leveland Clinic Children’s, an integral part of global health system Cleveland Clinic, has been named a leader in clinical care in the U.S., according to U.S. News & Report’s 2022 - 2023 “Best Children’s Hospitals” rankings. Cleveland Clinic Children’s earned national recognition in nine specialties: cancer (15), cardiology and heart surgery (6), diabetes and endocrinology (36), gastroenterology and gastrointestinal surgery (13), neonatology (10), nephrology (29), neurology and neurosurgery (40), pulmonology and lung surgery (30) and urology (24). For 14 consecutive years, Cleveland Clinic Children’s has ranked among the nation’s top 50 pediatric hospitals. This year, two specialties ranked in the top 10 in the nation (cardiology and heart surgery and neonatology) and two more ranked in the top 20 (cancer, gastroenterology and gastrointestinal surgery). “We are privileged to once again be recognized by U.S. News & World Report,” said Karen Murray, M.D., Chair of Cleveland Clinic Children’s. “These rankings reflect the hard work of our pediatric caregivers who strive to improve the health of our community’s children every day through world-class patient care, research, education and advocacy.”

Over the past year, Cleveland Clinic Children’s has been at the forefront of clinical innovation and research in pediatrics, including: •

•

Performed a rare and complex lifesaving fetal surgery to remove a tumor attached to the heart of a 26-week-old fetus. Enrolled as a clinical trial site for an experimental form of treatment to ward off some of the effects of Hunter syndrome, a rare genetic disorder that damages tissues and organs. Published a study showing healthy diets reduce cardiovascular risk factors in overweight children.

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•

Reported findings from a study which showed a rise in pediatric heart failure-related emergency department visits and primary heart failure hospitalizations. Called for continued surveillance and reductions of preventable risk factors.

Since it first opened in 1921, Cleveland Clinic has cared for infants, children and adolescents. That history of pediatric care has become Cleveland Clinic Children’s. Today, it is one of America’s leading and largest providers of comprehensive pediatric care. More than 300 pediatric specialists and subspecialists– at more than 50 outpatient sites – provide the full spectrum of pediatric care to the largest patient population of any children’s hospital in Northeast Ohio. According to U.S. News, the “Best Children’s Hospital” rankings score the top 50 children’s hospitals in 10 specialties, based on clinical and quality data and an annual survey of pediatric specialists. The rankings methodology factors in patient outcomes, such as mortality and infection rates, as well as available clinical resources and compliance with best practices and efforts to promote diversity, equity and inclusion among patients and staff in 2022. Pediatric specialists around the country are also asked to provide their opinions on the best hospitals based on their inside knowledge of the delivered healthcare.

PART OF GLOBAL HEALTH SYSTEM CLEVELAND CLINIC, THE PEDIATRIC HOSPITAL SEES 9 SPECIALTIES RANKED AMONG THE U.US' TOP 50; 2 IN TOP 10.

NEWS

Geltec Healthcare FZE officially rebrands as Bioventure Healthcare FZE to reflect strengthened position in supplements and pharmaceuticals manufacturing

lobalOne Healthcare Holding (GHH), Yas Holding’s Healthcare Division, announced the rebranding of its subsidiary Geltec Healthcare FZE as Bioventure Healthcare FZE, as part of its strategy to strengthen its business and drive growth in the pharmaceutical and supplement manufacturing industry. A strategic partner of multinational companies and a key exporter to the U.S., Bioventure Healthcare FZE plans to expand the production capacity of its manufacturing plant by introducing new products such as oral solid tablets, capsules and sachets lines by 2023. This will lead to an increase in the company’s market share in the therapeutic categories of antihypertensive, anti-diabetes, anti-hypercholesterolemia, cardiovascular (CV), gastroenterology, gastrointestinal (GIT) health, immunity, men and women’s health products, and other critical specialty products. It also plans to add more unique dosage forms to increase the range of delivery systems, with the aim of catering to the growing pharmaceutical needs of the UAE and the wider region. The rebranding is aligned with GlobalOne Healthcare’s commitment to delivering healthcare outcomes and patient quality of life, as well as the UAE Government’s ‘Operation 300bn’. An initiative that aims to develop the country’s industrial sector and enhance its role in stimulating the national economy, ‘Operation 300bn’ is set to raise the industrial sector’s GDP contribution from AED 133 billion to AED 300 billion by 2031. Its primary focus is on future industries that implement advanced technology and Fourth Industrial Revolution (4IR) solutions and applications aimed at sustainable development. Ashraf Radwan, CEO of GlobalOne Healthcare Holding, said: “The rebranding reflects our role in the regional healthcare industry, while capturing our approach for the future of pharmaceutical manufacturing through innovation and advanced technologies deployment, in light of market growth expectations.”

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In 2021, Bioventure Healthcare FZE (formerly known Geltec Healthcare FZE) was acquired by GlobalOne Healthcare Holding. Located at the National Industries Park in Dubai, the company has a state-of-the-art manufacturing facility, which is the largest soft gelatine capsule manufacturing and packaging facility in the region, and has plans to expand into various other dosage forms. Over the last two years, GlobalOne Healthcare also acquired WellPharma Medical Solutions, an IV solutions manufacturing plant, Gulf Inject, a leading player in the fluid management therapy, and Al Ittihad Drug Store (IDS), a major UAE pharmaceutical distributor. Together, this now makes GlobalOne Healthcare Holding among the top three regional players in medical distribution.

Specializing in dietary supplements and pharmaceutical products in soft gelatine capsules and gelatine-coated tablets, Bioventure Healthcare’s world-class production facility in Dubai has a manufacturing capacity of 1.5 billion units per annum, making it the largest soft gelatine capsule manufacturing and packaging facility in the region. It is approved by the UAE Ministry of Health and Prevention and certified by GCC and European Union Good Manufacturing Practices. “We will continue to invest in the future and the growth of the region’s healthcare industry, while ensuring a stable supply of dietary supplements and pharmaceuticals, as we strengthen our contribution to the economy and continuously improve access to quality healthcare,” Ashraf Radwan added.

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NEWS

Transasia unveils a range of IVD solutions with enhanced user experience at Medical Fair 2022

aking its presence felt at Medical Fair India, Transasia Bio-Medicals Ltd unveiled two new “Made in India” products in its growing portfolio of in vitro diagnostics, Erba XL 640 and ESL 30. The Erba XL 640, a fully automated random access clinical chemistry analyzer with the autoloader is designed to meet the high throughput needs of modern clinical laboratories. By thoughtfully automating the conveyor rack system (CRS), the Erba XL 640 helps establish more efficient workflows: it relieves staff from manual work, eases their burden, and aids in achieving faster TAT. The Erba XL 640 analyzer with CRS was unveiled by Dr. Mohan Joshi, Dean in the presence of Dr. Pramod Ingale, Vice Dean of Lokmanya Tilak Municipal Medical College and General Hospital (LTMGH), Mumbai. Erba XL 640 has been validated at LTMGH, Mumbai. Once programmed, the analyzer is a walk-away system. Besides, random sample access, innovative robotics and an advanced user interface using windows embedded operating system optimize time management and streamline the workflow. In its ESR portfolio, Transasia announced the launch of ESL 30, a truly automated walkaway ESR system with a touchscreen interface that improves workflow, turnaround time, and laboratory safety. This analyzer was unveiled by Mr. N Santhanam, CEO of Breach Candy Hospital in the presence of Dr. V P Antia, Head of the Department of Haematological Medicine at Breach Candy Hospital.

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Speaking on the occasion, Mr. Suresh Vazirani, Founder Chairman, Transasia-Erba International Group of Companies cited, “Transasia continues to bring in world-class quality products at an affordable cost to Indian patients through Made in India products. With the launch of these “Made in India” auto-analyzers, we seek to meet the needs of laboratory professionals for reliable and affordable diagnostic solutions in biochemistry, hematology, immunology as well as inflammatory and autoimmune diseases. This will aid them in providing clinicians with the information they need to make reliable and timely clinical decisions for patients.” With an over four-decade legacy, Transasia Bio-Medicals Ltd., India’s Leading In-vitro Diagnostic Company, is at the forefront of providing quality and affordable diagnostic equipment and test kits to pathology laboratories and hospitals even in the remotest areas of the country.

UNVEILS CLINICAL CHEMISTRY ANALYZER XL 640 WITH CONVEYOR RACK SYSTEM AND ESR ANALYZER ESL 30

NEWS

Emirates Health Services Signs MoU with Johnson & Johnson to Strengthen Healthcare Sector

mirates Health Services (EHS) signed a Memorandum of Understanding with Johnson & Johnson Middle East to strengthen collaboration towards developing more advanced health services, as well as innovative hi-tech solutions to support the sector and boost its regional and international competitiveness. The MoU outlines various areas of cooperation for EHS to work on with Johnson & Johnson (Middle East) Inc. and Johnson & Johnson Middle East FZ-LLC. It was signed by His Excellency Dr Yousif Mohammed Al-Serkal, Director-General of Emirates Health Services, and Loai Abu Elhawa, General Manager - MedTech Gulf at Johnson & Johnson, in the presence of H.E. Dr Abdulaziz Al Zarooni, Acting Executive Director of the Financial Sector and Support Services at EHS; Dr Kulthum Al Balushi, Chief Innovation Officer, Director of the Training and Development Centre at EHS; and Jimmy Farris, Managing Director of Johnson & Johnson Middle East FZ-LLC. H.E. Yousif Al Serkal said: “The Memorandum of Understanding we are signing today is consistent with our plans and strategic directions at Emirates Health Services, and supports our efforts to provide innovative and sustainable health services that boost efficiency across the entire health system and set the stage for more ambitious advancements in healthcare systems at the local and international levels. The areas of cooperation outlined in the agreement include developing a structured educational curriculum that guarantees the transfer of knowledge and allows healthcare professionals to upgrade and refine their skills through training programs and advanced digital learning tools, including simulations and virtual reality applications.” Meanwhile, H.E. Dr. Al Zarooni explained that signing the agreement aligns with EHS’

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aspirations to advance the health services sector and foster collaboration across all medical specialties, paving the way for new accomplishments that cement the UAE healthcare sector’s leadership. On a similar note, Dr. Kulthum Al Balushi noted: “The outputs we look forward to from this agreement will help cement Emirates Health Services as a pioneering health authority and a leader in providing services that adhere to international best practices in the medical field, and upskilling medical, nursing, and technical staff in healthcare facilities to deliver these services. EHS is committed to signing more and more agreements that achieve common goals.” For her part, Marzina Collis, Managing Director at Johnson & Johnson applauded the new partnership with Emirates Health Services, describing EHS as one of the leading health institutions in the UAE. “The Memorandum of Understanding will allow us to exchange expertise and work closely with outstanding healthcare professionals and use advanced technologies to help develop their skills and attract more talent to this vital sector.”

The agreement calls for collaboration to implement public awareness programs and campaigns covering various diseases, such as obesity, cancer, and atrial fibrillation. The two parties will work together to launch the ‘Silent Noise Campaign’ to raise awareness about and destigmatise mental health conditions – focusing particularly on schizophrenia and depression. This campaign is in line with EHS’ strategy to drive positive change and combat stereotypes associated with mental health.

NATIONWIDE CHILDREN’S HOSPITAL WORLD-CLASS PROGRAMS. TRAILBLAZING RESEARCH. PERSONALIZED CARE. Columbus, Ohio, may feel like a world away, but our faculty, researchers and facility have earned international reputations for expertise in rare and complex conditions. Our Cardiovascular team is leading groundbreaking development of a biodegradable tissue-engineered vascular graft for children with congenital heart defects. Our multidisciplinary Center for Colorectal and Pelvic Reconstruction excels in advanced care for even the rarest congenital disorders, motility issues, fecal incontinence concerns and more, for patients in more than 60 countries. And the powerhouse team at the helm of our Neurosurgery and Neuro-Oncology programs excels in both leadership and collaboration in multinational cancer research. When you’re here, you are the center of our attention. Come to Nationwide Children’s —nothing but the best in care, in an accessible, cosmopolitan city. Reach out to our Global Patient Services team to find out why we should be your new global destination for complex care. Learn more, refer a patient or plan a trip: NationwideChildrens.org/Global-Patient-Services GlobalPatientServices@NationwideChildrens.org +1 614 362 9127 Nationwide Children’s Hospital, Columbus, Ohio – USA

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NEWS

Multidisciplinary team at SSMC successfully reconstructs neck of UAE patient

heikh Shakhbout Medical City (SSMC), one of the UAE’s largest hospitals for serious and complex care and a joint venture partnership between Abu Dhabi Health Services Company (SEHA) and Mayo Clinic, successfully performed high risk, complex oral maxillofacial surgery on a patient with a recurring tumor. The 42-year-old, female Filipina patient’s journey dates back to 2009 when she noticed a small lump behind her ear similar to the size of a bean. When she consulted with her local doctor, she was initially prescribed paracetamol and eardrops. After a few years of ignoring acute pain, the lump continued to grow and the patient was then diagnosed with a parotid tumor. Dr. John Devine, maxillofacial, head and neck surgery consultant and division chair at SSMC, said: “The patient had presented with a parotid tumor which is an abnormal growth of cells that form in the parotid glands, the largest of the three major salivary glands. After the first surgery in 2016, the patient had a recurrence of the tumor in 2018, and later in 2020, she underwent a biopsy, which identified that the tumor is a malignant acinic cell carcinoma. The patient came to us in 2021, we found that the tumor had become quite advanced, the size of a fist and was ulcerating her skin.” Dr. Devine, along with a multidisciplinary team, conducted a full investigation of a CT scan and a biopsy, which then confirmed the malignant state of the tumor and the potential to spread to other areas of the body. The team determined that the patient required surgery and that the tumor was operable. The multidisciplinary team consisted of the maxillofacial surgeon, radiologist, pathologist, speech therapist, dietician, and physiotherapist. “The surgery itself carried several risks for the team to factor in and control, including facial paralysis being a key risk. We also had to

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design the surgery in a way that we were able to do reconstruction, which was needed due to the size of the tumor. We performed the procedure using a facial NIM alarm system to detect the nerves and remove the tumor along with a large part of the facial skin. We then took a segment of her upper arm, an artery, and a vein to reconstruct the area. We were pleased to have accomplished the removal and reconstruction within the same surgery,” continued Dr. Devine. Amira El-Sheshtawi, Senior Physiotherapist at SSMC, said: “Rehabilitation played a pivotal role in the patient’s recovery, as we focused on the treatment plan to restore the patient’s range of motion and activate the muscle strength of the neck and right shoulder. We also paid attention to the nerves that control the movements of the mouth and facial muscles and focused on deep breathing exercises and stimulating the lungs and respiratory system to avoid complications and improve the quality of her life after surgery.” The patient said: “I was very pleased that the surgery went well and that I was finally able to get the help I needed after living with the tumor for such a long time. I’m so happy with the results and I’m very grateful for Dr. Devine because he really went the extra mile, and the nursing staff were very caring and checking up on me daily.”

Dr. John Devine

During the post-surgery phase, SSMC provided the appropriate care where the patient underwent speech therapy, had sessions with a physiotherapist and consulted with a dietician. “We owe the success of this surgery to our team of multidisciplinary experts who provided a 360-degree care for the patient. We are extremely pleased that we were able to support the patient, not only by removing a potentially life-threatening tumor, but by significantly improving her quality of life after suffering from her condition for so many years,” concluded Dr. Devine.

AFTER OVER A DECADE OF MISDIAGNOSES, SSMC DOCTORS PUT AN END TO THE PATIENT’S DEBILITATING PAIN.

Award-winning care meets humankindness. Medical breakthroughs have continued to help people live healthier lives, and we’re honored to be recognized for them. With our new rankings by U.S. News & World Report, we celebrate these advancements and the power of humankindness to provide healing for our communities in the best way. Learn more at stlukeshealth.org./bslmcinternational

NEWS

The 25th Annual Congress of the Lebanese Society of Endocrinology, Diabetes and Lipids (LSEDL) Informative Lectures Presented by Distinguished Speakers

he 25th Annual Congress of the Lebanese Society of Endocrinology, Diabetes and Lipids (LSEDL) was held on the 24 – 26 June 2022 at Movenpick Hotel, Beirut. It gathered more than 250 attendees from all over the world, to discuss the updates on different subjects in endocrinology, diabetes and metabolic diseases. The Lebanese Society of Endocrinology, Diabetes and Lipids is the official scientific society of the Lebanese order of physicians that gathers endocrinologists in Lebanon. With around 200 members, LSEDL holds monthly scientific activities, disease-specific events as related to diabetes and obesity months. Its biggest activity is the annual congress held in June every year; this year’s congress was characterized by a return to in-person attendance with many international speakers coming to Lebanon, in addition to local speakers. Highlights of the congress were updates in pituitary diseases, therapies of thyroid cancer and polycystic ovary syndrome, pearls in adrenal disease, mechanism of bariatric surgery, in addition to topics related to diabetes management. The congress included informative lectures presented by distinguished speakers from different countries. The first day of the congress included lectures about ‘A New Future in the Management

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of Cushing’s Syndrome’, accompanied with clinical cases from MENA. ‘Uncontrolled Acromegaly’ was also discussed focusing on medical management of acromegaly. As for the second day, many topics were discussed such as Mechanisms of Action of Metabolic/Obesity Surgery, Cardio-Renal Approach in Diabetes, Pheochromocytoma, pituitary adenomas in pregnancy, transgender medicine and glucocorticoid withdrawal. The third and last day of the congress included different topics that cover many diseases including Management of Osteoporosis and Positioning of Denosumab, Prolactinomas: The Old and The New, Update on Pathophysiology, Diagnosis & Treatment of Adolescent PCOS, Innovation and Insulin Therapy: Improving Lives of Diabetic Patients.

HIGHLIGHTS OF THE CONGRESS WERE UPDATES IN PITUITARY DISEASES, THERAPIES OF THYROID CANCER AND POLYCYSTIC OVARY SYNDROME, PEARLS IN ADRENAL DISEASE, MECHANISM OF BARIATRIC SURGERY, IN ADDITION TO TOPICS RELATED TO DIABETES MANAGEMENT.

NEWS

Dubai Health Authority electronic medical record initiative to further bolster the health sector

he Dubai Health Authority (DHA) highlighted that the medical electronic record project for every individual in the Emirate known as ‘Nabidh’, has integrated 8.4 medical records; 31,800 doctors and 298 facilities. The system is linked to the Ministry of Health and Prevention’s ‘Riayati’ project to ensure a single medical electronic file for patients across the UAE. This was announced during Nabidh’s quarterly forum that was held in the presence of His Excellency Awadh Al Ketbi, Director General of the Dubai Health Authority, officials from the Ministry of Health and Prevention, the Abu Dhabi Health Department, private hospitals and health centers. The forum was attended by Dr. Shamsheer Vayalil, Chairman and Managing Director at VPS Healthcare. His Excellency Awadh Seghayer Al Ketbi highlighted that the Nabidh platform is in line with Dubai's aspirations to achieve global competitiveness in the health field. He said the DHA is proud to collaborate with key partners including the Ministry of Health and Prevention to ensure every patient in the UAE has one digital medical record. He said: “DHA prioritises the utilisation of the latest digital technologies and cutting-edge solutions to drive progress in line with its aim to provide patient-centered care of the highest quality. The NABIDH project will positively impact healthcare delivery in Dubai. It will securely store patients' health records from multiple healthcare facilities and provide healthcare professionals with complete medical histories in real time.” Dr. Shamsheer Vayalil, Chairman and Managing Director at VPS Healthcare, said: “Population health management has become an important method for improving community health. By connecting data in public and private healthcare facilities, Dubai’s NABIDH initiative

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facilitates a unified medical record for every individual in Dubai. It will enable data analysis from different sources, leading to significant improvement across all channels: in physician work with data-driven systems, in research and diagnostics, as well as contributing to an overall reduction in the cost of care and enhancing efficiencies. We are confident that this initiative will help us further strengthen the concept of personalised and value-based care.” Dr. Mohammad Al Redha, Director of Project Management Office, Health Informatics & Smart Health at Dubai Health Authority said: “In line with the vision of our leaders, the Dubai Paperless Strategy and the DHA’s strategy to foster and promote the use of technology across all spectrums of healthcare, we have been working towards building a seamless digital file for every patient in Dubai. A single electronic file for every patient will positively impact patients, enhance patient care as well as aid in the development of evidence-based preventive healthcare policies to benefit the community at large. The implementation of this project will help bolster patient-centered care and will enhance the health and wellbeing of our population.”

SO FAR 8.4 MILLION MEDICAL RECORDS, 31,800 DOCTORS, AND 298 FACILITIES HAVE BEEN INTEGRATED INTO THE NABIDH SYSTEM.

ARTICLE

A win-win strategy for patient transportation Putting Caregivers First with Advanced Motorized Stretchers By Dounia Benjelloun-Hack, Regional Sales Director LINET MEA

ne example of how advanced technology can bring a significant reduction in costs and at the same time contribute to a higher value of the well-being of caregivers is powered stretchers. These motorized devices are primarily intended for the area of emergency and generally for the area of transport within the hospital, but recently these stretchers are increasingly used for the growing segment of one-day surgery. The new SPRINT 200, a stretcher with I-Driver Power technology, brings all the advantages of motorized stretchers, which, according to independent studies and internal testing, mean a significant reduction in musculoskeletal disorders.

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It is a sad fact that despite all the technological developments, nurses and non-medical professionals in the health sector are exposed to extreme risks of work-related injuries. In the case of patient transport, the increased spinal force load caused when pushing and pulling occupied beds or stretchers has been identified as a high-risk activity and can lead to work-related musculoskeletal disorders, which affect not only the lower back, the shoulders, and neck are often affected too. Several studies have found that one of the most effective means of reducing or eliminating the risk of MSDs in the case of patient transport is the motorized drive of stretchers or beds. Im-

THE NEW SPRINT 200, A STRETCHER WITH I-DRIVER POWER TECHNOLOGY, BRINGS ALL THE ADVANTAGES OF MOTORIZED STRETCHERS, WHICH, ACCORDING TO INDEPENDENT STUDIES & INTERNAL TESTING, MEAN A SIGNIFICANT REDUCTION IN MUSCULOSKELETAL DISORDERS.

ARTICLE

plementing this technology was recognized as beneficial for the physical and mental well-being of hospital staff and can lead to cost savings for the organization. A 2017 study* compared 2 paramedic departments in different hospitals. Before implementing the powered stretchers, both hospitals had similar stretcher-related musculoskeletal disorders incidence rates. • One year after the introduction of powered drive stretchers, it was noted that musculoskeletal disorders had decreased by 78%. Powered stretchers were related to a 70% reduction in musculoskeletal disorders and 8% related to the load system. • In the department that continued to use manual stretchers, musculoskeletal disorders incidence rates were similar to the previous year.

musculoskeletal disorders has a positive impact on hospital budgets. • The total cost of investing in powered stretchers demonstrated an 80% saving on musculoskeletal disorders, and 73.5% fewer lost workdays year-to-year. Because the well-being of caregivers is important to us, LINET is launching a new generation of stretchers called SPRINT 200, the Stretcher Redefined. The main purpose of the new stretcher is to significantly reduce MSDs (musculoskeletal disorders) of the caregivers worldwide, optimizing patient flow and the cost of care. The motorized castor on the new LINET stretcher Sprint 200 is called i-Drive power. This system of motorized patient transport offers exceptional performance controlled with a unique Safety Sense handle to minimize transport-related physical effort and maximize comfort when driving the stretcher.

From this perspective, this study provides strong evidence that powered stretchers can reduce stretcher-related musculoskeletal disorders and the associated economic benefits are favorable. Reduced incidence of

*Armstrong DP, Ferron R, Taylor C, McLeod B, Fletcher S, MacPhee RS, Fischer SL. 2017. IMPLEMENTING POWERED STRETCHER AND LOAD SYSTEMS WAS A COST EFFECTIVE INTERVENTION TO REDUCE THE INCIDENCE RATES OF STRETCHER RELATED INJURIES IN A PARAMEDIC SERVICE. Appl Ergon. [Online] 2017. https:// pubmed.ncbi.nlm.nih. gov/28411738/

Choosing The Right Hospital . ARTICLE FEATURES

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Choosing The Right Hospital . ARTICLE FEATURES

hen a person suffers from a specific health condition that requires a hospital admission, the first question that comes to mind is which hospital to choose? In order for the patient to receive top medical service at an affordable price, there are several factors to consider when choosing the right hospital. Studies have shown that any element involved in the medical industry is key in improving the medical service and providing the patient with the optimal health and psychological atmosphere, thus creating the best image of the chosen hospital or medical center. Some patients choose the hospital based on medical competency, state-of-the-art equipment, or location and service. Furthermore, there are other factors that affect the patient’s choice, especially after the significant expansion of the hospitalization world, which has been based on modern concepts that have revitalized the medical tourism around the world. So why and on what basis do we choose the hospital? Before diving into the reasons behind choosing the best hospital, it is important to know that if a hospital is accredited, the patient can rest assured that it follows stringent standards as laid down by the accreditation body. However, this does not mean that it becomes the ultimate destination for those seeking treatment. There are also other reasons for the patient or his family to consider when choosing the best hospital. It is based not only on the hospital’s reliability, but also on the suitability and accuracy of the patient's medical condition, length of stay, location, costs, etc.

General features and guidelines Choosing the right hospital positively affects the patient's health condition. A positive patient experience is related to better health outcomes. This does not only apply to complex interventions and medical conditions that require special attention; all surgical interventions require a great deal of experience and utmost attention. How can a patient be sure that he is getting the optimal treatment in a hospital? What are the quality standards to be considered when searching for the best hospital?

It is worth noting that not every hospital is suitable for specific treatments or surgeries, even if it was renowned. The best hospital always promises to deliver the optimal treatment for the patient's condition. Not only do the competence and experience in certain treatment methods play a role in choosing a hospital, but also a large number of fundamentally important factors must be also taken into account. This starts with the quality of the consultation, as it also gives information about the hospital suitability, distinction and quality.

Therefore, the reasons behind choosing the appropriate hospital must be divided into two groups: •

•

Medical and technical factors such as the competence of the medical and nursing staff in addition to the state-ofthe-art equipment and tools. Environmental factors, both internally and externally, such as the hospital’s architecture and its surroundings, its adherence to safety conditions, the adoption of renewable energy, its location and the facilities it provides.

BEFORE DIVING INTO THE REASONS BEHIND CHOOSING THE BEST HOSPITAL, IT IS IMPORTANT TO KNOW THAT IF A HOSPITAL IS ACCREDITED, THE PATIENT CAN REST ASSURED THAT IT FOLLOWS STRINGENT STANDARDS AS LAID DOWN BY THE ACCREDITATION BODY. HOWEVER, THIS DOES NOT MEAN THAT IT BECOMES THE ULTIMATE DESTINATION FOR THOSE SEEKING TREATMENT.

Finnish researchers believe that when we talk about which hospital to choose, we are only thinking about non-critical and long-term treatment cases, in which the patient is able and have the time to think, research and choose. In such case, his condition requires special care, but it is not an emergency. In emergency and critical cases, the patient always aims to go to the nearest hospital, because the goal is to save his life first and foremost. Thus, the nearest hospital is preferred, even if it is not necessarily the best. Regardless of these cases and considerations, there are steps that patients usually take to choose the most appropriate hospital. The first step in choosing the right medical service provider, especially abroad, begins with collecting all possible information about the potential clinic or hospital. There are several ways to find this information, whether by looking at their website, or checking their leaflets, as well as read any article or evaluation about the hospital or clinic published in the media. It is also possible to coor-

Choosing The Right Hospital . ARTICLE FEATURES

dinate with medical intermediaries to obtain the required information about a medical institution.

The medical aspect of the evaluation and selection process During the consultation, the patient must be provided with a comprehensive explanation of the course of treatment in plain language, if possible. The specialist should also highlight in detail the risks, potential consequences and chances of recovery. The more informed the patient is about his upcoming treatment, the better he can understand and track what is happening to him in order to choose the right hospital. This has a critical impact on his sense of safety and trust in the surgeon or therapist. This benefits both the doctor and the patient. Consultation is required pre- and post-surgery. Moreover, a detailed discharge conversation about the necessary procedures is at the core of good patient care. Accreditation of healthcare services is recommended to ensure operation according to the highest quality standards. Accreditation is viewed as a reputable tool to evaluate and enhance the quality of healthcare. There is consistent evidence that shows that accreditation programs improve the process of care provided by healthcare services. The patient should make sure that the hospital or clinic is accredited by a recognized body, and that the accreditation is still valid. The patient can easily check the list of health centers accredited by international accreditation bodies. JCI standards serve as the foundation of an evaluation process that can help healthcare organizations measure, assess and improve performance. The ISO certificate is the right choice for streamlining the daily hospital work and adopting the best practices in the world. There are also some foreign hospitals affiliated with world-renowned health institutions or reputable universities. You can make sure whether the intended foreign hospital is owned, operated, or formally affiliated with one of its international counterparts.

Treatment and beyond A hospital’s top-notch healthcare services attract the patient when he is searching for the

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best place for treatment. Healthcare starts with hospitalization and continues with follow-ups. Therefore, it is important to ascertain the nursing services provided by the hospital, and whether it is possible to obtain a personal nurse around the clock to meet the patient’s needed follow-ups. Furthermore, it is key to investigate the medical team, which is an easy task given that the potential hospital is well-known and is distinguished by its medical team and achievements. It is also necessary to know the services provided by the hospital and the equipment used. Experts in the hospitalization field confirm that the main criterion in choosing a hospital is undoubtedly the presence of professional and brilliant specialists in the desired medical field. The expertise demonstrated by doctors in a particular treatment method or in surgery is the core of treatment quality. Thus, the numbers of cases can give information about the experience in a particular treatment and the medical outcomes. It is also worth noting the importance of having highly skilled specialists in specific fields other than merely treating the underlying disease, for instance a dietician, physical therapist, or psychotherapist. In some diseases, the ability to access a specialized staff, whether for the purpose of lymphatic drainage or pain management, is what makes a hospital the best.

Aftercare Aftercare is extremely important to any surgery or treatment. This is the period that the body needs to recover and heal after surgery or treatment. Therefore, it is important to know some aftercare details from the medical service provider, such as: Is having a close friend or a patient family member allowed in the post-treatment period? Should the patient stay in the hospital, or can he be taken home to continue treatment? Also, it is necessary to know the hospital’s emergency arrangements in case any complications arise during or after surgery and treatment. Moreover, it is important, especially for those receiving treatment abroad, to consider how the hospital or health institution they are looking for handles medical records and other treatment-related documents. These records

ACCREDITATION OF HEALTHCARE SERVICES IS RECOMMENDED TO ENSURE OPERATION ACCORDING TO THE HIGHEST QUALITY STANDARDS. ACCREDITATION IS VIEWED AS A REPUTABLE TOOL TO EVALUATE AND ENHANCE THE QUALITY OF HEALTHCARE. THERE IS CONSISTENT EVIDENCE THAT SHOWS THAT ACCREDITATION PROGRAMS IMPROVE THE PROCESS OF CARE PROVIDED BY HEALTHCARE SERVICES.

Choosing The Right Hospital . ARTICLE FEATURES

and documents are known to be extremely important references, especially if the patient needs to visit the doctor regularly after treatment, or if he needs to get routine check-ups. In this case, it is important to know whether the hospital uses electronic medical records to store and retrieve patient files and records, including X-ray films, laboratory results, and examination records. Also, the patient should make sure that copies of these records can be obtained for later use in other cases or in other medical centers.

Medical Tourism With the expansion of medical tourism in the world, attracting patients has become fundamental for the hospital. The goal of every hospital management is to achieve quality excellence, optimize the flow of processes and effectively manage the daily work. Most foreign hospitals working in the medical tourism field have special criteria to unveil their performance ratio and quality indicators. A remarkable feature is the hospital's ability and willingness to show these rates upon request. Thus, the patient or client can assess the hospital’s work history and the quality of the service provided with regard to a particular treatment or surgery. Regarding technologies and medical equipment used, it is worth noting that not every hospital has the same technical options in terms of diagnostics and innovative robotic-based surgery, for instance. Continuous and rapid medical developments always result in technical innovations linked to capital-inten-

sive investments. Therefore, it is important to learn about the latest updates adopted by the hospital. This would also make a big difference for the patient and could save his life, in terms of diagnosis or surgery.

Non-medical services or facilities Many hospitals and clinics, especially those providing medical tourism services, started providing integrated packages of services that include the costs of therapeutic procedures, analyzes and related treatments, in addition to packages that include accommodation costs. Some of these medical centers provide a five-star hotel accommodation in their own hotel rooms, or offer comprehensive packages that include reduced cost accommodation in hotels near the hospital, or provide offers that include airport/ hotel transfers, interviews with doctors as well as pre- and post-surgery medical examinations, in addition to post-treatment care services. Today, this concept has evolved and now includes visa facilitations, provision of an interpreter or a personal guide to accompany you during the trip. The languages spoken by the hospital and nursing staff also play a major role in choosing the desired destination. Furthermore, the hospital location is key; its proximity to all service/entertainment facilities and markets is a fundamental element. At the same time, it should be in a quiet place away from pollution and noise. Medical seekers now prefer environmentally friendly hospitals over those that consume large amounts of fuel and

MEDICAL SEEKERS NOW PREFER ENVIRONMENTALLY FRIENDLY HOSPITALS OVER THOSE THAT CONSUME LARGE AMOUNTS OF FUEL AND USE TRADITIONAL METHODS OF MEDICAL OR EVEN REGULAR WASTE DISPOSAL.

Choosing The Right Hospital . ARTICLE FEATURES

use traditional methods of medical or even regular waste disposal. Protecting the environment is a key factor in choosing a hospital or medical institution. A clean hospital environment plays a major role in controlling germs, and it must be completely free of any kind of contaminants. The expert in charge of this unit manages all activities related to the hospital environment safety, by examining and monitoring the water used in the hospital, following the right sewage disposal method, taking potable water and wastewater samples from the sewage filter, and programming the control of insects, vectors and rodents, in addition to supervising the examination of disinfection and sterilization materials, etc. Additionally, ensuring the cleanliness and safety of all environmental factors (light, sound, physical environmental factors, etc.) for the various departments and units is imperative. Soaps now used limit the use of chemicals, give good results with cold water and can be used as an alternative to cleaning products in washing machines, dishwashers and consumer products. Furthermore, hospotels have become a very sought-after destination for anyone seeking treatment. A growing number of patients are seeking treatment at hospotels. The best hospital for these patients is the one that combines both medical competence and excellence while providing highly trained front desk receptionists, hotel architecture in terms of halls, rooms, wall colors, bathrooms and food service. Generally, the management department plays a crucial role in the facilitation of patient service, whether the paperwork is completed in a timely manner or the treatment seeker is greeted in a hospitable and attentive way. Moreover, the hospital’s elegant and beautiful surroundings should be designed to provide comfort for patients and visitors, while its green spaces and convenient location make it a wonderful place for everyone. Experts confirm that all these features involve considerable costs, significant expertise and continuous care, but on the other hand, they effectively contribute to ensuring the best treatment for the patient and providing greater comfort for his family. It has also been scientifically proven that is contributes to accelerating

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patient recovery. Most importantly, it ensures patient satisfaction, especially to those whose condition requires a long hospital stay. Other factors can contribute to a successful treatment in addition to the various languages used in the hospital to deal with various nationalities. The presence of close relatives is important to some people. In this case, it is best to choose a hospital that offers inpatient accommodation. In conclusion, investments in physical and human capital is the main factor that provides the hospital's integrated environment.

Highlights and Abstracts Searching for the best hospital for treatment is a wise step and the patient ought to consider all these factors that actually let the hospital stand out and make it more suitable for different medical conditions.

However, experts recommend using several sources of information in order to make sure that the right choice is made. This includes: •

•

Recommendations from friends, family members, neighbors, co-workers, or anyone who underwent treatment or surgery in the same location you would like to inquire about. Find hospital reviews and opinions on independent healthcare websites, as well as on the websites of institutions responsible for evaluating services provided in healthcare centers. Read the testimonies and cases of former patients who received treatment in the same hospital, on forums or websites, electronic support groups, flyers and medical journals.

In the research process, the patient can turn to specialized companies and centers to learn more about this, and they will send them a list of the available hospitals and specialists, and provide them with important information that may be useful to them during their stay. Patients or their relatives usually tend to choose a hospital based on proximity to the place of residence. Nevertheless, the patient is advised to objectively

HOSPOTELS HAVE BECOME A VERY SOUGHT-AFTER DESTINATION FOR ANYONE SEEKING TREATMENT. A GROWING NUMBER OF PATIENTS ARE SEEKING TREATMENT AT HOSPOTELS. THE BEST HOSPITAL FOR THESE PATIENTS IS THE ONE THAT COMBINES BOTH MEDICAL COMPETENCE AND EXCELLENCE WHILE PROVIDING HIGHLY TRAINED FRONT DESK RECEPTIONISTS, HOTEL ARCHITECTURE IN TERMS OF HALLS, ROOMS, WALL COLORS, BATHROOMS AND FOOD SERVICE.

Choosing The Right Hospital . ARTICLE FEATURES

try to find the best hospital suitable for the treatment of his illness. It is worth noting that the best hospitals always prioritize the patient’s comfort and convenience at each stage of their journey. They focus on making the patient’s experience as seamless as possible, right from appointment booking to discharge. Great hospitals always put their patients first. Their policies, facilities, and pricing structure are developed to provide a hassle-free experience to all patients. In addition, they focus on empowering their patients by giving them access to all the necessary information.

The importance of legal liability in choosing a hospital Hospitals, healthcare clinics and treatment centers may be liable for medical malpractice that occurs in their facilities. Thus, doctors, nurses and medical staff who are employees at a medical facility can cause the facility to be liable if they are negligent or commit malpractice at the facility. When doctors or other healthcare providers commit medical malpractice, the treating hospitals may bear legal liability. It is important to learn about the legal liability when choosing a hospital to receive treatment. For instance, what about contracts for the services provided? Do they include a clause on

accountability and legal liability in the event of any complications arising from negligence? What is the hospital's history of dealing with cases of medical malpractice and negligence? It is also important to have a person in charge of covering the costs of medical procedures as well as the relevant terms and conditions. It is also imperative to be aware of the country's local procedures in dealing with cases of malpractice and medical negligence. There are foreign treatment seekers who are interested in inquiring about the possibility of receiving special assistance, whether from the government or non-governmental organizations in the host country, in the form of legal aid or advice on malpractice and medical negligence issues. This is of significant importance in choosing a hospital In addition to learning about legal liability and cases of medical malpractice, the patient should be also informed about the way foreign hospitals or clinics deal with patient safety. This include the hospital's safety policy, and whether they have a special policy regarding the disposal of dangerous or infectious materials such as contaminated needles as well as health policies related to food and patient facilities, hospotel safety in addition to safety precautions during the post-treatment phase.

HOSPITALS, HEALTHCARE CLINICS AND TREATMENT CENTERS MAY BE LIABLE FOR MEDICAL MALPRACTICE THAT OCCURS IN THEIR FACILITIES. THUS, DOCTORS, NURSES AND MEDICAL STAFF WHO ARE EMPLOYEES AT A MEDICAL FACILITY CAN CAUSE THE FACILITY TO BE LIABLE IF THEY ARE NEGLIGENT OR COMMIT MALPRACTICE AT THE FACILITY.

INTERVIEW

Dr. Sohaila Cheema

Assistant Dean for the Institute for Population Health Associate Professor of Clinical Population Health Sciences

“In the IPH, we believe all current and future health professionals must be trained so that they can incorporate lifestyle medicine in their medical practice."

he Institute for Population Health (IPH) at Weill Cornell Medicine-Qatar (WCM-Q) helps to build a healthier community in Qatar through a wide and diverse range of programs, initiatives and activities grouped under the broad themes of education, research, and community outreach. "Hospitals" Magazine spoke with Dr. Sohaila Cheema, Assistant Dean for the Institute for Population Health and Associate Professor of Clinical Population Health Sciences at WCM-Q, to find out more about the work of the IPH, which recently celebrated its 10th anniversary of promoting population health. Dr. Cheema, a medical doctor by training, completed a fellowship in Integrative Medicine at the Arizona Center for Integrative Medicine, University of Arizona. She received her Master of Public Health degree from Johns Hopkins Bloomberg School of Public Health and is certified in public health by the National Board of Public Health Examiners, USA. Additionally, she is a diplomate of the International Board of Lifestyle Medicine. Dr. Cheema’s research interests include integrative medicine, lifestyle health, population health and emerging aspects of healthcare.

There is a lot of discussion about lifestyles and their role in several chronic diseases like diabetes, obesity, cancer, heart disease and other serious conditions. But life expectancy is increasing in most parts of the world. Can you explain what is happening? First, let’s review the context of today’s world and the way modernity and its trappings impact health. The good news is that we

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INTERVIEW

have advanced medically and technologically, and along with this we see an increase in life expectancy in several countries. However, at the same time, and in general, an increase in lifestyle-related diseases has been observed. We now understand that the root causes of these diseases are unhealthy behaviors like sedentary habits, unhealthy eating (increased intake of fast food and processed food), poor sleep habits, substance misuse, and an increase in stress. There has also been a tremendous uptake of social media usage, which appears to be linked to sedentary behavior and a global increase in mental health issues. We also see an interplay of psychosocial factors, with more competition, time pressure, social isolation, and less intimate engagement with the family unit. Living longer is of course good, but aging does impact healthcare delivery, family structure, and social infrastructure, and we can see that many older people have health conditions that impact their quality of life. The challenge is to remain healthy while living longer. For us to prosper and thrive, the focus should be on a healthy lifespan, and that is where lifestyle medicine can play an important role.

Can you give us a definition of lifestyle medicine and discuss which specific lifestyle-related factors we need to think about? Evidence suggests that 80 percent of chronic diseases can be prevented, treated, and often reversed by adopting healthy lifestyle measures like physical activity, healthy diet, stress management, restorative sleep, maintaining healthy relationships and social connectedness, tobacco cessation, and avoiding the use of other risky substances. These practices/behaviors form the core pillars of lifestyle medicine (LM) - an emerging healthcare discipline gaining acceptance worldwide. The definition of lifestyle medicine used by the American College of Lifestyle Medicine (ACLM) states: “Lifestyle Medicine is the use of a whole food, plant-predominant dietary lifestyle, regular physical activity, restorative sleep, stress management, avoidance of risky substances and positive social connection as a

LIVING LONGER IS OF COURSE GOOD, BUT AGING DOES IMPACT HEALTHCARE DELIVERY, FAMILY STRUCTURE, AND SOCIAL INFRASTRUCTURE, AND WE CAN SEE THAT MANY OLDER PEOPLE HAVE HEALTH CONDITIONS THAT IMPACT THEIR QUALITY OF LIFE. THE CHALLENGE IS TO REMAIN HEALTHY WHILE LIVING LONGER. FOR US TO PROSPER AND THRIVE, THE FOCUS SHOULD BE ON A HEALTHY LIFESPAN, AND THAT IS WHERE LIFESTYLE MEDICINE CAN PLAY AN IMPORTANT ROLE.

primary therapeutic modality for treatment and reversal of chronic disease.”

Can you elaborate on the evidence base for lifestyle medicine approaches to nutrition and how can this be used to address chronic diseases? The nutrition promoted by the ACLM is a dietary pattern centered on whole plant foods, such as vegetables, fruits, whole grains, legumes, nuts, and seeds. Processed foods and animal foods are limited or excluded. Research shows that diets high in whole plant foods have numerous health benefits. These include weight loss, favorable change in lipid profile, decreased risk of diabetes, improved glycemic control or normalized blood glucose levels for those with diabetes, and decreased risk (and even reversal) of cardiovascular disease. Plant-based diets are associated with decreased risk of some cancers, improved migraine symptoms, and a decrease in all-cause mortality. New studies are coming out all the time showing numerous other benefits of predominantly plant-based diets. There also appear to be benefits for mental health disorders; research studies have shown an association between Western or highly processed diets and increased risk of developing psychiatric symptoms such as depression and anxiety. And not only does shifting to a whole-food, plant-predominant dietary lifestyle protect human health, it can also reduce commercial agriculture’s carbon footprint, enabling the preservation of natural resources while decreasing greenhouse gas emissions.

What is the role of physical activity in lifestyle medicine? Physical inactivity has been described as the biggest problem of the 21st century. Our lifestyles are now increasingly sedentary, with the resultant side effect of obesity currently recognized as a major health problem worldwide. It is important that adults engage in gener-

INTERVIEW

al, incidental, and purposeful physical activity. General physical activity can burn calories and is important in combating the negative effects of sedentary behavior. Purposeful exercise meanwhile improves cardiorespiratory fitness and strength and leads to substantial health benefits. In children and adolescents, physical activity improves cardiorespiratory and muscular fitness, cardiometabolic health (blood pressure, dyslipidemia, glucose, and insulin resistance), bone health, cognitive outcomes (academic performance, executive function), mental health (reduced symptoms of depression), and reduced adiposity (excess fatty tissue). All adults should undertake regular physical activity and limit the amount of time spent being sedentary. The evidence shows that physical activity improves sleep quality, reduces anxiety, and lowers blood pressure. Additionally, physical activity reduces the risk of dementia, depression, heart disease, stroke, and type 2 diabetes. It lowers risks of cancers of the bladder, breast, colon, endometrium, esophagus, kidney, lung, and stomach, reduces the risk of weight gain, improves bone strength and reduces risks of falls, enhances the immune system, and reduces the incidence of osteoarthritis.

Why is social connectedness considered important in lifestyle medicine? Social connection is a well-established determinant of mental and emotional well-being, physical health outcomes, and longevity. Humans appear to be “wired” for social connection, which is why the social isolation and associated loneliness due to COVID-19 lockdowns have been such a concern. Social support can also buffer the negative effects of stress on mental and physical health. Low-quality and low-quantity social ties are linked to heart attacks, atherosclerosis, high blood pressure, delayed cancer recovery, slower wound healing and development, and progression of cardiovascular disease. Enhanced social connection can improve prevention and help in the treatment of leading chronic diseases and lead to increased life expectancy.

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SOCIAL CONNECTION IS A WELLESTABLISHED DETERMINANT OF MENTAL AND EMOTIONAL WELLBEING, PHYSICAL HEALTH OUTCOMES, AND LONGEVITY. HUMANS APPEAR TO BE “WIRED” FOR SOCIAL CONNECTION, WHICH IS WHY THE SOCIAL ISOLATION AND ASSOCIATED LONELINESS DUE TO COVID-19 LOCKDOWNS HAVE BEEN SUCH A CONCERN. SOCIAL SUPPORT CAN ALSO BUFFER THE NEGATIVE EFFECTS OF STRESS ON MENTAL AND PHYSICAL HEALTH.

What are the other important elements of lifestyle medicine? The other key points are optimizing restorative sleep, management of stress, and avoidance of tobacco products and other unhealthy, habit-forming substances. Sleep is now known to be essential for health and optimal functioning. In fact, sleep deprivation can be used as a form of torture. Yet many of us continue to get inadequate sleep, either because we deliberately deprive ourselves of sleep or because we seem unable to get a good night’s rest. Getting good restorative 7-8 hours of sleep as an adult is extremely important for our body to function optimally. Over time, sleep deprivation increases the risk for a number of chronic health problems, including obesity, diabetes, high blood pressure, depression and anxiety, and heart disease. Stress is ubiquitous in modern society, and it has been further exacerbated by the COVID-19 pandemic. Chronic stress is linked to many illnesses, including coronary artery disease, heart failure, asthma, rheumatoid arthritis, and psoriasis. Stress is also intimately related to mental illness—especially anxiety. In addition to the physiologic changes that accompany the stress response, stress can adversely affect health behaviors resulting in poorer dietary choices, inactivity, disordered sleep, and substance use. Stress is unequivocally linked to poor health outcomes and evidence-based stress management should be considered foundational for the management of chronic health conditions. Regarding smoking and the use of other substances, there is a very large body of evidence that demonstrates the negative effects of these habits. As an example, if an individual quits smoking, benefits include a decrease in blood pressure within one hour, decreased heart attack risk within 24 hours, and a 50 percent lower risk of myocardial infarction after nine months.

Are hospitals and educational institutions considering lifestyle medicine when providing care for patients and educating healthcare professionals? Healthcare professions education is tra-

INTERVIEW

ditionally disease-focused with a predominant emphasis on pharmacotherapy and interventional and surgical approaches to treatment. This focus continues to dominate the healthcare sector and education of healthcare professions. However, health practitioners who utilize lifestyle medicine in their practice report benefit both for their patients and themselves. And several published studies report high patient satisfaction with lifestyle medicine and support the benefits of lifestyle medicine for the treatment and prevention of chronic diseases. Nevertheless, many healthcare providers remain unfamiliar and/or skeptical about its usefulness. I believe the evidence shows that lifestyle health approaches are indeed effective and that education should therefore be incorporated into health professions curricula globally to allow for better acceptance and familiarity among healthcare providers. Lifestyle medicine competencies should also be integrated into the current healthcare environment to become a routine aspect of healthcare practice. Healthcare professionals must take the lead in creating a culture change within communities so that they embrace the importance of living a healthy lifestyle as opposed to being solely dependent on medication for health and longevity. In the IPH, we believe all current and future health professionals must be trained so that they can incorporate lifestyle medicine in their medical practice. The time is now to prioritize and optimize lifestyle health learning to curb the tide of chronic disease and shift the care model from one based on treating disease to a truly holistic healthcare model.

THE TIME IS NOW TO PRIORITIZE AND OPTIMIZE LIFESTYLE HEALTH LEARNING TO CURB THE TIDE OF CHRONIC DISEASE AND SHIFT THE CARE MODEL FROM ONE BASED ON TREATING DISEASE TO A TRULY HOLISTIC HEALTHCARE MODEL.

initiated. To date, approximately 800 healthcare professionals are members of the Group to help us in the journey to reduce the burden of disease and improve the health of future generations. In tandem, the IPH leadership forged relationships with the American College of Lifestyle Medicine and the International Board of Lifestyle Medicine leadership. The IPH hosted a two-day symposium on lifestyle medicine with local and international speakers in 2019. The journey led to the development and implementation of the 60-hour Certificate in Lifestyle Medicine in January 2020. To date, four successful offerings of the course have taken place with 164 healthcare professionals awarded the certificate. The evaluations show the course is successful and beneficial to improve healthcare professionals’ knowledge, competency, and skills to practice lifestyle medicine. Additionally, to date 51 healthcare professionals – who registered on our IPH platform- have been board certified in lifestyle medicine. We continue on this enthusiastic journey to support health professionals, patients, and communities.

What is the role of the Institute for Population Health in building the lifestyle medicine movement? In April 2016, we launched our hugely successful Certificate in Clinical Nutrition program for healthcare professionals. Four offerings of the course were successfully delivered and a total of 200 healthcare professionals were awarded the certificate. However, we realized that nutrition was only one piece of the puzzle. To promote the spirit of lifestyle medicine, the Lifestyle Medicine Interest Group-Qatar was

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Wissam Daoud: A Visionary Leader Catalyzing Transformation in the Diagnostic Space of Middle East & Africa at Sysmex Middle East FZ – LLC, a subsidiary of Sysmex Europe SE, one of Europe’s top laboratory diagnostics and healthcare companies, and the global leader for hematology diagnostics and service. Sysmex Middle East FZ was established in April 2008 as a regional hub for Sysmex activities throughout Middle East countries, operating from its offices in Dubai. Under the insightful leadership of Wissam, the company is marching ahead on the path of growth and success.

Lighting the Way with Diagnostics

here is a most famous quote by Donald McGannon — "Leadership is action, not a position." Leadership is not about title or position. It is about being a positive influence on those around you and motivating others toward success. Great leaders make the purposeful choice to empower everyone they lead to help them be the best version of themselves. They acknowledge the strengths and potential contributions of their employees and provide them with the opportunity to grow and learn effectively. They lead by example with integrity and inspire the people around them to push themselves – and, in turn, the company – to greatness. An embodiment of such exemplary leadership is Wissam Daoud, the Managing Director

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WISSAM HAS ALWAYS BELIEVED IN SERVANT LEADERSHIP STYLE AND HE HAS FOLLOWED THIS AT SYSMEX TOO.

Sometimes it’s the tragedy or unfortunate events that pave your way to achieving a greater purpose. As Robert Thomas aptly said in his excellent book, Crucibles of Leadership: "Great leaders become great by finding meaning in adversity - in traumatic and unplanned crucible experiences—and then transforming those experiences into improved performance.” For Wissam, one such pivotal incident was when one of his favorite uncles was wrongly diagnosed with arthritis while he had bone cancer. That wrong diagnosis worsened his life and they didn’t discover it until the last stage. This startled Wissam to the core and made him think — how a single diagnostic error can have serious, lasting, and sometimes tragic results. He realized that diagnostic error is one of the most important safety problems in healthcare today and leading the transformation in the industry can reflect in so many lives. Thus, he decided to illuminate the blind spot of diagnostic error and improve diagnosis in healthcare through Sysmex through successful partnerships with healthcare providers and various governmental bodies across our region.

Attributes that Diff erentiate Sysmex Over the years, Sysmex Middle East FZ-LLC has grown to become one of the Middle East region’s leading diagnostic suppliers with a reputation for high-quality products, service, and

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reliability. However, its unique proposition lies in its ability to have direct existence in 3 different regions and chains of strong partners, a professional team, and optimal after-sales support. Besides this, what further gives the company a unique edge in the market is its focus on hiring the right people and training them to meet its customer expectation, having the right geographical coverage and right strategies regarding what to focus on, what to develop, what to transform and what are the opportunities. Sysmex also acts as a knowledge provider for the systemic academy, where employees are trained and encouraged to expand their knowledge and maximize their potential. “We don’t sell me-too products. We sell unique products. The Sysmex value-added services provide our customers with a personalized, tailored approach; whether you require standalone diagnostic solutions or a fully integrated managed service agreement,” opines Wissam.

Relinquishing the Challenges Undoubtedly establishing a successful company is not a piece of cake. But what Wissam finds even more challenging is to be consistently successful in the region. Initially, building brand equity and brand awareness was quite challenging for the company. “It requires multiple factors to build this including state-of-the-art products, technology and results, and after-sales service. If you’re having a product and if you don’t offer the support that customer needs then it is just a piece of metal sitting on the shelf," asserts Wissam. With state-of-the-art products, groundbreaking technology, optimal customer service, and a highly proficient team, Sysmex was able to overcome all the obstacles along its way to reach where it is today.

Redefining Leadership Wissam has always believed in servant leadership style and he has followed this at Sysmex too. Highly inspired by the book called “Leaders Eat Last,” which speaks about serving the employees and working for the employees, he always strives to put this leadership style into practice and makes sure everybody in the organization has everything to be successful.

OVER THE YEARS, SYSMEX MIDDLE EAST FZ-LLC HAS GROWN TO BECOME ONE OF THE MIDDLE EAST REGION’S LEADING DIAGNOSTIC SUPPLIERS WITH A REPUTATION FOR HIGH-QUALITY PRODUCTS, SERVICE, AND RELIABILITY. HOWEVER, ITS UNIQUE PROPOSITION LIES IN ITS ABILITY TO HAVE DIRECT EXISTENCE IN 3 DIFFERENT REGIONS AND CHAINS OF STRONG PARTNERS, A PROFESSIONAL TEAM, AND OPTIMAL AFTER-SALES SUPPORT.

According to Wissam, a leader must ensure that everyone in the organization has the right tools, right knowledge, right mindset, time, and the capacity to be successful at the job they are doing. “It’s not really about how successful I’ll be or how successful the company will be. It’s also about how successful our employees are. As a leader, it gives me great pleasure and a sense of pride when I see one of the people I worked with, are accelerating in their careers and gaining great success in the market,” adds Wissam.

Continues Reshaping the Future of Diagnostics While there are several attributes that played a key role in Wissam’s success story, it’s his firm belief in his capability, unwavering courage to take risks, and strong determination to get out of his comfort zone to try different things that make him the impeccable leader he is. Imparting the key lessons from his years of experience, Wissam advises emerging entrepreneurs to take calculated risks, step out of their comfort zone and try new things no matter how crazy it looks. Going forward, Wissam aspires to see Sysmex Middle East as a partner of choice for medical laboratories across the Middle East area. As a complete solution provider, now the company is enhancing its capabilities internally and further improving its solutions to help its clients become more effective, doing the job they need to do with high accuracy and efficacy. “Our goal is to not only deliver best in class products but to also increase the number and quality of tests that are being made, and be a true healthcare company where we can help people diagnose any symptoms early before they get sick rather than being a sick care company treating people after they get sick,” elucidates Wissam. As the company continues to thrive, Wissam also envisions growing as a leader and as a person to take this venture to a new height in the coming years.

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Reimagining Nursing for the Future: 6 Ways to Improve Communication for Nurses

ursing holds a critical and unique place in the world’s healthcare infrastructure. Without nurses, patient care and safety would be at risk, but their impact is much greater. The safety and well-being of communities, nations, and the world would be at risk without nurses, which is why we must protect them and the nursing profession. The future of nursing is threatened today by many variables, including a staffing shortage that is beyond anything ever seen in the industry. In a survey by Nurse.org of 1,500 nurses worldwide from September to November of 2021, 80% of nurses said their units are inadequately staffed. Unfortunately, we cannot backfill our way out of the current crisis because we simply do

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TO REVERSE THESE TRENDS, WE MUST, FIRST, LISTEN TO NURSES DESCRIBE THEIR EXPERIENCES, AND SECOND, IMPLEMENT INNOVATIONS TO IMPROVE THEIR WORKING ENVIRONMENT. AT THE CENTER OF BOTH IS BETTER COMMUNICATION.

not have enough nurses in the funnel. The World Health Organization estimates that by 2030, there will be a need for 36 million nurses practicing around the globe with a potential global shortage of 13 million nurses. To reverse these trends, we must, first, listen to nurses describe their experiences, and second, implement innovations to improve their working environment. At the center of both is better communication.

Communication: Every hospital’s foundation Communication is at the heart of nursing work. When communication is difficult, everything slows down. When nurses must take extra steps, spend more time, and use cognitive

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resources searching for the right person or information, they lose valuable time and resources that could be used caring for their patients at the bedside. As vacancies leave gaps in shifts and add additional pressures to already fatigued and stressed nurses, the healthcare industry must find ways to use technologies to simplify clinical workflows and processes to improve patient care and safety. Nurses are asking for help.

Here are six ways to address nurses’ calls for innovation to improve their work environment: 1. Simplify and unify communication workflow: Streamlining workflows for nurses starts with improving communication. A single, unified communication platform is essential. 2. Connect mobile care teams: In response to staffing pressures, many hospitals are turning away from primary nursing and moving to team nursing where one nurse manages a team of healthcare assistants. For such a team to function effectively, effective communication and workflows designed for mobility are imperative. 3. Transform the hospital’s systems into nurse extenders: A nurse extender is a technology, tool, process, or protocol that extends a nurse’s reach and influence. Start with the patient in the bed. Many hospitals use smart, connected beds that can be integrated with a communication system that notifies the correct caretaker when a patient is in a compromised state and at risk for injury. 4. Innovate care models: Two of the most time-consuming tasks a nurse has are admission assessment and discharge teaching. Hospital leaders should consider enabling virtual nurses to assist with admissions and discharges using video. 5. Identify tasks to offload from the nurse: Nurses should not have to spend their valuable time performing tasks that patients can do for themselves if the patient has the cognitive capabilities to perform these functions. Hospitals can give patients the means to document their own intake and output, blood sugar, ambulation in the room, and the like.

COMMUNICATION IS AT THE HEART OF NURSING WORK. WHEN COMMUNICATION IS DIFFICULT, EVERYTHING SLOWS DOWN. WHEN NURSES MUST TAKE EXTRA STEPS, SPEND MORE TIME, AND USE COGNITIVE RESOURCES SEARCHING FOR THE RIGHT PERSON OR INFORMATION, THEY LOSE VALUABLE TIME AND RESOURCES THAT COULD BE USED CARING FOR THEIR PATIENTS AT THE BEDSIDE.

6. Empower nurses to manage the patient and family experience: Keeping patients’ families informed and at ease can be a timeconsuming task. Give nurses greater control of this communication by equipping them with mobile technology that helps automate the process as part of their rounding process. Nurses remain the largest work group in the healthcare system and their impact on the safety and well-being of patients is immeasurable. Difficult times have presented never-before challenges. Nurse leaders must listen and respond to nurses’ appeals to change the work environment and innovate care models to improve systems, technologies and processes that will ensure quality patient care. The future of nursing is in peril if we ignore them. Woods, Anne Dabrow. WHO: State of the World’s Nursing 2020. Lippincott Nursing Center Blog. 9 Apr 2020. https://www.nursingcenter.com/ncblog/april-2020/ who-state-of-the-worlds-nursing-2020. Gooch, Kelly. “World could be short 13 million nurses by 2030, report finds.” Becker’s Hospital Review. 25 Jan 2022. https://www.beckershospitalreview.com/nursing/ world-could-be-short-13-million-nurses-by-2030-reportfinds.html

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Closed-Loop Oncology from Medication Compounding to Administration and Beyond

The order string barcode applied during compounding allows bedside confirmation of right patient, and the auto-population of the smart pump with the right dose and duration for the oncology regimen medication, the loop is closed by auto-documentation of administration.

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James Waterson. RN, M.Med.Ed. MHEc. Medical Affairs Manager, Medication Management Solutions, Becton Dickinson. Middle East and Africa. James.waterson@bd.com Lisa Gangol. RN, BSN. Senior Clinical Resource Consultant, Medication Management Solutions, Beckton Dickinson. MMS-MENAT. Aya A.Kabbani. Pharm.D. Product & Clinical Manager, Medication Management Solutions, Beckton Dickinson. MMS-MENAT. Larry Neal. Regional Marketing Manager, Medication Management Solutions, Becton Dickinson. 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 through to administration- medication errors which occur at the point of administration are the most prevalent at 38% of all medication errors. [1] 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. IV-medication administration is therefore associated with a far greater risk of medication error than oral administration. [2,3] 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.[4]

Bidirectional-interoperability capable IV pumps achieve this through direct communication with the patient’s Electronic Health Record (EHR):

Bidirectional Interoperability is the most advanced form of Barcode Medication Administration: The smart pump directly communicates with the EHR to confirm the prescription is current and correct confirms the patient identity, and auto-documents administration.

This is truly streamlined safety as it can also reduce the time spent programming the pump by over 80%,[5] and oncology care needs streamlining badly. One estimate suggests that by 2040, globally, the number of patients requiring at least first-line chemotherapy each year will have increased from a 2018 baseline by 53% (from 9.8 million to 15 million individuals) [6] In one recent study the annual compounding requirements for oncology IV-medications in a regional cancer care unit increased by over 15 times between 2012 and 2020 [7]. The hospital pharmacy is central to the above EHR interoperability workflow as it is here where the order 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. It is possible to manage this process manually, but many of the critical steps involved in compounding carry potential errors, [8] 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. [9] 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 EHR and IV Pumps is an ideal solution for whole hospital medication safety, as it requires an investment

THE HOSPITAL PHARMACY IS CENTRAL TO THE ABOVE EHR INTEROPERABILITY WORKFLOW AS IT IS HERE WHERE THE ORDER 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.

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in communication engines to link pumps to the EHR 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 32,000 pump channels with full, and secure, bidirectional interoperability across hospital campuses with multiple sites. Updating Dose Error Reduction Software (DERS) libraries on pumps to match central formulary changes with new medications and oncology regimens is vital to ensuring the presence of a second FMEA medication safety gate. Updating DERS libraries rapidly and safely across large oncology facilities and ambulatory care units can only really be achieved when there is the capability to deploy the new library to connected pumps via extensive wired or wireless networks. [4] Auto-population of infusion orders to connected pumps facilitates the utilization of DERS, with all scanned orders utilizing the customized drug library when programmed, verified, and started. A large capacity DERS smart pump library of holding at least 3,000 to 10,000 medication entries is also vital as we see more and more novel drug treatments, an expanding array of Monoclonal Antibodies (MAB) [10], and a need for multiple protocols for individual medications becoming standard practice. [11] As mentioned above, efficient oncology compounding software is a central part of any EHR 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

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interaction interface with step-by-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 (±4% tolerance is accepted by most institutions). [12] 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. [7,8] The software must also 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 can assist 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. Tracking of medications and the ability to reintroduce unused but highly valuable oncology medications back into the system can be a real challenge. Medication stock tracking can include integration between pharmacy applications and Enterprise Resource Planning (ERP) systems for ‘stock-in stock-out’ reconciliation. Of course, once the oncology product is com-

INTEROPERABILITY BETWEEN THE EHR AND IV PUMPS IS AN IDEAL SOLUTION FOR WHOLE HOSPITAL MEDICATION SAFETY, AS IT REQUIRES AN INVESTMENT IN COMMUNICATION ENGINES TO LINK PUMPS TO THE EHR AND AN ORGANIZATIONWIDE 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) 128BIT KEY ENCRYPTION USING CIPHER BLOCK CHAINING (CBC).

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pounded there can be an issue of the storage of bulky and high-volume infusions requiring refrigeration with issues of track and control as, commonly, the refrigerators used in facilities are not connected to the pharmacy system. Full integration of infusion pumps allows the central pharmacy to view dashboards of each patient’s current infusion, and the time at which it will end. This can help with preparation of the next oncology medication for the patient’s regimen to be delivered Just In Time (JIT). Aggregation of this data and integration with par-level reporting data from Automated Dispensing Cabinets (ADC) for oral medications and networked and integrated ADC style medication fridges for IV-preparations also allows for more accurate forecasting going forward. This data can also theoretically feed directly into regional and national systems, many of which currently rely on individual facilities regularly reporting critical oncology medication stock-levels. These are currently often calculated from weighted averages, and projected needs based on historical order volumes. National or regional coordination of large-scale oncology strategies needs a dynamic real-time data-feed to allow for centralized ordering and distribution and inter-facility ‘lending’ arrangements for critical need. Sharing of scarce medications during shortage-crises can be a central part of

Integrating infusion pumps and automated dispensing cabinets allows for more accurate forecasting of oncology medication needs as infusion rates can be viewed in real-time and overall medication consumption can be assessed and shared across facilities.

our strategy to streamlining services with the goal of increasing cancer survival rates across healthcare systems. For organizations without extensive EHR penetration compounding connectivity can also be used to extend medication safety beyond the pharmacy and into the nursing unit via ‘lighter touch’ Bar Code Medication Administration (BCMA) Systems. Such solutions are less expensive than full EHR bidirectional interoperability and can work alongside solutions with all the advantages of compounding software to smooth the workflow of production, married to barcode-supported right patient-right medica-

FOR ORGANIZATIONS WITHOUT EXTENSIVE EHR PENETRATION COMPOUNDING CONNECTIVITY CAN ALSO BE USED TO EXTEND MEDICATION SAFETY BEYOND THE PHARMACY AND INTO THE NURSING UNIT VIA ‘LIGHTER TOUCH’ BAR CODE MEDICATION ADMINISTRATION (BCMA) SYSTEMS. Oncology patients have complex medication requirements beyond their specific oncology regimen. Assessing the impact of interventions is made easier by data-analytics. ‘Big data’ allows for rapid review of therapies across the organisation and by individual care-unit and helps guide us to do ‘the right thing in the right way’.

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tion verification. It is possible to use this as a pitstop on the journey to full EHR-interoperability. Medication safety should always be an ongoing journey to zero patient harm and scalability and adaptability of solutions. ‘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 EHR or have touchpoint integration only, such as access to Admission Discharge and Transfer (ADT) data from the EHR. This requires investment in wireless connected handheld barcode scanning devices or the deployment of a proprietary application to nurses’ smartphones, but these scanning devices and applications have many other functions for nurses in terms of scanning for a positive-patient-ID for laboratory studies, oral medication administration, and for documenting patient transfers between units. In the light BCMA solution, the patient ID band and the patient-medication barcode label on each compounded product are scanned and this potential match is transmitted to a listening-post interface and through to the compounding solution server, where the match is checked. 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 on the bedside scanning device, 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 and then a mix up occurring due to distraction or other error at the patient’s bedside. 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. [11,13] Printed pages for regimens, which can be mislaid or placed in the wrong patient record, are also eliminated in the BCMA 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

Workflow for integrated CPOE to compounding with bedside BCMA scanning by nursing staff to support right patient-right medication verification at the bedside supported by a compounding solution

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IN THE LIGHT BCMA SOLUTION, THE PATIENT ID BAND AND THE PATIENTMEDICATION BARCODE LABEL ON EACH COMPOUNDED PRODUCT ARE SCANNED AND THIS POTENTIAL MATCH IS TRANSMITTED TO A LISTENING-POST INTERFACE AND THROUGH TO THE COMPOUNDING SOLUTION SERVER, WHERE THE MATCH IS CHECKED.

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produced 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 gave a saving of nursing time equivalent to 0.43 fulltime nurses per year. [7] The savings for a 1,000-bed hospital compounding 40,000 oncology medications per year would be 1.21 full time nurses.

Such savings are vital as nursing staff shortages are now chronic and worsening, particularly in specialist areas like oncology. The world is ‘short of’ 30·6 million nurses and midwives and the Middle East has one of the lowest Human Resources for Health (HRH) densities for nurses, physicians and pharmacists globally. [14] Technology cannot do everything that healthcare staff can do, but what it can do is release our most valuable asset, our highly skilled pharmacists, oncologists and oncology nurses, to undertake patient work of real value and to allow them to work in an environment that supports them in keeping patients safe.

References:

1. Stanhope N, Vincent C, Taylor-Adams S, O'Connor A, Beard R. Applying human factors methods to clinical risk management in obstetrics. Br J Obstet Gynaecol 1997 Nov;104(11):1225-32. 2. Quinn C. Smart practice: the introduction of a dose error reduction system. Br J Nurs. 2011. 20(8 Suppl): S20–5 3. Maddox R, Danello S, Williams C, Fields M. Intravenous Infusion Safety Initiative: Collaboration, Evidence-Based Best Practices, and “Smart” Technology Help Avert High-Risk Adverse Drug Events and Improve Patient Outcomes. In: Henriksen K, Battles JB, Keyes MA, Grady ML, editors. Advances in Patient Safety: New Directions and Alternative Approaches (Vol. 4: Technology and Medication Safety). Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Aug. PMID: 21249948. 4. Waterson J. Making Smart Pumps smarter, making IV-therapy safer. British Journal of Nursing 22. 2013: 22-27. 5. Biltoft J, Finneman L. Clinical and financial effects of Smart Pump-electronic medical record interoperability at a hospital in a regional health system. Am J Health Syst Pharm 2018 Jul 15;75(14):1064-1068. 6. Wilson B, Jacob S, Yap M, Ferlay J, Bray F, Barton M. Estimates of global chemotherapy demands and corresponding physician workforce requirements for 2018 and 2040: a population-based study. May 8, 2019. Lancet. 7. Meren ÜH, Waterson J. Evaluating an Automated Compounding Workflow Software for Safety and Efficiency: Implementation Study. JMIR Hum Factors 2021;8(4):e29180 8. Reece K, Lozano M, Roux R, Spivey S. Implementation and evaluation of a gravimetric i.v. workflow software system in an oncology ambulatory care pharmacy. Am J Health Syst Pharm 2016 Feb 01;73(3):165-173. 9. South DA, Skelley JW, Dang M, Woolley T. Near-miss transcription errors: a comparison of reporting rates between a novel error-reporting mechanism and a current formal reporting system. Hosp Pharm 2015 Feb;50(2):118-124. 10. Liu J. The history of monoclonal antibody development - Progress, remaining challenges and future innovations. Ann Med Surg (Lond). 2014 Sep 11;3(4):113-6. 11. Waterson J, Al-Jaber R, Kassab T, Al-Jazairi AS. Twelve-Month Review of Infusion Pump Near-Miss Medication and Dose Selection Errors and User-Initiated "Good Save" Corrections: Retrospective Study. JMIR Hum Factors. 2020 Aug 11;7(3). 12. Terkola R, Czejka M, Bérubé J. Evaluation of real-time data obtained from gravimetric preparation of antineoplastic agents shows medication errors with possible critical therapeutic impact: Results of a large-scale, multicentre, multinational, retrospective study. J Clin Pharm Ther 2017 Aug 21;42(4):446-453. 13. Schwappach D, Pfeiffer Y, Taxis K. Medication double-checking procedures in clinical practice: a cross-sectional survey of oncology nurses’ experiences. BMJ Open. 2016;6(6). 14. GBD 2019 Human Resources for Health Collaborators. Measuring the availability of human resources for health and its relationship to universal health coverage for 204 countries and territories from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2022 Jun 4;399(10341):2129-2154.

ARTICLE FEATURES . How does expenditure turn into health?

How does expenditure turn into health? The Gulf raised budgets and achieved outcomes

he Gulf States put the citizens' health at the top of their priorities. Therefore, special attention has been given to the health sectors. In the past years, the health sector kept pace with the accelerating health developments globally while facing the coronavirus pandemic, which exhausted many countries around the world. In order to achieve this, the Gulf countries have been increasing the budget allocations to the health sector year after year. Expenditures have been increased in hospitals and health facilities that provide citizens with top-notch healthcare and optimal care and protection. The Global Health Security Index (GHS Index) stated the Gulf countries’ plans to increase healthcare spending, as spending in 2017 was about $76 billion, and is expected to exceed $104 billion by the end of 2022. According to the World Bank, the overall government expenditure on the healthcare sector was 45% of the total size of the economy. Two years ago, there were 118,000 beds in Gulf hospitals, and they are expected to reach 123,000 beds by the end of 2022. In the midst of this utmost care given to the health sector, four Gulf countries ranked among the best in local and international studies indicators in the field of health service, sector development and expenditure volume.

Qatar: Expenditures to improve the quality of the sector Qatar is ranked fifth in the Health Index by the London-based Legatum Institute, thanks to improved life expectancy and health outcomes for patients and a high level of investment in health infrastructure. This progress, which was ranked 13th in the Middle East by the UAE, is ranked first in the Middle East in terms of life expectancy and is among the top 25 in terms of quality of health services and access to healthcare. Qatar is the only country in the region to secure its

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THE TOTAL ALLOCATIONS FOR THE HEALTH SECTOR IN THE GENERAL BUDGET AMOUNTED TO APPROXIMATELY 22.6 BILLION RIYALS, WHICH REPRESENTS 11% OF THE TOTAL EXPENDITURES. THE MOST IMPORTANT PROJECTS IN THE HEALTHCARE DEVELOPMENT FIELD THAT THE COUNTRY IS CURRENTLY WITNESSING INCLUDE EXPANSIONS OF HAMAD MEDICAL CORPORATION’S HOSPITALS AND FACILITIES AS WELL AS THE ESTABLISHMENT OF NEW PRIMARY CARE CENTERS.

top five positions on Singapore's annual prosperity index, followed by Luxembourg, Japan and Switzerland. The country's spending in the region's top healthcare sector was 22.7 billion riyals in healthcare in 2018, up 4 percent from the previous year. The Minister of Public Health Dr. Hanan Mohammed Al-Kuwari said: “The State of Qatar has invested heavily in the health sector under the wise leadership of His Highness Sheikh Tamim Bin Hamad Al Thani, Emir of the country.” The first place on the international index reflects the State's commitment to health-system priorities designed to meet the needs of future generations and to improve the health of the population at present, she confirmed. Qatar scored highly on its e-health readiness as well as site quality. In 8 out of 10 quality categories measured by the authors, Qatari websites scored higher than the GCC average. The team of researchers stressed that Qatar is now uniquely placed to take a leading role in Internet-based health information in the region. Factors such as Qatar’s high Internet connectivity and penetration rates, planned broadband infrastructural upgrades, a positive youth attitude towards technology, and health sector improvements are all valuable assets for future development of e-health in Qatar. Regarding the development of spending in the State’s health budget, expenditure allocations for major projects in the year 2020 increased by 0.6% to reach 90 billion riyals, compared to 89.5 billion riyals for Qatar’s budget in the fiscal year 2019. The total allocations for the health sector in the general budget amounted to approximately 22.6 billion riyals, which represents 11% of the total expenditures. The most important projects in the healthcare development field that the country is currently witnessing include expansions of Hamad Medical Corporation’s hospitals

How does expenditure turn into health? . ARTICLE FEATURES

ARTICLE FEATURES . How does expenditure turn into health?

and facilities as well as the establishment of new primary care centers. In 2021, the government continued to focus on the education and health sectors, as the allocations for the sector are estimated at 16.5 billion riyals, which include more major projects in the healthcare development field and the expansion of approved medical and health facilities for the next year. Qatar Chamber’s Chairman HE Sheikh Khalifa bin Jassim Al Thani said: “The new budget reflects the power of the Qatari economy, despite the coronavirus pandemic and its repercussions related to the precautionary measures against the virus outbreak, as the budget included continued spending on major projects, as well as the allocation of large sums to education and health projects, which are the two sectors that always get the attention of His Highness the Emir.” Qatar’s Minister of Finance Ali bin Ahmad Al Kuwari said that revenues are expected to amount to 196 billion riyals ($53.8 billion), a 22.4 percent rise compared to last year's budget estimates. While the expected oil revenues amount to about 154 billion riyals ($42.3 billion), the budget is based on an average oil price of $55 per barrel. He pointed out that the State continues to focus on the education and health sectors, as the health sector allocations are estimated at 20 billion riyals, representing 9.8 percent of total expenditures that include more development projects and programs in order to improve the healthcare services provided.

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ACCORDING TO THE REPORT OF THE MINISTRY OF FINANCE, THE FEDERAL AND LOCAL GOVERNMENTS IN THE COUNTRY HAVE REDUCED OPERATING COSTS IN GOVERNMENT AGENCIES, IN ORDER TO PROVIDE FISCAL SPACE TO INCREASE HEALTHCARE SPENDING, AS WELL AS REDUCE GOVERNMENT REVENUES DUE TO THE ECONOMIC SLOWDOWN CAUSED BY THE SPREAD OF THE PANDEMIC.

UAE: Increasing spending on health projects The Global Health Security (GHS) Index had predicted that the UAE would rank first in the Gulf region, in terms of growth by 9.6% in healthcare spending to reach $25.6 billion during the period from 2017 to 2022. Data issued by the Ministry of Finance revealed that the expenditures allocated to the Ministry of Health and Community Protection, which initially constituted 7% of the federal budget for 2020, were increased to 9.07%, in order to cover the increase in spending on precautionary measures to fight against the spread of the pandemic, ensuring rapid response to the urgent needs of employees in the healthcare sector. Federal spending on the health sector in the UAE amounted to about 5.564 billion dirhams until the end of 2020, equivalent to 9.07% of the total federal budget of 61.35 billion dirhams. The spending of the local governments of the seven emirates on the health sector and the measures taken to curb the pandemic increased the number even further, which appeared in the aggregate federal and local expenditure data issued by the Ministry of Finance. According to the statistics of that data, 1.37 billion dirhams were spent during the first quarter of 2020 from the increased allocations to the health sector. According to the report of the Ministry of Finance, the federal and local governments in the country have reduced operating costs in government agencies, in order to provide fiscal space to increase healthcare spending, as well as reduce government revenues due to the economic slowdown caused by the spread of the pandemic. Measures taken in this regard included reprioritizing spending on ongoing construction projects, hiring slowdown, and reconsidering spending on non-urgent conferences and training. The Ministry of Finance confirmed that these steps have resulted in the UAE’s success in dealing with the pandemic efficiently and distinctly, as the UAE ranks first globally in Covid-19 screening per capita with more than 3.5 million coronavirus tests for early detection of Covid-19

How does expenditure turn into health? . ARTICLE FEATURES

infections, isolating the infected persons, providing them with the best necessary healthcare, and preventing complications of the disease. Despite the ongoing effects of the pandemic in 2021, His Highness Sheikh Mohammed bin Rashid Al Maktoum affirmed that “despite the global economic conditions, our projects are continuing and our priorities are permanent, the social development sectors will not be touched,” considering that “the efficiency of government spending in the UAE is among the highest in the world, and we look forward to a better and more accomplished year in 2021.” He said: "The Union's general budget in 2021 keeps pace with global economic changes without prejudice to national development priorities.” The federal budget for the year 2021 aims to expand development plans and projects to raise the standard of living for Emiratis and UAE residents. A large share of the 2021 budget will be allocated to social development including social welfare, health and education in addition to projects and initiatives that would improve the quality of healthcare in order to provide top-notch medical services to UAE residents, support housing programs for citizens and enhance the quality of life for various members of society. 4.97 billion dirhams, or 8.1% of the total general budget, were allocated to healthcare and community protection to provide the highest levels of medical care services to citizens and residents, while all the necessary funds were allocated to confront the coronavirus pandemic. The Minister of Health and Community Protection Abdul Rahman bin Mohammad Al Owais said: “Headed by H.H Sheikh Mohammed bin Rashid Al Maktoum, Vice President and Prime Minister of the UAE and Ruler of Dubai, the Council of Ministers has approved the Union’s general budget 2021 and its ambitious projects that foresee new horizons, which will strengthen the UAE’s position among the highest in world in terms of government spending efficiency and will continue to develop government services to achieve global leadership, making the UAE among the fastest to recover in 2021.”

A LARGE SHARE OF THE 2021 BUDGET WILL BE ALLOCATED TO SOCIAL DEVELOPMENT INCLUDING SOCIAL WELFARE, HEALTH AND EDUCATION IN ADDITION TO PROJECTS AND INITIATIVES THAT WOULD IMPROVE THE QUALITY OF HEALTHCARE IN ORDER TO PROVIDE TOP-NOTCH MEDICAL SERVICES TO UAE RESIDENTS, SUPPORT HOUSING PROGRAMS FOR CITIZENS AND ENHANCE THE QUALITY OF LIFE FOR VARIOUS MEMBERS OF SOCIETY.

He points out that “the budget allocated to the health sector reflects the leadership's keenness to raise the level of healthcare services in accordance with the highest international practices in terms of quality and sustainability, as it is among the highest priority vital sectors, while ensuring a balance in spending on health services and setting flexible plans to develop performance efficiency, in a way that supports the implementation of precautionary and preventive measures in light of COVID-19.” Al Owais explains, “The Ministry will set operational plans in line with the Union’s budget to complete national initiatives within their time frame and adhere to the government's directions in innovation and foreseeing the future, developing the infrastructure of health facilities, raising the efficiency of hospitals and health centers and providing them with state-of-theart equipment and medical laboratories. The Ministry will also continue to integrate artificial intelligence techniques in medical services and develop the appropriate technology to manage the health system.” As for the current year's budget, it was described as the healthcare budget, since healthcare is one of the most important service sectors in the UAE. It holds a special position in the government's agenda, as the health sector received 8.4% of budget 2022.

ARTICLE FEATURES . How does expenditure turn into health?

Saudi Arabia: High expenditure and pioneering care Saudi Arabia ranked first in the Arab world as it held the largest share of budget expenditure in 2019 with a value of SAR 172 billion, which represents 15.6% of the Kingdom's government spending. Saudi Arabia decided to increase the private sector’s contribution to total healthcare spending during 2020 from 25% to 35% in addition to raising the sector’s contribution to the economy from 40% to 65% in 2030. Public spending in the 2020 budget was distributed to the Kingdom’s various sectors, as spending on health and social development ranked first with SAR 197 billion, followed by the education sector with SAR193 billion. The Saudi Minister of Finance Mohammad Al-Jadaan said that the budget confirms “the government's keenness to continue implementing major spending plans, implementing major projects, Vision Realization Programs, developing infrastructure, social protection network programs, and developing services provided to citizens in accordance with Saudi Vision 2030.” In 2021, Saudi Arabia raised spending on vital sectors in the budget, which included health, social development and public administration sectors. The spending on these sectors has increased by 7.4% in Budget 2021, reaching about SAR 361 billion, compared to SAR

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THE HEALTH AND SOCIAL DEVELOPMENT SECTOR COMES FOURTH WITH ALLOCATIONS AMOUNTING TO SAR 138 BILLION, AND THE PROMINENT TASKS OF THE SECTOR INCLUDE HEALTH ASPECTS RELATED TO LEGISLATIVE SERVICES, RESEARCH AND THE OVERALL SOCIAL ASPECT, INVOLVING SECURITY, SOCIAL, CULTURAL, MEDIA, SPORTS, AND ENTERTAINMENT SERVICES, IN ADDITION TO THE MANAGEMENT OF QUALITY OF LIFE PROGRAMS.

336 billion in Budget 2020. In Budget 2022, the education, health and social development sectors accounted for about 33.8 percent of the budget allocations. This confirms the Saudi government's keenness to enhance the development process and drive economic growth, which makes these two sectors among the top budget priorities. According to the general budget, the spending on these two sectors is expected to amount to about SAR 323 billion out of the total estimated spending. The health and social development sector comes fourth with allocations amounting to SAR 138 billion, and the prominent tasks of the sector include health aspects related to legislative services, research and the overall social aspect, involving security, social, cultural, media, sports, and entertainment services, in addition to the management of quality of life programs. Next year, the Ministry of Health plans to develop government health centers into advisory centers to include all specialties, as well as build and equip comprehensive specialized centers.

Kuwait: Ranked third in the Arab world in the Global Health Security Index Kuwait ranked third in the Arab world in the Global Health Security (GHS) Index and healthcare spending is expected to increase to $5.8 billion by the current year 2022. Although

How does expenditure turn into health? . ARTICLE FEATURES

Kuwait has reduced spending in many fields, it kept focusing on the healthcare sector and has set plans to develop it this year until 2023. In the State budget 2020, spending on healthcare reached $2.4 billion, as the Global Health Security (GHS) Index expectations show that Kuwait ranked third in the Gulf in terms of healthcare spending during 2020, with a growth of 3.4% annually, bringing the value of spending to $2.4 billion. Although Kuwait was forced to reduce spending in the past two years on several fields and sectors, it kept paying attention to the health sector as much as possible. Aspirations indicate that Kuwait plans to further develop the sector and increase its quality in the future. No matter how circumstances change, whether financial, which is sometimes stressful, or health-related, with the various fluctuations in normal times or during pandemics, health concerns remain a top priority for the Gulf States. After successfully emerging from the Covid-19 crisis, these countries are planning

ALTHOUGH KUWAIT WAS FORCED TO REDUCE SPENDING IN THE PAST TWO YEARS ON SEVERAL FIELDS AND SECTORS, IT KEPT PAYING ATTENTION TO THE HEALTH SECTOR AS MUCH AS POSSIBLE. ASPIRATIONS INDICATE THAT KUWAIT PLANS TO FURTHER DEVELOP THE SECTOR AND INCREASE ITS QUALITY IN THE FUTURE.

to take strategic steps in the healthcare field, backed by the rise in oil prices globally to more than $120 per barrel, while they prepared their Budgets 2022 on an average oil price of about $55 per barrel. This difference is expected to be the reason for increasing spending budgets of the coming years, so that the health sector receives greater budget allocations and attention, which is expected to make it among the first and most developed health sectors in the world. This is compared to what these countries did in previous years, specifically between 2017 and 2022. After the UAE, which recorded a growth in healthcare spending during the mentioned period amounted to 9.6% to reach $25.6 billion, Saudi Arabia ranked second with a growth of 6.1 percent to reach $59.5 billion, while Bahrain came third, with a growth of 5.1% to reach $2.4 billion, then Kuwait, with a growth of 3.4 percent and a value of $5.8 billion, and finally Qatar, with a growth of 2.6 percent, reaching $6.6 billion in healthcare spending.

ARTICLE FEATURES . Heat Stroke

What’s the difference between heat stroke and heat exhaustion?

eat stroke is a medical emergency and is the most serious form of heat injury. Rapid intervention is necessary to lower the body temperature and quickly replace the lost fluids. How can we differentiate between heat stroke and heat exhaustion?

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Heat Stroke . ARTICLE FEATURES Heat exhaustion occurs when the body loses excess amounts of water and salt, typically from sweating. On the other hand, heat stroke is a serious medical emergency that occurs when your body is unable to control its internal temperature. Both conditions lead to fainting and possibly death if the person isn’t treated immediately. High body temperature can lead to reduced blood flow to the heart and other circulatory problems.

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Heat Stroke Heatstroke is a condition caused by your body overheating as a result of prolonged exposure to high temperatures. How can we prevent heat strokes? One of the main ways to prevent heat stroke is to keep your body temperature cooler. Stay hydrated by drinking a lot of water as long as you are outside in the heat or direct sun and stay out of the sun about every half hour. Symptoms include dizziness, headache, back pain, fatigue, nausea, vomiting, dizziness, ringing in the ears, fever, extremity pain, abdominal cramps, tremors and fainting.

Heatstroke signs and symptoms include: • • • • • •

High body temperature of 40 C or higher. Severe fatigue and fainting Headache, dizziness and flushed skin Rapid breathing Racing heart rate Nausea and vomiting

If you think a person may be experiencing heat stroke, seek immediate medical help and take immediate action to cool the overheated person. You should get the person into shade or indoors and cool them with whatever means available while making them drink a lot of water.

How to help an overheated person? Take immediate action to cool the overheated person while waiting for emergency treatment. • Get the person into shade or indoors. • Remove excess clothing. • Cool the person with whatever means available

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Put in a cool tub of water or a cool shower, spray with a garden hose, sponge with cool water, fan while misting with cool water, or place ice packs or cold, wet towels on the person's head, neck, armpits and groin. Monitor vital signs, such as breathing, pulse rate and temperature, and give IV fluids if possible. CPR should be performed immediately on the person if they became unconscious or pulseless, while checking the vital signs every five minutes. Transfer the person to the nearest medical center to check on his general health condition.

HEAT EXHAUSTION IS CHARACTERIZED BY A COMBINATION OF SALT AND WATER DEPLETION THAT OCCURS UNDER CONDITIONS OF HEAT STRESS.

Heat Exhaustion

Prevention

Heat exhaustion is characterized by a combination of salt and water depletion that occurs under conditions of heat stress. Without proper intervention, heat exhaustion can progress to heat stroke, which can damage the brain and other vital organs, and even cause death.

Prevention of heat stroke or heat exhaustion is possible when following these guidelines. Choose lightweight, lightcolored, loose-fitting clothing, stay in an air-conditioned place as much as possible, wear sunscreen, drink more fluids, regardless of how active you are. Don’t wait until you’re thirsty to drink. If you must go outdoors, protect yourself from the sun by wearing a wide-brimmed hat, sunglasses, and by putting on sunscreen of SPF 15 or higher. Reapply it according to the package directions.

The most common signs and symptoms associated with heat exhaustion include: • • • • •

Heavy sweating and pale skin Headache, dizziness and nausea Muscle cramps Rapid pulse, fast breathing and blurred vision Low blood pressure

First aid treatment for heat exhaustion If you suspect heat exhaustion, take these steps immediately: • Move the person out of the heat and into a shady or air-conditioned place. • Lay the person down and elevate the legs and feet slightly. • Remove tight or heavy clothing. • Have the person sip chilled water, a decaffeinated sports drink containing electrolytes or other nonalcoholic beverage without caffeine. • Cool the person by spraying or sponging with cool water and fanning. • Monitor the person carefully.

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Our results are equivalent to the international records, if not better

By Dr. Maher Yousef, Consultant Orthopedic Surgery at Al-Ahli Hospital - Doha / Qatar

n this current time and with the great and accelerating scientific progress the world is witnessing, it has become difficult and even impossible to fully understand all aspects of any science, so it has become necessary to specialize in a narrower and more accurate field, focus on that field and be familiar with all its new developments and updates. There is no doubt that this will reflect positively on the patient, as the doctor will be more knowledgeable and informed in his specialty, and he will have accumulated experience in the specialization that no other has, and this is what is unique to the orthopedic clinics in Al-Ahli Hospital, as it has the capabilities and equipment that have enabled it to achieve several successes. Dr. Maher Yousef, Consultant Orthopedic Surgery at Al-Ahli Hospital, talked about these clinics and the successes they have achieved. Dr. Maher Yousef, Consultant Orthopedic Surgery, is highly specialized in total knee and hip-joint replacement surgery and sports injuries of the knee, such as anterior cruciate ligament injuries, tear of meniscus, and other knee injuries, as well as treatment of injuries and fractures for all age groups. Here, the distinction of those with a sub-specialty is distinguished by outstanding results represented in the rapid recovery from surgeries in the near term and the persistence of these results for decades over the internationally sanctioned level, or even better.

Outstanding Success He said: "We are proud that I had performed an artificial knee joint or hip replacement surgery on patients who had undergone a similar surgery of an artificial knee joint or hip replacement of the other side in another hospital, and they were able to compare the two experiences, where everyone confirmed that there is a vast and wide difference between the two experiences, that their last operation was accompanied by much less pain than the

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first, and that recovery from the last operation was much faster than the first operation." He added: "There is also the accurate diagnostic aspect that distinguishes us from the rest of the medical centers. We are also distinguished in orthopedic clinics at Al-Ahli Hospital, by using the latest technologies and joints available that give the patient the best results, such as bending the knee fully, the ability to sit on the ground and the ability to pray on the ground, as is the case of a healthy, natural joint. The latest technologies and joints also give the patient the longest sustainability for his new joint."

Global Level Moreover, he continued: "According to the British and Scandinavian records, more than 90% of the patients who underwent knee joint replacement surgeries, on which 20 years have passed, their joints are still in good condition. With an experience of more than thirty years in this field, I acknowledge that our results are equivalent to the global records mentioned above, if not better. Sometimes the patient's condition becomes very critical, with which parts of the bone are lost due to neglect of the patient and being left for a long time, which constitutes a challenge with that we successfully deal with in our hospital."

Many Cases He concluded by saying: "There are many cases that have been successfully dealt with, such as the removal of tumors from the shinbone, and bone transplant with supporting the locality with metal plates, and there are also sports injuries of the knee that occur to the younger youth group, which may result in tearing of the anterior cruciate ligament, tear of cartilagines falcatae on both sides, and possibly other parts of the knee, which require dealing with all these injuries simultaneously, by replacing the cruciate ligament and repairing the cartilagines falcatae, all through speculum, using the most modern methods used globally.

WE SUCCESSFULLY DEAL WITH CASES OF SHINBONE ABLATION, CRUCIATE LIGAMENT REPLACEMENT, AND MENISCUS REPAIR.

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Healthy ways to overcome stress at work

By Nursing Education Department at Al-Ahli Hospital - Doha / Qatar

veryone at some point felt the pressure of work-related stress. Any job can have stressful elements even if you love what you do. We can’t always avoid stress, but we can take on steps to manage it!

What is stress? Stress is common and is a response that anyone can have to an event or situation that causes pressure or worry. From time to time we all say things like "this is stressful" or "I'm stressed".

What are the causes?

Simple ways to deal with stress at work 1.

Stress may be triggered by situations or events that put pressure on us that we do not have much control over. The most common situations that cause stress involve work, education, peer pressure, financial matters, family relationships, physical illness or major life events such as divorce, unemployment and bereavement.

What are the signs & symptoms?

Stress affects everybody in different ways and symptoms may be physical, emotional or behavioral. • Physical: Headaches, nausea or indigestion, lack of energy, faster breathing, increased perspiration, palpitations and/or muscle aches and pains. • Emotional: Frequent changes in mood, feeling constantly under pressure or overwhelmed and feelings including worry, fear, anger, frustration and sadness. • Behavioral: Becoming withdrawn or indecisive, finding it hard to relax or concentrate, changes to sleep patterns, being irritable or tearful and/or verbal or physical aggression.

8. 9.

Start Your Day off Right. Start off the day with planning, good nutrition, and a positive attitude Stay Away from Conflict! If conflict finds you, make sure you know how to handle it appropriately. Beat workplace stress by reaching out: Sometimes the best stress-reducer is simply sharing your stress with someone close to you. Support your health with exercise and nutrition through regular exercise to lift your mood, increase energy and relax both mind and body. Eat more Omega-3 fatty acids to give your mood a boost and minimize sugar and refined carbs or foods that can adversely affect your mood, such as caffeine, alcohol, trans fats. Learn tools to de-stress, especially during challenging times Improve the quality of your sleep by aiming for 8 hours a night Taking a 5-minute break and focusing on some deep breathing helps eliminate the effects of stress by slowing the heart rate and lowering blood pressure Stay Organized: Prioritize and organize task and time. Be Comfortable! Sit comfortably and create a quiet, comfortable, and soothing workspace.

Stress can have a positive eff ect too! Completely removing stress from life is unrealistic. Some stress can be positive and assist a person to be more alert, energized and motivated about achieving tasks both within work and in social life.

STRESS MAY BE TRIGGERED BY SITUATIONS OR EVENTS THAT PUT PRESSURE ON US THAT WE DO NOT HAVE MUCH CONTROL OVER.

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Installing a subcutaneous device that emitselectric shocks

Al-Ahli hospital saves the life of a Qatari whose heart suddenly stopped By Dr. Abdurrazzak Gehani, Consultant Cardiologist and Head of the Cardiac Center at Al-Ahli Hospital - Doha / Qatar

r. Abdul Razaq Gehani, Consultant Cardiologist and Head of the Cardiac Center at Al-Ahli hospital, revealed that the hospital installed an implantable cardioverter-defibrillator (ICD) for a Qatari teenager under the skin and delivered wires to the heart chambers, adding that the device can constantly monitor and record heart rhythm and provide rapid intervention to give electric shocks to treat severe acceleration leading to cardiac interruption.

Gehani continued: "Last year, he came to my clinic at Al-Ahli hospital and asked to install the device that he had rejected before. In fact, the device was successfully installed and during the installation process, all the factors related to the electrocardiogram and the wires that were successfully installed were tested. Then he continued coming to the clinic periodically, to follow up and monitor the device on his computer and things were going well, and during all the follow-ups there was no imbalance in the beats."

According to Gehani, in such cases, heart muscle weakness is a major cause of severe and sudden acceleration of the heart rhythm, rendering the heart's pumping of blood ineffective and leading to what is known as sudden cardiac arrest or sudden heart arrest.

He lists the development of the patient after the installation of the device, reporting, "On December 27, his heart suddenly stopped completely and he fell unconscious with grief and great distress among his parents. But the device directly recognized the severe confusion in the heart rhythm that evolved into a complete stop of heart function and then the device gave him the appropriate electric shock according to the program we put in place for him to deal with such a condition. After only one trauma, his heart rhythm became normal, and he rose from his coma, wondering what had happened to him, in the midst of his family's daze".

Survival from death The consultant cardiologist reviewed the patient's pathological history. The patient was saved from certain death due to a complete cardiac arrest at home by a special electric shocks device, which Al-Ahli hospital successfully installed nearly a year ago. He added that the Qatari teenager began his therapeutic journey several years ago after suffering from an acute coronary clot and had coronary stents that saved him from an acute coronary clot. However, unfortunately the heart muscle was affected by the clot's inflation, causing him to suffer from severe heart muscle weakness. That's why I advised him to install an electric shocks device, and to regulate his heart rhythm according to numerous studies because he became at risk of sudden cardiac arrest. But unfortunately, he refused to install the device at the time and wanted time to think, but this took several years.

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Gehani asserted that "Without Bounty of Allah first, then the existence of the device and its response at that time, the patient would not be with us today." Explaining that the device installed deals with cases of slow heart rhythm such as conventional devices, as well as dealing with cases of stopping the acceleration of beats and returning them to their normal level even if they reached the cardiac arrest stage thanks to electric shocks to the heart chambers where the device performs this function through complex programs placed in it, where it can determine the speed of heart rhythm if it is rapid

THROUGH COMPLEX PROGRAMS INSTALLED IN IT, IT DEALS WITH THE SLOWING AND ACCELERATING OF HEARTBEATS.

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or medium and in the case of abnormal beats, it directs self-electric and automatic shocks, and if any slowdown occurs in the heart rhythm, the device gives additional pulses to make the number of beats return to a normal rate. Dr. Gehani, concluded talking about the device, by saying that the technique of these devices has evolved considerably in recent years. It has also become possible to install the device under local anaesthesia without the need for general anaesthesia or surgery except in some cases, explaining that after the operation, the patient stayed in the hospital for a short period

of time before being released to resume his normal activities. He emphasized that the device had been tested several times after installation to ensure that it was functioning properly. The patient was allowed to go to Umrah whenever he wanted as long as he brought a special identification card in case he needed to visit a hospital for any reason, and he was also allowed to pass through airports without being exposed to electronic detectors that might interfere with the device.

MEDICAL INSTITUTION

New horizons in infertility treatment German mom welcomes her miracle baby at 43

oday, having a baby after age 40 is not impossible. Innovations in reproductive medicine mark the beginning of a new era for infertility treatment. A poor ovarian response is one of the major causes of infertility. It is tough to create quality embryos in these patients. In ACIBADEM IVF Centers, we apply PRP (Platelet-rich plasma) which is one of the newest techniques in IVF (in vitro fertilization) treatment for increasing the quality of embryos. PRP helps to stimulate the ovaries and increases the quality of the ovarian reserve. With PRP treatment, the amount and quality of oocytes and embryos could be augmented. Thus, we can increase the chance of conception.

What is PRP, and how is it applied? PRP, as a non-operative treatment, is an innovative approach applied in reproductive medicine in recent years. It can play an important role in tissue regeneration and healing. It has been applied in different disciplines of medicine for years. When the PRP procedure is applied for the first time, a blood sample is taken from the patient. The sample is separated into red blood cells and leukocytes. The liquid which contains platelet-rich plasma is then concentrated. This sample is used for PRP, and it is injected directly into the ovaries using the ultrasound-guided method.

Having a baby at 43 thanks to PRP Laura and Thomas are a German couple who have been married for 16 years. The couple had three failed IVF attempts. They were about to give up on having a child. They wanted to give themselves a last chance and search for IVF treatment abroad. Laura explains her first journey to Turkey and ACIBADEM Hospital: “I am not exactly sure what prompted me to

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search for IVF treatment abroad. When you’re well in your 40s, you are most likely to give up on having a baby. So here we are, a married couple for 16 years, who have tried IVF treatments 3 times. We were still aspiring to have a baby, but at the same time, we were getting used to the idea that not having a baby is not the end of the world. After a while, we started thinking about going abroad for treatment. There were different options. I saw some ads and videos from ACIBADEM Healthcare Group from Turkey. I read some papers about the hospital and its IVF capacity. They are the biggest private healthcare provider in the country and have a great reputation in infertility treatment. I also read convincing comments about the hospital on some health blogs. We visited ACIBADEM Hospital to meet gynecology and reproductive medicine specialist Prof. Bülent Tıraş, MD. He listened to us carefully, examined our medical records, and shared his opinion and the treatment plan in mind.”

PROFESSOR BÜLENT TIRAŞ STATES THAT PRP OFFERS NEW HOPE OF FERTILITY TO WOMEN, PARTICULARLY THOSE WHO HAD EXPERIENCED FAILED IVF CYCLES BEFORE.

MEDICAL INSTITUTION

cess rates, new innovative solutions like PRP, the legality of Preimplantation Genetic Screening procedure in Turkey, affordable prices, skillful doctors, and modern laboratory are some of the attractive reasons to choose ACIBADEM. Laura states: "The cost we paid at ACIBADEM was a quarter of an IVF center in Germany. Before we came to Turkey, we had a look at the IVF centers in the USA. We did not see higher success rates there. What’s more, the cost was almost 10 times compared to ACIBADEM.”

Laura was 42 at the time, and they had three unsuccessful IVF attempts before in their hometown. After considering Laura’s age and previous failed attempts, Professor Bülent Tıraş and his team decided to apply PRP treatment. After PRP, ovarian stimulation, egg retrieval, and finally embryo transfer, the couple returned to their country. Two weeks later, they visited Turkey again, just to find out that they would be mom and dad. Laura gave birth to a baby girl 7 months ago in her hometown.

Thousands of couples visit ACIBADEM every year with the hope of having a child Just like Laura and Thomas, thousands of couples are visiting Turkey and ACIBADEM Hospital from foreign countries every year. High suc-

Professor Bülent Tıraş states that PRP offers new hope of fertility to women, particularly those who had experienced failed IVF cycles before. “With PRP treatment, we are trying to increase ovarian reserve, the number and at the same time the quality of the eggs. I want to say that we have been seeing inspiring outcomes with PRP treatment. For about 3 and a half years, we have been using this treatment in Turkey, in ACIBADEM Maslak IVF Center. We are providing services to different age groups and our clinic has many patients who are in their 40s. Thanks to PRP, we can increase the likelihood of pregnancy in these age groups. We had a patient who got pregnant at 48 after PRP and IVF procedures.” In addition, there are different studies in the medical field about PRP’s effects in IVF treatment on pregnancy. Professor Bülent Tıraş and his team have one of the most extensive research projects in this area. They researched PRP’s effect on infertility treatment in 311 women and witnessed really promising results.

How is PRP applied in IVF treatment

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THE COST WE PAID AT ACIBADEM WAS A QUARTER OF AN IVF CENTER IN GERMANY. BEFORE WE CAME TO TURKEY, WE HAD A LOOK AT THE IVF CENTERS IN THE USA. WE DID NOT SEE HIGHER SUCCESS RATES THERE. WHAT’S MORE, THE COST WAS ALMOST 10 TIMES COMPARED TO ACIBADEM. LAURA

MEDICAL INSTITUTION

Being parents Laura shared with us how their life changed after the baby; "Our lovely little girl is 7 months now. We finally became parents, and I would like to think we are good parents. Maybe even great parents. Being a mom and a dad became our primary role. Our world now revolves around our baby. I know it is a bit cliché to say this but having a baby is the greatest feeling that can be experienced by a human being. It’s a story as old as time.”

About Acıbadem Maslak Hospital Opened in 2009 and expanded in 2018, Acıbadem Maslak is the largest hospital of the leading private healthcare provider in Turkey and the region Acibadem Healthcare Group. Incorporating the latest technologies and

internationally acclaimed physicians, Acıbadem Maslak serves as a national and international referral center for many complex treatments and surgeries. It provides comprehensive services for pediatric and adult patients across multiple medical specialties, including oncology, heart care, intensive care, IVF treatment, spine health, robot-assisted surgery, etc. The hospital has international JCI quality accreditation and LEED Gold Certificate for environment-friendly building. With its 106.000 m2 indoor area, 364 beds, 36 intensive care beds, and 20 operating theatres, Acıbadem Maslak provides world-class healthcare in a relaxing and healing environment.

OPENED IN 2009 AND EXPANDED IN 2018, ACIBADEM MASLAK IS THE LARGEST HOSPITAL OF THE LEADING PRIVATE HEALTHCARE PROVIDER IN TURKEY AND THE REGION ACIBADEM HEALTHCARE GROUP. INCORPORATING THE LATEST TECHNOLOGIES AND INTERNATIONALLY ACCLAIMED PHYSICIANS, ACIBADEM MASLAK SERVES AS A NATIONAL AND INTERNATIONAL REFERRAL CENTER.

How is PRP applied in IVF treatment

ARTICLE

WCM-Q’s Intersection of Law and Medicine series highlights legal, ethical perspectives in healthcare Local and international experts in medicine, law and academia gather to bridge the gap between law and medicine in patient care

xperts have established that a synergy between legal practice and medicine is necessary for healthcare systems to operate seamlessly. Even as the healthcare sector experiences changes and reforms, the legal and ethical aspects of care must not be compromised so that people’s health is adequately taken care of. To bridge that gap, the Intersection of Law and Medicine series was started in 2015 by Weill Cornell Medicine-Qatar (WCM-Q) and in 2019, WCM-Q continued the series in collaboration with Hamad Bin Khalifa University (HBKU) College of Law and Public Policy to improve the understanding of healthcare practitioners in Qatar about the legal aspects of the healthcare system, both locally and globally, and to enhance their role as physicians and advocates of their patients. The series brings together physicians and other healthcare professionals, lawyers, academics and ethicists in one space to discuss and create awareness about legal and ethical issues that impact the healthcare practitioners in Qatar. The meetings, which are convened three times a year, gather healthcare practitioners from government and private healthcare providers. It is worth noting that those who practice complementary and alternative forms of medicine are also involved in the forums. Coordinated and delivered by the Division for Continuing Professional Development at WCM-Q, the subjects covered so far include elderly care, mental health, telemedicine, ethical and legal challenges in healthcare, Islam and bioethics, and end-of-life care. Besides the locally renowned speakers, the program has hosted internationally renowned speakers who inform the participants of developments in the law and best practice. Dr. Thurayya Arayssi, Professor of Clinical Medicine and Vice Dean for Academic and Curricu-

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lar Affairs at WCM-Q said: “As healthcare practitioners, we realized that our relationship with the patient extends beyond just taking care of their disease. We must understand the context where they are coming from, the healthcare system, and legal and ethical aspects that would enhance the care of our patients. We need to know and understand the laws and how they impact our healthcare practice. Understanding both the ethical and legal perspectives will enhance the care of the patients and will enhance our roles as healthcare practitioners in advocating for our patients.” Dr. Thurayya Arayssi

THE SERIES BRINGS TOGETHER PHYSICIANS AND OTHER HEALTHCARE PROFESSIONALS, LAWYERS, ACADEMICS AND ETHICISTS IN ONE SPACE TO DISCUSS AND CREATE AWARENESS ABOUT LEGAL AND ETHICAL ISSUES THAT IMPACT THE HEALTHCARE PRACTITIONERS IN QATAR.

The Intersection of Law and Medicine series exists to ensure physicians and healthcare professionals are aware of the laws governing the practice of medicine in Qatar, it provides an opportunity for dialogue to examine the law on issues like legal protection for patients, medical malpractice and challenges with creating a universal understanding in a diverse healthcare workforce and patient base. Whilst rapid advances in medicine in areas such as artificial intelligence and stem cell research provide healthcare professionals with new opportunities for treating their patients, they present new ethical dilemmas which require robust legal and ethical frameworks to protect patients, practitioners and communities. Since Qatar’s healthcare sector is diverse, with healthcare professionals and patients from all over the world, a needs assessment was conducted to inform the design and development of the Law and Medicine series. Healthcare practitioners were surveyed in Qatar and the region to find out what their needs were, and the educational series was then designed based on these identified needs. This is also evident in the diversity of the speakers who come from different parts of the world, reflecting the diversity in Qatar. In addition, the speakers address not only

ARTICLE what is happening in Qatar but also discuss legal and ethical issues affecting healthcare in the wider region and globally. The diversity of Qatar’s population is also an advantage to the healthcare professionals when it comes to law and ethics. This enhances the practitioners’ understanding about the needs of the diverse population across the world and provides an opportunity for them to learn from each other and about each other. This gives an opportunity to enhance the skills and understanding of the healthcare practitioners of the diverse patient population. Although the COVID-19 pandemic presented many challenges to the healthcare sector, there were also major developments in the area of patient care. The use of telehealth has been enhanced during the time of COVID-19, giving virtual healthcare services to patients who were not able to access their physicians physically, due to various reasons such as COVID restrictions, living in rural areas or not having anyone to take them to the physician. For the Law and Medicine series, shifting online enhanced the feasibility of the program because it allowed more people to attend the series. Discussions included the latest topics related to the impact of COVID-19 on healthcare; for instance, the importance of telehealth and challenges of telehealth which was used tremendously during the time of COVID-19. As the fields of medicine and research continue to evolve, there are challenges that will come along because of the proliferation of technology; for instance, in the areas of Artificial Intelligence (AI), genome editing and stem cell therapies. Artificial Intelligence or genetic research will likely have a huge impact on the standard of care provided by physicians. Currently, anything the physicians do has to comply with certain standards of care as recognised in their field, whether it is treating the patient, prescribing the drugs or even performing operations. However, AI is potentially paradigm shifting and could end up assisting or guiding the decisions and actions of physicians, for instance by making a recommendation to a physician about how to treat a patient or which drugs to prescribe. This poses a challenge relating to legal and ethical standards because if, for instance, AI is used in robotic surgery and something goes wrong, it

AS THE FIELDS OF MEDICINE AND RESEARCH CONTINUE TO EVOLVE, THERE ARE CHALLENGES THAT WILL COME ALONG BECAUSE OF THE PROLIFERATION OF TECHNOLOGY; FOR INSTANCE, IN THE AREAS OF ARTIFICIAL INTELLIGENCE (AI), GENOME EDITING AND STEM CELL THERAPIES.

Dr. Barry Solaiman

could potentially be difficult to determine who is ultimately responsible for injuries or suboptimal health outcomes sustained by the patient. Qatar’s regulatory environment has developed tremendously in the recent past, with many new guidelines being implemented. The Ministry of Public Health has created guidelines in consultation with experts, thus impacting the practice or research. In addition, when it comes to practice, new laws have been implemented to regulate areas such as mental health and organ transplants, for example. The mental health law covers the requirements to be admitted to a psychiatric unit hospital, while the organ transplant law tackles who can donate organs or tissues. From the legal perspective, there has been the creation of laws but there are still developments that need to be done in the legal framework for instance in medical research law and medical liability law. Despite Qatar having a crossroads community, the Islamic law and ethics interact harmoniously with western legal concepts. This is largely because the Ministry of Public Health consults a wide variety of stakeholders locally, regionally and internationally and investigates laws from a variety of jurisdictions when formulating new policy and legislation. International laws such as those from US, UK and Canada as well as the Gulf region, some of which might have been informed by Islamic perspectives, are investigated. Regarding the collaboration between WCM-Q and HBKU, Dr. Barry Solaiman, Assistant Professor of Law in the College of Law and Public Policy at Hamad Bin Khalifa University, said: “For the Law and Medicine series, we identified that there was a need in the region generally for legal expertise in the area of healthcare law. We need to bridge the gap between law practice and medicine and physicians who are qualified, need to navigate all these issues, which they may not learn about, to a deep degree, during their medical education. Therefore, this collaboration is important because it impacts directly on the practice of healthcare professionals in Qatar and we are able to measure those areas of expertise and offer excellent care to the local community.”

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Physiotherapy and Rehabilitation Department at Marble Medical Center; Unique Programs with The Best Medical Equipment

arble Medical Center noticed the importance of rehabilitation in helping the patient reach maximum body efficiency within the limits of his illness. Based on that, a comprehensive Department was established. The goal of the Physiotherapy and Rehabilitation department at Marble Medical Center is to treat patients with different types of problems, ranging from sports injuries and low back pain, lymphodema after liposuction and lifting operation. The importance of this major increased within the past few years; the reason behind it is

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mainly the increase in the average life expectancy and the surge in the health problems people are facing. In fact, after getting over their health crisis, people need the new techniques of physiotherapy to help them recover as much as possible of their lost functional capacities.

Unique Program Physiotherapists at Marble Medical Center are able to design a unique program for recovery, health and wellness to fit the patient’s individual needs. The rehabilitation medicine works on restoring the handicapped organ so that the patient

PHYSIOTHERAPISTS AT MARBLE MEDICAL CENTER ARE ABLE TO DESIGN A UNIQUE PROGRAM FOR RECOVERY, HEALTH AND WELLNESS TO FIT THE PATIENT’S INDIVIDUAL NEEDS.

MEDICAL INSTITUTION

will be again an active member in his society without being affected by any disability. The role of rehabilitation is to adapt the patient with his functional disability through teaching him how to benefit from all his functional capacities. Rehabilitation helps a child, adult or older person to be as independent as possible in everyday activities. Rehabilitation can help to reduce, manage or prevent complications associated with many health conditions such as spinal cord injury, stroke, or a fracture.

Here are the most common medical conditions treated by physical therapists: • • • • • •

Sports Injuries. Muscular Dystrophy. Back and Neck Pain. Rheumatology disease. Women’s health Muscle tears & soft tissue injuries.

Physiotherapy helps the person affected by physical injury, illness or disability. It treats specific musculoskeletal issues, improves movement, function and strength, as well as reduces swelling and pain.

Best Medical Equipment The Physiotherapy and Rehabilitation Department at Marble Medical Center has the best medical equipment to meet the needs of patients. Here are different equipment pieces

frequently used in clinics: Treatments tables, ultrasound, electrical stimulation, Pressotherapy machine, exercise balls, infrared. Physiotherapists at Marble Medical Center employ the right clinically-proven healing techniques to improve movement, flexibility and strength.

Thorough clinical assessment and individualized management plan such as: • • • •

Medical massage. Manual lymphatic drainage. Stretching and strengthening exercises. Dry cupping.

Who Needs Rehabilitation Rehabilitation is for people who have lost abilities that they need for daily life. Some of the most common causes include: • Injuries and trauma, fractures (broken bones). • Chronic pain, including back and neck pain. • Shoulder pain, heel pain, elbow pain, chronic strains and sprains. • Muscle tears and soft tissue injuries. • Swelling and lymphedema. Rehabilitation can reduce the impact of a broad range of health conditions including diseases (acute or chronic), illnesses or injuries. It can also complement other health interventions such as medical and surgical interventions, helping to achieve the best outcome possible.

THE PHYSIOTHERAPY & REHABILITATION DEPARTMENT AT MARBLE MEDICAL CENTER HAS THE BEST MEDICAL EQUIPMENT TO MEET THE PATIENTS’ NEEDS.

ARTICLE FEATURES . Tendon Injuries and Treatments

TENDON INJURIES AND TREATMENTS JULY.AUG 2022

Tendon Injuries and Treatments . ARTICLE FEATURES

tendon is a fibrous connective tissue that attaches muscles to bones. A tendon serves to move the bone or structure. Tendons connect the ends of muscles to bones, whereas ligaments connect bones to other bones. Tendons connect the skeletal system to the muscular system by attaching muscle to bone. When muscle contracts, the tendon acts on the bone, causing movement. The most important tendons in the human body are the tendons of the shoulders and arms, pelvis and feet, head, neck and trunk.

Tendinitis Tendinitis is inflammation of a tendon, the thick fibrous cords that attach muscle to bone. The condition causes pain and tenderness just outside a joint. While tendinitis can occur in any of your tendons, it's most common around your shoulders, elbows, wrists, knees and heels. Although tendinitis can be caused by a sudden injury, the condition is much more likely to stem from the repetition of a particular movement over time. Most people develop tendinitis because their jobs or hobbies involve repetitive motions, which put stress on the tendons such as tennis, swimming, basketball, baseball and golf. Using proper technique is especially important when performing repetitive sports movements or job-related activities. Other causes of injury include incorrect movements while walking or standing, or abnormal pressure on one of the body parts due to a congenital defect in one of the joints. Some diseases may cause tendinitis, such as rheumatoid arthritis, osteoporosis, diabetes, and in some cases, metabolic problems, or as a side effect of taking some medications. As people get older, their tendons become less flexible, which makes them easier to injure. While tendinitis can occur in any of your tendons, it's most common around your shoulders, elbows, wrists, knees and heels. Signs and symptoms of tendinitis tend to occur at the point where a tendon attaches to a bone and typically include pain often described as a dull ache, especially when

moving the affected limb or joint, tenderness and mild swelling. The goals of tendinitis treatment are to relieve your pain and reduce inflammation. Often, taking care of tendinitis on your own — including rest, ice and overthe-counter pain relievers — may be all the treatment that you need. Physical therapy is essential in tendinitis. You might benefit from a program of specific exercise designed to stretch and strengthen the affected muscle-tendon unit. For instance, eccentric strengthening — which emphasizes contraction of a muscle while it's lengthening — has been shown to be a very effective treatment for many chronic tendon conditions, and is now considered first line treatment. Sometimes your doctor may inject a corticosteroid medication around a tendon to relieve tendinitis. Injections of cortisone reduce inflammation and can help ease pain. Corticosteroids are not recommended for tendinitis lasting over three months, as repeated injections may weaken a tendon and increase your risk of rupturing the tendon. Platelet-rich plasma (PRP) treatment involves taking a sample of your own blood and spinning the blood to separate out the platelets and other healing factors. The solution is then injected into the area of chronic tendon irritation. In situations where physical therapy hasn't resolved symptoms, your doctor might suggest ultrasonic treatment. This minimally invasive procedure uses a small incision to insert a special device that removes tendon scar tissue with ultrasonic sound waves. Also, dry needling involves making small holes in the tendon with a fine needle to stimulate factors involved in tendon healing. Depending on the severity of your tendon injury, surgical repair may be needed, especially if the tendon has torn away from the bone.

TENDINITIS IS INFLAMMATION OF A TENDON, THE THICK FIBROUS CORDS THAT ATTACH MUSCLE TO BONE. THE CONDITION CAUSES PAIN AND TENDERNESS JUST OUTSIDE A JOINT. WHILE TENDINITIS CAN OCCUR IN ANY OF YOUR TENDONS, IT'S MOST COMMON AROUND YOUR SHOULDERS, ELBOWS, WRISTS, KNEES AND HEELS. ALTHOUGH TENDINITIS CAN BE CAUSED BY A SUDDEN INJURY, THE CONDITION IS MUCH MORE LIKELY TO STEM FROM THE REPETITION OF A PARTICULAR MOVEMENT OVER TIME.

Tendon Rupture A tendon rupture is a partial or complete tear of your tendon. Tendons are tough bands of tissue that attach your muscles to your bones. A tear may be caused by an injury or increased pressure on the tendon that occurs during sports or a fall.

ARTICLE FEATURES . Tendon Injuries and Treatments

The signs and symptoms of a tendon rupture include tearing or popping sound at the time of the injury, pain or tenderness in the area of the ruptured tendon, weakness or stiffness in the injured area, swelling, bruising and trouble walking or moving the area where the tendon rupture occurred. The Achilles tendon is a large, strong fibrous cord that connects the calf muscles in the back of the leg to the back of the heel bone. An Achilles tendon tear is most often caused by a sudden, forceful motion that stresses the calf muscle. This can happen during an intense sports activity or even when you just run or jump. Symptoms of an Achilles tendon tear may include a sudden, sharp pain. Most people feel or hear a pop. You may have swelling and bruising. You may not be able to point your foot down or stand on your toes. Some people with partial tears may not have any symptoms. When the calf muscles flex, the Achilles tendon pulls on the heel. This movement allows us to stand on our toes when walking, running, or jumping. Despite its strength, the Achilles tendon is also vulnerable to injury, due to its limited blood supply and the high tensions placed on it. Treatment for a ruptured Achilles tendon often depends on your age, activity level and

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the severity of your injury. In general, younger and more active people, particularly athletes, tend to choose surgery to repair a completely ruptured Achilles tendon, while older people are more likely to opt for nonsurgical treatment. Non-surgical treatment typically involves resting the tendon by using crutches, applying ice to the area, taking over-the-counter pain relievers and keeping the ankle from moving for the first few weeks, usually with a walking boot with heel wedges or a cast, with the foot flexed down. However, a nonsurgical approach might increase your chances of re-rupture and recovery can take longer. The procedure generally involves making an incision in the back of your lower leg and stitching the torn tendon together. Depending on the condition of the torn tissue, the repair might be reinforced with other tendons.

Ruptured tendons Ruptured tendons in the finger or shoulder is a common health problem that can occur in sports, or because of an accident or carrying heavy objects. The patient needs an operation to repair the ruptured tendon. Physical therapy and rehabilitation are needed after the operation because they are essential to help the

SYMPTOMS OF AN ACHILLES TENDON TEAR MAY INCLUDE A SUDDEN, SHARP PAIN. MOST PEOPLE FEEL OR HEAR A POP. YOU MAY HAVE SWELLING AND BRUISING. YOU MAY NOT BE ABLE TO POINT YOUR FOOT DOWN OR STAND ON YOUR TOES. SOME PEOPLE WITH PARTIAL TEARS MAY NOT HAVE ANY SYMPTOMS.

Tendon Injuries and Treatments . ARTICLE FEATURES

patient regain his normal movement. A jammed finger is a common injury that can cause pain, swelling, and difficulty moving the finger, a crackling sound at the time of the injury and bruising two days after the injury. It is necessary to consult a doctor immediately after the injury in order to start following the appropriate treatment plan that is determined after the diagnosis. Surgery is often needed to repair the ruptured tendon. In light of the medical breakthroughs, miniature surgical instruments are inserted to remove the damaged part of the tendon and injured surrounding tissue. The damaged ends of the tendon are sewn together. Depending on the location of the injury, it can take up to 3 months for the repaired tendon to regain its previous strength.

Physical Therapy and Rehabilitation Physical therapy and rehabilitation is an inevitable stage during treatment as it contributes to strengthening the tendons and muscles of the foot by combining strength and stretching exercises to relieve the symptoms of tendinitis. The goal of rehabilitation is to strength-

en the muscles so that the patient regains his normal movement, which requires a few months, whether after surgical or non-surgical treatment. Rehabilitation will help the patient improve muscle function, increase endurance and maintain range of motion. Physical therapy plays a major role in treating tendinitis through therapeutic exercises, whether carried out by the physical therapist or performed by the patient at home under the supervision of the specialist. Cold and heat therapy works by improving circulation and blood flow to a particular area due to increased temperature. Increasing the temperature of the afflicted area even slightly can soothe discomfort and increase muscle flexibility. It can relax and soothe muscles and heal damaged tissue. In addition to exercises, thermal and infrared devices in addition to electrical muscle stimulators (EMS devices), as well as ultrasound and laser devices can be used. Physical therapy requires several sessions, and the number of sessions varies according to the condition and severity of the pain, but it is not less than 6 sessions and often does not exceed 24 sessions.

THE GOAL OF REHABILITATION IS TO STRENGTHEN THE MUSCLES SO THAT THE PATIENT REGAINS HIS NORMAL MOVEMENT, WHICH REQUIRES A FEW MONTHS, WHETHER AFTER SURGICAL OR NON-SURGICAL TREATMENT.

NEWS

Sheikh Shakhbout Medical City launches new interventional neuroradiology service to treat stroke

heikh Shakhbout Medical City (SSMC), one of the UAE’s largest hospitals and a joint venture partnership between Abu Dhabi Health Services Company (SEHA) and Mayo Clinic, established a new state-of-the-art Biplane Angio Suite for the diagnosis and treatment of ischemic strokes. The brand new service is under the Division of Interventional Neuroradiology which is part of the Clinical Imaging department. The Interventional Neuroradiologists work closely with the recently launched Stroke Unit. This new service will cover a large geographical area of the emirate of Abu Dhabi and will provide an essential life-saving procedure which will significantly reduce the long-term or permanent adverse effects of stroke.

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Every year, 8,000 to 10,000 patients suffer a stroke in the UAE , leaving many with a longterm disability. Ischemic stroke, which occurs when a blood clot blocks an artery leading to the brain, causes the blood to stop flowing to the brain. For every minute that the blood supply to the brain is stopped, two million brain cells die, resulting in potential brain damage. Access to stroke care as quickly as possible does not only mean getting the patient to the right hospital in time, but also reducing the time between diagnosis and treatment. A mechanical thrombectomy is a minimally invasive procedure, which has become a common first line of treatment for patients with ischemic strokes . During the procedure, the blood clot is removed under image

SSMC BRINGS IN LATEST TECHNOLOGY TO HELP PROVIDE BETTER, FASTER TREATMENT FOR EMERGENCY STROKE AND CEREBROVASCULAR DISEASE PATIENTS IN ABU DHABI.

NEWS

guidance using a microdevice inserted into the artery. Despite international guidelines having widened the time window for this procedure, allowing more patients to be eligible for mechanical thrombectomies, one-third of stroke patients still become ineligible due to lost time . Dr. Aiman Quateen, Chair of the Division of Interventional Neuroradiology at SSMC, explained: “Typically, patients rushed to a stroke center first receive a CT or MRI scan to get a definitive stroke diagnosis, afterwards, if the patient is a suitable candidate for mechanical thrombectomy, our Interventional team will be on stand by for immediate intervention and the patient will be taken to the Angio Suite. Recent studies have clearly demonstrated that the faster the intervention, the better the long-term outcome for the patients. SSMC’s new state-of-the-art integrated set-up allows interventional neuroradiologists, like Dr. Aiman Quateen, to perform urgent angiograms (a type of x-ray) of the brain arteries to identify the blockage site, followed by the mechanical thrombectomy to retrieve the blood clot obstructing the artery and restore normal blood flow to the brain in a time-effective way.

“We are extremely excited to have installed the new suite within the Neuroradiology Department, which will be hugely beneficial in providing faster quality stroke care, and therefore, significantly improving patient outcomes. ‘Time is brain’ is a term we often use to emphasize the importance of acting quickly when it comes to stroke care as every minute counts. Restoring blood flow to the brain vessels is crucial in ensuring that the effects of stroke are minimized, and that the patient regains normal function”, said Dr. Aiman Quateen. Dr. Holland Ravelle, Chair of the Department of Clinical Imaging at SSMC, said: “At SSMC, we are committed to fostering innovation and bringing the latest technologies and treatments to enhance the quality of care that is being delivered to UAE patients. Our cutting-edge suite adds to the comprehensive multidisciplinary care we provide for a wide range of common and complex neurological conditions, enabling our experts to deliver better and faster results. Additionally, given the hospital's strategic location we are able to reach a large amount of the capital’s population, which is important as we are one of the very few providers that offer this service.”

SSMC’S NEW STATE-OF-THEART INTEGRATED SET-UP ALLOWS INTERVENTIONAL NEURORADIOLOGISTS, LIKE DR. AIMAN QUATEEN, TO PERFORM URGENT ANGIOGRAMS (A TYPE OF X-RAY) OF THE BRAIN ARTERIES TO IDENTIFY THE BLOCKAGE SITE, FOLLOWED BY THE MECHANICAL THROMBECTOMY TO RETRIEVE THE BLOOD CLOT OBSTRUCTING THE ARTERY AND RESTORE NORMAL BLOOD FLOW TO THE BRAIN IN A TIMEEFFECTIVE WAY.

NEWS

Dr. Khaled Machaca (far left), Shaikha AlQahtani (second from right) and Tembela Eweje (far right) with graduates of WCM-Q's Biomedical Research Training Program for Nationals.

WCM-Q training program provides a boost for budding local researchers

even aspiring biomedical scientists gained key research skills by completing Weill Cornell Medicine-Qatar’s (WCM-Q) Biomedical Research Training Program (BRTP) for Nationals. The BRTP is designed to give Qatari nationals and long-term residents who have recently graduated from college a solid foundation in practical lab skills, experience of working on real research projects alongside WCM-Q’s highly qualified scientific faculty, clinical research competencies, and an understanding of key concepts in research administration. In recognition of their successful mastery of the skills and competencies covered on the program, the interns were presented with certificates of graduation at a special ceremony held at WCM-Q. This year’s ceremony also celebrated the tenth anniversary of the BRTP, which has provided training to 44 interns since its launch in 2011, including this year’s cohort. The program was paused in 2020 during the COVID-19 pandemic but restarted in 2021. In its decade of activity, the BRTP has become an established bridge for college graduates to transition to the workplace and kickstart careers in research, with many who have completed the program going on to gain positions at leading institutions such as Qatar National Research Fund, Anti-Doping

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Lab Qatar, Sidra Medicine, Qatar University (QU), Hamad Medical Corporation, the Ministry of Public Health, Qatar Foundation, the Ministry of Environment and Climate Change, the Ministry of Transport and Communications, and WCM-Q itself. In addition to providing individuals with key research skills, the wider aim of the BRTP is to produce a generation of highly skilled scientists from the local talent pool in order to endow Qatar with the capacity to build the knowledge-based economy of the future. Shaikha AlQahtani, BRTP alumna and Research Training Manager at WCM-Q, said: “Although we had to pause the program in 2020 due to the pandemic, we were able to relaunch it and now we are celebrating a decade of running the program. We met amazing researchers during these years, and what pleases me the most is that our own graduates are recommending the program to their friends and relatives. We have a number of our previous BRTP graduates attending our graduation ceremony today celebrating the successful decade with us and I am very happy that we have this strong bond with them.” The interns who completed the BRTP this year were Alanoud Al-Thani, Jawaher Al-Hamaq,

THE BRTP IS DESIGNED TO GIVE QATARI NATIONALS AND LONG-TERM RESIDENTS WHO HAVE RECENTLY GRADUATED FROM COLLEGE A SOLID FOUNDATION IN PRACTICAL LAB SKILLS, EXPERIENCE OF WORKING ON REAL RESEARCH PROJECTS ALONGSIDE WCM-Q’S HIGHLY QUALIFIED SCIENTIFIC FACULTY, CLINICAL RESEARCH COMPETENCIES, AND AN UNDERSTANDING OF KEY CONCEPTS IN RESEARCH ADMINISTRATION.

NEWS

Aysha AlSaad, Anoud Duale, Hana Mohamed, Rwedah Ajeeb, and Sondos Yousef. All are graduates of Qatar University, apart from Anoud Duale, who graduated from Bangalore University. The WCM-Q faculty who provided mentorship were Dr. Nancy Nader, Assistant Professor of Research in Physiology and Biophysics; Dr. Anna Halama, Assistant Professor of Research in Physiology & Biophysics; Dr. Amal Robay, Assistant Professor of Research in Genetic Medicine/Director of Research Compliance; Dr. Ali Sultan, Professor of Teaching in Micro,Biology and Immunology; Dr. Laith Abu-Raddad, Associate Dean for Extramural Research Funding/Professor of Population Health Sciences/Director of the Biostatistics, Epidemiology, and Biomathematics Research Core; and Dr. Frank Schmidt, Director of the Proteomics Core & Associate \ Professor of Biochemistry. QU biology graduate Jawaher Al-Hamaq interned on the BRTP under the mentorship of Dr. Nader. Jawaher said: “The BRTP program offers a great insight about the backstage work

of research and how to apply previous knowledge gained in my undergraduate studies. Being involved in a real research project and overcoming obstacles along the way made it possible to acquire essential skills as an upcoming researcher. Such experience would not be gained without the guidance of phenomenal researchers such as Dr. Nader, who presented all the key attributes of a researcher. The experience was fruitful, and I am pleased to have completed the program.” WCM-Q’s Dr. Khaled Machaca, Professor of Physiology and Biophysics/Senior Associate Dean for Research, Innovations, and Commercialization, said: “I offer my warmest congratulations to our latest cohort of BRTP graduates, and my thanks to our growing community of BRTP alumni for continuing the mission of the BRTP through building excellent careers in research in Qatar. The success and national contribution of our ambitious, talented, and dedicated BRTP graduates are a wonderful asset for the State of Qatar and its booming R&D sector.”

Dr. Khaled Machaca of WCM-Q

Healthcare professionals boost research skills with WCM-Q course

ealthcare professionals in Qatar enhanced their understanding of qualitative research thanks to a course delivered by the Division of Continuing Professional Development at Weill Cornell Medicine-Qatar (WCM-Q). The five-day course demonstrated the merit of using qualitative research in clinical settings, where it can help researchers gain greater understanding of patient experiences than when using quantitative methods alone. The course also equipped participants with an understanding of the operation of the scientific process when conducting qualitative research and explained how to integrate scientific rigor and ethics into qualitative research studies. Dr. Ziyad Mahfoud, Professor of Research in Population Health Sciences at WCM-Q, and Dr. Gladys Honein-AbouHaidar, Assistant Professor in the Hariri School of Nursing at the American

THE COURSE, TITLED INTRODUCTION TO QUALITATIVE RESEARCH, WAS ACCREDITED LOCALLY BY THE MINISTRY OF PUBLIC HEALTH’S DEPARTMENT OF HEALTHCARE PROFESSIONS – ACCREDITATION SECTION AND INTERNATIONALLY BY THE ACCREDITATION COUNCIL FOR CONTINUING MEDICAL EDUCATION (ACCME).

University of Beirut, directed the course. Dr. Mahfoud said: “Developing a good understanding of the fundamentals of qualitative research is very useful for healthcare researchers because it provides opportunities for gaining insight into the context and complexity of the experiences of patients in clinical settings. It can therefore help us to understand the meaning and relevance of observable phenomena in ways that elude quantitative research methods.”

Dr. Gladys Honein-Abou Haidar and Dr. Ziyad Mahfoud

ARTICLE

In a preemptive effort to trigger post-war capital inflow into Ukraine

Data analytics platform launched to attract $1 billion in AI and DeepTech investments to Ukraine

n a preemptive effort to trigger capital inflow into Ukraine for the post-war era, Deep Knowledge Analytics (DKA), the flagship subsidiary of Deep Knowledge Group, announced the launch of the beta version of a data analytics platform that aims to attract $1 billion in AI and DeepTech investments to Ukraine over a foreseeable period of time. DKA has previously created similar platforms that cater to DeepTech sectors in the UK and Switzerland. DKA’s post-war rebuilding effort aims to support Ukrainian entrepreneurs and companies in finding the right partners, raising

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capital and gaining access to the data, tools and expertise they need to set up and scale their businesses. The platform will also allow Ukrainian companies to automate and manage their relationships with existing and potential partners and investors. It enables international investors to identify, assess and directly invest, choosing from 450 Ukrainian DeepTech and AI companies that were mapped in DKA’s recent DeepTech and AI Ecosystem in Ukraine report. An analytical case study also details 250 investment funds and angel investors represented on the platform. The influx of capital this platform aiming to achieve is meant to shift Ukraine’s pre-war posi-

DEEP KNOWLEDGE ANALYTICS AIMS TO HELP UKRAINIAN ENTREPRENEURS AND BUSINESSES FIND THE RIGHT PARTNERS, INVESTORS, DATA, TOOLS AND EXPERTISE.

ARTICLE

tion from a tech outsourcing hub to becoming one of the leading international tech centres in Europe following the war. In 2021, Venture Capital and Private Equity investments in Ukrainian companies applying AI stood at $440.9 million, significant increase from the drop in 2020. According to a Ukrainian Startup Fund survey, since the start of the war, 71% of Ukrainian startups haven't relocated abroad, 39% are dealing with quite a short cash runway and 28% decided to pause their operations. The DeepTech and AI platform represents the cornerstone of tech business recovery, which is a key pillar in the redevelopment of the overall Ukrainian economy. Emma Brodina, Deputy Managing Partner at Deep Knowledge Group, said: “Ukraine stands every chance of becoming a new DeepTech and AI hub in the heart of Europe. We are glad to assist Ukrainian companies in their fundraising by providing the first iteration of our analytical platform, which will connect investors and startups, inform investment decisions, and enhance tech innovation across the country. We are working on the next iteration which will also facilitate LegalTech and InvestTech components, accelerating investments in Ukrainian tech companies by international investors.” Prior to the war, Ukraine held a leading position in the AI field across Eastern Europe. According to the 2020 Oxford Government AI Readiness Index, Ukraine was the number one AI provider in Eastern Europe with 150 recognized companies. Capitalizing on the country’s strong tech foundation, this platform aims to provide the sector with a much-needed push for recovery. And according to IT Ukraine Association, the growth rate of the IT services market in Ukraine stands at 20-25% annually as of the beginning of 2022. “Ukraine's unique approach to regulating private medical facilities creates a rare opportunity for the most advanced regenerative treatments. Precision Medicine empowered

by AI and DeepTech synergy will be a crucial element in post-war national health restoration. The emerging sector of Regenerative Medicine and Digital Healthcare solutions will provide a baseline for the country's recovery”, said Andrii Savitskyi, Head of Longevity Analytics at Deep Knowledge Group.

THE PLATFORM ENABLES INTERNATIONAL INVESTORS TO IDENTIFY, ASSESS AND DIRECTLY INVEST IN ADVANCED TECH COMPANIES RELATED TO UKRAINE.

The world’s AI industry players have always recognized the talent of Ukrainian AI and Machine Learning engineers. Ukrainians have been known to hold leading positions in top AI companies globally. Due to the establishment of specialized R&D centres in the country, Ukrainian specialists are able to exchange tech knowledge with peers from global markets including the US and Europe. In addition to relatively high levels of English language proficiency, proactivity and flexibility, Ukrainian AI engineers strive to constantly enhance their expertise by keeping abreast of the latest global tech trends and developments. “AI and DeepTech technologies have a direct impact on economic growth. An example is the use of space technologies for precision agriculture, when AgriTech companies, using satellite vision combined with Data Science and AI, can apply predictive analytics of soil, weather and other factors for more efficient harvesting”, said Dmytro Kharchenko, Head of SpaceTech Analytics. DeepTech and AI companies have a multiplier effect on other sectors of the economy due to their disruptive nature and practical applications. In this context, a $1 billion investment in Ukrainian tech companies will have a profound impact on the country’s economy.

Ukrainian DeepTech ecosystem mindmap. Source: DeepTech and AI Ecosystem in Ukraine, Deep Knowledge Analytics (Interactive map)

Link to the Ukrainian AI and DeepTech data analytics platform: www. invest-in-ukraine.tech

NEWS

Cleveland Clinic Performs First-In-World Full Multi-Organ Transplant to Treat Rare Appendix Cancer

lobal health system Cleveland Clinic has successfully performed a first-in-theworld full multi-organ transplant to treat a patient with a rare form of appendix cancer called pseudomyxoma peritonei (PMP). Upon completion of the lifesaving transplant surgery, the patient received five digestive organs: liver, stomach, pancreas, duodenum, and small intestine. Anil Vaidya, M.D., Cleveland Clinic’s Intestinal Transplant Program Co-Director, led the seven-surgeon team that completed the pioneering operation on a 32-year-old man in September 2021. “The patient had one of the most advanced cases of PMP I have seen,” said Dr. Anil Vaidya. “While about 80% of patients with the condition can be treated with traditional therapies, what do you do with the 20% for whom the traditional therapy isn’t successful? In some cases, the answer may be a multi-organ transplant.” During the 17-hour operation, surgeons removed the patient’s diseased organs. He then received the following deceased donor’s organs all together and at the same time: liver, stomach, pancreas and duodenum (pancreaticoduodenal complex), spleen, small intestine, and right colon. The donor spleen was initially transplanted to boost the immune protection of the newly transplanted organs and improve blood flow to the pancreas until fully transplanted. The donor right colon was initially transplanted to help protect the new intestine from infection and improve its ability to absorb nutrients. Both the donor spleen and donor right colon were removed prior to the completion of the transplant after they successfully served to protect the other organs during the operation. “As far as we know, it is the first time in the world that a full multi-organ transplant, including the liver and four other digestive organs, is performed to treat PMP,” said Dr. Vaidya.

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Prior to joining Cleveland Clinic in 2020, Dr. Vaidya performed in England the world’s first modified multi-organ transplant (excluding the liver) to treat a patient with PMP who had exhausted all other management strategies. PMP is a rare cancer that typically originates as a tumor in the appendix. When the slow-growing tumor ruptures, its jelly-like content spreads to other digestive organs, with additional tumors developing that impair gastrointestinal function. Malnutrition and life-threatening complications ultimately occur. Following the diagnosis in 2019, the patient began a long odyssey of treatments. He was one of the 20% of patients with PMP for whom the traditional treatments were ineffective. Often, this population of patients is left with few to no treatment options. The patient was referred to Cleveland Clinic in 2021 in the end stage of his disease. He was receiving hospice care at that time. The patient had stopped working and could no longer eat solid foods. He was receiving nutrients intravenously through total parenteral nutrition (TPN). “We needed to perform an evaluation to determine if transplantation in his case was safe, feasible and could provide long-term benefits,” said Dr. Vaidya. Dr. Vaidya completed a thorough assessment of the patient’s case and received approval from Cleveland Clinic’s Intestinal Transplant Selection Committee to proceed. The patient was placed on the national transplant waiting list in July 2021. “The patient – who needed a liver and four other digestive organs – had started to deteriorate quite rapidly,” said Dr. Vaidya. “It was touch-and-go that he would make it.” In September 2021, a donor was found, and less than 24 hours later, the patient was undergoing the groundbreaking surgery. The first three hours were preparatory, in essence removing the diseased abdominal organs. Next, the donor organs were inserted into the abdom-

Dr. Anil Vaidya

UPON COMPLETION OF THE LIFESAVING TRANSPLANT SURGERY, THE PATIENT HAD RECEIVED FIVE ORGANS .

NEWS

Masato Fujiki, MD, (center) and the Cleveland Clinic surgical team, led by Anil Vaidya, MD, performing the first-in-world multi-organ transplant to treat a rare type of appendix cancer. (Photo courtesy of Cleveland Clinic)

inal cavity, all the necessary vascular connections were completed and a left-sided ileostomy was created to handle bodily waste and let the body recover from the surgery. “The operation was well planned and went like clockwork,” said Dr. Vaidya. “The team members knew exactly what they were going to do, and the timing was perfect. It went really well.”

Amazing recovery Following the transplant, the patient remained in the hospital for 51 days. Soon after he was discharged, he returned because he was suffering from a case of graft-versus-host disease, a common occurrence following intestinal or bone marrow transplants where the donated organs’ immune cells recognize the recipient’s tissues as foreign and attack the recipient.

The patient underwent a procedure perfected and performed by Amy Lightner, M.D., Colorectal Surgeon and Director of Cleveland Clinic’s Center for Regenerative Medicine and Surgery. Dr. Lightner administered three doses of mesenchymal stromal cell (MSC)-derived exosomes, a first ever, novel treatment in solid organ transplants — another first for a patient who received a full multi-organ transplant to treat PMP. According to Dr. Vaidya, “The patient’s recovery was absolutely amazing. His symptoms abated within two hours of the first dose.” Nine months post-transplant, the patient, now 33, can eat and digest solid foods again and has energy to do what he loves, including walking and biking outdoors. “There is currently no evidence of cancer recurrence,” said Dr. Vaidya.

Read more about the patient’s story. For more information about Cleveland Clinic’s Transplant Center, visit https://my.clevelandclinic. org/departments/ transplant

ARTICLE

Surgical Table Market: Top trends boosting the industry expansion through 2028

ccording to a recent study from market research firm Graphical Research, the global surgical table market size is set to register a significant growth during the forecast timeframe, due to the rising patient inflow rate across hospitals and clinics. These tables are undergoing technological improvements to enhance the comfort level of both patients and doctors. The prevalence of chronic diseases has significantly increased the number of surgeries carried out every year. The top trends that will impel global industry growth are as follows:

North America (regional valuation will cross USD 580 million by 2028) Demand for powered surgical tables will improve: North America powered surgical table market size will observe a 3.2% CAGR through 2028 because of the technological advancements

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NORTH AMERICA POWERED SURGICAL TABLE MARKET SIZE WILL OBSERVE A 3.2% CAGR THROUGH 2028 BECAUSE OF THE TECHNOLOGICAL ADVANCEMENTS INTRODUCED IN THESE PRODUCTS. TECHNOLOGIES, SUCH AS ELECTROHYDRAULIC, ELECTRIC, AND HYDRAULIC POWER SYSTEMS DRIVEN BY BATTERIES ARE BEING INTRODUCED, IMPROVING THEIR DEMAND.

introduced in these products. Technologies, such as electro-hydraulic, electric, and hydraulic power systems driven by batteries are being introduced, improving their demand. For example, U.S.-based healthcare solutions provider Skytron LLC, in 2020, launched its next-gen operating table, the GS70 Salus surgical table. The product provides unique features, such as a powered split-leg with detachable leg sections, back & head to support general surgeries, smart accessories attachment, and visual table lock indicators. These characteristics will enhance the accuracy and comfort of doctors and patients during procedures.

Robust need for operating tables across hospitals & clinics: The regional hospitals and clinics will exceed USD 376 million in revenue by 2028. Most patients prefer hospitals and clinics to avail post-surgery care and gain access to best-in-

ARTICLE class surgical treatments. North America has a strong presence of highly trained surgeons and well-equipped operation theaters. The incidence of urological, cardiovascular, neurological, and orthopedic conditions is also rising, thereby prompting admissions across hospitals and clinics.

Europe (regional valuation to surpass USD 474 million by 2028) General surgical tables will facilitate ease in carrying out complex surgeries: Europe general surgical table market share will reach USD 208 million in revenue by 2028. Growing frequency of general surgeries, including appendectomy, cardiovascular surgery, colon procedure, and gynecological & vascular surgeries will aid product uptake. Rise in specialty procedures, such as orthopedic, spinal, and urological surgeries have propelled the demand for advanced operating tables. These tables offer comfort to patients while being laid in a certain position to complete the operation.

EUROPE GENERAL SURGICAL TABLE MARKET SHARE WILL REACH USD 208 MILLION IN REVENUE BY 2028. GROWING FREQUENCY OF GENERAL SURGERIES, INCLUDING APPENDECTOMY, CARDIOVASCULAR SURGERY, COLON PROCEDURE, AND GYNECOLOGICAL & VASCULAR SURGERIES WILL AID PRODUCT UPTAKE.

Non-powered surgical tables will be a cost-eff ective alternative: Europe non-powered surgical table market will generate over USD 70 million in revenue by 2028 due to the robust growth in patient inflow rate and the rising prevalence of chronic diseases across the region. These tables help surgeons in executing a variety of surgical procedures, such as gynecological and cardiovascular surgeries and are a cost-effective option for healthcare organizations. Manufacturers are investing heav-

Asia Pacific (regional valuation will exceed USD 469 million by 2028) Metal surgical tables will witness robust demand: APAC market revenue for metal surgical table reached USD 249 million in 2021. Metal tables offer several advantages to patients and surgeons before, during, and after a surgical procedure. For instance, stainless steel is a widely used raw material to manufacture operating tables as it possesses antimicrobial properties. It also has an anti-porous surface which prevents the growth of harmful viruses and pathogens, creating a safer environment for doctors and patients. The growing network of hospitals and clinics will favor the product use.

China surgical table market share will grow:

Composite surgical tables to gain traction: The Europe surgical table market size from composite materials will register 4% CAGR through 2028. These tables provide support to patients during operation and help in maintaining an optimum position to ensure that surgeons get proper access during the procedure. Composite materials are lightweight and stronger than meta-based products. The rust-resistance and cost efficiency of fiber and carbon will ensure higher customer preference.

ily in their research and development activities to make advanced non-powered tables and improve their performance & efficiency during operations.

CHINA INDUSTRY SIZE WILL CROSS USD 163 MILLION BY 2028 DUE TO THE RISING CASES OF CARDIOVASCULAR AND PERIPHERAL DISEASES. DRASTIC CHANGES IN THE DAILY LIFESTYLE OF THE POPULATION IS ONE OF THE MAJOR FACTORS ADDING TO THE BURDEN OF CHRONIC DISORDERS.

China industry size will cross USD 163 million by 2028 due to the rising cases of cardiovascular and peripheral diseases. Drastic changes in the daily lifestyle of the population is one of the major factors adding to the burden of chronic disorders. This has notably increased the overall patient hospitalization rates. The high-pressure healthcare ecosystem across Chinese provinces of Shandong and Sichuan will foster the surgical table market outlook through 2028.

Ambulatory surgical centers will increase product adoption: The ambulatory surgical centers generated more than USD 94 million in revenue in 2021. Patients are preferring to get admitted in these centers because of the wide availability of advanced treatment facilities, medicines, and surgical devices. These centers accommodate several patients at a time and do not compromise on the quality of care offered to them. Governments are also launching various initiatives to support these medical centers and enhance patients’ access to highly skilled healthcare professionals and treatments.

ARTICLE FEATURES . Monkeypox

Monkeypox

The virus is spread through close contact with people

onkeypox is caused by the monkeypox virus with symptoms very similar to those seen in the past in smallpox. Most monkeypox patients experience only fever, body aches, chills and fatigue. People with more serious illness may develop a rash and lesions on the face and hands that can spread to other parts of the body. Most people recover within about two to four weeks without needing to be hospitalized, monkeypox can be fatal for up to 6% of cases and is thought to be more severe in children.

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Monkeypox is transmitted to humans through close contact with an infected person or animal, or with material contaminated with the virus. It is also transmitted from one person to another by close contact with lesions, body fluids, respiratory droplets and contaminated materials. The illness begins with fever, severe headache, swollen lymph nodes and back pain, then new symptoms such as a skin rash begin to appear. Symptoms last from 14 to 21

Monkeypox . ARTICLE FEATURES

-days, while the incubation period for the virus is usually 7-14 days. The virus enters the body through cracks in the skin, open tissues such as the mouth, nose, eyes, or the respiratory system.

Transmission You can catch monkeypox from an infected animal if you're bitten or you touch its blood, body fluids, spots, blisters or scabs. It may also be possible to catch monkeypox by eating meat from an infected animal that has not been cooked thoroughly, or by touching other products from infected animals, such as animal skin or fur. Monkeypox can also spread from person to person through the coughs or sneezes of a person with the monkeypox rash, touching clothing, bedding or towels used by someone with the monkeypox rash, touching monkeypox skin blisters or scabs including during sexual intercourse. The incubation period (time from infection to symptoms) for monkeypox can range from 5−21 days. Most people recover within two to four weeks without requiring hospitalization, but monkeypox can be fatal in up to 1 in 10 people, and may be more severe in children, pregnant women and persons with immune suppression due to other health conditions.

What are the symptoms of monkeypox? Doctors divide the symptoms that affect patients into two stages:

1. The invasion period ranges between 0 and 5 days. Symptoms include: • • • • •

Fever Severe headache Swollen lymph nodes Back and muscle pain Fatigue

2. Skin rash A rash usually appears 1 to 5 days after the first symptoms. It often begins on the face, then spreads to the arms and legs and then to the

hands and feet. It starts as raised spots, which turn into small blisters filled with fluid. These blisters eventually form scabs which later fall off. The symptoms usually clear up in a few weeks. Some patients may develop swollen lymph nodes before the rash appears, a symptom that distinguishes monkeypox from other similar diseases.

Monkeypox is diagnosed by: • • • •

Sending samples of infected tissues to the lab for culture and analysis. Do blood tests to check for antibodies for the monkeypox virus. Detection of the DNA in the infected tissue. Microscopic examination of samples from the infected tissues.

Protecting yourself against monkeypox Practice good hand hygiene, especially after coming into contact with infected — or suspected infected — animals or humans. This includes washing your hands with soap and water or using an alcohol-based hand sanitizer. Avoid coming into contact with animals that could be carrying the virus, this includes sick or dead animals. You should also avoid coming into contact with people recently diagnosed with the virus or those who may have been infected, and you must only eat meat that has been thoroughly cooked.

AT THIS TIME, THERE ARE NO SPECIFIC TREATMENTS AVAILABLE FOR MONKEYPOX INFECTION, BUT MONKEYPOX OUTBREAKS CAN BE CONTROLLED. THE APPROVED TREATMENTS AIM TO RELIEVE SYMPTOMS AND KEEP THE PATIENT COMFORTABLE UNTIL HE RECOVERS. FURTHERMORE, A PATIENT WITH SUSPECTED OR CONFIRMED MONKEYPOX INFECTION SHOULD BE PLACED IN A SINGLE-PERSON ROOM.

Treatments and Vaccines At this time, there are no specific treatments available for monkeypox infection, but monkeypox outbreaks can be controlled. The approved treatments aim to relieve symptoms and keep the patient comfortable until he recovers. Furthermore, a patient with suspected or confirmed monkeypox infection should be placed in a single-person room. Past data suggests that the smallpox vaccine is at least 85% effective in preventing monkeypox. The original (first generation) smallpox vaccines from the eradication program are no longer available to the general public.

ARTICLE FEATURES . Monkeypox

The diff erence between smallpox and monkeypox Transmission of the two viruses occurs through close physical contact with animals or humans, their body fluids, contaminated droplet particles from respiratory secretions or infected skin lesions. The main difference between symptoms of smallpox and monkeypox is that monkeypox causes lymph nodes to swell while smallpox does not. Monkeypox virus belongs to the family of Poxviruses, while chickenpox belongs to the family of Varicella Zoster viruses. Skin rash is different in both illnesses. In chickenpox, spots do not appear simultaneously and they spread at different times. However, monkeypox blisters appear and develop at the

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same time. Symptoms of monkeypox last two to four weeks, but some strains can lead to severe forms of the disease. According to the WHO, the case fatality ratio has recently been around 3–6%. Symptoms of chickenpox last for two weeks, and quickly subside within seven days. Within 1 to 3 days after the appearance of fever, the patient develops a rash, often beginning on the face then spreading to other parts of the body. The rash goes through different skin eruption phases. It starts off flat and red, but then gets bumpy and blistered, before forming scabs. While chickenpox is common and highly contagious, monkeypox remains a rare disease and does not spread easily between people.

THE MAIN DIFFERENCE BETWEEN SYMPTOMS OF SMALLPOX AND MONKEYPOX IS THAT MONKEYPOX CAUSES LYMPH NODES TO SWELL WHILE SMALLPOX DOES NOT.

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

MEDICAL EXHIBITION

Success stories written by MEDICA – how a small developer team with a prototype in their pocket became one of the biggest exhibitors Again, many programme highlights feature start-ups

s one of the world's leading medical trade fairs, MEDICA in Düsseldorf is one of the most important platforms for start-up teams seeking to enter the healthcare industry and who are looking for investors, opportunities for cooperation and also first-time users of their product ideas. From November 14 to 17, 2022, for the duration of MEDICA, numerous programme highlights will again offer young entrepreneurs the perfect opportunity to present themselves to international experts from the healthcare sector: the 11th MEDICA Start-up COMPETITION, 14th Healthcare Innovation World Cup, the MEDICA START-UP PARK and a total of over 100 start-up exhibitions at the MEDICA CONNECTED HEALTHCARE FORUM are just an example. In addition, several hundred start-ups or scale-ups (which have entered the next phase of development) will participate as exhibitors at MEDICA 2022, either with joint stands or with a stand of their own. The current trend in registrations for exhibitors points towards

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a participation rate that exceeds that of the previous year (MEDICA 2021: 3033 participants) with a notable expansion in the booked floor capacity. Young companies like Rapid Response Revival are responsible for this increase in booked floor capacity. In 2018, they participated for the first time, at the central meeting point for start-ups, MEDICA START-UP PARK. Since then, their business has grown exponentially. Thus, Rapid Response Revival is travelling from Australia to MEDICA this year, too, and will occupy one of the largest stands. The team of developers has committed themselves and their product to meeting a global challenge; sudden cardiac arrest. Every year, six million people worldwide die of this condition. This often happens at home, where no life-saving defibrillator is present in time. Therefore, Rapid Response Revival developed "CellAED", an inexpensive defibrillator for use by lay persons, and started marketing it. In 2019, the first prototype was exhibited at MED-

THE TEAM OF DEVELOPERS HAS COMMITTED THEMSELVES AND THEIR PRODUCT TO MEETING A GLOBAL CHALLENGE; SUDDEN CARDIAC ARREST. EVERY YEAR, SIX MILLION PEOPLE WORLDWIDE DIE OF THIS CONDITION. THIS OFTEN HAPPENS AT HOME, WHERE NO LIFE-SAVING DEFIBRILLATOR IS PRESENT IN TIME.

MEDICAL EXHIBITION ICA: "We met many people who recognised our potential and wanted to be part of our endeavour in different parts of the world", Luke Starr, Chief Communications Officer at Rapid Response Revival, remembers the promising startup phase. Much has happened since then. "We will be presenting a matured product at MEDICA 2022", says Starr, looking forward to the trade fair which will take place in mid-November.

As compact as a bar of chocolate, with huge potential The new version of the defibrillator is no bigger than a bar of chocolate, connects to a network and shows that it is ready for action. "CellAED" helps first responders save lives until professional aid arrives. The device is intended for integration into various emergency alert systems, and according to Starr, could dramatically change first aid response globally. More than 70 countries have already issued a certification. The device has been approved for the market in the EEA, the UK, Australia and New Zealand.

er competitors, this company concentrates on a single application. This experience is probably very similar to that of other start-ups which haven't yet progressed as much as Rapid Response Revival has, and which nevertheless have chosen MEDICA as a suitable platform – for example, because of its competitions.

The 11 th MEDICA Start-up COMPETITION has kicked off

The device should remain affordable wherever it is sold: "The device costs around 240 Euro. A subscription of approximately ten Euros each month is also required for ongoing support, which for example includes access to diagnostic data", says Starr. CellAED is one-tenth the price, size and weight of many of the other current systems on the market, which makes the defibrillator perfect for home use. "This device will change society's reaction to sudden cardiac arrest in a fundamental way", says Starr. To this end, the upcoming participation in the trade fair is vital: "At MEDICA 2022, we will present both our development and the opportunities that it proffers to a professional audience", says Starr, adding: "We want to sell millions of devices. We're therefore cooperating with several manufacturers and are aiming to produce 200,000 devices each month by the end of 2023". Starr thinks this is realistic: "We have the capacity to meet this challenge, we meet the legal requirements and we have a team that can solve potential problems".

The 11th MEDICA Start-up COMPETITION is seeking outstanding healthcare solutions from start-ups in the health app, laboratory diagnostics and artificial intelligence (AI) sectors in healthcare and robotics. The previous year, the winning team was 'Phonolyser' from Finland, with their eponymous product solution that offers intelligent analysis of cardiac sounds. The cardiac sound analyser combines artificial intelligence (processing and analysing signals), Doppler technology (ultrasound) and sound analysis to comprehensively assess and examine for the presence of congenital heart defects in children. The system aids in exact diagnosis. Bahman Doaeian, co-founder and Chief Business Officer of Phonolyser, says: "Particularly in the first weeks following our victory in Düsseldorf, we received a lot of attention from the media and from investors in Europe". For Doaeian, MEDICA is one of the best platforms on which to introduce medical technology in the world. "Here, we meet exactly the target group we want to reach", he says.

One important reason for their success up to now is attributed to the fact that, unlike larg-

Since last November, the "Phonolyser" has Since last November, the &quot;Phonoly-

THE 11TH MEDICA START-UP COMPETITION IS SEEKING OUTSTANDING HEALTHCARE SOLUTIONS FROM START-UPS IN THE HEALTH APP, LABORATORY DIAGNOSTICS AND ARTIFICIAL INTELLIGENCE (AI) SECTORS IN HEALTHCARE AND ROBOTICS. THE PREVIOUS YEAR, THE WINNING TEAM WAS 'PHONOLYSER' FROM FINLAND, WITH THEIR EPONYMOUS PRODUCT SOLUTION THAT OFFERS INTELLIGENT ANALYSIS OF CARDIAC SOUNDS.

MEDICAL EXHIBITION ser&quot; has been developed further; specifically, sensitivity has been improved (goal: over 98 %) and the software has been optimised to make it easier for less experienced doctors to operate the device. Clinical studies have seen a lot of progress – for example, for testing a new algorithm. In this context, Doaeian sees the extensive legal requirements in the European Union as a challenge that means that more support is needed for start-ups in particular. Applications for the 11th MEDICA Startup COMPETITION can be submitted up until September 21, 2022. The finals for the winning pitch will be held on November 15 on the event stage at the MEDICA CONNECTED HEALTHCARE FORUM. Information on the competition and registration is available online at: https://www. medica-tradefair.com/mac2.

The 14 th Healthcare Innovation World Cup for “ Internet of Medical Things" solutions Start-ups, scale-ups and small and medium businesses are also free to submit their solutions for the "Internet of Medical Things (IoMT)" to the 14th Healthcare Innovation World Cup. The best 12 selected finalists will be invited to present their products – which can range from wearable technologies to digital biomarkers, intelligent plasters and smart implants – at MEDICA 2022. In 2021, the "eyemate" system by the Implandata Ophthalmic Products company won the finals in Düsseldorf. This is an intelligent, implantable and biocompatible microsensor that provides telemedical care for glaucoma patients. Glaucoma patients experience elevated intraocular pressure that can cause irreversible damage to the optic nerve and lead to blindness. Current methods only allow this to be measured

at an ophthalmologist's office. However, "eyemate" enables patients to continuously monitor themselves at home. Ophthalmologists can use telemedicine to monitor the data and, if necessary, intervene early on. The device gives patients a feeling of security, as they will be informed in time and can act before elevated intraocular pressure can damage their optical nerve. For Max Ostermeier, CEO & Founder of Implandata Ophthalmic Products, this is a form of patient empowerment, which also contributes to adherence to therapy: "This will completely transform glaucoma therapy". Ostermeier also states that winning at the competition at MEDICA was a huge award and was important for motivation. He says the media response led to being invited to more presentations, which made it easier to win over investors.

Step by step towards international success Nevertheless, the following still remains true for this start-up: "The dominant factor is still the cost", says Ostermeier. The implant is currently being piggyback implanted in the eye during operations for glaucoma or cataracts, where it remains indefinitely. "We meet the exacting CE demands for permanent implants", says Ostermeier. In the future, the implant should be able to be implanted via minimally invasive injection, without surgery, so that intraocular pressure can be monitored continually during the early stages of the disease. Ostermeier went on to state that the start-up works closely with ophthalmologists. In one or two years at the earliest, the company will strive for further internationalisation – outside German-speaking countries. The current focus: approval by the US Food and Drug Administration (FDA).

START-UPS, SCALEUPS AND SMALL AND MEDIUM BUSINESSES ARE ALSO FREE TO SUBMIT THEIR SOLUTIONS FOR THE "INTERNET OF MEDICAL THINGS (IOMT)" TO THE 14TH HEALTHCARE INNOVATION WORLD CUP. THE BEST 12 SELECTED FINALISTS WILL BE INVITED TO PRESENT THEIR PRODUCTS – WHICH CAN RANGE FROM WEARABLE TECHNOLOGIES TO DIGITAL BIOMARKERS, INTELLIGENT PLASTERS AND SMART IMPLANTS – AT MEDICA 2022.

The application phase for participation in this year's Healthcare Innovation World Cup ends on September 21, 2022. The pitches of the 12 finalists will also take place on the event stage at the MEDICA CONNECTED HEALTHCARE FORUM (on November 14). The MEDICA START-UP PARK (Hall 12, E53), which has established itself as a central venue for the creative founder scene, also prioritises networking. At least 40 start-ups have already announced that they will participate, most of them focusing on innovative digital healthcare solutions. All information on MEDICA 2022 and the parts of the programme mentioned above is available online at: https://www.medica-tradefair.com

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HOSPITALS Magazine issue 65

Articles inside

Cleveland Clinic Performs First-In-World Full Multi-Organ

WCM-Q training program provides a boost for budding

Sheikh Shakhbout Medical City launches new interventional neuroradiology service to treat stroke

Tendon Injuries and Treatments

Physiotherapy and Rehabilitation Department at

WCM-Q’s Intersection of Law and Medicine series

ACIBADEM IVF Centers: New horizons in infertility treatment

Al-Ahli hospital saves the life of a Qatari whose heart suddenly stopped

What’s the difference between heat stroke

Our results are equivalent to the international records, if not better

Healthy ways to overcome stress at work

How does expenditure turn into health? The Gulf raised budgets and achieved outcomes

Closed-Loop Oncology from Medication Compounding

Reimagining Nursing for the Future

Dr. Sohaila Cheema, Assistant Dean for the Institute for Population Health, Associate Professor of Clinical Population Health Sciences

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The 25th Annual Congress of the Lebanese Society of Endocrinology, Diabetes and Lipids (LSEDL)

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Emirates Health Services Signs MoU with Johnson Johnson to Strengthen Healthcare Sector

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Al Qassimi Hospital in Sharjah Performs Rare Surgery to

Emirates Health Services Discusses Committee Recommendations, Showcases Strategic Projects at 3rd Board Meeting of 2022

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NYU Abu Dhabi Researchers Develop New Tool That

Transasia unveils a range of IVD solutions with enhanced user experience at Medical Fair 2022

Cleveland Clinic Children’s Ranked Among the Best Children’s Hospitals by U.S. News & World Report