Issue 43 / 146 NOV - DEC 2018
THE ARAB HOSPITAL APPLICATION IS AVAILABLE
Al MOOSA GROUP
ACIBADEM
Al-Ahli Hospital
Specialty Hospital
State-of-the-art facility VR-designed Oasis of Rehabilitation
International Reaccreditation, Another Milestone in Excellence
BLOCKCHAIN
The future of healthcare
An ECOSYSTEM that sets an example for the world in healthcare service in Turkey
New horizons in the Jordanian healthcare sector
NEWS
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The issue of allocating funds for the provision of cancer drugs and medicines for chronic conditions has reached the danger zone in Lebanon, which has threatened the lives and health of tens of thousands of patients who only take refuge in God. Hence, this matter will be acknowledged after a meeting held by the Parliament’s Health Committee to discuss the proposed law submitted in this regard. In fact, no one other than the sick will know how critical the situation is and the bitterness and pain to be deprived of enjoying life. It is true that the issue has been or will be resolved, and medicines will be provided by the Lebanese Ministry of Health. But is it acceptable to be satisfied with this, knowing that the matter has been repeated for years, albeit to a lesser extent? According to the WHO, cancer incidence in Lebanon is among the highest in the Middle East with around 17,000 cases. An increase of 6 percent has been recorded this year, which is a higher rate than the previous year and the year before. Hence the importance of initiating two urgent issues: First, raising the level of prevention, early detection and immediate reduction of the causes of cancer, carcinogenic, environmental and life factors, etc. Second, providing the necessary funds based on studies that show the expected increase in cancer incidence, as well as the increase rate of the prices of new drugs required for treatment, even if it will be at the expense of other issues. Nothing is more important than an individual’s life. The disease can obviously create a conflict between life and death, and a race between the disease and those who seek to eradicate it and overcome it. It is not surprising that people are crying for life. We will not succumb to the disease and its difficulties; as this was rejected by everyone, especially those involved in disease control, given that the world and science are achieving a new victory every day.
Editors Aline Debes, Mark Steven, Don Karn, Andrew Weichert, Colette Semaan, Abbas Moussa Advertising & Marketing advertising@tahmag.com Mirna Khayrallah mirna@tahmag.com Business Development Manager Ralph Rahal tahmag@tahmag.com Offices & Adresses AHMC, Lebanon Mansourieh High way, Jihad Wakim center, 3rd floor. T/F: +961 4 53 40 58 M: +961 3 60 61 00 tahmag@tahmag.com Simon Chammas schammas@tahmag.com Dubai Schammas@tahmag.com +967 50 2971007 KSA Elias Aramouni Business Dot Sulaimaniah Offices building • 2nd flr M: +966 55 1595 000 T: +966 11 4568282 F: +966 11 2253666 P.O. Box: 085092 Riyadh 11691
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NEWS
4 Centre for Arab Genomic Studies uncover 33 new disease-causing genetic mutations related to a broad spectrum of disorders 12 King Saud Medical City Unveils Academy for Postgraduate Studies in Family Medicine 16 Hôtel-Dieu de France, the first e-hospital in Lebanon 24 Baylor St. Luke’s Physicians Save Patient’s Limb from Amputation 60 Abington - Jefferson Health Names New Senior Vice President and Chief Nursing Officer 68 The University of Manchester Middle East Centre invites healthcare professionals to a free Masterclass on leadership in healthcare 71 Royale Hayat Hospital Patient Identification Project Improvement 74 Aster DM Healthcare wins Special Recognition at Arabia CSR Awards 2018 78 ‘Nursing Now Qatar’ Campaign and Doha Healthcare Week
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82 Sidra Medicine welcomes UNESCO Artist for Peace Zara 92 International Reaccreditation, Another Milestone in Excellence for Al-Ahli Hospital 98 10 years of French Lebanese Cooperation in Health Matters celebrated at ESA Business School
34 100 UAE provides the best medical care in the Middle East
104 Amyotrophic Lateral Sclerosis
ARTICLES
34 Blockchain, the future of medicine 28 Why global healthcare should step
TURKEY
up to blockchain technology for enhanced patient health outcome? 46 Lung cancer 50 Carotid Artery Disease 72 Safe patient care with LINET 88 Osteoarthritis of the knee joint 90 Low back pain
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INTERVIEWS
hearing support: contact forte 84 COAGULATION TESTING Sysmex CA-100 Series
Director, Cerner Middle East & Africa, Bachir Awad 54 General Manager of the Specialty Hospital, Dr. Fawzi Al-Hammouri 108 President of the Emirates Gastroenterology and Hepatology Society Dr. Maryam Al Khatry
MEDICAL INSTITUTIONS
6 Sidra Medicine 14 The University of Nicosia Medical School
20 AL MOOSA GROUP 26 ACIBADEM HEALTHCARE GROUP
32 High-end technology for optimum
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86 HbA1c Test 94 Platelets 2
42 Vice President & Managing
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Centre for Arab Genomic Studies uncover 33 new disease-causing genetic mutations related to a broad spectrum of disorders techniques will significantly improve our understanding of the genetic basis of inherited diseases in Lebanon and the Arab world”.
Dr Mahmoud Taleb Al-Ali
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collaboration between researchers at the Centre for Arab Genomic Studies (CAGS), a division of the Sheikh Hamdan bin Rashid Al Maktoum Award for Medical Sciences (HMA), the genetic center “Institut Jerome Lejeune Paris” in France, and several universities and hospitals across Lebanon has resulted in the publication of a study of 213 pediatric patients who underwent genetic analysis for a range of genetic disorders including neuromuscular, cardiac, and metabolic disorders.
The study was led by Professor Andre Megarbane, member of the CAGS Arab council, and clinical geneticist working in Lebanon and Paris. For Lebanon, this study is important as the Catalogue of Transmission Genetics in Arabs, which is maintained
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H.E Abdullah Bin Souqat by CAGS, shows that less than half of diseases reported in Lebanese patients are still lacking molecular diagnosis. DNA sequencing techniques such as the ones utilized in this study, can greatly improve genetic diagnosis in Lebanon and other countries. Dr. Mahmoud Taleb Al-Ali, Director of CAGS, said: “The study is entitled: “Contribution of Next Generation Sequencing in pediatric practice in Lebanon. The study utilized the latest diagnostic technologies and was able to uncover 33 new disease-causing genetic mutations related to a broad spectrum of disorders”. He added, “This collaboration thus highlights how valuable these tools are for an improved clinical diagnosis, and provides further evidence that the increased adoption of such
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On his part, H.E Abdullah Bin Souqat CEO of HMA said that the Award supports the activities of the Centre for Arab Genomic Studies as part of the directives of His Highness Sheikh Hamdan bin Rashid Al Maktoum, Deputy Ruler of Dubai, Minister of Finance and Chairman of the Health Authority, patron of the Award. The Centre’s activities constitute one of the most important priorities of the award due to its importance in the field of human genetics. He also praised the role of the Center in the field of clinical and molecular genetic research, which has enabled impressive results in this field at the regional level in record time. He added, “CAGS is an important icon in defining new horizons through strengthening relationships among researchers around the world and reaching results that contribute to the advancement of health and medical sectors within the United Arab Emirates.” Neurological and neuromuscular disorders were the most common categories of genetic disorders identified in the current study. In this context, it is worth mentioning that one of the focuses of the 10th edition of the Sheikh Hamdan Bin Rashid Al Maktoum Award for Medical Sciences is on Musculoskeletal disorders. The ceremony honoring the Award winners will be held on the 12th of December, 2018 at the Dubai World Trade Center.
MEDICAL INSTITUTIONS
Sidra Medicine: a new era in personalized healthcare
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idra Medicine is a new healthcare organization in Qatar that provides comprehensive specialist healthcare services for children and young people, as well as maternity and gynecology care for women. Chaired by Her Highness Sheikha Moza bint Nasser and established by the Qatar Foundation for Education, Science and Community Development, Sidra Medicine embraces best practice medical education; innovative biomedical and clinical research and discovery; and exceptional patient and family focused care. This unique combination makes Sidra Medicine one of the handful of healthcare organizations in the world that embeds the concept of personalized medicine into its very ethos of treatment and care. With the aim of becoming a center of excellence, Sidra Medicine has been designed to the highest international standards, with state-of-the-art medical equipment, robotic surgeries and sophisticated laboratories to nurture innovation and clinical advancement. It has over 4,000 staff including 2,350
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healthcare professionals representing more than 85 different nationalities. Since welcoming inpatients in January 2018, we have successfully cared for children with complex diseases such as bladder exstrophy, short bowel syndrome, congenital heart diseases, craniofacial and neurological complications. We recently separated conjoined twins joined at the liver and lower sternum; heralding a medical milestone for the country. As an academic medical center, we are training the next generation of healthcare professionals in one of the most technologically advanced facilities in the world. Through biomedical and clinical research, we are embarking on a journey towards personalized medicine for our patients. Sidra Medicine’s mission is to be a beacon of learning, discovery and exceptional care, ranked among the top academic medical centers in the world. The ultramodern healthcare organization is a testament to Qatar’s pioneering spirit and sustained commitment to its human and social development.
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We accept international patients, who can contact us via international.services@sidra.org For details please visit www.sidra.org
NEWS
Innovating medicine, delivering care. Home to specialized care extending from pediatrics, adolescent medicine to reproductive surgery and more, Sidra Medicine is a people-focused healthcare organization for women, children and young people in Qatar and beyond. One of the most technologically advanced facilities in the world, our hospital is designed to promote healing and care. Our intellectual ecosystem also consists of medical education and biomedical research, training the next generation of healthcare professionals and driving us on a journey toward personalized medicine. 7 sidra.org
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NEWS
King Saud Medical City Unveils Academy for Postgraduate Studies in Family Medicine the Academy seeks to provide advanced educational programs for the Saudi specialty in Family Medicine, closing the gap in the sufficiency of Primary Care Centers, and more so to improve the health, curative and preventive services, in addition to building partnerships with relevant academic, professional and social institutions inside and outside the Kingdom.
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he establishment of King Saud Medical City’s (KSMC) Academy for Postgraduate Studies in Family Medicine is poised to be a tremendous legacy and meaningful experience of academic platform driving a step ahead to achieve the goal of Vision 2030 of creating a vibrant society by providing the community specialized Family Medicine doctors close to them and address their healthcare needs.� Dr. Haitham Alfalah, KSMC CEO, stated during the launching of the Academy in September 30th at King Saud Medical City. KSMC, one of the largest medical facilities in Riyadh with 1500 bed capacity, is home to multi-specialties and referral center of most complex cases and considered as a training hub in medical training in the Kingdom. In partnership with the Saudi Commission for Health Specialties
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(SCFHS) and Irish College of General Practitioners (ICGP), the KSMC Academy will graduate annually 100 Family Medicine doctors with Saudi Board Certification. Expected to fill 400 physician trainees during the 4-year academic program, Dr. Alfalah explained that
Dr. Haitham Alfalah
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With 25 trainees on board, Dr. Alfalah further stated that with the advanced academic curriculum including virtual, electronic, bedside trainings, it will be the pathfinder for the new modality platform in medical training. He stressed the importance of providing the necessary support to the Academy as it contributes in a national and global arena to the enhancement of Family Medicine in the community.
NEWS
MEDICAL INSTITUTIONS
The University of Nicosia Medical School Pioneering Medical Education in Cyprus and the Region
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he University of Nicosia has pioneered medical education in Cyprus, establishing the first Medical School in the country in 2011. Seven years on, the Medical School has become renowned in Cyprus and abroad for its innovative and quality education. It has more than 740 students from 58 countries, 132 academic and administrative staff, and 496 clinical part-time teaching staff. Its programmes include not only medical degree but also postgraduate courses aimed at working professionals that are delivered entirely online.
Postgraduate Online Programmes in Healthcare Administration & Public Health Ideal for working professionals and new graduates The Master of Science in Health Services Administration prepares students for a leadership position in this rapidly growing and ever-changing field, with a multi-disciplinary curriculum accommodating individual professional advancement goals. The Master Public Health addresses critical policy issues and public health challenges in developed and developing countries,
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with an opportunity to specialize in a broad range of public health topics • Fully online degrees from the first university in the European Union to earn a 5-Star rating for online/distance learning. • Study full-time or part-time. • Opportunity to sample the programme through a free 1-week trial. • Scholarships available.
Two medical degrees and a postgraduate course for Family Doctors: MBBS – 4-year graduate-entry British medical degree awarded by St George’s, University of London, quality assured by the UK General Medical Council MD – 6-year medical degree for high school graduates, certified and quality approved by the Cyprus Ministry of Education and Culture PG / MSc in Family Medicine – Postgraduate Programme offered online for practising doctors. The Postgraduate Diploma has received educational accreditation from the UK Royal College of General Practi-
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tioners (RCGP), and students with the requisite clinical experience can take the examinations in Cyprus to become International Members of the RCGP
Tracking the Career Advancement of our Graduates The success of a medical school’s graduates reflects that institution’s quality of education. Of the Medical School’s 255 graduates so far (2015 – 2018), 252 or 99% have already been offered positions at over 200 medical centres around the world for residency training and research. These include medical centres such as John Radcliffe Hospital in Oxford, Addenbrooke’s Hospital in Cambridge, St Mary’s Hospital, King’s College Hospital and the University College Hospital in London, Massachusetts General Hospital in Boston (Harvard University affiliated), Thomas Jefferson University Hospital in Philadelphia, Mount Sinai in New York, and the University of Toronto and Dalhousie University in Canada. This recognition by the global medical community is a testament to the high-quality education offered by the first and largest Medical School in Cyprus.
Tel: +35722471999
Email: admissions@med.unic.ac.cy
Website: med.unic.ac.cy
NEWS
Hôtel-Dieu de France, the first e-hospital in Lebanon In her speech after the national anthem, Mrs. Jocelyn Ziadeh, HIS Director at HDF, described the early stages of the project in 2014 leading up to this day, noting the staff’s considerable efforts and distinctive skills. She also thanked ITB, Medasys, Menaitech and SAP for their contributions to the completion of this project. Father Nassar followed with his speech, welcoming first and foremost Mr. Hasbani for his continuous support and praising his efforts in the Ministry of Public Health. “We are incredibly proud of today’s event, he said, as it is part of the HDF 2020 plan, set up by the Administration Board in 2011. The acquisition and adoption of this integrated hospital information system has been achieved thanks to ITG’s cooperation.”
Minister of Public Health M. Ghassan Hasbani
Father Daccache noted that “Newer technologies, this system being one of them, are one of the key success factors when it comes to developments in the health and care sectors”, he went on saying, “the
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n October 23, 2018 Hôtel-Dieu de France celebrated the launch of its integrated Hospital Information System (HIS), the first of its kind in Lebanon. This system’s major advantage is that it combines three of the hospital’s main components: the patient’s medical file, the financial operations file, and the HR management file; therefore, making Hôtel-Dieu de France the first integrated e-hospital in Lebanon. The event was held under the patronage and presence of the Deputy Prime Minister and Minister of Public Health, M. Ghassan Hasbani, and was attended by a number of public figures from both private and public sectors.
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system cannot be improved from a professional point of view, however from an ethical stand point; we need to do everything we can in order to preserve medical confidentiality.” Mr. Hasbani spoke last and congratulated Hôtel-Dieu de France for all the advancements it’s making in the Lebanese health sector after the country’s digital revolution and the establishment’s serious investment in the Fourth Industrial Revolution. He then announced that the launch of the first digital hospital in Lebanon coincides with the approval of the health card’s main laws after having gone through many amendments in previous years to fit the Lebanese Ministry of Public Health’s long-term plan, Health 2025. Hôtel-Dieu de France remains a leading hospital in Lebanon and a pioneer when it comes to medical and health developments, all the while staying true to its main objective: to provide patients with the best possible care and treatments.
NEWS
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MEDICAL INSTITUTIONS
Unveils Plans for New VR-designed Oasis of Rehabilitation and Long-term Care in Al-Ahsa At over 60,000 square meters, the new facility, planned to achieve LEED gold, was designed within the virtual environment and will bring modern architecture and best-in-class medical care to the Kingdom of Saudi Arabia. The final design of the over 60,000-square-meter facility was recently unveiled by Malek Al Moosa, the CEO of Al Moosa Medical Group as part of the group’s greater mission to expand their reach across the Kingdom to address a need for specialized rehabilitation and long-term care hospitals in the region.
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his new facility was designed within the virtual environment, employing virtual reality (VR) to design each major space as a means of design iteration, allowing for real-time feedback. The new facility will be a rehabilitation and long-term care oasis in the region, including rehabilitation programs for sports injuries, bone inju-
MEDICAL INSTITUTIONS NEWS
ries for adults and children, spinal injuries, and neural and brain injuries. The state-of-the-art facility was designed by HDR, who consistently ranks among the best in global hospital design and fifth among the top 100 international design companies. HDR brought together design and planning experts to create a master plan for the new facility for Al Moosa that reflects the highest level of international medical and architectural design. The rehabilitation and long-term care hospital will be located in Eastern Al Ahsa. It is designed as a micro village that embraces nature and the surrounding landscape. The master plan take its inspiration from the Al-Ahsa region’s natural landform of an oasis, while the building design fosters healing through its
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MEDICAL INSTITUTIONS
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connection to nature. The new facility will stand as the northern gateway to Al-Ahsa that will leave a lasting impression as a striking landmark.“The new project is aligned with the Saudi 2030 Vision for the future of healthcare and empowering the private sector. It will transform Al Ahsa city from an agricultural oasis into a thoughtful healing oasis, where patients and their families are truly in the center of our care,” said Malek Al Moosa. “It will be the healthcare destination for patients from all over the Kingdom and the GCC region. Patients and their families will feel welcome, respected and comfortable to make this place their home away from home.” All spaces were designed to create the most positive experience for patients, with the least amount of anxiety and stress possible. Patients and visitors will arrive through a five-star hotel-style lobby with ample waiting areas flanked by retail outlets, including a pharmacy and dining, as well as a hanging garden and water features. The double-height volume and clear layout will allow visitors to navigate the facility intuitively. Patient rooms are designed to enhance the patient and visitor experience, allowing space for families and loved ones to visit and connect socially, and with views to the local steppe landscape. “We are thrilled to be working
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with Al Moosa Group to bring an answer to the increasing need for rehabilitation and long-term care services in Al Ahsa,” said Mohammed Ayoub, Vice President and Design Director at HDR. “The simple, yet elegant plan is based on an efficient model of world-class care, while it also embraces the local culture and values of the residents of the Kingdom.”
The new facility takes into great consideration reducing energy consumption and preserving the surrounding environment. Key features of the master plan include: •
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Tiered green steps originating on the ground level rise to the rehab center containing the gym and pool, shading the parking below and offering healing and visual engagement for patients and staff as part of the rehabilitation regimen. The gym and pool structure exhibits an expansive green roof. An enclosed garden within the lobby, supplemented by personalized gardens and rehabilitative green spaces at every inpatient floor of the bed tower, assures that everyone has access to nature, irrespective of mobility.
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A protective enclosure created by the seamless and continuous solar screen wraps both the taller inpatient bed tower, as well as the lower rehab gym and pool. Expressing the human instinct to care for our most vulnerable, the sinuous screen follows an undulating pattern and is designed to parametrically change from façade to façade to compensate for the solar heat gain of its specific location and function. On the inpatient tower, the screen opens up to the multi-level hanging gardens at the corners of each triangular floor plate.
The 300-bed unit is efficient and functional, setting the framework for a universal model of care and allowing the facility to flex and change to accommodate the way particular units function, evolve, expand and contract. This flexibility further represents the dynamic changes in health delivery taking place in the Kingdom. The project team is slated to break ground on the project before the end of 2018. Its development will create more than 850 construction jobs, and, once complete, the building will employ at least 1000 employees .
ARTICLE MEDICAL INSTITUTIONS NEWS
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NEWS
Baylor St. Luke’s Physicians Save Patient’s Limb from Amputation Physicians restore circulation so Roy Puckett can put his best foot forward
Dr. Miguel Montero Baker
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ike most diabetics, losing a lower leg due to poor circulation to the toes was a scary thought for Roy Puckett, Jr. After he noticed some cracking in the toes in his right foot, Roy visited a hospital near his hometown of Alexandria, Louisiana. He thought that maybe he had gotten athlete’s foot from going to the gym. But, it was much worse. “It turned out that I didn’t have the necessary blood flow and oxygen to the toes and they started dying on me,” said Roy, 60. “They told me I would have to get my leg cut off below the knee.” Not satisfied, Roy got a second opinion at Baylor St. Luke’s Medical Center. He had heard good things about Baylor St. Luke’s before—doctors had saved the foot of a relative of his sister’s husband who had a similar
condition to Roy’s. His father had also been a patient at Baylor St. Luke’s in the past. “This gave me some hope,” Roy said. On January 2, 2018—the day before his leg amputation was scheduled—Roy instead rode in an ambulance from Louisiana to Baylor St. Luke’s. There, he was seen by Dr. Jeffrey Ross, podiatrist at Baylor College of Medicine; Dr. James Livesay, cardiovascular surgeon at Texas Heart® Institute at Baylor St. Luke’s; and Dr. Miguel Montero, endovascular surgeon at Baylor College of Medicine. Drs. Ross and Montero both specialize in diabetic foot amputation prevention and limb salvage. All three physicians performed a successful surgery on his foot on January 12. “They did an angiogram scan on me and found out that my lower leg
didn’t need to be cut off after all,” Roy said. “Instead, they only had to do a mid-foot amputation to reestablish blood flow. I was so relieved. I was elated.” Roy’s recovery took about six months. Today, his foot has completely healed, and he is once again able to do activities he enjoys. “I can get out of bed without any problems, and I can still go hunting, fishing, and walking my dog, Sassy,” he said. Roy said he is grateful for the doctors at Baylor St. Luke’s. “I’m so glad I went to Baylor St. Luke’s for a second opinion,” he said. “I was very happy with the staff. The doctors were very kind and they acted like they cared. If I have another problem with my leg or foot, I’ll be going to doctors at Baylor St. Luke’s from this point on. I would recommend Baylor St. Luke’s to anyone.”
FOR MORE INFORMATION CONTACT INTERNATIONAL SERVICES AT BAYLOR ST LUKE’S MEDICAL CENTER Via email at international@stlukeshealth.org or call +1 832 355 3350 or visit StLukesInternational.org Texas Medical Center, Houston, Texas - USA
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NEWS
MEDICAL INSTITUTIONS
ACIBADEM HEALTHCARE GROUP TURKEY An ECOSYSTEM that sets an example for the world in healthcare service…
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eveloping rapidly since 1991, Acıbadem Healthcare Group became one of the leading institutions in Turkey in the field of private healthcare services, and now moves forward globally with its partner IHH Healthcare Berhad, one of the biggest groups in the Far East, in 2012. Comprised of 21 hospitals and 16 medical centers, Acıbadem has become a part of the world’s second largest Healthcare Chain with this agreement under the auspices of IHH Healthcare Berhad. Each year, many patients from different parts of the world choose Turkey to receive treatment, and they prefer Acıbadem which provides services using the most advanced technology worldwide featuring an expert team meeting international quality standards. Its quality of the services also supported by independent institutions; Joint Commission International (JCI) and “ISO 15189 Clinical Laboratory Accreditation Certificate”.
Globally competitive integrated healthcare services in Healthcare Apart from hospitals and medical centers, Acıbadem Healthcare Group offers a worldwide example setting integrated special healthcare system model, and includes various healthcare support institutions:
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MEDICAL INSTITUTIONS
Acıbadem University Acıbadem University establishes the scientific infrastructure of the healthcare services provided within Acıbadem Healthcare Group, with its influential and experienced academic faculty and the international research studies it has conducted. Advanced Simulation Center CASE, established under the university, is one of the most comprehensive three centers worldwide, with all of the depart-
ments and technological infrastructure that it embodies. The center, which is comprised of two sections,
includes a Clinical Simulation Training Center and an Advanced Endoscopic and Robotic Surgical Training Center.
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APlus APlus Hospital and Accommodation Services was structured on the principle that “a hospital is a hotel in which healthcare services are provided” and meets the needs of health institutions such as patient catering, staff catering, cafeteria operation, cleaning, housekeeping and laundry through a single organization.
Acıbadem Mobile Healthcare Acıbadem Mobile Healthcare Services provides all integrated mobile healthcare services with its experienced and specialized personnel and the quality standard of the Acıbadem Healthcare Group. It carries out both urgent and non-urgent pre-hospital and post-hospital healthcare processes at the highest level.
Acıbadem Labvital Acıbadem Labvital, which provides food control and analysis services in conformity with the importance Acıbadem Healthcare places on human health and its pioneering applications, carries out chemical and physical analyses in relation to food safety, hygiene, microbiology, molecular biology (GMOs, identification meat type, etc.), toxins, residues and labels.
Acıbadem Project Management Acıbadem Project Management, which embodies planning, application, control and consultancy in project management, enables large investments such as hospitals to achieve success by providing “turnkey” services. The organization offers all planning, application, control and consultancy services in project management, which has been long-needed in Turkey, under the same roof with its specialized team and national-international solution partners.
Acıbadem Labcell In 2003, Acıbadem Labcell which started out as the Acıbadem Cord Blood Bank expanded its service area to cellular therapy and preparation and storage of peripheral stem cells and bone marrow stem cells. As the provider of many cellular therapy products with authorization for manufacture from the Ministry of Health, Acıbadem Labcell offers advanced treatment options to all healthcare institutions, including public universities.
Acıbadem Labgen Acıbadem Labgen provides services to both Acıbadem Healthcare Group and other prestigious health institutions in the fields of genetic diagnosis and personalized medicine. Its strong and new generation technological infrastructure and specialists who are skilled in R&D operations and closely follow scientific developments makes Acıbadem Labgen one of the leading institutions in the genetic field in Turkey.
Acıbadem Labmed Acıbadem Central Pathology Laboratory, which started providing its services in 2006, analyzed more than 130.000 cases. Currently, in addition to the two central laboratories, there are divisions in all Acıbadem hospitals which provide intraoperative pathology consultation (frozen section), macroscopic examination, bedside sample evaluation and hospital sample collection and transport services.
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MEDICAL INSTITUTIONS
International Patient Services Center International Patient Services Center within AcÄąbadem Hospitals Group offers a comprehensive range of services for international patients and visitors. AcÄąbadem staff are dedicated to providing a range of services including consultations, diagnostic procedures, billing and insurance, travel and accommodation arrangements and translation services.
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Acibadem Maslak Hospital in Turkey introduces next generation cancer care with MRIdian MR Image-guided radiation therapy the state-of-the-art radiotherapy device to cancer patients. On table and continuous soft tissue imaging enables plan adaptation to reshape radiation doses based on the anatomical changes which occur from one day of treatment to the next. Using a novel streaming video perspective, the technology also allows oncologists to visualize and automatically control beam delivery based on the real-time position of the tumor and surrounding organs.
MR Linac is the newest technology that combined MRI and Linac for the first time in the world and Acibadem Maslak Hospital in Istanbul in Turkey has begun treating patients with it. With this technology, radiation oncologist can treat the patient as a surgeon, because this device enables the physicians to see tumour precisely, even in soft tissues. Acıbadem Maslak Hospital is the ninth MR Linac center in the world. MRIdian, MRI-guided radiotherapy, presents
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We are pleased to have commenced Turkey’s first MRI-guided radiation therapy program and believe it offers cancer patients in Turkey a number of distinct benefits over traditional radiation therapy,” said Prof. Enis Ozyar, M.D., the Chief of Acibadem Mehmet Ali Aydınlar University, School of Medicine, Department of Radiation Oncology. “Most importantly, MRIdian allows for clinical improvements in visualization and precision daily plan adaptation, and it provides us with the tools to deliver higher and potentially more effective radiation doses.” Turkey is currently one of the leading countries in health tourism due to the country’s advanced diagnostic and treatment services offered.
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9th CENTER IN THE WORLD 3rd CENTER IN EUROPE
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MRIdian, the newest smart radiotherapy, can deliver precise and accurate radiation to cancerous tumors. Combined MRI, provides real time and continuous imaging and is spares surrounding tissues from radiation beams.
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njoy outstanding hearing – provided with the latest technology on the market. For BHM, innovation and the satisfaction of customers are the most important things. BHM’s requirements remain forever the same: to restore significant quality of life to people with impaired hearing, using state-of-the-art hearing systems. Continuously developed and upgraded by BHM to be in line with the latest technology.
acquisition and for communicating with other people – that‘s why babies and children with a hearing impairment need swift action in particular. This is where contact forte steps in: as an alternative to surgery or to bridge the time until an operation becomes necessary. contact forte‘s unique technology also provides adults with excellent hearing, especially when playing sports or pursuing outdoor activities.
Optimum hearing is yours, thanks to contact forte‘s leading-edge technology, everyday practicality and highly comfortable fit for all ages. Live everyday life effortlessly with the world‘s most modern, robust and flexible digital hearing system and its numerous key functions. Babies over eight months old and small children will benefit from contact forte just as much as adults. Hearing is indispensable for language
contact forte is a digital, miniature bone conduction hearing system which compensates for mild to moderate hearing impairment, processing and amplifying sound and then transmitting it to the inner ear. There are a number of fashionable accessory options: headbands, hair bands and headwear such as caps and hoods are all fixtures in the BHM accessory range. contact forte can also be attached to your own pair of glasses
by means of an adapter, or anchored onto a magnetic implant under the skin. Users can also consider attaching the innovative hearing system directly behind the ear using an adhesive tape, fixing this high-end system securely in place. It‘s an innovation that gives users full freedom of movement and unlimited hearing in any life situation. The entire contact forte hearing system is housed in a single casing. This means no external cable connections, ensuring easy handling and a system that is particularly robust and compact. Thanks to its solid workmanship, it is resistant to sweat and dirt, and is waterproof up to one metre. So there‘s nothing standing in the way of any sporting or recreational activity, thanks to contact forte. contact forte also proves its mettle as a high-end hearing system from a technical perspective. It can be linked to MP3 players, smartphones or other electronic devices via Bluetooth. Making or receiving phone calls is pleasantly straightforward; so too is adjusting the volume through the specially developed smartphone app. In addition, BHM has optimised the bone conduction receiver components, now offering a wider frequency spectrum and extending the battery life. contact forte thus offers outstanding hearing with full freedom of movement – giving children the chance to broaden their impressions of the world with ease and allowing adults to go about their activities with no limitations whatsoever!
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MEDICAL EQUIPMENTS
Quality made in Austria BHM is a specialist in non-surgical solutions using bone conduction technology. The Austrian specialist manufacturer offers full range of hearing systems – from miniature bone conduction hearing aid up to a power pocket hearing device that can be adapted – due to being extremely flexible – to the individual needs of each wearer. BHM develops sophisticated hearing systems that are manufactured exclusively in Austria and marketed worldwide. Its wealth of experience and commitment to perfection make BHM a globally respected specialist in bone and air conduction hearing devices. BHM thus offers its customers the best technology for an unrivaled listening experience - without the risk of surgery!
BHM-Tech Produktionsgesellschaft mbH Grafenschachen 242 7423 Grafenschachen Austria Telephone: +43 3359 200 78 0 E-mail: nice_2_hear_u@bhm-tech.at Web: www.bhm-tech.at
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NOVEMBER.DECEMBER 2018
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E
ven if you are not a technology expert, if you follow the media and social networks of the specialized press you must have heard about Blockchain, one of the biggest tech trends to emerge in recent years. Although you may have known of its existence because it was used with bitcoin, the truth is that this revealing system for exchanging information can be applied to very diverse fields of knowledge. Medicine, of course, is one of them. But what does Blockchain consist of? It is neither more nor less than a decentralized and globalized database where recorded transactions between users cannot be edited or deleted. These transactions are encrypted using cryptographic methods and stored in servers (called nodes) which belong to the network and are located anywhere in the world. To give you an idea, it’s like a ledger that shows all the information transfers made and all the data uploaded with their exact date and time. Blockchain is a kind of digital auditor and cannot be fooled. With a simple example it could be better understood how this chain of blocks works. User A wants to send a vital document to user B, but before that, this transaction is represented as a block in the Blockchain network. This independent block is transmitted to thousands of nodes that certify that the transaction is valid. At this point, the block is added to the string and recorded in such a way that it is unmodifiable. User B then receives the document from user A.
The fingerprint, a key to security Each block created has 3 parts: the first is the information to be transmitted, the second is the block’s own fingerprint and the third is the pre-
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vious block’s fingerprint. The block’s own fingerprint is a unique and unmodifiable alphanumeric cipher that identifies the content. This fingerprint would detect any attempt to edit the block. If the fingerprint changes, this indicates that the block is no longer the same as it was at the beginning, so it is no longer the original. The earlier block’s fingerprint is what generates the block structure and makes the procedure safe. The first block is called “genesis”, since it does not have a previous fingerprint, which instead characterizes all the other blocks. In fact, an attempt to change any of the fingerprints would irreversibly change the previous fingerprint making the entire chain invalid. To make sure that this procedure cannot be tampered with and that it is impossible to change the string fingerprints, Blockchain has a “working test” based on delaying the creation of the new block; that is, before creating a new block, the members of the network would audit the entire chain of original blocks. If it detects a change, the block is not formed. Blockchain does not use a single server. Instead, the network users themselves make sure the security of
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the block chain through their servers. These servers are called nodes and are in charge of verifying the created blocks and keeping the information unalterable. So... if you also want to join the latest technological revolution, how do you do it? It’s very simple, you only have to look for a platform that offers the Blockchain service, download the software they show you and pay for the service every time you want to use it.
Blockchain in Medicine Although it was first used in 2009 with bitcoin cryptocurrencies, this technology can be used for several things: bank transactions without intermediaries, certification of copyrights in literary works or musical pieces, execution of contracts, streamlining bureaucracy in the civil service, elections and, of course, in medicine. Can you imagine a world full of hospitals or health centers that could share data with their patients no matter where they are and without anyone being able to change them? With an authoring system like Blockchain, relevant medical information could be exchanged from anywhere in the world. A patient’s allergies, history, clinical analysis, treatments...
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all his medical information would be available to his doctor with a single click, always maintaining his privacy and certifying the authenticity of the exchanged documents. With Blockchain, health and technology come together in a revolutionary system to ease the exchange of reports between doctors or between doctor and patient. The confidentiality of medical records, which is currently managed in a rather rudimentary way, will be unquestionable. In addition to this, Blockchain technology will allow secure transfers of data into wearable devices and improve the patient’s information retrieval from medical centers. The healthcare industry is changing little by little and the laws are becoming stricter in terms of data protection. Proof of this is the HIPAA (Health Insurance Portability and Accountability Act) and the GDPR (General Data Protection Regulation), which regulate the transfer of sensitive data with special attention. Despite these policies are intended to regulate and protect patient care, many healthcare organizations still see a weakness in the exchange of information that Blockchain might actually solve.
Personalized medicine gains strength MedLab Media Group (MMG), the Spanish start-up that offers technological solutions to the physician of the future, has integrated Blockchain in all its products to offer the greatest transparency and security in its services to physicians anywhere in the world. With this technology, doctors and patients validate and verify health-related data through digital identities impossible to manipulate.
“BLOCKCHAIN WILL REVOLUTIONIZE THE HEALTHCARE SECTOR AND WILL BE A TURNING POINT IN
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THE HEALTHCARE INDUSTRY. EXCHANGE OF INFORMATION. COMMUNICATIONS BETWEEN DOCTOR AND PATIENT WILL BE SAFE, EASY AND STRAIGHTFORWARD. BLOCKCHAIN CHANGES EVERYTHING” Oleg Vorontsov, Executive Director of MedLab Media Group This technology is characterized by the fact that it is decentralised, the information exchanged cannot be corrupted and there is a certain anonymity between all the agents involved. Transactions are linked to a person, but their identity is not revealed at any time; this relationship of trust makes it unnecessary for a third party to verify the transaction.
But how would Blockchain work in the health sector? A doctor could carry out a list of records with all the patient’s health data. The first step is to create a clinical history; then, a digital signature is generated to ensure the authenticity of the document and is finally encrypted. At all times, the patient can know who has access to their data and, of course, if it was modified at any time in the chain. This technology offers advantages for research by allowing personalized patient facts to be tracked
in real time and in a completely secure way. Medicine could become more accurate and have a large amount of valid study data available by collecting patients from different social and demographic backgrounds.
“BLOCKCHAIN HAS COME TO REVOLUTIONIZE THE BUSINESS WORLD. SINCE THE BEGINNING OF THE SECOND MILLENNIUM, THE LACK OF CONFIDENCE IN TRANSACTION SYSTEMS HAS LED TO THE EMERGENCE OF TRANSACTION SECURITY SYSTEMS. WITH THESE NEW TECHNOLOGIES, WE FINALLY HAVE THE POSSIBILITY TO CREATE IMMUTABLE AND PERMANENT RECORDS”, Daniel Gimeno, Web architect of MedLab Media Group. Blockchain offers the possibility of sharing millions of health data and involving different agents related to it: foundations, researchers, doctors, patients... all united by the same interest: to store and share sensitive information to prevent diseases, diagnose them, treat them, investigate them and make Medicine a data science only. As Gimeno explained, any process that requires recording sensitive information and certifying
its immutability could use Blockchain. From there, the possibilities are very wide, even in the field of health. The Web architect of MMG said that the way to safeguard medical records, the possibility of prescribing drugs from one end of the world to the other without intermediaries are the first services of this technology. “Document signatures, drug patents, copyrights, anything that can be registered and stored in a guaranteed document has a common denominator and that is: Blockchain,” he concluded. The main property of the distribution and replication of information through thousands of nodes around the world makes it almost impossible to alter the information. Initially, the financial world was the first to rely on Blockchain to create the crypto currencies, but Blockchain is more than that,” said MMG’s Web architect. At the moment,the technological means available cannot break the algorithms that guarantee the authenticity of the data that Blockchain technology offers. To know what will happen next, we have to look into the power of computational speed; quantum computers for instance might bring new insights into the world of Blockchain and its invaluable advantages.
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Why global healthcare should step up to blockchain technology for enhanced patient health outcome? By Dr Prem Jagyasi
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lobal healthcare today demands the highest level of efficiency to deliver value-based care in patient health management. Blockchain technology with its smart data-management and information-sharing system has the right solution to this. Its adoption in healthcare is inevitable for its shareability, interoperability and data security that promise to simplify the existing complexities of healthcare systems. The peer-to-peer sharing ledger technology significantly reduces the operating cost of a healthcare system maintaining the best possible security standard.
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Frost and Sullivan research on Blockchain Technology in Global Healthcare 2017-25 reports that blockchain has the potential to save billions of dollars by optimizing operation and removing high-cost intermediation. No other technology till date has offered such unique benefits of streamlining operations along with giving back the power of data control to users. This implies that users can update information and take the responsibility of managing their own medical data. But the tangible benefits of blockchain need to be demonstrated first to make its widespread adoption to happen.
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Improved data interoperability, the basis of value-based care: Ever since the massive digitization of patient health records in the form of EHR (Electronic Health Records), patient data has remained fragmented in silos that do not communicate with each other. This can be crucial in the diagnosis and deciding successive treatment plans. For example, a patient suffering from chronic treatment is rushed to the emergency room. The attending doctor, if he has no access to the patient’s prior medical history, may suggest some expensive tests to play safe which may not be required at all but has to be done for proper diagno-
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sis. The patient’s medical history of his chronic condition may be recorded with the primary care provider or with a medical specialist. Even the health insurance provider may not have any information on this. If there is a smooth information exchange between the different parties like patients, providers and payers, the patient may have been brought under specific care management programs which would have saved the huge emergency medical cost. Healthcare system needs to fast bring in data interoperability from disparate systems to escalate the operation efficiency where redundant activities will be automatically eliminated improving patient outcome.
Decentralized information flow to enhance value-based care: The efficiency of the providers lies in the fact that how they are helping patients in managing their chronic ailments to reduce their impact and hospital visits. The cloud-based information system of blockchain technology offers a great opportunity for healthcare providers, researchers, scientists and innovators to maintain a consistent progress in public health. In fact, this decentralized information storage is the key to the efficiency of blockchain technology where the users or members can have quick access to their medical records and share with the healthcare providers as and when necessary.
Core areas where blockchain can deliver value-based care •
•
Real-time communication with providers informing of available incentives for specific patients. Real-time identification of gaps in care and resolving them immediately.
•
•
•
Direct patients timely and efficiently into various care programs meant for them. All providers have the visibility regarding continuous patient care. Help physicians in improving decision-making at the time of treatment.
Drug traceability Counterfeit drugs snatch thousands of lives annually. About 10-30% drugs produced in the developing countries are fake, reports Health Research Funding Organization (HRFO). The US healthcare bears an annual loss of around $200 billion for fake drugs. Immutability of any transaction time-stamped in the Blockchain can be utilized in drug traceability. The drug can be tracked in the blocks as the information once registered cannot be altered. To ensure the authenticity of drugs, trustworthy pharmaceutical companies can register any specific drug in the blockchain. Private blockchains controlled by a central authority would be more effective in this matter as they will have a proof that drugs manufactured by these companies are genuine. Different stakeholders of the supply chain like manufacturers, wholesalers or retailers would have different accessibility options depending on their position of the supply chain. The ‘hash’ attached to a block containing drug information will be linked to another block which will make it easy to track as it moves down the supply chain. This gives a data transparency where the drug can be tracked from the origin. This automatically eradicates the circulation of fake drugs.
Ensured security to healthcare data A centralized data system is
prone to hacking as a single point entry by a hacker can put the entire system in jeopardy. The encryption-embedded blockchain ledger with different levels of database access can save the system from such external attacks and threats. If implemented properly, blockchain can prevent data corruption and collapse of hardware. This would also simplify the objective of HIPAA (Health Insurance Portability and Accountability Act) of keeping PII (Personally Identifiable Information) and Personal Health Information (PHI) private and secure.
Creating an easy payment system without any intermediary The decentralized architecture of blockchain has another important benefit – elimination of intermediaries. Settling of bills and claims through automated payment systems and smart contracts removes the intermediaries and lowers the administrative costs. Insurance companies, on which many patients depend to settle their medical claims, can operate without any apprehension for frauds and scams. Payment through cryptocurrencies would be another major shift where each and every transaction irrespective of geographical location can be made in a secured manner without disclosing the identity of the payer.
Smart data management to aid in medical research In today’s healthcare, innovation is the order of the day. Advanced medical research plays a great role in ushering treatment breakthroughs. Of the number of clinical trials conducted, it is unfortunate that most of them are not accurately reported. Even if the benefits are assured, the shadow of doubt remains regarding the accuracy of the trials and patients remain deprived of the latest medical advancements.
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Blockchain’s digital ledger technology has the potential in creating effective collaboration between researchers and inventors through the authentication of documents registered in the system which is not easy to tamper. Results of clinical trials in the blockchain will remain secure as the data is immutable.
How the present healthcare is responding to blockchain disruption? The success of blockchain technology will ultimately depend on the willingness of the healthcare systems in adopting it. Like healthcare, blockchain also functions as a team. Larger the participants in the team more are the benefits. The recent survey by PwC Health Research Institute states that nearly 50% of healthcare executives are considering adopting blockchain in their organizations. But hesitation persists owing to lack of trust, proper governance and proven expertise. In spite of blockchain’s inherent security that forms the basis of trust, 47% of the 74 global healthcare organizations surveyed do not feel confident in using blockchain. A wholehearted acceptance scenario is not visible. With any transformative technology, the biggest challenge lies in creating a new work culture and operational changes to align with it. The same is true with Blockchain technology. The Hyperledger’s survey states that 49% of healthcare organizations assume that ‘interoperability’ factor will help in faster adoption of blockchain technology of which 28.6% respondents are willing to implement it in the current settings. Lack of knowledge in blockchain technology is one of the prime reasons for healthcare organizations hes-
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itating in adopting it. About ¼ of the respondents in the above survey are still in the knowledge-development phase while a significant fraction is still unaware of this technology and its potential benefits. Black Book Market Research Survey in 2018 states that only 19% of hospital executives are considering its implementation and only 9% of provider health systems are supposed to implement it by 2018. Caregivers, however, are optimistic of blockchain where 37.9% predict that within next the five years it would be widely adopted. Adoption of blockchain would need to pass several higher level milestones for full-scale adoption to take place. The undetermined cost of blockchain solutions is certainly another factor that is holding back healthcare executives in going for a time-bound commitment in its adoption. Currently, the healthcare sector is in the wait and watch mode. The pilot projects run by several organizations hopefully will drive in tangible proof convincing enough for this sector to build confidence in this new technology.
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About Dr. Prem Jagyasi A globally acclaimed, award-winning strategic leader and speaker, Dr Prem Jagyasi is a world-renowned medical tourism consultant. He has authored Medical Tourism Guidebook and Wellness Tourism Guidebook. He has also delivered numerous keynote speeches and focused corporate workshops in 45+ countries. More than 150 international organizations have benefited from his expertise through conferences, expert training, consultancy and brand management services. http://drprem.com
INTERVIEWS
Vice President & Managing Director, Cerner Middle East & Africa
Bachir Awad “We are focused on working together with our partners to transform the delivery of health and care in the Middle East & Africa”
H
ospitals and The Arab Hospital magazines discussed with Bachir Awad, Vice President & Managing Director of Cerner Middle East & Africa, the future of healthcare and the impact of the new technologies in shaping healthcare services. Below is the full interview:
Can we have a brief resume about your career? I joined Cerner in 2006 in Australia, where I started in consulting and held multiple leadership roles across operations and client partnerships. In 2012, I relocated to the United States to Cerner’s World Headquarters in Kansas City, Missouri, where I was responsible for developing an approach to enhance the overall user experience and drive strategic alignment between Cerner and its clients. In 2014, I moved to the Middle East to establish the strategic
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alignment between Cerner and the Ministry of Health & Prevention – UAE. As the Vice President & General Manager of Cerner’s global partnerships, I led a team responsible for supporting our highly aligned clients to achieve maximum value from their relationships with Cerner and deliver on the shared strategic vision and goals of both our organizations. Earlier this year, I was promoted to Vice President & Managing Director of Cerner Middle East and Africa, where my focus is to continue building on our relationships with our clients while improving business outcomes. We always strive to support our clients to attain their goals and execute their strategic vision, whilst focusing on delivery of better healthcare outcomes.
Artificial intelligence will play a major role in redefining the
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healthcare sector worldwide. What is your perspective about it? Artificial intelligence (AI) is a broad term and as of late has created a lot of hype within the industry. At Cerner, our systems have embraced these types of technologies for years and naturally have been part of our DNA, as we continually advance and invest in R&D to deliver smarter healthcare. As you look at the future, the use of AI capabilities will redefine the healthcare industry, providing more advanced predictive insights and better supporting the caregivers in diagnosing diseases and complex patient conditions. This is really exciting stuff and will open up many more opportunities to innovate, explore complex healthcare problems, create new insights and more importantly deliver smarter and more reliable healthcare.
INTERVIEWS
In addition, AI is becoming increasingly sophisticated in diagnosing and prescribing treatments for diseases, allowing doctors to focus less on data collection and more on preventive care, as well as creating a customized care plan unique to their patients. AI will allow health providers to monitor the patient’s health status at any time and in any place, whilst the intelligence provides real-time information, allowing the care providers to take appropriate actions. Imagine this – if I was to relate technology to my children’s health records, they are disconnected and span over three continents. With such a disconnect often either my wife or I need to provide the same data to different care providers over and over again every time they present at a different care provider, which is not ideal. Imagine a world where
health records can be centralized and different data sources, like data streaming from technology such as personal and fitness trackers, can be stored. Then let’s now layer in sophisticated AI capabilities to analyze and effectively utilise information to deliver the best possible healthcare to your children and family. For instance – if someone in my family happens to have a heart condition and was on a complication hypertension and diabetic care plan, the system will know them as an individual. Whilst streaming key vitals from a range of personal fitness and medical devices, the system will be smart enough to pick up any irregularities and immediately notify their care provider and family members to take action. Ai is personal, predictive and more importantly intelligent as it continues to evolve throughout a patient’s life.
How do you evaluate the technological advancement in healthcare in the region? The region is moving from a volume-based care delivery to valuebased. It now means we need to be delivering smarter healthcare, based on value outcomes. Hence, we will see the increased reliance on technology to support the process of care delivery with caregivers focused on delivering the best possible patient experience and not be burdened with time consuming administrative tasks. In this respect, technology is absolutely the foundational and transformative vehicle that will allow information to flow freely. No matter where a patient goes, it’s crucial to have the right information available at the right time and the right place to make the best possible decision on care delivery. The region is adopting technology at a rapid pace and if done correctly, could
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leapfrog many other countries. Cerner has a unique opportunity in the Middle East and Africa to make this vision a reality. To achieve this vision, we first need to overcome the hesitance that surrounds data governance in the region. This will allow us to connect technologies and bring healthcare management to the next level. I truly believe that similar to the disruption that technology had on social media and consumerism, once consumers take control of their healthcare records it will rapidly change the way healthcare is delivered, the ownership of personal healthcare data and more importantly how consumers select and interact with their care providers.
Your systems are one of the best worldwide. In your opinion, what is the reason behind your success? With more than 27,500 facilities worldwide and nearly 40 years of experience, we offer unique services in our proposition to the market. We have more than 28 years of experience just in the Middle East. This has helped us to truly understand and appreciate the healthcare delivery models in region, tailor our services and solutions to meet the needs of our partners and in turn drive smarter healthcare delivery. Cerner is a healthcare organization, not simply a software provider or consultancy group. We have a set of best practices and guidelines that help our partners deliver the best experience not only for their patients
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but their care providers. This is a major differentiator and key to our success as a healthcare organization. When I visit my doctor at a clinic, I provide information that goes into the doctor’s healthcare information system. However, when I go home and measure my blood pressure or get on the digital scale, where does that information go? How does the rest of my health data outside of the physical walls of the hospital or clinic make its way into my record? It’s simple, today in most cases it doesn’t and that’s not good enough. Cerner, as a healthcare organization, is focused on innovation that puts the patient at the center and creates a holistic view of the patient’s end to end healthcare data, whilst making meaningful insights and recommendations to better manage the health and wellbeing of each individual patient. As today’s technology evolves at a rapid pace, the healthcare landscape will change dramatically. Helping organisations leverage the latest technology and innovation, will support them to continue to succeed, and this is what has contributed to Cerner’s success over the years.
How do you foresee the future of healthcare? I envision the healthcare of tomorrow to have the consumer at the center of everything we do. Whilst big data, use of AI and predictive modeling is important for providing smarter healthcare delivery, consumers want a better experience. Consumer want
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to simply turn on their smartphones, enter information about themselves, connect it to their electronic health record (EHR), have easy access to a personalized care plans and more importantly have on-demand access to their care providers or chat bots to instantly connect. This is what I foresee in terms of a consumer-based healthcare model of the future. Moreover, I believe proactive care will eventually replace reactive care in the long term. By rewarding wellness, reactive healthcare will become secondary as consumers get more engaged with their personal healthcare and the industry starts to introduce technology and incentive programs to drive it. This practice is starting to emerge in many markets including the United States and I believe will slowly start to make its way to the Middle East. This shift toward a highly centralized, highly digitalized, consumer-based healthcare delivery model has already begun and Cerner is at a forefront of it. The most exciting thing about where we are today and where we are going to tomorrow, is the Middle East is uniquely positioned to deliver such a vision through use of smarter systems and population health management. Cerner is proud to work collaboratively with many governmental organizations across the Middle East and has shown that such strategic partnerships within healthcare can help them achieve their vision and ultimately delivery better healthcare outcomes across their populations.
Do you want to excel in your healthcare career? Sign up for the opportunity! EXECUTIVE PROGRAM IN HOSPITAL MANAGEMENT The Executive program in hospital management is targeted on multiple professional profiles wherein the common denominator is the search for competencies, skills and managerial tools to understand and personally manage, coordinate or head healthcare provider institutions or departments, units and services. The full executive program is made up of 5 modules of 3 days face-to-face training and a final field project. At the end, SDA Bocconi School of Management will provide a certificate of advanced training in hospital management. The full executive program will be CME accredited by Dubai Health Authority. During each module, a privilege talk with key note speaker on hot topic of the future of healthcare will take place and it will be open to the public. More information: https://bit.ly/2l81p8T Module 1: Organization and Leadership, 27 - 29 September 2018 Module 2: Clinical Management & Operations, 15 - 17 November 2018 Module 3: Budgeting and Performance Management, 17 - 19 January 2019 Module 4: Quality, Risk Management and Audit, 7 - 9 March 2019 Module 5: Innovation and Technologies, 11 - 13 April 2019
PROGRAM DIRECTOR
Verdiana Morando Professor, SDA Bocconi School of Management, Italy
WHO SHOULD ATTEND Managerial and Administrative Staff, Experienced Healthcare Managers, Clinical Professionals Training Organized by:
Certified by:
MEDIA PARTNERS
Register now to secure your seat for the program.
Email us on info@gsdhealthcare.ae for more information or call us on +971 4 568 3374. Website: www.gsdhealthcare.ae
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cause of cancer deaths in the United States, among both men and women
Dr. Hassan Sawaf Pulmonary consultant - HOD
NOVEMBER.DECEMBER 2018
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L
ung cancer claims more lives each year than do colon, prostate, ovarian and breast cancers combined. People who smoke have the greatest risk of lung cancer, though lung cancer can also occur in people who have never smoked. The risk of lung cancer increases with the length of time and the number of cigarettes you’ve smoked.
Symptoms Lung cancer typically doesn’t cause signs and symptoms in its earliest stages. Signs and symptoms of lung cancer typically occur only when the disease is advanced. Signs and symptoms of lung cancer may include: • A new cough that doesn’t go away • Coughing up blood, even a small amount • Shortness of breath • Chest pain • Hoarseness • Losing weight without trying • Bone pain • A headache
Lung Cancer Screening For those without symptoms, it has now been approved for early detection in people who have smoked for at least 30 pack-years, and smoke or quit smoking within the past 15 years. It’s important to note, however, that screening is meant to be a test performed for those who do not have any symptoms. If you have any possible symptoms of lung cancer, further tests, including a full CT scan will be needed.
When to see a doctor Make an appointment with your doctor if you have any persistent signs or symptoms that worry you. If you smoke and have been unable to quit, make an appointment with your doctor. Your doctor can recommend strategies for quitting smok-
ing, such as counseling, medications and nicotine replacement products.
Causes Smoking causes the majority of lung cancers — both in smokers and in people exposed to secondhand smoke. But lung cancer also occurs in people who never smoked and in those who never had prolonged exposure to secondhand smoke. In these cases, there may be no clear cause of lung cancer.
Types of lung cancer Doctors divide lung cancer into two major types based on the appearance of lung cancer cells under the microscope. Your doctor makes treatment decisions based on which major type of lung cancer you have. The two general types of lung cancer include: • Small cell lung cancer. Small cell lung cancer occurs almost exclusively in heavy smokers and is less common than nonsmall cell lung cancer. • Non-small cell lung cancer. Non-small cell lung cancer is an umbrella term for several types of lung cancers that behave in a similar way. Nonsmall cell lung cancers include squamous cell carcinoma, adenocarcinoma and large cell carcinoma.
Risk factors A number of factors may increase your risk of lung cancer. Some risk factors can be controlled, for instance, by quitting smoking. And other factors can’t be controlled, such as your family history.
Risk factors for lung cancer include: •
Smoking. Your risk of lung cancer increases with the
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•
•
•
number of cigarettes you smoke each day and the number of years you have smoked. Quitting at any age can significantly lower your risk of developing lung cancer. Exposure to secondhand smoke. Even if you don’t smoke, your risk of lung cancer increases if you’re exposed to secondhand smoke. Exposure to asbestos and other carcinogens. Workplace exposure to asbestos and other substances are known to cause cancer — such as arsenic, chromium and nickel — also can increase your risk of developing lung cancer, especially if you’re a smoker. The family history of lung cancer. People with a parent, sibling or child with lung cancer have an increased risk of the disease.
Complications Lung cancer can cause complications, such as: • Shortness of breath. People with lung cancer can experience shortness of breath if cancer grows to block the major airways. Lung cancer can also cause fluid to accumulate around the lungs, making it harder for the affected lung to expand fully when you inhale. • Coughing up blood. Lung cancer can cause bleeding in the airway, which can cause you to cough up blood (hemoptysis). Sometimes bleeding can become severe. Treatments are available to control bleeding. • Pain. Advanced lung cancer that spreads to the lining of a lung or to another area of
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•
•
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the body, such as a bone, can cause pain. Tell your doctor if you experience pain, as many treatments are available to control pain. Fluid in the chest (pleural effusion). Lung cancer can cause fluid to accumulate in the space that surrounds the affected lung in the chest cavity (pleural space). Fluid accumulating in the chest can cause shortness of breath. Treatments are available to drain the fluid from your chest and reduce the risk that pleural effusion will occur again. Cancer that spreads to other parts of the body (metastasis). Lung cancer often spreads (metastasizes) to other parts of the body, such as the brain and the bones. Cancer that spreads can cause pain, nausea, headaches, or other signs and symptoms
depending on what organ is affected. Once lung cancer has spread beyond the lungs, it’s generally not curable. Treatments are available to decrease signs and symptoms and to help you live longer.
Prevention There’s no sure way to prevent lung cancer, but you can reduce your risk if you: • Don’t smoke. • Stop smoking and avoid secondhand smoke. • Avoid carcinogens at work. Take precautions to protect yourself from exposure to toxic chemicals at work. Follow your employer’s precautions. For instance, if you’re given a face mask for protection, always wear it. • Eat a diet full of fruits and vegetables. • Exercise .
NEWS
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C
arotid artery disease is a disease in which a combination of substances called plaque builds up inside the carotid arteries. There are two common carotid arteries, one on each side of your neck. They each divide into internal and external carotid arteries.
Dr. Hisham Osman Consultant Vascular and General Surgeon
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The internal carotid arteries supply oxygen-rich blood to your brain. The external carotid arteries supply oxygen-rich blood to your face, scalp, and neck. Carotid artery disease is very serious because it can cause a stroke. A stroke occurs if blood flow to your brain is cut off. If blood flow is cut off for more than a few minutes, the cells in your brain start to die. This impairs the parts of the body that the brain cells control. A stroke can cause lasting brain damage; long-term disability, such as vision or speech problems or paralysis (an inability to move); or death. The sooner treatment occurs, the better your chances of recovery.
Carotid artery disease seems to start when damage occurs to the inner layers of the carotid arteries. Major factors that contribute to damage include: • • • • •
Smoking High cholesterol in the blood High blood pressure Diabetes Older age. As you age, your risk for atherosclerosis increases • Overweight and obesity. • Lack of physical activity. • Family history of atherosclerosis. • Unhealthy diet When damage occurs, your body starts a healing process. The healing may cause plaque to build up where the arteries are damaged. The plaque in an artery can crack or rupture. If this happens, blood cell fragments called platelets will stick to the site of the injury and may clump together to form blood clots. The buildup of plaque or blood clots can severely narrow or block the
carotid arteries. Clots may dislodge at the site of the narrowing and travel to the brain circulation causing stroke. Having any of these risk factors does not mean that you’ll develop carotid artery disease. However, if you know that you have one or more risk factors, you can take steps to help prevent or delay the disease. If you have plaque buildup in your carotid arteries, you also may have plaque buildup in other arteries. People who have carotid artery disease also are at increased risk for coronary heart disease. Carotid artery disease may not cause signs or symptoms until it severely narrows or blocks a carotid artery. During a physical exam, the vascular surgeon will listen to your carotid arteries with a stethoscope. He may hear a whooshing sound called a bruit. Not all people who have carotid artery disease have bruits. This sound may suggest narrowing in the carotid artery. To find out more, Doppler ultrasound test will be requested.
Transient Ischemic Attack (Ministroke) For some people, having a transient ischemic attack (TIA), or “ministroke,” is the first sign of carotid artery disease. During a ministroke, you may have some or all of the symptoms of a stroke. However, the symptoms usually last less than 24 hours. Stroke and ministroke symptoms may include: • Dizziness or loss of balance • Inability to move one or more of your limbs • Sudden trouble seeing in one or both eyes • Sudden weakness or numbness in the face or limbs,
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often on just one side of the body Trouble speaking or understanding speech
A ministroke is a warning sign that you’re at high risk of having a stroke. You shouldn’t ignore these symptoms. Getting medical care can help find possible causes of a ministroke and help you manage risk factors. These actions might prevent a future stroke. Although a ministroke may be a warning of an impending stroke, it doesn’t predict when a stroke will happen. A stroke may occur days, weeks, or even months after a ministroke.
Stroke The symptoms of a stroke are the same as those of a ministroke, but the results are not. A stroke can cause lasting brain damage; long-term disability, such as vision or speech problems or paralysis (an inability to move the limbs); or death. Most people who have strokes have not previously had warning ministrokes. Getting treatment for a stroke right away is very important. You have the best chance for full recovery if treatment to open a blocked artery is given within 4 hours of symptom onset. The sooner treatment occurs, the better your chances of recovery.
Diagnostic Tests The following tests are common for diagnosing carotid artery disease. If you have symptoms of a ministroke or stroke, your doctor may use other tests as well.
Carotid Ultrasound Carotid ultrasound (also called sonography) is the most common test for diagnosing carotid artery disease. It’s a painless, harmless test that uses sound waves to create pictures of the insides of your carotid arteries. This
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test can show whether plaque has narrowed your carotid arteries and how narrow they are. A standard carotid ultrasound shows the structure of your carotid arteries. A Doppler carotid ultrasound shows how blood moves through your carotid arteries.
Carotid Angiography Carotid angiography is a special type of x ray. This test may be used if the ultrasound results are unclear or don’t give your doctor enough information. For this test, your doctor will inject a substance (called contrast dye) into a vein, most often in your leg. The dye travels to your carotid arteries and highlights them on x-ray pictures.
Magnetic Resonance Angiography Magnetic resonance angiography (MRA) uses a large magnet and radio waves to take pictures of your carotid arteries. Your doctor can see these pictures on a computer screen. For this test, your doctor may give you contrast dye to highlight your carotid arteries on the pictures.
Computed Angiography CT angiography, takes x-ray pictures of the body from many angles. A computer combines the pictures into two- and three-dimensional images. For this test, your doctor may give you contrast dye to highlight the carotid arteries on the pictures.
Treatment Treatments for carotid artery disease may include heart-healthy lifestyle changes, medicines, and medical procedures. The goals of treatment are to stop the disease from getting worse and to prevent a stroke. Your treatment will depend on your symptoms, how severe the disease is, and your age and overall health.
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Lifestyle Changes We always recommend healthy lifestyle changes if you have carotid artery disease. This include: • Healthy eating • Aiming for a healthy weight • Managing stress • Physical activity • Quitting smoking
Medications If you have a stroke caused by a blood clot, you may be given a clot-dissolving, medication. This type of medication must be given within 4 hours of symptom onset. The sooner treatment occurs, the better your chances of recovery. Medicines to prevent blood clots are the mainstay treatment for people who have carotid artery disease. They prevent platelets from clumping together and forming blood clots in your carotid arteries, which can lead to a stroke. Two common medications are: • Aspirin • Clopidogrel Sometimes lifestyle changes alone aren’t enough to control your cholesterol levels. For example, you also may need statin medications to control or lower your cholesterol. By lowering your blood cholesterol level, you can decrease your chance of having a heart attack or stroke. We usually prescribe statins for people who have arterial disease and: • Diabetes • Heart disease or have had a stroke • High LDL cholesterol levels You may need other medications to treat diseases and conditions that damage the carotid arteries. Your doctor also may prescribe medications to:
• • •
Lower your blood pressure. Lower your blood sugar level. Prevent blood clots from forming, which can lead to stroke.
Medical Procedures You may need a medical procedure if you have symptoms caused by the narrowing of the carotid artery. Doctors use one of two methods to open narrowed or blocked carotid arteries: carotid endarterectomy and carotid artery angioplasty and stenting.
Carotid Endarterectomy Carotid endarterectomy is mainly for people whose carotid arteries are blocked 70 percent or more. For the procedure, a surgeon will make a cut in your neck to reach the narrowed carotid artery. Next, he will make a cut in the narrow part of the artery and remove the artery’s inner lining that is blocking the blood flow. Finally, your surgeon will close the artery with stitches sometimes using a patch and stop any bleeding. He will then close the cut in your neck.
Carotid Artery Angioplasty and Stenting We use a procedure called angioplasty to widen the carotid arteries and restore blood flow to the brain. A thin tube with a deflated balloon on the end is threaded through a blood vessel in your neck to the narrowed carotid artery. Once in place, the balloon is inflated to push the plaque outward against the wall of the artery. A stent (a small mesh tube) is then put in the artery to support the inner artery wall. The stent also helps prevent the artery from becoming narrowed or blocked again.
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INTERVIEW
General Manager of the Specialty Hospital
Dr. Fawzi Al-Hammouri NOVEMBER.DECEMBER 2018
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he Specialty Hospital in Jordan has a special footprint in the medical sector in the Hashemite Kingdom of Jordan thanks to the hospital’s advanced services with unique capabilities, both in terms of modern technologies and highly qualified personnel.
Would you like to start by talking about the most important achievements you have made over the last 25 years? The Specialty Hospital has accomplished many achievements in a quarter of a century, since its inauguration in 1993, we were keen to attract the best healthcare providers and we were pioneers in introducing the latest medical technologies in Jordan and in the Arab world. We gained the trust of the Jordanians, Arab and foreign patients. Over the past 25 years, we served more than 5 million people from them half a million in-patient admissions, 1.25 million emergency visits and a quarter-million operations. The hospital is unique in achieving high success rates in cardiac surgeries both for adults and children and in organ transplant surgeries, especially in kidney transplant success rate is 97% in addition to cornea and bone marrow transplant and orthopedic surgeries such as total knee replacement and spinal surgeries, dental surgeries and many other surgeries. In addition to the availability of specialized centers such as IVF, the Nutrition and Slimming Center and the Cozmo Center for Skin Care.
What is the special footprint provided by the Specialty Hospital under your leadership to the medical sector in Jordan? The Specialty Hospital competes at the regional and the global level and not only at the local level, it became the first medical destination and attracted patients from 100 Arab and foreign nationalities. The hospital is the first and only hospital in Jordan to achieve the Medical Tourism Certification from MTQUA and was ranked from the top 10 hospitals in medical tourism worldwide in 2017, and in 2018 it was ranked as the 3rd best hospital worldwide in medical tourism. The hospital became a wellrecognized teaching and training institute for healthcare providers locally and internationally. And more than 3500 trainees have benefited from the training programs for doctors, nurses, pharmacists and other health professions.
The hospital has a long record of awards, certificates and accreditations, will you tell us about the most important ones? What was their added value to the hospital? Yes the Specialty Hospital is known to be one of the most awarded and accredited hospitals internationally. It is accredited by The Joint Commission International (JCIA) for four times, and accredited four times by the Healthcare Accreditation Council (HCAC). It has recently become the first in Jordan
and the seventh in the world to be recognized by the Joint Commission International as a center of Excellence for Cardiac diseases specifically in Acute Myocardial Infraction and in Heart Failure. Also it’s the first and only hospital to achieve King Abdullah II Award for Excellence for two consecutive cycles. In addition to; MECCAward, Prince Faisal Award, ISO 9001, Occupational Health and Safety OHSAS 18001, Environmental Safety ISO14001, Hazardous Analysis and Critical Control Points HACCP and ISO 22000 for food safety, and quality management system for medical laboratories ISO 15189. The Specialty Hospital is the first and only hospital in Jordan to achieve the Medical Tourism Certification from MTQUA and was ranked from the top 10 hospitals in medical tourism worldwide in 2017, and in 2018 it was ranked as the 3rd best hospital worldwide in medical tourism. In addition to all of that, the Specialty Hospital was recognized by the Arab Hospitals Federation as The Best Hospital in the Arab World in Patient Centered Care.
The Specialty Hospital administration is keen to stay updated with the latest medical technologies through attracting the latest diagnostic and radiology techniques and devices. As well as introducing modern therapeutic techniques, can you tell us about the latest
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technologies available at the hospital? The Specialty Hospital administration is always keen to introduce the latest technologies; it was the first in Jordan to introduce the Silent MRI that is distinguished for its high accuracy in imaging with a comfortable atmosphere for the patients and without noise, in addition to the first and only CT 512 in Jordan which can scan the coronaries in one heartbeat, and patients are exposed to 80% less radiation than other CT devices. In addition to establishing the first Hyper-Baric Oxygen Therapy Center in Jordan. Also the cath lab is distinguished in the region, and it serves more than 3,500 patients annually which includes three wellequipped rooms and a hybrid cardiac catheterization room. And the lithotripsy center has the latest machine in the world “Sonolith” which is distinguished in tracking the stone using infrared during the procedure and it has superior ability to break stones in the ureter, kidneys and the bladder.
The first mini CAB (Coronary Artery Bypass) in Jordan and in the Middle East was performed at the Specialty Hospital. Can you tell us about this achievement? The first mini CAB (Coronary Artery Bypass) in Jordan and in the Middle East was performed at the
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Specialty Hospital. The operation was performed using a laparoscope with only a small incision on the left side of the chest without the need to cut the chest wall as in the usual open heart surgery. This surgery is a complete alternative to the traditional openheart surgery. The most important feature is that it is minimal invasive, speedy recovery, return to normal life quickly, shorter length of stay at the hospital, and it leaves very minimal scars.
FOR THE FIRST TIME IN JORDAN, IMPLANTATION OF A LEADLESS PACEMAKER INSIDE THE HEART BY CATHETERIZATION AND WITHOUT SURGERY The first of its kind procedure in Jordan was carried at the Specialty Hospital, where a leadless pacemaker was implanted inside the heart by catheterization and local anaesthesia without any surgical intervention. The procedure was performed for a Sudanese patient who was over 85 years old at the Specialty Hospital where he was suffering from a slow heartbeat and he came to Jordan after two previous traditional pacemaker operations carried in Sudan that failed. Due to the difficulty of the patient’s condition and his age, a multi-disciplinary team decided that the optimal solution for this patient is to perform the leadless pacemaker implantation without surgery by
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catheterization and under local anaesthesia. The pacemaker is small in size (1 cm2) and doesn’t leave scars on the skin. It is implanted inside the heart and connected directly to it. When compared to the normal pacemaker, they both have the same life span, which is 10 years.
Continuous quality is a fundamental principle for you; what are the steps followed by quality and continuous improvement department to get the best results? Quality is one of the main strategic dimensions adopted by the hospital’s management. There are many steps taken by the quality department to sustain improvement and to implement quality plans for patients’ safety and monitoring the performance: 1. Continuously searching for updates in the quality standards and excellence and working on implementing them. 2. Continuous training of staff. 3. Setting annual priorities for improvement to raise the efficiency and effectiveness of the procedures. 4. Writing new clinical protocols and guidelines corresponding to the latest evidence and monitoring their implementation and continuous improvement. 5. Having proper policies,
INTERVIEW
procedures and guidelines for all work procedures in the hospital in coordination with the related departments and continuously monitoring the implantation and improvement. 6. Continuous performance monitoring by collecting and analyzing key performance indicators for all the departments which will assist in decision-making.
What is the Specialty Hospital’s role in social responsibility? Serving the local and Arab communities is one of the main strategic directions of the hospital. We focus on social responsibility through many activities in Jordan and abroad. We perform many free medical days annually in all governorates of the Kingdom. And for many years, the Specialty Hospital has been an active partner in the Goodwill campaign that is led by HRH Princess Basma Bint Talal. The Specialty Hospital and the Encouragement of Organ Donations Association, chaired by HRH Prince Raad bin Zaid, succeeded in listing Jordan in the World Guinness Book of Records in collecting the largest number of cornea donors after the previous record was recorded for the United States of America. And we believe that the humanitarian message is not limited to the borders of our homeland, so
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we reached many countries of the world. The hospital’s team was the first medical team to arrive in Libya to treat the wounded during the Libyan revolution. It was the first Jordanian medical team to arrive to the Republic of Chad. And a medical mission went to support the Rohingya refugees in Bangladesh. The hospital’s staff contributed to relieving the suffering of Gaza Strip. The hospital cooperates with charitable foundation and other Sudanese institutes to carry out many voluntary activities and free medical days in Sudan. The hospital’s social responsibility activities were recognized by achieving CSR ARABIA Award as well as a letter of recognition for adopting ISO 26000.
In our interview with you, we have to shed light on medical tourism in Jordan. What is new in this sector, especially in the proposed medical tourism strategy and its role in the development of the medical tourism industry? What is your assessment of this strategy? Jordan has succeeded in being the first medical tourism destination in the region, we have all the resources that qualify us for this, but the sector has faced many challenges in the past few years including the visa restrictions imposed on some Arab and foreign patients, as well as the regional events in some Arab countries which led to the decline in the number of medical tourists
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coming to the Kingdom. We recently prepared a national strategy for medical and wellness tourism and it was approved by the Council of Ministers and we hope that it will be implemented as it is, in order to increase the number of medical tourists which will increase Kingdom’s revenues from medical tourism.
How do you assess the health situation in Jordan today? There are major challenges facing Jordan in general and the health sector in particular. The public sector may face major challenges due to the deficiency in the government’s budget and the high public debt and the Syrian refugees’ crisis, which has placed a great burden on Jordan. The private sector challenges include the high operating costs due to the increase in electricity bills, brain drain, the multiplicity of regulatory bodies and the increase in taxes.
In closing, tell us about your vision for the future to accomplish more achievements in the Specialty Hospital? Based on the trust that the Specialty Hospital gained locally and internationally and due to the increasing demand for the hospital services, we are currently conducting studies and plans to build a new stateof-the-art hospital, as well as building a hotel with luxurious suites to serve our guests from around the world.
NEWS
Abington - Jefferson Health Names New Senior Vice President and Chief Nursing Officer
Annmarie Chavarria
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nnmarie Chavarria, MSN, RN has been appointed senior vice president (SVP) and chief nursing officer (CNO) for Abington – Jefferson Health.
A resident of Warminster, Chavarria brings more than 20 years of clinical and administrative experience to the role. As CNO, Chavarria will focus on patient safety and quality by creating
and supporting the key elements needed to maintain the standards of a highly reliable healthcare organization. Using her two decades of experience, Chavarria will empower other nurses and staff to uphold a professional, caring environment that fosters healing and well-being, using strategies proven to improve patient care and outcomes. Working with other leaders, she will help to streamline various processes atAbington Hospital and Abington - Lansdale Hospital in an effort to best utilize resources and improve overall workflow. “During my tenure as CNO, my goal is to teach and inspire those around me about the importance of working as a team and treating each other and our patients and families with the kindness and respect Abington is known for,” says Chavarria. “People thrive in environments where everyone feels supported and everyone’s suggestions and contributions are valued. I want to help our staff learn and grow so that in
turn, they can move our hospital from good to great.” Chavarria joined Abington – Jefferson Health in 2005 as a nurse manager, and since 2015 has served as nurse director of Medical Services. During that time, she has been instrumental in developing the Geographic Coverage Model implemented on the medical units, has led patient experience training and contributed to other projects, such as Create a Safe Night, Bedside Report and The Nurse Leader Rounding Program. “Annmarie has always shown a commitment to patient safety and satisfaction throughout her career at Abington,” says Meg McGoldrick, President, Abington – Jefferson Health. “She is intelligent, ambitious and very dedicated to the quality of care our patients receive and the growth of our organization and staff. Annmarie is committed to a learning environment and the continuing education of nurses.”
Frost & Sullivan to Host Healthcare Meeting to Discuss Growth Opportunities and Digital Health Tech Readiness in Morocco
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rost & Sullivan is hosted its very first Healthcare Meeting on October 11, 2018 at the Hyatt Regency Hotel, Casablanca, Morocco. 2018 will be a tipping point for mainstream adoption of popular digital health tech/solutions and the transition of noble technologies from research/proof-of-concept to actionable healthcare and clinical applications. Envisaging huge growth opportunities, Frost & Sullivan hosted the meeting and discussed
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the global trends and the growth opportunities in the healthcare and life sciences sector. The Frost & Sullivan Healthcare and Life Sciences experts are predicting big disruptions, transformations and innovations in the coming years as the healthcare industry continues to overhaul outmoded business models. “Our interactive workshop is designed to help managers and CEOs understand key issues affecting the
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healthcare industry globally,” noted Sandeep Sinha, Vice President & Head, Healthcare and Life Sciences, Frost & Sullivan. “Advances in areas ranging from cancer immunotherapy products to blood testing, as well as the convergence of cutting-edge technology such as artificial intelligence and blockchain will help shape the healthcare industry into a much-anticipated, value-based care paradigm.”
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Weill Cornell Medicine - Qatar Dean’s Honor List recognizes high-achieving students successful career in medicine. I have no doubt that you are ready to take on the challenges of what comes ahead and will excel as medical students and future doctors.”
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eill Cornell Medicine-Qatar (WCM-Q) has recognized the outstanding academic achievements of 36 students by inducting them onto the Dean’s Honor List for 2018. To be included on the Dean’s Honor List, students must have achieved a Grade Point Average (GPA) of 3.75 or higher in either the Fall 2017 or Spring 2018 semesters, a measure that is approximately equivalent to receiving an average of an A grade for every piece of graded work for an entire semester.
The keynote speech was given by former WCM-Q student Dr. Karima Becetti, who graduated in 2011. Dr. Becetti, who is now a consultant rheumatologist at Hamad Medical Corporation, said: “Congratulations to all of you on this incredible achievement. You have worked hard, shown a high level of scholarship and determination, and earned yourself the honor of making it onto the Dean’s List. Most importantly, you have proved to yourself and everyone else that you have the necessary sturdy foundation for a
Speaking at a ceremony held to acknowledge the students’ inclusion on the honor list, WCM-Q Dean Dr. Javaid Sheikh said: “To achieve a GPA of 3.75 across an entire semester demands not only great talent but also absolute dedication to one’s studies over a prolonged period of time. I hope you will each take a moment to enjoy this remarkable accomplishment, and also to give thanks to the family members, friends, faculty and staff who have supported you to help make this moment possible.”
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First-year medical student Haya Al-Taweel made it onto the Dean’s Honor List. Haya, who was also included on the list in her first year of pre-med studies, said: “When I heard I had made it onto the Dean’s Honor List I was so happy and excited, and it still feels great. Good time management and occasionally interacting with my professors have really been the key for me through the semester, as well as making time to rest and do fun things to avoid getting overwhelmed by my studies. I’m really pleased that my hard work has paid off.” The Dean’s Honor List usually only features students on WCM-Q’s SixYear Medical Program, but this year two students - Maryam Al-Quradaghi and Tala Abu Samaan - made it onto the list for their academic performance on the WCM-Q Foundation Program.
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Transasia showcases total diagnostic solutions at MAPCON 2018
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he recently concluded MAPCON, Transasia offered the attending pathologists an opportunity to gain insights into the latest advancements in the in-vitro diagnostic industry. In its 39th year, the Annual Conference of the Maharashtra Chapter of IAPM (MAPCON) was held between 7th and 9th September, 2018 and hosted by the Armed Forces Medical College (AFMC), Pune.
As the principal partner, Transasia organized two scientific sessions: ‘Acquired bleeding disorders’ by Dr. (Col.) Jyoti Kotwal, Sr. Consultant, Dept. of Hematology, SGRH & GRIPMER, New Delhi and ‘Pathophysiology and diagnosis of Hemophilia’ by Dr. Swati Pai, Head of Dept.- Lab Medicine, Manipal Hospitals, Bengaluru. At its booth, Transasia commemorated the trust, commitment and service of our armed forces. It further harnessed its position as a leader in the Indian IVD Industry by showcasing its latest and best technologies. ‘Make in India’, fully automated biochemistry analyzers, XL-1000 and EM 200 and coagulation analyzer ECL 760 were on display. Additionally, Hb-Vario, its HPLC system and urine chemistry systems, Laura XL and Laura Smart were also exhibited along with the automated ESR system, Vesmatic Easy. Transasia is the sole distributor in India of the world-class Sysmex hematology analyzers, of which the 3 PDA, XP-100 and 6 PDA, XN 330 were showcased. Further, Transasia’s rapid diagnostic kits, that offer unmatched sensitivity and specificity for dengue and malaria detection were well received at the booth.
Menarini Will Bring Lunaphore’s Ultra-Rapid Tissue Staining Solution LabSat™ Frozen to Market
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unaphore Technologies SA, a Swiss Company developing innovative next-generation devices for cancer tissue diagnostics, and A. Menarini Diagnostics S.r.l., one of Europe’s leading diagnostic solution providers and part of the Menarini Group, jointly announced the start of a strategic partnership bringing to the market a new and innovative system, using Lunaphore’s technology. LabSat™ Frozen is an ultra-rapid automated tissue staining solution performing immunohistochemistry (IHC) assays in a few minutes. Thanks to this breakthrough technology, patients will be able to benefit from a faster, better and more personalized treatment starting in the operating room. Shorter turnaround times may provide clinical pathologists with higher degrees of responsiveness for urgent testing and enable IHC consultation during biopsy procedures. Lunaphore’s CEO, Ata Tuna Ciftlik, commented: “Menarini has not only a long-rooted experience across the entire tissue diagnostics market, but also an impressive understanding of the frozen sections segment. Their complementary product portfolio, their expertise in introducing innovative automation systems as well as their passionate sales and
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marketing teams, naturally made Menarini the best partner of choice”. He added “Menarini will bring our first product LabSat™ to pathologists while Lunaphore will continue providing highly innovative solutions. A perfect match”. Menarini Diagnostics’ GM, Fabio Piazzalunga, said: “The Menarini Group is making important investments in oncology and this agreement confirms the commitment of the company in this field. A. Menarini Diagnostics has extensive experience in anatomical pathology and immunohistochemistry and, at the same time, it has always focused its activity on high-tech solutions bringing innovation into the IVD field. Lunaphore Technologies perfectly suits our strategic decision to consolidate our position in the cell pathology space, following Menarini Group’s efforts and investments towards better therapies and solutions for cancer.” He added “Lunaphore and Menarini will together offer a unique solution to pathologists for a more accurate diagnosis, starting from the crucial segment of the frozen sections”. The partnership between A. Menarini Diagnostics and Lunaphore Technologies opens a new era of the anatomical pathology field, paving the way to one-day diagnosis.
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UNESCO renews Dr. Mansoor Al Awar’s chairmanship of the Governing Board of Institute for Information Technologies in Education
H.E Lieutenant General Dhahi Khalfan Tamim
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NESCO has issued a decision to renew the chairmanship of Dr. Mansoor Al Awar, Chancellor of Hamdan Bin Mohammed Smart University (HBMSU), to the Governing Board of the UNESCO Institute for Information Technologies in Education (IITE). The renewed term covers a period of four years and will end on 31 December 2021. Dr. Mansoor AlAwar was unanimously elected as Chairman of the Governing Board by members of the Council in 2014. The renewal of Dr. Mansoor’s term as Chairman proves to be highly significant as the move reflects his remarkable success in leading the governing board, especially in achieving the objectives it has set out to do—prompting UNESCO to initiate the renewal of his term as Chairman. The extension of the term is also a clear indication of the ability of UAE nationals to lead international organizations with excellence, which is an unprecedented achievement for the Arab world as Dr. Mansoor is
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Dr. Mansoor Al Awar
the first Arab to hold this prestigious position. Moreover, the renewal of Dr. Al Awar’s chairmanship affirms the UAE’s wise leadership’s efforts in choosing leadership positions in the country and that the choice is subject to strict rules and criteria based on impartiality and merit. H.E Lieutenant General Dhahi Khalfan Tamim, Deputy Chairman of Police and General Security in Dubai and Chairman of Hamdan Bin Mohammed Smart University’s (HBMSU) Board of Governors (BOG),expressed his happiness over UNESCO’s decision to renew the chairmanship of Dr. Mansoor Al Awar to the Governing Board of the UNESCO Institute for Information Technologies in Education (IITE). He said: “I hope that what Dr. Mansoor achieved on the global stage will serve as an inspiration for all the people of the country to promote a culture of excellence. UNESCO’s confidence in a prominent Emirati figure such as Dr. Al Awar represents a clear message that the people of the UAE, with the
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support of our wise leadership, are capable of achieving international leadership and excellence in realizing UAE’s unparalleled ambitions.” Commenting on the decision of UNESCO to renew his chairmanship, Dr. Mansoor Al Awar said: “I would like to affirm that this achievement would not have been possible without the great support provided by the UAE to its people, under the leadership of His Highness (H.H.) Sheikh Khalifa bin Zayed Al Nahyan, President of UAE, as well as the unlimited support from H.H. Sheikh Mohammed Bin Rashid Al Maktoum, Vice President and Prime Minister of the UAE and Ruler of Dubai. I would also like to emphasize that I am indebted to H.H Sheikh Hamdan Bin Mohammed Bin Rashid Al Maktoum, Crown Prince of Dubai, Chairman of Dubai Executive Council and HBMSU’s President, for the guidance that he has given, supporting my performance and setting the road ahead, which has enabled me to reach this prestigious international position.”
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The University of Manchester Middle East Centre invites healthcare professionals to a free Masterclass on leadership in healthcare ent healthcare systems can be better integrated across diverse primary, secondary and tertiary providers. This can help in supporting a vision of championing healthier nations and allowing its leaders to share good practice with others and to learn from other systems across the globe.
Dr Stephen Brookes
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he University of Manchester Middle East Centre in Dubai hosted a free Masterclass on leadership in the healthcare sector for qualified working professionals in the industry. Attendees were also able to learn more about the university’s programmes including the new part-time MSc International Healthcare Leadership, which was launched in the Middle East in 2017 with a first cohort of 21 students. The director of the new MSc programme, who is also a senior fellow in public policy and leadership at the university, led the Masterclass.
Masterclass: Leading our global future for healthcare
Dubai: Wednesday, 12th September 2018, 6.30pm-8.30pm Location: The University of Manchester Middle East Centre, Classroom F11, Block 2B, Dubai Knowledge Park Speaker: Dr. Stephen Brookes, senior fellow public policy and leadership, The University of Manchester The University of Manchester’s new Part-time MSc International Healthcare Leadership is a two-year part-time blended learning programme designed for experienced and qualified medical and management professionals in the Middle East, with regular face to face workshops in Dubai. The programme is designed for experienced clinicians and managers already in general management or leaders in healthcare who need to enhance their leadership skills, and those managers who need practical preparation before moving into clinical, project, specialist or business
Healthcare leaders across the globe face constant and ever-growing demands across an increasingly multi-faceted healthcare system. Leaders need to be equipped with the knowledge and skills to respond to these challenges. This Masterclass explored how to lead across different levels of healthcare in a timely, cost-effective and seamless manner, giving prevention as much priority as treatment and considering how differ-
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leadership positions. It aims to equip leaders and managers with the latest knowledge and global healthcare best practice, and to help facilitate experienced managers transfer their skills into the healthcare economy. Dr. Stephen Brookes, Masterclass leader and Programme Director for the MSc International Healthcare Leadership, comments: “The regional healthcare sector is one of the most active and dynamic industries, facing unique leadership challenges around the rapid expansion and digital transformation of the sector, whilst continuing to meet international standards, and the need for public and private sector collaboration to meet the needs of a young and growing population with a range of chronic lifestyle diseases. This Masterclass was of interest to clinical and healthcare business leaders in the region.” The University of Manchester Middle East Centre has supported more than 2,300 part-time MBA students based in the region and has graduated more than 1,300 students since opening in Dubai Knowledge Park in 2006, making it the largest and fastest growing centre in the University’s international network.
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4-7 FEB 2019 DWTC, DUBAI
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Royale Hayat Hospital Patient Identification Project Improvement
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oyale Hayat Hospital conducted evaluation of one of their Quality Improvement Projects on 27th September 2018. Realizing the importance of right identification of patient’s all times and to create awareness Quality Improvement Project team organized this as part of improving patient safety.
Dr. Dina Maher Ali, Dr. Samaa Zenhom and Dr. Talal Al Fadalah from the Directorate of Quality and Accreditation, Ministry of Health, Kuwait were special invitees. Additionally, Ms. Ebaa Al Boiny, Project Manager, Accreditation Canada also graced the occasion. Dr. Ahmad Al Mosawi, Dr. Lobna Bassiouni and Ms. Kareena Handa from
Royale Hayat Hospital participated in evaluating the project. This QIP was started in February this year with active involvement of three different teams - The Identifiers, Mind Bogglers and Goal Diggers. The teams had a preliminary presentation in May 2018. Later it was decided to work as one team with one goal, one vision and this collaborative effort led to the formation of a single Patient Identification QIP team called the Unified Identifiers. Increasing the awareness of staff and patients and streamlining and revising the existing process were the main objectives of the QIP. Royale Hayat Hospital management and staff endeavor to be committed towards quality improvement so that patients can receive safe care.
Live everyday life flexibly and with ease – thanks to BHM. Our requirements for a fulfilled, independent, self-determined life are always changing. But BHM requirements remain forever the same: restoring a significant quality of life to people with impaired hearing, using state-of-the-art hearing systems. Continuously developed and upgraded by BHM to be in line with the latest technology. Just like the new contact forte: the new Bluetooth-enabled generation of bone conduction hearing systems connects to your smartphone, impressing users with its high-end technology and wide range of wearing options for even greater freedom in everyday life.
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www.bhm-tech.at
BHM-Tech Produktionsgesellschaft mbH . 7423 Grafenschachen . Austria
ARTICLE
Safe patient care with LINET of LINET bed side-rails varies greatly with a comprehensive type range of shapes for the different needs of individual departments. All side-rails on all beds meet the strict European EN 60601-2-52 standard for medical beds thus preventing high-risk situations. Another protection factor in combination with the safe side-rails is the low bed settings, particularly during the bed’s sleep mode and night backlight for better orientation at night and dusk. The sophisticated system for supporting mobilization and verticalization not only facilitates this process but ensures that the bed has the necessary safety protection. Thus in combination with professional assistance from nurses and physiotherapists, the patient has reliable support to practice bed exiting.
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id you know that according to WHO, as many as 1 in 10 patients in developed countries is harmed while receiving hospital care? The harm can be caused by a range of errors, safety failures or adverse events. Ensuring safety during hospitalization particularly for patients in bed is therefore a key issue for LINET. On an international scale, patient falls rank among the criteria for measuring nursing care quality. They are one of the most common causes of prolonged hospitalization, can have serious even fatal implications, and complicate the process of convalescence considerably. The basic condition of safe care for a patient in bed is to ensure the maximum possible effective prevention of falls and further accidents. All without unnecessary restrictions while respecting the individual condition and needs of patients. The side-rails form the keystone of safety on hospital beds. The design
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Another bed safety level is smart technology. LINET beds are equipped with a Bed exit alarm system monitoring the patient’s movements and presence in bed. The systems of the SafeSense and SafetyMonitor are based on the interaction of sensors and applications, operating automatically and eliminating human error. They display risk situation alerts and statuses such as if the bed is at a safe setting. The nurse can see everything online on monitors at the nurses’ station or from any place on a mobile phone. As a result the nurse can promptly and preventively intervene where this is truly required. Our further safety measures are “invisible”, hidden in the bed’s structure. An example is the SWL – safe working load ensuring the bed’s safe operation even for patients weighing up to 185 kilograms. LINET has this SWL parameter in an entire portfolio of electrically adjustable beds from TOP models Multicare and Eleganza 5 to economic beds such as the Eleganza 1 with an above standard value of 250 kg. For us at LINET it is top quality construction and smart safety functions that form the cornerstone of the complex solution for in bed patient care. We provide professional product training as well as training aimed at the maximum effective possible ways of utilising the bed for quality and safe care. The global service network of our professionals – technicians ensures a top and authorised after-sales service anywhere in the world so that we can guarantee a bed’s long-term and reliable function.
Jiri Plecity, Managing Director LINET MEA
NEWS
Eleganza 5 Multiple safety Safety is a key parameter. All the bed’s functions are set so the patient can not just feel but really be as safe as possible. Siderails concept
Siderails are high and sturdy and provide maximum safety even while using active mattress systems.
i-Brake
Automatic wheel-lock activates itself within 10 seconds of the bed remaining unbraked and being plugged in to prevent falls caused by an unstable bed.
Multizone bed exit alarm
Sensitive sensors detect the patient’s motion activity and presence in the bed.
SafetyMonitor
Using sensors and applications the SafetyMonitor provides an overview of hospital bed safety architecture settings in real time, ensuring that these settings match hospital requirements.
30 Degree autostop
The automatic backrest stops at 30 degrees to improve respiration.
Lowest height
The lowest bed height significantly reduces the risk of injuries due to bed falls, especially during the night.
www.linet.ae
NEWS
Aster DM Healthcare wins Special Recognition at Arabia CSR Awards 2018 ed providers of business assurance, DNV-GL. The criteria of the award are derived from global and regional frameworks and standards, namely, the UN Global Compact Ten Principles, GRI and the European EFQM business excellence model. Today, Aster’s CSR programmes, run by Aster DM Foundation and Dr. Moopen’s Family Foundation, are successfully running across 9 countries including GCC and India. Aster Volunteers programme which was launched on occasion of the Group’s 30th anniversary in 2017, aims to bridge the gap between people who would like to help with those who are in need. Today, there are 8386 volunteers who have been able to impact 738,610 lives. Aster DM Foundation has been contributing across geographies over the years through its community dialysis centres, mobile clinics providing free healthcare in remote areas, early diseases detection & cancer screening centres, international disaster relief initiatives, and free check-ups and surgeries for the under-privileged.
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t the 11th Arabia CSR Awards 2018, Aster DM Healthcare was felicitated with a special recognition in the healthcare category, for its outstanding contribution to the society through its corporate social responsibility programmes. The award was presented by Dr. Saeed Al KindiFormer Minister of Environment & Water, UAE and Honorary Member of Emirates Environmental Group along with Dr. Radhiya Al Hashimi- Executive Committee Member of Emirates Environmental Group. Commenting on the occasion, Dr. Azad Moopen, Founder Chairman and Managing Director of Aster DM
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Healthcare, said: “At Aster DM Healthcare, we firmly believe that profit should be a by-product in healthcare. Guided by this philosophy, we have been constantly exploring ways to give back to our society and environment. In all our endeavors our motto “We’ll Treat You Well” is our guiding star, be it enabling access to quality healthcare to all sections of the society or helping people who are in need. We are very happy that our efforts have been recognized by the Arabia CSR Network.” The award is in collaboration with the United Nations Environment Programme (UNEP) and externally verified by one of the world’s most reput-
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Aster DM Healthcare Aster DM Healthcare Limited is one of the largest private healthcare service providers operating in multiple GCC states and is an emerging healthcare player in India. With an inherent emphasis on clinical excellence, the company is one of the few entities in the world with a strong presence across primary, secondary, tertiary and quaternary healthcare through its 20 hospitals, 112 clinics and 213 pharmacies. These are manned by our 17,600+ employees from across the geographies that we are present in, delivering on a simple yet strong promise to its people: “We’ll treat you well.”
Patient safety solution
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The LINET patient safety concept is focused on minimizing risks, safe recovery, including mobilization and maximum comfort.
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www.linet.ae
NEWS
Certain Uterine Fibroids May Impact Your Ability to Conceive
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ainful and heavy periods, bloating and constipation are common indicators of women with uterine fibroids. However, in the UAE many young women ignore these symptoms because of a common misconception that such fibroids only affect older women. According to Dr Laura Melado, IVF Specialist, Abu Dhabi, IVI Middle East Fertility Clinic, uterine fibroids can affect any woman in the reproductive age group, as their growth is dependent on the production of oestrogen and progesterone - hormones that maintain and regulate the female reproductive system. It is noted that 30-50 percent of women of childbearing age suffer from this condition. Studies indicate that 20-50 per cent of women have fibroids at least once during their lifetime.In the UAE, greater number of women are developing fibroids as most of them are choosing to start a family later in life. In addition, genetic factors are also leading causes of uterine fibroids with women in the UAE. “Uterine fibroids are abnormal growths that consist of muscle cells and fibrous tissues that form a mass within the uterus. These fibroids are benign (non-cancerous) growths and can be found in or around the uterus. Though they are common, they can vary in size and number, there are also multiple types of uterine fibroids, each characterized based on their location,” said Dr Laura Melado. If fibroids grow mainly outward away from the cavity of the uterus, they are called subserosal. If they stay within the muscle wall they are called intramural fibroids. If they extend into the uterine cavity, they are called submucosal fibroids. While women with fibroids can conceive but a percentage of women do face interference with conception, pregnancy or birth. If a fibroid is inside the uterine cavity (submucosal) or is larger than six cm in diameter, then it may impede conception by up to 70 percent. Uterine fibroids may impact fertility by changing the shape of the cervix or the uterus interfering with the movement of the sperm or embryo.They can also block fallopian tubes and can impact the size of the lining of the uterine cavity.
Multi Michelin-starred chef Gordon Ramsay surveys the choicest fresh ingredients at the Waterfront Market to Dubai to launch his latest ‘Fit Food’ menu at Bread Street Kitchen & Bar at Atlantis The Palm. The host of popular TV food show ‘MasterChef’ is known to give premium value to sourcing and serving fresh food in his numerous restaurants in major cities around the world. Chef Ramsay surveyed the fresh food section of the Waterfront and expressed a pleasant surprise at the diversity of the choicest fresh ingredients available in the market.
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ne of the world’s most popular chefs, multi Michelin-starred Gordon Ramsay, had a refreshing encounter in Dubai with the widest range of fresh produce on display at The Waterfront Market, the largest integrated fresh food destination in the emirate, during his visit over the weekend. Ramsay recently returned
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The Waterfront Market in Deira covers the widest range of fresh produce such as seafood, vegetables and fruit that come from local, regional and international sources. The market continues to gain popularity among leading celebrity chefs, visiting and shopping firsthand for fresh food to offer to their restaurants. The market has hosted several chefs including
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Chef Barza, Chef Nobu, chef Boy Logro and Chef Levant Karahan from Pullman Hotel. Their visits at the Waterfront Market further underpins Dubai’s position as one of the most visited places for international celebrities. Lachlan Gyde, Executive Director Ithra Dubai, said: “Seeing a culinary superstar like Gordon Ramsay at the Waterfront Market is a delightful scene for all of us and we are more than happy to host him here to explore the wide variety of fresh ingredients we offer to our customers. His keen sense for freshness quite fits with Waterfront Market’s goal of promoting healthy eating lifestyle in Dubai. We have been witnessing a growing number of celebrity chefs visiting the market, which demonstrates the importance of the market as an ideal and convenient source for fresh food.”
NEWS
NEWS
‘Nursing Now Qatar’ Campaign and Doha Healthcare Week Highlight the Important Role of Qatari Nurses young nurses and another Qatari nurses. Both sessions are led by Dr. Catherine Hannaway, Global Campaign Project Manager for Nursing Now and have been developed in close consultation with HMC and WISH.
Ms. Mariam Al-Mutawa
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he ‘Nursing Now Qatar’ campaign has been the driving force behind a number of activities held during Doha Healthcare Week and is also highlighting the important role played by Qatari nurses and midwives working across the healthcare sector. Nursing Now Qatar, which was launched earlier this year, aims to improve healthcare globally by raising the profile and status of nurses worldwide, influencing policy-makers, and supporting nurses to lead, learn, and build a global movement. The Nursing Now Qatar board brings together senior representatives of Hamad Medical Corporation (HMC), the World Innovation Summit for Health (WISH), Primary Healthcare Corporation (PHCC), Sidra Medicine, Al Ahli Hospital, and the University of Calgary in Qatar (UCQ). The two leads of Nursing Now Qatar, Dr. Nicola Ryley, Chief Nursing Officer, HMC and Ms. Sultana Afdhal, CEO of WISH, said that among the many objectives of the campaign is the development of initiatives and events that promote nursing in Qatar and training programs for Qatari nurses. Among the activities aimed at nurses taking place during the week are two workshops, one targeting
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Ms. Mariam Al-Mutawa, Executive Director of Nursing at Rumailah Hospital, supported the planning of the workshops. She is passionate about developing nurses, especially young Qatari nurses. “Qatari and long-term residents are the future of the nation’s healthcare services and we need to inspire them to be the best healthcare professionals they can be in order to deliver the high standards of patient care that we all expect to see from our health sector,” said Ms. Al-Mutawa. “I am delighted that this year’s WISH program has a focus on nursing and has brought such eminent nursing professionals to Qatar to share their knowledge and expertise during Doha Healthcare Week.” Ms. Al-Mutawa, a Qatari nurse who has 20 years of nursing experience, is part of Rumailah Hospital’s executive team, where she has oversight of daily hospital operations which includes the supervision of over 1,200 nurses currently assigned across all major divisions within the hospital and its satellite services. “We are investing in developing the leadership skills of our senior nurses and midwives who have demonstrated a desire to really make a difference to the profession and how it is perceived within our healthcare system. The nursing leadership workshops are a wonderful opportunity, especially for our Qatari nurses, to learn about leadership principles and their practical application,” added Ms. Al-Mutawa.
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Mrs. Ebtisam Abdulla, Head Nurse at PHCC, said there are around 1,900 nurses currently working across PHCC who are delivering a variety of services within health centers and in the community, either as a part of a larger team or independently. She said the Nursing Now initiative in Qatar has been supported by nursing teams across the country, in both the public and private sectors. “A number of important activities related to nursing are being held as part of Doha Healthcare Week, including a training session for nurses at the Orbis Flying Eye Hospital and a lecture on nursing and mental health services led by Dr. Eve Byrd, Director of the Carter Center’s Mental Health Program. These training courses aim to increase the competence and confidence of PHCC nurses who are working in our clinics,” said Mrs. Abdulla. Another activity that took place during the week provided an opportunity for secondary school students to get a unique insight into working in healthcare, and particularly nursing. The ‘Nurse for a Day’ activity provided an opportunity for students (girls and boys) from secondary schools to shadow key Qatari nurses and leaders at Al Ahli Hospital and HMC hospitals. This activity was arranged by Ms. Asmaa Mosa Al-Atey, Director of Nursing for the Trauma Service at Hamad General Hospital. Ms. Al-Atey is another young Qatari nurse who is passionate about promoting nursing and encouraging the next generation of nurses and midwives to choose this important profession. She is also passionate about promoting road safety awareness among young people.
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NEWS
Qatar Biobank reaches 15,000 participants milestone providing biological samples and information, volunteer participants help Qatar Biobank enable medical researchers and healthcare professionals to form a clearer picture of the prevalent health-related issues in Qatar and the region. Dr. Asmaa Al Thani, Chairperson of the Qatar Genome Programme Committee and Board Vice Chairperson of Qatar Biobank, said: “We are delighted to celebrate the screening of our 15,000th participant – a milestone that represents the local population’s eagerness to contribute to their improved health. Qatar Biobank is an important initiative that will play a pivotal role in contributing to a healthier local population for generations to come.”
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atar Biobank, a member of Qatar Foundation (QF), recently marked a major milestone with the screening of its 15,000th participant, as part of its medical health research initiative to improve the health of the local population through personalized medicine. Through
Researchers at the Qatar Genome Programme (QGP), another member of QF, are already using Qatar Biobank’s samples to gain important insights into the health of the local population, including the prevalence of diabetes, obesity, and vitamin D deficiency. Dr. Nahla Maher Afifi, Education and Scientific Manager and Acting Director of Qatar Biobank, said: “Qatar Biobank serves as a large-scale
biomedical research initiative that is based on population in the Arab world, thus ensuring far more accurate and effective targeted medical treatments. We encourage the people of Qatar who are eligible and have not yet been screened to participate in this vital initiative – the success of which is dependent on large-scale participation by the local population, particularly Qatari youth.” A regular visit to the Qatar Biobank includes standard medical tests such as blood pressure and lung function. However, the tests carried out also include new screenings that are not included in other large-scale biobanks, including advanced imaging techniques to measure whole-body composition and the health of carotid arteries, and a treadmill test to measure physical fitness. Qatar Biobank welcomes Qataris over the age of 18 and adult expatriates who have lived in Qatar for at least 15 years to take part in this pioneering medical research endeavor. All participants receive feedback in approximately two weeks after their initial visit, however, Qatar Biobank immediately notifies participants who are found to have serious or life-threatening conditions.
Pharmacogenomic survey of Qatari populations using whole-genome and exome sequences
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he Arabs represent one of the most genetically heterogeneous populations characterized by a high prevalence of Mendelian disorders due to consanguinity. Population-scale genomic datasets provide a unique opportunity to understand the epidemiology of variants associated with differential therapeutic response. We analyzed publicly available genomic data for 1005 Qatari individuals encompassing five subpopulations. The frequencies of known and novel pharmacogenetic variants were compared with global populations. Impact of genetic substructure on the pharmacogenetic landscape of the population was studied.
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NEWS
Sidra Medicine welcomes UNESCO Artist for Peace Zara
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idra Medicine, Qatar’s specialist women and children’s hospital and a member of Qatar Foundation, has welcomed United Nations Educational, Scientific and Cultural Organization (UNESCO) Artist of Peace and the 2018 FIFA World Cup Russia™ Ambassador, prominent Russian artist, Zarifa Pashaevna Mgoyan, known as Zara. During her visit, Zara was introduced to the hospital’s services and facilities including the children’s Heart Center, dialysis units and women’s services. Zara was welcomed with a musical performance by Sidra Medicine’s resident pianist who regularly performs for patients and visitors as part of the hospital’s focus on creating a healing environment. Commenting on her visit to Sidra, Zarifa Pashaevna Mgoyan said: “I was fascinated by the design of the building, created by the renowned architect Cesar Pelli. The center resembles three large sails, which, are meant to symbolize calmness and healing. Sidra Medicine pays particular attention to the health of the mother and child. I was impressed that everything in Sidra was set up to make children feel as comfortable as possible.” She added: “I was touched when I was greeted by Sidra Medicine’s pianist in the lobby who played three of my songs when I arrived. Music has its own healing properties, so it was great to know that the pianist plays here every morning.” This visit comes on the sidelines of Zara’s week-long trip to Qatar, which concludes on Monday, November 5th. The artist was invited by Qatar Museums to perform at the Katara Opera House as part of the Qatar Russia Year of Culture, the latest edition of Qatar Museum’s (QM) annual Years of Culture program.
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MEDICAL EQUIPMENTS
COAGULATION TESTING Sysmex CA-100 Series
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aemostasis is the body’s physiological method of maintaining blood circulation. The combination of complex actions between the blood vessel, smallest blood cells (platelets) and specific proteins in the plasma stop bleeding if a blood vessel is damaged.
The mechanisms involved need a regulatory system to ensure a proper balance between the need to stop bleeding and causing a blockage in the vessel. Those suffering from an imbalance in the haemostasis system can have a higher bleeding risk (haemophilia) or a higher risk of blockage of the blood vessels by undesired clot formation (thrombosis). Through our analysers and other services, Sysmex has significant experience in helping doctors diagnose patients with haemostatic disorders or treating patients
to prevent them bleeding or thrombosis. From basic to highly specialised tests, our analyser portfolio covers the needs of all kinds of laboratories.
Coagulation is complex When blood vessel walls are damaged, blood vessels contract to slow down the blood stream. The damaged cells from vessel’s inner wall (endothelium) trigger several processes, including the activation of platelets and the clotting mechanism. Activated platelets stick together (adhesion) and
form complexes (aggregation) that result in the first haemostatic plug in the vessel wall to stop the bleeding. Activated platelets also form the surface for the clotting process. Clotting (coagulation) occurs through the formation of a network of fibrin, which in turn is the result of many other so-called clotting factors being activated. The fibrin network and the haemostatic plug form a secure solution for stopping bleeding and give the body the opportunity to repair the blood vessel.
Our semi-automated systems Your straightforward, compact coagulation solution
CA-101 NOVEMBER.DECEMBER 2018
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MEDICAL EQUIPMENTS
CA-101
CA-104
The CA-101 uses turbo-densitometry and combines the best of both mechanical and optical detection principles. The lamp intensity automatically adjusts to sample turbidity, which means all samples are properly analysed with constant high quality results. Results are automatically calculated for PT and fibrinogen. They can be output to an optional external printer.
The instrument incubates and mixes sample and reagent automatically and indicates when to add starting reagent. The auto-start function automatically detects when reagent is added (pipetting is done manually) and triggers mixing and clot detection. This procedure requires only little manual intervention, is easy to perform and ensures consistent, high quality results so you can focus further on standardisation in your lab.
Standardised procedure
Running analyses on the CA is simple, but you can perform other tasks easily and safely too. You can load method-specific data and parameters into the analyser via a pre-programmed ChipCARD, which is read by the integrated ChipCARD reader. This reduces the risk for errors significantly. During measurement, recorded data such as results, reaction curves and patient data can be saved to an SD-card via the integrated SD-card interface.
The instrument incubates and mixes sample and reagent automatically and indicates when to add starting reagent. The auto-start function automatically detects when reagent is added (pipetting is done manually) and triggers mixing and clot detection. This procedure requires only little manual intervention, is easy to perform and ensures consistent, high quality results so you can focus further on standardisation in your lab. Ideal for laboratories that require minimum manual intervention in performing routine coagulation assays. It is designed to simplify coagulation testing making it more standardized and reproducible. • Coagulation testing is made easy with built-in timer, temperature control and auto-start and timing of measuring process. • Easy to use with pre-programmed methods. • Objective detection of clot formation. • Automatic light intensity adjustment according to the turbidity of the plasma, making it possible to measure icteric or lipemicplasma reliably. • Sophisticated standard curve tool to maintain accuracy and precision. • Increased throughput with short incubation time.
Ideal for laboratories that require minimum manual intervention in performing routine coagulation assays. It is designed to simplify coagulation testing making it more standardized and reproducible. • Coagulation testing is made easy with built-in timer, temperature control and auto-start and timing of measuring process. • Easy to use with pre-programmed methods. • Automatic light intensity adjustment according to the turbidity of the plasma, making it possible to measure icteric or lipemicplasma reliably. • Sophisticated standard curve tool to maintain accuracy and precision. • Increased throughput with short incubation time. • A technology that requires only half the sample and reagent volume for testing as compared to manual method.
www.sysmex-mea.com
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ARTICLE FEATURES . Medical Laboratory
HbA1c Test Measures the average blood sugar level over the past 3 months
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very patient with diabetes should undergo the HbA1c test, which is one of the most important tests given its ability to measure the average blood sugar level for the past three months. The doctor can then have a close follow-up to know about the person’s blood sugar levels, hence protecting him from complications that can appear over time due to irregular blood sugar levels. However, before diving into the details of this test, we must remember that the patient should keep doing Blood Glucose Level (BGL) tests daily at home with a glucose meter since the doctor compares the daily results with those of the HbA1c test. Hence, he will be able to develop a suitable treatment plan in order to help normalize the patient’s blood sugar level while trying to prevent future complications. When glucose builds up in your blood, it binds to the hemoglobin in your red blood cells. The HbA1c test measures how much glucose is bound. Red blood cells live for about 3 months, so the test shows the average level of glucose in your blood for the past 3 months. If your glucose levels have been high over recent weeks, your hemoglobin A1c test will be higher. A blood sample is taken and sent to the lab.
Understanding the test results For people without diabetes, the normal range for the hemoglobin A1c level is between 4% and 5.6%. Hemoglobin A1c levels between 5.7% and 6.4% mean you have a higher chance
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of getting diabetes. Levels of 6.5% or higher mean you have diabetes. The target A1c level for people with diabetes is usually less than 7%. If your rate is higher, your doctor suggests changing the treatment. The higher the hemoglobin A1c, the higher your risk of having complications related to diabetes.
In order to maintain healthy HbA1c levels, you should follow these steps: • • • •
Stop or reduce your sugar intake Replace sugar used in juices and sweets with saccharin Stop eating fatty foods and smoking Consume plenty of vegetables and avoid fruits such as bananas, figs and grapes as they increase blood sugar and HbA1c levels.
Symptoms of high HbA1c levels High HbA1c levels mean that the patient is unable to control his blood sugar rate and therefore, he must adhere to a strict diet and follow the doctor’s instructions in terms of treatment plan. Symptoms of high HbA1c levels
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and high glucose levels are the same and the only difference is that HbA1c test measures the average blood sugar in the body for the past 3 months.
Symptoms are as follows: • • • • • • • •
Increased thirst Frequent urination Constant fatigue and tired feeling Unexplained weight loss Blurred vision Increased hunger Wounds take a long time to heal Infections (recurrent yeast infections in the genitals, tooth infections, skin infections, recurrent urinary tract infections)
According to the World Health Organization, HbA1c test should be performed once a year in case of pre-diabetes, and twice a year in case of controlled type 2 diabetes; but if not controlled, it must be done four times a year, three to four times in the case of type 1 diabetes. The doctor will request this test in order to diagnose type 1 and type 2 diabetes, or to check the effectiveness of the patient’s treatment plan.
ARTICLE FEATURES . Medical Laboratory
ARTICLE
Osteoarthritis of the knee joint
Dr. Stanley Jones Consultant Orthopedic and Spine Surgeon
Dr. Balaji Talaseela Specialist Orthopedic Surgery
What is osteoarthritis of the knee?
previous injuries to the knee or have a deformity to their leg.
It is a clinical condition in which the cartilage that covers the ends of the bones that form the knee joint are worn-out, leading to exposure of the underlying bone. This process of “wear and tear” occurs over time.
How common is it? Worldwide estimates are that 9.6% of men and 18% of women aged over 60 years have osteoarthritis that causes symptoms. It is mostly seen in people above 50 years, but may occur in younger people.
Who can get osteoarthritis of the knee? Anybody above 50 years. Women are more likely than men. People who are overweight or those who had
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How will I feel? Pain around the knee is the most common complaint and may be worse in the morning or with activity. There may be limitation of movement of the knee and sounds (crepitus) maybe noted with movement. In addition swelling of the knee may be observed. •
How do I know I have osteoarthritis of the knee? You will need to see your doctor, preferably an orthopedic surgeon to make a diagnosis. After talking to you, he will examine you and observe any or all of the following: • Walking with a limp • Swelling and /or deformity
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• •
around the knee Tenderness (pain on pressure) around the knee Limitation of movement Crepitus (sounds) with knee movement.
X-Rays of the knee are usually sufficient to confirm the diagnosis and may show narrowing of the joint space, osteophytes (bone spurs)
ARTICLE
Lifestyle modifications: help in relieving symptoms and delaying progress of arthritis and include losing weight, switching to low impact activities like swimming and cycling to minimize stress on your knees. Physiotherapy: helps to strengthen muscles around the knee, which may help increase the range of movement and flexibility of the affected knee. Assistive devices: like canes help in offloading the knee and relieving pain. Medications: NSAIDS (Painrelievers like Voltaren, Brufen) will offer pain relief, but long-term usage can lead to other medical problems like kidney failure, hence they should be taken taken under a doctor’s supervision. Applying heat and pain relieving gels can provide pain relief. Glucosamine and chondroitin sulfate are dietary supplements, that are found naturally in the joint cartilage, and may give pain relief, but there is no evidence to support, that their use decreases or reverses progression of arthritis.
and sub-chondral cysts. MRI may be required to assess the soft tissues around the knee.
What are the treatment options? Unfortunately there is no treatment to reverse or cure the wear and tear changes. The options currently available are to help relieve the pain and disability.
Surgical Treatment Arthroscopy: is a procedure where special instruments and equipment are used through small incisions (key hole) to treat degenerative meniscal tears which is usually seen in people with osteoarthritis of the knee, and may be a cause of pain,locking, instability in the knee. Osteotomy: is a procedure where the tibia (shin bone) or femur (thigh bone) are cut and realigned to relieve pressure on the knee joint. It is usually done in the early stages of osteoarthritis where only one side of the knee joint is damaged, and the osteotomy would help in shifting weight off the damaged side of the joint, giving pain relief and improved function. Knee replacement (Arthroplasty): is the best option for people with severe osteoarthritis and limitation of movements. In this procedure, the damaged cartilage and bone are removed and replaced with new metal /plastic joint surfaces to restore knee function.
Corticosteroid injections can provide pain relief by reducing the inflammation, but the effects do not last indefinitely. You may require repeat injections but should not be more than three to four injections per year as that also may cause further damage to the cartilage. Visco-supplementation (hyaluronic acid) injections may improve quality of joint fluid and help in pain relief.
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ARTICLE
Low back pain is a common health problem, experienced by most age groups
Dr. Reham Elgafy Head of Physical Medicine and Rehabilitation Department
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ow back cause may be attributed to the muscles, nerves, and bones of the back or organs within the pelvis. Lower pain may be classified by the duration of pain; as acute (pain lasting less than 6 weeks), sub-acute (6 to 12 weeks), or chronic (more than 12 weeks). The condition may be further classified by the underlying cause as either mechanical, non-mechanical, or referred pain. The symptoms of low back pain usually improve within a few weeks from the time the pain starts, with around 40-90% of people completely better by six weeks. Most acute low back pain results from injury to the muscles, ligaments, joints, or discs. The body also reacts to injury by initiating an inflammatory healing response which can cause severe pain.
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In most episodes of low back pain, a specific underlying cause is not identified or even looked for, with the pain believed to be due to mechanical problems such as muscle or joint strain. If the pain does not improve with conservative treatment or if it is accompanied by “red flags” such as unexplained weight loss, fever, or significant abnormal sensation or muscle weakness in the lower limbs, further investigations may be needed to look for the underlying problem. The lumbar spine, or low back, is a remarkably well-engineered structure of interconnecting bones, joints, nerves, ligaments, and muscles all working together to provide support, strength, and flexibility. However, this complex mobile structure also leaves the low back susceptible to injury and pain. The low back supports the weight of the upper body and provides mobility for everyday motions such as bending and twisting. Muscles in the low back are responsible for flexing and rotating the hips while walking, as well as supporting the spinal column. Nerves arising from the low back supply sensation and power to the skin and muscles in the pelvis, legs, and feet. There is a significant overlap of nerve supply to many of the discs, muscles, ligaments, and other spinal structures, and it can be difficult for the brain to accurately localize the pain or determine its type. For example, a degenerated or torn lumbar disc can feel the same as a strained muscle – both creating inflammation and painful muscle spasm in the same area.
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Depending on the underlying cause of the pain, symptoms can be experienced in a variety of ways. For example: • •
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Pain that is dull or achy, confined to the low back. Stinging, burning pain that moves from the low back to the posterior aspect of the thighs, sometimes into the lower legs or feet; can include numbness or tingling (sciatica). Muscle spasms and tightness in the low back, pelvis, and hips. Pain that worsens after prolonged sitting or standing. Difficulty standing up straight, walking, or going up from the sitting position.
Thorough investigations and setting the proper diagnosis is important to lay the foundation for appropriate treatment and rehabilitation. Conservative treatment is the first line of management using medical treatment and designing a rehabilitation program. The Physical & Rehabilitation medicine department offers a wide range of treatment modalities for back pain, the core of rehabilitation of low back pain is exercise; weight reduction, core muscle strengthening, stretching of tight muscles, manipulation, proprioception…etc. Proper lower back pain management reduces the likelihood of recurrent back pain, flare-ups and helps prevent the development of chronic lower back pain.
NEWS
International Reaccreditation, Another Milestone in Excellence for Al-Ahli Hospital
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l-Ahli Hospital has been awarded four years full healthcare reaccreditation by the Australian Council on Healthcare Standards International (ACHSI), one of the top healthcare accreditation bodies in the world. This event marks the four years since the Hospital first achieved full international accreditation under the ACHSI Evaluation and Quality Improvement Program (EQuIP). The accreditation evaluation was conducted by peers from Australia, Hong Kong and India who evaluated full compliance with 46 demanding standards and extensive evidence of continuous quality improvement activities across all aspects of the Hospital’s operations. The team were also satisfied that the recommendations made during the previous accreditation cycle have been fully implemented. The survey team, led by Mr. Vincent Gaglioti congratulated the hospital on its measureable improvements across all evaluation areas and on the
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significant enhancements implemented in team collaboration and focus on improving the quality of care. Mr. Khalid Al-Emadi, Chief Executive Officer welcomed the opportunity for an in-depth peer review and feedback and acknowledged the commitment demonstrated by all staff to strive for the highest international standards of care and quality. He said “achieving ACHSI accreditation originally was a significant boost to the team and this helped propel them to higher levels of achievement”. He added that “sustaining and improving this standard over the longer-term is very gratifying and underscores the Hospital’s mission and values”. Mr. Jamal Hamad, the Deputy Of Chief Executive Officer of Al-Ahli Hospital said, “The Hospital is eager to achieve and excel in international standards for patients safety and we are doing our best to achieve the highest quality in healthcare for patients
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by enhancing education and professional development for medical, nursing and allied health professionals. Also,this creates an entrepreneurial spirit among them as they strive for best possible practice”. He said, “Al-Ahli Hospital initially achieved full international accreditation in 2014 for a four-year period. However, this reaccreditation gives us more challenge to reach higher and higher standards and to sustain our extensive improvements. As a private hospital, it is very important to be at the forefront of safety and quality initiatives and this collaboration with ACHSI now shows the long-term result. Also Al-Ahli Hospital is always interested in implementing the best medical services and being comparable with the healthcare leaders around the world, this can only be achieved by focusing primarily on patient safety. In addition, Mr. Jamal said that “Al-Ahli Hospital has implemented systems that work and add to the success of the hospital in providing top-class care to patients”. According to Dr. Abdul Azim Abdul Wahab Hussain, the Medical Director of Al-Ahli Hospital “Al-Ahli Hospital is characterized by professional medical and nursing staff who are dedicated and the proof of this is the strong communication between them which demonstrates a dynamic team focused on patient safety and excellent clinical outcomes. This has been part of the longer-term strategy to provide excellent service and the best quality of care.” He said, “Al –Ahli Hospital management will always be persistent to support of developments in the
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medical care and patient’s safety at its highest level”. Mr. David Miller, Director - Safety and Quality at Al-Ahli Hospital said “Achieving international healthcare accreditation is not an easy task and maintaining it is even tougher. This can only be achieved by constantly focusing on the quality of the services
provided”. He said “The ACHSI EQuIP system creates an ever increasing benchmark and expectation that drives continuous quality improvement and the requirement for strong connections between clinical and non-clinical departments”. He said “the beauty of the EQuIP system is that it evaluates every part of the
hospital’s operations from facilities management to the provision of complex clinical care and everything in between. Achieving such a good result from the reaccreditation survey demonstrates the sustainability of all of our improvements which is a great accolade for all of our clinical and supporting staff.”
Hemya diet centre opens doors at Al Ahli Hospital They said the food items are carefully prepared to meet a growing range of taste preferences and health conditions of the customers. They said the Hemya chefs would prepare a wide range of recipes with fresh ingredients from different world cuisines in collaboration with the hospital’s qualified dietitians. The hospital’s food safety officers will ensure the quality of the highly nutritional food produced in the kitchen.
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l Ahli Hospital has launched Hemya, a center offering a unique diet programme and door delivery of food items prescribed by the hospital’s clinical dietitians for their customers. More than 200 varieties of dishes, prepared under the supervision of the hospital’s highly professional team of dietitians, could be ordered through a mobile application. Customers have the option of choosing from nearly 56 varieties of food every week. “Our hospital’s team of specialised clinical dietitians and professional
chefs has designed this diet programme to assist customers (patients) in balancing their calorie intake, shaping their body and losing extra weight,’ said Deputy CEO Jamal Hammad. Al Ahli Hospital’s chief of medical staff Dr Abdul Azim Abdul Waheb Hussain, CEO Khaled Al-Emadi, chief dietician Alia al-Massri and catering manager Dominique Richard were among others present at the launch of the centre. The hospital officials said Hemya centre would help one design his or her own diet plan day by day, by choosing from a variety of food recipes.
Payment for the food ordered is made on a daily basis and based on the quantum of the order. But the diet consultation fee needs to be paid separately. It was also informed that the diet food order should be done before 2pm for next day delivery. Right now, delivery services are available in all places in Doha and its immediate surroundings. Delivery is also made in places up to Umm Slal Ali. “However, soon the centre would be equipped with more refrigerated vehicles and delivery would be made to farther areas as well,” added Jamal Hammad.
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ARTICLE FEATURES . Platelets
Platelets
What are they? What is their function in the body? (purpura) Superficial bleeding into the skin that appears as a rash of pinpoint-sized reddish-purple spots (petechiae), usually on the lower legs. • Prolonged bleeding from cuts. • Bleeding from your gums or nose. • Blood in urine or stools. The situation here varies depending on the low platelet count. If the deficiency is minor, the patient may not need treatment; in severe cases, it can be very dangerous as excessive bleeding may occur. •
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latelets (PLT) are tiny but important cells in your blood that help your body control bleeding. The blood normally contains between 150, 000 and 400, 000 platelets per microliter of blood. Having more than 400,000 platelets is a condition called thrombocytosis that may be caused by an underlying condition such as an infection or cancer; having less than 150,000 is known as thrombocytopenia. Thrombocytopenia often occurs as a result of a separate disorder, such as leukemia or an immune system problem. Or it can be a side effect of taking certain medications. It affects both children and adults. Platelets are tiny blood cells that help your body form clots to stop bleeding. If one of your blood vessels gets damaged, it sends out signals that are picked up by platelets. The platelets then rush to the site of damage and form a plug, or clot, to repair the damage. The process of spreading across the surface of a damaged blood vessel to stop bleeding is called adhesion. This is because when platelets get to the site of the injury, they grow sticky tentacles that help them adhere. They also send out chemical signals to attract more platelets to pile onto the clot in a process called aggregation.
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Although platelets are the smallest blood cells in size, their function in the human body is very important as they prevent bleeding in the veins and arteries when exposed to wounds. Platelets and the 13 blood clotting factors play a major role in this function.
Low Platelet Count In low platelet count or thrombocytopenia, your bone marrow makes too few platelets, or your platelets are destroyed. If your platelet count gets too low, bleeding can occur under the skin as bruising, inside the body as internal bleeding, or outside the body through a cut that won’t stop bleeding or from a nosebleed. Thrombocytopenia can be caused by many conditions, including several medicines, cancer, kidney disease, pregnancy, infections, and an abnormal immune system. It can be caused by failure of the bone marrow to produce normal numbers of platelets. Bone marrow failure has multiple causes. Thrombocytopenia can also be caused by increased destruction of platelets once they are produced and released into the circulating blood.
Signs and symptoms of low platelet count may include: •
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Easy or excessive bruising
High Platelet Count In the case of High Platelet Count (or thrombocythemia), your bone marrow makes too many platelets. A blood clot may be the first sign that something is wrong. Blood clots can develop anywhere in your body, but they’re more likely to form in your feet, hands, or brain. The symptoms of a blood clot can vary depending on where the clot is located. Symptoms generally include headache, lightheadedness, weakness, fainting, numbness or tingling in the feet and hands and chest pain. High platelet count is a sign of cancer, arthritis, gastrointestinal disorders, spleen removal and iron deficiency. There are many health conditions that lead to high platelet count, including a bone marrow disorder, leukemia and bone marrow fibrosis. Some of the causes may be considered secondary, including lung cancer, breast cancer, cancer of the lymph nodes and gastrointestinal tract, hemolytic anemia, autoimmune disorder, or certain infections or other diseases such as chronic kidney failure, tuberculosis, etc.
ARTICLE FEATURES . Platelets
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Abu Dhabi’s Smart Solutions and Services Authority launches new integrated journey within ‘TAMM’
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bu Dhabi’s Smart Solutions and Services Authority (ADSSSA) launched the second integrated journey titled ‘New Medical Journey’ at “TAMM” Platform during its participation at GITEX 2018, in the presence of H.E. Saif Mohammed Al Hajeri, Chairman of the Department of Economic Development – Abu Dhabi; and Dr. Rauda Saeed Al Saadi, Director General of ADSSSA. The “New Medical Journey” offers several advantages, including saving more than three months of rent to the investor; a comprehensive and centralized source of information; permanent access to licensing; accelerated building approvals and employment hiring; faster issuance and approval of commercial and health licenses - from two weeks to less than one hour; and reduced number of required documents, from 15 to one. This initiative designed and developed through a single digital platform came on the heels of the successful launch of the ‘Moving to a New Home’ journey, which offers integrated fourstage procedures through a unified digital channel. It opens up opportu-
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nities as well as offers proactive, fast, and efficient processes in terms of license approvals, building completion, staffing, and health audit to start the business. In this regard, H.E Sheikh Abdulla Bin Mohamed Al Hamed, Chairman of Department of Health stated: “We are happy to join efforts to ensure that all investors seeking opportunities in the Emirate, healthcare sector have smooth journey and easy start, I thank Abu Dhabi Systems and Information Centre for taking this important step for its role in attracting more investments in the sector, thus helping in the expansion of services and improving its outcomes” H.E. Saif Mohammed Al Hajri, Chairman of Abu Dhabi Department of Economic Development, underscored the Abu Dhabi Government’s commitment to develop a smart system for government services provided by various entities by leveraging the latest digital technologies and smart applications, which will pave the way for the development of a single integrated platform for all stakeholders. H.E. Al Hajri cited recent initiatives led
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by ADSSSA such as the TAMM which has just launched its new end-to-end journey services, the ‘Opening a New Medical Center’, which came soon after the ‘Moving to a New Home’ journey services was introduced. These services is a major leap in ADSSSA’s efforts in boosting digital transformation and providing government services to all stakeholders in Abu Dhabi, including businesses, by ensuring they obtain the required approvals while saving on cost and time to complete their transactions. He added that GITEX Technology Week 2018 is an opportunity for the Abu Dhabi Government to launch these smart digital services that meet the needs of businesses, positioning Abu Dhabi as a leading global hub for technological innovation and thereby attracting international companies to invest in the emirate. He said that the government entity’s presence at GITEX further contributes to Abu Dhabi’s goal of maintaining excellence and efficiency in government services and boosting our innovation capabilities with the latest information and communications technologies in the world. HE Saif Al Hajri commended ADSSSA’s efforts in accelerating Abu Dha-
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bi’s vision in transforming government services through digital strategies and the creation of an integrated system under TAMM, which provides a single platform for all government entities and help them keep pace with the rapid technological evolutions across the world. H.E Dr. Rauda Al Saadi said: “The “New Medical Journey” success has been made possible through the joint efforts of eight government entities to provide customers with a unique experience. Their collaboration reflects their common goal of enhancing the performance of government entities and providing the best services within ‘TAMM’, which seeks to deliver a unique experience and an integrated journey for customers through multiple channels and a unified platform. This is within the framework of provid-
ing the next generation of integrated government services. These end to end journeys reduce a lot of time, effort, and costs by taking advantage of the latest technologies. We aim to meet our customers’ expectations and provide them with easy and fast services that serve their individual needs. By reducing time, effort, and cost, we are encouraging our investors to establish businesses and invest in Abu Dhabi.”
in February 2018 as part of its plan to develop an integrated electronic services system to achieve a comprehensive transformation in the field of government services and ensure customer happiness and welfare. This is in line with the vision of the Abu Dhabi Government to enhance the emirate’s economic environment and increase the quality of living in the Emirate.
The journey was developed by several government entities including the Department of Economic Development, Department of Health, Department of Urban Planning and Municipalities, Civil Defense, the Ministry of Human Resources, and Ministry of Interior. ADSSSA launched its first journey titled ‘Moving to a New Home’
Health Shield Medical Center to Celebrate Women of the Capital
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n honor of breast cancer awareness month, Health Shield Medical Center partnered with leading medical equipment distributors Dansys and Samsung to bring free screenings to the female residents of Abu Dhabi
on October 9th. The multi-specialty healthcare facility operated by private integrated healthcare group, Capital Health, will also celebrated women by paving a path to wellness through complimentary 3D/ 4D ultrasounds and revolutionary Regenlab PRP gynecology treatments. Health Shield Medical Center is just one of the facilities that Capital Health has developed in line with UAE Vision 2021 and Plan Abu Dhabi 2030. With a strategy to pioneer new healthcare models, patients will be provided with the best quality care possible from Capital Health. As spots were limited, residents took part in Health Shield’s Instagram competition to win a Regenlab PRP gynecology treatment worth AED 2,000. Two lucky winners were selected.
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10 years of French Lebanese Cooperation in Health Matters celebrated at ESA Business School
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he ESA Business School organized a ceremony celebrating the 10 years of French Lebanese cooperation in health matters on Monday 15 October 2018. The School was honored to host His Excellency M. Ghassan Hasbani, Minister of public health in Lebanon (MPH), His Excellency M. Bruno Foucher, Ambassador of France in Lebanon, Dr. Walid Ammar, Director General of Health as well as three leaders of major health agencies in France : Mrs Dominique Le Guludec, President of French National Authority of Health (HAS), Mr. Dominique Martin, Director of the National Agency for the Safety of Medicine and Health Products (ANSM) and Mr. François Toujas, President of the French Establishment of Blood (EFS). On this occasion, the Lebanese Republic honored two personalities who have worked hard in developing this cooperation by awarding them the Gold Medal of the Order of Merit of Lebanese Health, delivered by H.E Mr. Ghassan Hasbani in the name of the President of the Lebanese Republic, General Michel Aoun. Mr. Stéphane Attali, ESA CEO, For his contribution in establishing and developing this cooperation and his support as the CEO of ESA”. Dr. Alain Beauplet, Previous Director of International Affairs of the EFS, for his engagement in reinforcing the quality and security of blood transfusion in Lebanon.
A major event celebrating the advancement brought by the French-Lebanese Cooperation
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The meeting of these three agencies, considered to be among the most prominent in France, is an exceptional event for Lebanon. Their presence highlights and reinforces several years of cooperation and collective work with the Lebanese Ministry of Public Health leading to the enhancement of the Lebanese health system. • Through its scientific and technical expertise, the ANSM contributes to the development of the medicine and medical devices circuit. Over the past 10 years, the ANSM allowed the MSP to strengthen and regulate the marketing of medication and health products. • HAS supports the MPH in the accreditation process of hospitals leading to the enhancement of the Lebanese hospital system and the quality of care towards patients. • The EFS offers Lebanon its
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scientific and technical expertise in the blood transfusion specialty. This cooperation allowed the unification of the practices on a national level in order to warranty a similar quality of product of labile blood all over the Lebanese territory. A big effort was also made towards spreading the awareness regarding blood donations, so it becomes an anonymous, free, and voluntary act in Lebanon as it is in France. Many prominent figures were present including the presidents of the Syndicate of Importers and Manufacturers of Medicine, Mr. Armand Phares and Mrs Carole Abi Karam, the President of the Syndicate of Private Hospitals, Mr. Sleiman Haroun, the President of the Syndicate of Biologists Mr. Christian Haddad, and the representative of the President of
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the Order of Doctors in the North Dr. Omar Ayache.
Ceremony Sequence Mr. Stéphane Attali, Dr Walid Ammar, Mr. Dominique Martin, Mrs Dominique Le Guludec, M. Francois Toujas, H.E Mr. Bruno Foucher and H.E Mr. Ghassan Hasbani, respectively, gave a speech at the event. In regards to the French Lebanese cooperation, H.E Mr. Ghassan Hasbani confirmed that “the solicitation of French agencies such as the National Authority of Health (HAS), the National Agency for the Safety of Medicine and Health Products (ANSM) and the French Establishment of Blood (EFS) began 10 years ago while we were in full reconstruction mode. Different agreements were signed over the years including an inter-ministry agreement in 2011 which was renewed in 2017. It didn’t take time to render working with France an evidence in as we share the same values and similar challenges.” The different addresses highlighted the success of this French-Lebanese cooperation as well as the
achievements made by the concerned parties in enhancing the quality of health. The three French agencies confirmed the importance of their cooperation with Lebanon, qualifying it as an international model and assured their intention in pursuing and developing this cooperation. In the matter of blood transfusions, the president of the EFS confirmed that the progress made in 10 years are considerable since Lebanon went from a quasi-non-existent organization of blood transfusion to a structure and centralized operation of the activity. As for the Lebanese Minister of Health, he addressed the challenges which included the enabling and empowerment of blood transfusion centers, blood safety and monitoring as well as blood donation awareness. Regarding hospital accreditation, the president of HAS reiterated the support of her agency to the Ministry of Public Health through the establishment of the “Technical Committee of Hospital Accreditation” (CTAH) by French experts suggested by HAS, the training, in Paris, of Lebanese trainers who will train Lebanese evaluators, a
support to the creation and the drafting of the procedures and documents necessary for the organization as well the governance of a new iteration of accreditation. She also commended the continuous efforts deployed by the health establishments in Lebanon in order to enhance the quality of care and the security of patient including the use of new cross–cutting methodologies such as the evaluation of professional practices (EPP) or the longitudinal follow up track. Regarding the matter of quality of medicine, the director of the ANSM also highlighted the remarkable improvement of practices, commending the professionalism of the ministry experts who developed an efficient system of quality control and traceability for both medicine and implantable medical devices. The current challenge is to continue these efforts so that products become available securely and equally all over the country, allowing access to quality generic and biosimilar medicine while controlling the whole chain, from registration to distribution of products.
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ARTICLE FEATURES . Healthcare in UAE
Advanced systems, new technologies and international accreditations
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he UAE adopts a practical approach to the development of the health sector, which aims to establish a distinctive health model that responds to the increasing challenges to high-quality health services and enhances the competitiveness of the country by providing specialized medical services according to the best international practices and the latest state-ofthe-art medical devices and specialized staff that contribute to improving the level of health services.
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ARTICLE FEATURES . Healthcare in UAE
The country has witnessed a significant development in the health development, and has made a major leap in this field, providing the best international practices associated with the international accreditations that are necessary to upgrade the work systems in health facilities. The State is also seeking to raise the capacity of hospitals to reach about 14,000 beds until the end of 2020 across the United Arab Emirates. Today, the health sector in the UAE includes world-class hospitals and health facilities that meet international standards in order to ensure the provision of high-quality services within qualified and safe facilities. Innovation is always the desired goal through the use of modern technologies and innovative solutions. These health facilities also seek to develop infrastructure to provide a safe and patient-friendly environment.
World-class hospitals In recent years, a number of hospitals have been established to provide an added value to the health sector through the provision of world-class services that meet the needs of UAE citizens and residents. In addition, the remarkable developments achieved by the existing hospitals in the country have been keen to adopt the best health practices according to global protocols that contributed to upgrading the health system in the country.
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Hospitals in the UAE are offering advanced multidisciplinary treatments available only in the world’s largest hospitals. This allowed them to receive international accreditation, in addition to keeping abreast of the rapid developments in the medical sector while utilizing and harnessing global technologies to serve patients. For the fourth year in a row, the UAE has been ranked first globally for the number of healthcare establishments accredited by Joint Commission International (JCI), the world’s largest health-care accrediting agency. A total of 178 hospitals, medical centres and facilities in the UAE were approved by JCI, accounting for 76 per cent of all hospitals in the UAE. The numbers show that the UAE has surpassed the best healthcare systems in the world, announced the Ministry of Health and Prevention. It is noteworthy that JCI Accreditation follows 14 primary standards, which are then divided into different criteria that cover all patient services received that may be more than 1,300 requirements. These standards include the assessment of the following: patient safety objectives; criteria for admission to hospitals and visit accidents sections; evaluation and diagnosis of patients; application of treatment plan; surgical and anaesthesia procedures; drug administration; patients’ rights; patients’ education standards; senior management and re-
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ARTICLE FEATURES . Healthcare in UAE
sponsibilities; infection control; quality and development; human resources and staff; safety of health facilities and medical equipment; and medical file and health information.These state-of-the-art hospitals help meet patient expectations by providing the best healthcare services, expanding the development of services and providing more time and effort to citizens. The UAE healthcare sector seeks to regulate and facilitate access to health services. In addition, more than 200 international medical policies have been adopted with the aim to improve health services in hospitals and medical centers accredited by the Ministry of Health. The UAE Government guarantees the patients their rights and obligates them with responsibilities. Patients’ rights and responsibilities are listed in the patient’s charter of rights and responsibilities which are displayed at all clinics and hospitals. Patients can file complaints about improper service or malpractices to the respective health authorities. The healthcare sector also strives to provide distinguished health services to the community in hospitals through the provision of specialized, safe, integrated, evidence-based medical services in accordance with the highest international standards and best practices.
health insurance in Abu Dhabi and Dubai, and the continuous adoption of new technologies in the healthcare system will support the UAE’s position. Innovation in clinical services and the use of new technologies in disease diagnosis and treatment will drive a more patient-centric healthcare system. Spending on healthcare in the Arabian Gulf is projected to grow at an average of 6.6 per cent annually to $104.6 billion (Dh384.2bn) in 2022 from an estimated $76.1bn in 2017, according to a March report by Alpen Capital. An expanding population, high prevalence of non-communicable disease, rising cost of treatment and increasing availability of health insurance are the main factors driving growth. The BMI report found that new technologies including 3D printing, artificial intelligence, advanced robotic surgeries and virtual reality will support disease management and treatment in the UAE.
Innovation and Artificial Intelligence The Dubai Health Authority (DHA) is driving the use of AI and machine learning in the healthcare sector to improve clinical decisions, in line with the Dubai Health Strategy 2016-2021 and the UAE Strategy for AI. It is an
Best Healthcare in the Middle East The UAE earned the highest regional score on the Middle East Healthcare Access Index compiled by BMI Research, a unit of Fitch group. Patients in the UAE have the best access to healthcare in the Middle East as the country rolls out mandatory medical insurance and harnesses new technology for disease treatment. The report said that advanced healthcare systems and compulsory
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important step taken by the DHA to keep abreast of the qualitative changes witnessed by the UAE. DHA launched its Innovation and AI framework, which consists of four main themes that include enriching the culture of innovation within the authority, improving the innovation governance and processes, and the main innovation pillars that will contribute to happier stakeholders. The strategy consists of main four objectives with 21 initiatives that aim to contribute to the achievement of DHA innovation mission — harnessing creativity and innovation by generating and transforming ideas into reality to deliver value-based and sustainable healthcare services through engaging all partners and stakeholders. The strategy is aligned with Dubai plan 2021, the UAE innovation strategy and the AI strategy. The Innovation and Artificial Intelligence strategy workshop organized by the Department of Health, the regulator of healthcare sector in Abu Dhabi in cooperation with “IBM” was aimed at gathering the healthcare sector to draw a road map for adopting AI in the Emirate’s healthcare sector. It identifies strategic objectives, and discusses how to position Abu Dhabi as an innovation hub in health and to lead the health sector in
ARTICLE FEATURES . Healthcare in UAE
application of Artificial Intelligence. The workshop discussed the strategic objectives that help to drive the application of AI in the Emirate’s healthcare sector that include building predictive analytics capabilities to enable evidence-based decision-making, establishing the Abu Dhabi Health Observatory to monitor the health status of the community, artificial Intelligence in patient treatment to support improved diagnostics, exchange of patient’s health information to improve treatment and optimize cost, health education and monitoring to improve the efficiency of the healthcare system, telehealth to improve diagnosis in healthcare facilities and to position Abu Dhabi as an innovation hub in health. The workshop spotted light on enabling of AI application in the Health sector of Abu Dhabi by building partnerships to innovate the application of Artificial Intelligence in the health sector, governance and monitoring, policies and regulations, training and education, healthcare information and develop a comprehensive research network in Abu Dhabi. AI is defined as ‘simulation of human intelligence processes by computer systems and other machines’. This is a form of copying or mimicking of the human to solve complex problems automatically through the power of technology and the computer.
UAE Vision 2021 Providing world-class healthcare is one of the six pillars of the National Agenda in line with Vision 2021. The Government will work in collaboration with all health authorities in the country to have all public and private hospitals accredited according to clear national and international quality standards of medical services and staff. Furthermore, the National Agenda emphasizes the importance of preventive medicine and seeks to reduce cancer and lifestyle related diseases such as diabetes and cardiovascular diseases to ensure a longer, healthier life for citizens. In addition, the Agenda aims to reduce the prevalence of smoking and increase the healthcare system’s readiness to deal with epidemics and health risks. This will result in the UAE becoming among the best countries in the world in terms of quality of healthcare by the year 2021. The strategy will promote advanced technologies in healthcare services. It will stimulate the growth of the biotechnology and pharmaceutical industries while also working with strategic partners to support medical research. Emphasis is also placed on the provision of integrated healthcare for all individuals and increasing capacity. However, at the same time, health sector leaders are seeking to improve the quality of healthcare services, safety standards and patient experience in addition to attracting qualified people to work in the health sector and electronic health data.
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ARTICLE FEATURES . Amyotrophic Lateral Sclerosis
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ARTICLE FEATURES . Amyotrophic Lateral Sclerosis
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myotrophic lateral sclerosis (ALS) is a progressive nervous system disease that destroys nerve cells responsible for controlling voluntary muscle movement and causes disability. It refers to a group of progressive, neurological diseases that cause dysfunction in the nerves that control muscle movement. This leads to muscle weakness and changes in how the body works. In the later stages, amyotrophic lateral sclerosis affects the nerves that control breathing, and this can be fatal. Over time, ALS attacks certain cells in the brain and spinal cord needed to keep our muscles moving. Early signs and symptoms of ALS include muscle cramps and muscle twitching, weakness in hands, legs, feet or ankles and difficulty speaking or swallowing. People with ALS can still think and learn. They have all of their senses -sight, smell, hearing, taste, and touch. Yet the disease can affect their memory and decision-making ability.
Causes Researchers still don’t know exactly what causes motor neurons to die with ALS. Gene changes, or mutations, are behind 5% to 10% of ALS cases. More than 12 different gene changes have been linked to ALS. One change is to a gene that makes a protein called SOD1. This protein may be toxic to motor neurons. Other gene changes in ALS might also damage motor neurons. Environment could also play a role in ALS. Scientists are studying whether people who come into contact with certain chemicals or germs are more likely to get the disease. For example, people who served in the military during the Gulf War have gotten ALS at higher rates than usual. Scientists are also looking at these other possible causes such as gluta-
mate, which sends signals to and from the brain and nerves. It’s a type of neurotransmitter. With ALS, glutamate builds up in the spaces around nerve cells and may damage them. Your immune system protects your body from foreign invaders such as bacteria and viruses. In your brain, microglia is the main type of immune cell. They destroy germs and damaged cells. With ALS, microglia might also destroy healthy motor neurons. Mitochondria are the parts of your cells where energy is made. A problem with them might lead to ALS or make an existing case worse. Your cells use oxygen to make energy. Some of the oxygen your body uses to make energy may form into toxic substances called free radicals, which can damage cells.
Symptoms ALS is a rapidly progressive neurological disease that attacks the nerve cells responsible for controlling voluntary muscles, such as those in the arms, legs, and face. It causes weakness with a wide range of disabilities. Early signs and symptoms include: • Difficulty walking or difficulty doing your normal daily activities • Weakness in your leg, feet or ankles • Tripping • Hand weakness or clumsiness • Slurring of speech or trouble swallowing • Muscle cramps and twitching in your arms, shoulders, and tongue • Difficulty holding your head up or keeping a good posture Eventually, all muscles under voluntary control are affected, and individuals lose their strength and the ability to move their arms, legs, and body. ALS does not affect all muscles
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ARTICLE FEATURES . Amyotrophic Lateral Sclerosis
and organs in the body. The heart and bladder, for instance, usually stay healthy. Amyotrophic lateral sclerosis is difficult to diagnose early because it may mimic several other neurological diseases. Tests to rule out other conditions may include electromyogram (EMG), a test that evaluates the electrical activity of your muscles when they contract and when they’re at rest. Nerve conduction study measures your nerves’ ability to send impulses to muscles in different areas of your body. This test can determine if you have nerve damage or certain muscle diseases. Also, Magnetic resonance imaging (MRI), Using radio waves and a powerful magnetic field, an MRI produces detailed images of your brain and spinal cord. An MRI can spot spinal cord tumors, herniated disks in your neck or other conditions that may be causing your symptoms. Spinal tap (lumbar puncture) as well as muscle biopsy also help in the diagnosis of ALS.
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Complications As ALS progresses, those who suffer from it may experience some of the below complications:
the condition begins to progress over time. Speech problems tend to begin as mild and occasional slurs of words, however, these can develop further to become far more severe.
Breathing issues In time, ALS will progress and paralyze the muscles needed for breathing. At this stage, the patient may require a breathing device that helps them to breathe during the night. This air can be given through a BiPAP (bi-level positive airway pressure) or via a CPAP (continuous positive airway pressure). Both of these devices are non-invasive pressure support ventilation systems that make use of a flow-cycled or time-cycled process that alternates between the two mechanically applied levels of positive airway pressure.
Eating issues Those with ALS may develop dehydration and malnutrition due to the damage done to the individual’s muscles needed for swallowing. These individuals also have an increased risk of developing pneumonia as liquids, food and saliva can get into their lungs as a result of their inability to swallow properly. Thus, the introduction of a feeding tube may be necessary to aid in reducing these risks. This can also ensure that the patient does not suffer from dehydration and malnutrition.
Speech issues The majority of patients who suffer firm ALS will start to have issues with their ability to speak once
Dementia Some patients who have ALS may suffer from memory issues and battle to make decisions.
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Treatments The treatments for ALS are unable to reverse any of the damage done by the condition, however, they are able to slow down the rate at which the symptoms progress, prevent some of the complications and allow for the patient to be more independent and comfortable. Effective treatment may require a cooperative team consisting of various doctors and specialists that are trained in a number of different areas as the treatment is often complex, it does, however, prolong the patient’s life and the quality thereof. Breathing will become increasingly difficult as the disease progresses and the muscles needed for breathing weaken. Because of this, the patient’s breathing may be regularly tested and he or she may be given non-invasive devices to help them to breathe at night. As previously mentioned, mechanical ventilation may be needed.
This requires a tube to be inserted through a hole in the patient’s neck that leads to their windpipe. This tube will be connected to the respirator. A respirator is a machine that induces artificial respiration. Physical therapy involves a physical therapist who is able to address and assist with the pain associated with mobility and walking and provide the individual with equipment to aid them in staying somewhat independent. Walkers, wheelchairs and braces can be adjusted for the patient. A PT (physical therapist) is able to assist the patient in practicing some low-impact stretches and exercises in order for them to maintain their cardiovascular fitness, motion range and muscle strength until the condition progresses into complete paralysis. Some cases require Occupational Therapy (OT); this form of treatment is done through an occupational ther-
apist who can help the patient find ways that they can remain as independent as possible, regardless of their arm and hand weakness. Speech therapy is also required to help the patient communicate more clearly as communication for a patient with advanced ALS can become an issue due to ALS affecting the muscles needed to speak. Nutritional support – The medical team will work with the patient and their family to ensure that the individual is meeting their nutritional needs. Eventually, a tube for food to enter the body will be introduced as swallowing becomes an issue. Social and psychological support is a must in order to help with the overall wellbeing of the patient and their loved ones. Psychologists can also help in providing counseling and emotional care and support for the patient and their family.
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President of the Emirates Gastroenterology and Hepatology Society
Dr. Maryam Al Khatry “Our ambition is to establish a strong consensus about NASH”
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n the occasion of the 3rd International Hepatology Summit held in Dubai on October 12 and 13, 2018, “Hospitals” met Dr Maryam Al Khatry, President of the Emirates Gastroenterology and Hepatology Society. Dr Al Khatry said that the main subject of the Summit was NASH (Non-Alcoholic SteatoHepatitis) Due to the continuous rise of this disease across the globe.
Would you brief us about the activities of Emirates Gastroenterology and Hepatology Society? What is your vision? And what is the mission that you are working on? From humble beginnings, Emirates Gastroenterology and Hepatology Society (EGHS) has grown to become one of the most active professional medical societies in the UAE. Currently, EGHS has around 160 active members from various specialties such as Medical and Surgical Gastroenterology, Pediatrics, Radiology, Pathology, General Medicine and Surgery. We meet every month with a set agenda to ensure its members have an active schedule of events, seminars
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and forums covering clinical problems related to the specialty. In addition, we have ongoing plans to conduct epidemiological studies, clinical trials and basic research so as to have authentic data on the common and relevant clinical problems in the UAE. As an example of our activity, in March of this year we have launched ‘Ready to Be Hepatitis C Cured’ campaign, which was a natural evolution of the collaboration between the EGHS, MOHAP, DHA and our partners in the effort to raise awareness about the hepatitis C and provide better disease management solutions to the patients and their families, with the ultimate goal to eradicate hepatitis C in the UAE. Through the educational efforts of this campaign, the EGHS aims to increase the awareness about the importance of testing and early detection for the successful treatment of the HCV. In addition, our support program will empower and guide the patients to seek the treatment and adhere to it, but also provide a moral support which is often lacking throughout the patient journey.
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What is your strategy to fight liver diseases? Our objective is to elevate the level of science in gastroenterology and hepatology in the region and foster knowledge sharing and exchange of experiences, but more importantly to increase awareness and education amongst patients and healthcare professionals.In the UAE, the risk of liver failure is greater because liver damage is closely linked to diabetes, hypertension and obesity, which are all highly prevalent among the population.
What is the program of the 3rd International Hepatology Summit? This year, International Hepatology Summit focused on NASH. Due to the continuous rise of the NASH epidemic across the globe and particularly in the Middle East, it was of utmost importance to build a coalition of key stakeholders, particularly best hepatology and metabolic disease experts in the region to spread awareness and help to address patients’ unmet needs. Our ambition is to establish a strong consensus to drive progress
INTERVIEWS
and better support people affected by NASH across the region, as well as support the healthcare community in the Middle East effectively identifying and treating this widespread, sever and ‘silent’ liver disease. The Summit also discussed recent updates and developments in the fields of hepatitis C virus (HCV) and hepatitis B virus (HBV). HCV is curable if people are screened, diagnosed and treated. World Health Organisation has put clear targets to scale up testing efforts to ensure that 90% of those with hepatitis C are aware of their condition, and that 80% of them are treated by 2030. However, many people are often faced with barriers to testing and linkage to care. These barriers often include lack of awareness, knowledge and understanding that can lead to stigma and discrimination. We need to be aware that success is possible if the access to HCV testing is increased and more people get tested. On the other hand, chronic HBV is a lifelong disease that requires longterm or potentially indefinite therapy. Because chronic HBV endures, management of the condition must account for the changing needs of patients. Therefore, the experts at the International Hepatology Summit focused on evolving epidemiology of HBV patients as well as added value of the latest therapies in the treatment of HBV and current treatment guidelines.
The society is leading a regional coalition to raise awareness about a ‘silent
killer’ called NASH (NonAlcoholic SteatoHepatitis). What are the steps that you are working on? Emirates Gastroenterology and Hepatology Society (EGHS), Saudi Association for the Study of Liver Diseases and Transplantation (SASLT), and European Association for the Study of the Liver (EASL) have signed a Call to Action to raise awareness about this ‘silent killer’.
Can you give us an idea about the Non-Alcoholic SteatoHepatitis? What are its symptoms? NASH (Non-Alcoholic SteatoHepatitis) is a severe form of Non-Alcoholic Fatty Liver Disease (NAFLD), affecting over 10% of the global population with high incidence across the Middle East. Namely, overall global prevalence of NAFLD is estimated at just over 25%, with the highest prevalence in the Middle East reaching almost 32%, while NASH prevalence among NAFLD patients reaches almost 60%. NASH is closely related to the triple epidemic of obesity, prediabetes, and diabetes and can be defined as the liver manifestation of the metabolic syndrome. In most cases, NASH is the consequence of high sugar, high fat diets and insufficient physical exercise. It is heavily influenced by lifestyle (e.g. chronic excessive calorie intake, sedentary activity) and is distinct from other fatty liver diseases caused by alcohol abuse or medication side effects. It is a chronic yet silent disease, which means that most patients live with it for several years
without experiencing any symptoms and are mostly unaware of their liver condition.
What should be done for preventive awareness? The prevalence of NASH mirrors the rising epidemics of diabetes and obesity and it is estimated that more than half of diabetics have NASH, as do nearly a third of bariatric surgery patients. It is imperative to lead the awareness and education efforts toearly identify patients at risk of progressing to most advanced stages of NASH, such as obese patients, diabetes patient and those suffering from hypertension and other metabolic disorders and educate them to adopt a healthy lifestyle based on weight loss to reach the appropriate body mass index. NASH patients with fibrosis (liver scaring) are at a higher risk, therefore it is critical to identify them before disease has a chance to progress to cirrhosis or end stage liver disease and hepatocellular carcinoma (liver cancer) and associated lifethreatening outcomes. NASH prevalence and incidence will significantly increase over the next few years unless we act on time. Obesity and diabetes epidemic have provided us a sharp learning curve, and we should take those lessons seriously. If the global medical community reacted on time with obesity and diabetes and started awareness initiatives sooner, we might have slowed down their rise. We are now at that stage with NASH and global and the Middle East medical community have an opportunity to affect the change.
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Healthcare leaders sign in Dubai a Call for Action to raise awareness about ‘silent killer’ Non-Alcoholic SteatoHepatitis (NASH) or medication side effects. It is a chronic yet silent disease, which means that most patients live with it for several years without experiencing any symptoms and are mostly unaware of their liver condition. NASH can progress to more serious disease stages, such as advanced fibrosis, cirrhosis, liver failure or liver cancer, and will soon become a leading cause of liver transplant.
Dr Al Zaabi and Dr Al Awadhi sign NASH Call for Action
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regional coalition led by the Emirates Gastroenterology and Hepatology Society (EGHS), Saudi Association for the Study of Liver Diseases and Transplantation (SASLT), and European Association for the Study of the Liver (EASL) signed a Call to Action to raise awareness about a ‘silent killer’ called NASH (Non-Alcoholic SteatoHepatitis). A severe form of Non-Alcoholic Fatty Liver Disease (NAFLD), NASH is already affecting over 10% of the global population with high incidence across the Middle East. The Call for Action was announced on the sidelines of the 3rd International Hepatology Summit (IHS 2018) endorsed by the Emirates Gastroenterology and Hepatology Society, accredited by the Dubai Health Authority and supported by Gilead Sciences. This year IHS 2018 has seen over 170 international and Middle East experts convened in Dubai on October 12 and 13, 2018. Dr. Samer El-Ali, Medical Director, Gilead Sciences Eastern Europe and Middle East stated: “Due to the continuous rise of the NASH epidem-
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ic across the globe and particularly in the Middle East it was of utmost importance to build a coalition of key stakeholders, particularly best hepatology and metabolic disease experts in the region to spread awareness and help to address patients’ unmet need. Our ambition is to establish a strong consensus to drive progress and better support people affected by NASH across the region, as well as support the healthcare community in the Middle East effectively identifying and treating this widespread, sever and ‘silent’ liver disease.” Overall global prevalence of NAFLD is estimated at just over 25%, with the highest prevalence in the Middle East reaching almost 32%, while NASH prevalence among NAFLD patients reaches almost 60%. NASH is closely related to the triple epidemic of obesity, pre-diabetes, and diabetes, and can be defined as the liver manifestation of the metabolic syndrome. It is heavily influenced by lifestyle (e.g. chronic excessive calorie intake, sedentary activity) and is distinct from other fatty liver diseases caused by alcohol abuse
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Dr Maryam Al Khatry, President of the Emirates Gastroenterology and Hepatology Society, and one of the leaders of the coalition stated: “Non-Alcoholic Steatohepatitis patients with fibrosis have a higher risk of progression to cirrhosis, end-stage liver disease and hepatocellular carcinoma (liver cancer). Therefore, it is critical to resolve NASH in NASH patients with fibrosis before it has a chance to lead to cirrhosis or cancer and associated life-threatening outcomes. To achieve this, it is our role to lead the awareness and education efforts to early identify patients at risk of progressing to most advanced stages of NASH, such as obese patients, diabetes patient and those suffering from other metabolic disorders, and educate them to adopt a healthy lifestyle based on weight loss to reach the appropriate body mass index.” The Summit also discussed recent updates and developments in the fields of hepatitis C virus (HCV) and hepatitis B virus (HBV). An estimated 170 million people are infected with hepatitis C virus (HCV) worldwide. The Middle East and North Africa (MENA) region has the highest prevalence of HCV infection in the world, affecting more than 20 million people in Arab countries. However, HCV is curable if people are screened,
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diagnosed and treated. World Health Organisation has put clear targets to scale up testing efforts to ensure that 90% of those with hepatitis C are aware of their condition, and that 80% of them are treated by 2030. Dr. Mohamed Al Zaabi, Consultant Transplant Hepatologist and Gastroenterologist Zayed Military Hospital, Abu Dhabi stated: “Many people are often faced with barriers to testing and linkage to care. These barriers often include lack of awareness, knowledge and understanding that can lead to stigma and discrimination. Therefore, focused testing for most affected populations such as people who inject drugs, people who were born between 1945 and 1965, individuals transfused before 1992, sexual partners and close family of people who are hepatitis C positive, and healthcare workers would lead to the solution of the problem. Success is possible if the access to HCV testing is increased and more people get tested.” To support screening and HCV elimination efforts in the UAE, Dubai Health Authority (DHA) announced in July the inclusion of free screening and treatment for Hepatitis C under
the basic benefit plan of the Dubai Mandatory Health Insurance Scheme. In addition, ‘Ready to Be Hepatitis C Cured’ campaign run by EGHS and MOHAP, and supported by DHA was launched in March, in the effort to raise awareness about the hepatitis C and provide better disease management solutions to the patients and their families, with the ultimate goal to eradicate hepatitis C in the UAE. Out of all viral hepatitis deaths, approximately 47% is attributed to Hepatitis B (HBV) For some patients, chronic HBV is a lifelong disease that requires long-term or potentially indefinite therapy. Because chronic HBV endures, management of the condition must account for the changing needs of patients. Therefore, the experts at the International Hepatology Summit focused on evolving epidemiology of HBV patients as well as added value of the latest therapies in the treatment of HBV and current treatment guidelines. Dr. Sameer Al Awadhi, Consultant Gastroenterologist, Rashid Hospital and Emirates Specialty Hospital said: “People with chronic HBV are at risk for developing comorbidities, including diabetes, metabolic syndrome, and renal and bone conditions. One
Dr. Maryam Al Khatry of the most advanced medicines for treatment is tenofovir alafenamide, which treats chronic HBV in adults with stable liver disease and may lower the amount of HBV in the body as well as improve the condition of the liver with the high safety profile.” Hepatology leaders at the IHS 2018 shared insights and best practices for optimizing the disease management. Experts from across Middle East had an opportunity to exchange knowhow and challenges with some of the world’s leading hepatologists. By creating a continuous medical education platform that empowers local, regional and international hepatology experts to connect and exchange ideas, Gilead Sciences reaffirms its commitment to the Middle East and educational efforts for healthcare professionals in the field of Hepatology.
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TSV Introduces Integrated Healthcare Facilities Management Services
T
SV, an Alliance of three well-established UAE-based companies, TAHPI, Strive Facilities Management and Voltas (TSV) has unveiled an innovative suite of Integrated Facilities Management services focused on the Healthcare sector in the UAE. The United Arab Emirates (UAE) is rapidly expanding and improving its healthcare infrastructure as it aims to become a favoured destination for Medical Tourism. Healthcare operators and new investors seek financially sustainable business models to provide high-quality healthcare. There are significant competitive forces within the healthcare industry putting pressure on profit margins. The cost of every aspect of healthcare is increasing year by year. Healthcare operators are looking for greater efficiency in every aspect of the business. Success depends on good healthcare outcomes. Therefore, funds
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need to be focused on frontline experienced staff, cutting-edge equipment and efficient models of care. This leaves the challenge of managing the facilities and equipment which enable the healthcare functions. The answer is Integrated Facilities Management (IFM) thus enabling operators to focus on Healthcare. TSV will provide IFM to healthcare facilities of all types from hospitals to clinics and medical centres. Operators can fully outsource the Facilities Management to TSV. TAHPI is widely known as the A to Z of Health Planning, Design, Due Diligence, Compliance Audits as well as the author of numerous healthcare standards and guidelines.
including reactive and preventive maintenance of all MEP systems, energy management, retrofitting and refurbishment. Together, TSV brings certainty and confidence combined with guaranteed service and price. The TSV mission is to Save Money, Increase Efficiency and Improve Outcomes.
The services provided by TSV include: • •
• •
Strive covers all aspects of Soft FM including Concierge services, Cleaning, Security, Laundry, Catering, Repairs and Property Management Voltas specialises in Hard FM
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• • •
Hard and Soft FM services. Reactive and Preventive maintenance of MEP systems * Facility upgrades and authority approvals. Concierge, security and cleaning services. Laundry and Catering services. Energy management services. Tenancy management. Compliance audits. Housekeeping.
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