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Issue 50 / 160 JAN-FEB 2020

THE ARAB HOSPITAL APPLICATION IS AVAILABLE

Beyond Healthcare. Experience the difference at Clemenceau Medical Center, now in Dubai.


Publisher Arab Health Media Communication

Arab Health 2020 A leading health platform and window to a healthy world The Arab Health Exhibition and Congress 2020 is the leading healthcare event that will take place in the new year. It is the largest gathering of healthcare companies, technology, products and services in the MENA region. This year, the exhibition will allow its visitors to interact with a large group of the top international companies, and to communicate with large numbers of healthcare professionals from across the region. This year, Arab Health will address the exacerbation of asthma in the Middle East and North Africa as part of the “Emergency Medicine Conference”, where it will host more than 250 companies to showcase the latest technologies related to the respiratory system, and will include the best ventilation solutions, oxygen and nebuliser masks, as well as ICU ventilation. In addition to the Emergency Medicine Conference, a total of 13 Continuing Medical Education (CME) conferences and one educational forum will take place during the four-day Arab Health Congress. More than 5,000 delegates are expected to attend popular returning tracks including Obs & Gyne, Diabetes and Total Radiology, as well as eight new conferences and a Healthcare Investment Forum, amongst others. An anticipated 4,250+ exhibitors from more than 64 countries and 55,000 visitors are expected to attend the 2020 edition of the show. As usual, “Hospitals” and “The Arab Hospital” magazines will be following Arab Health as they will take part in it and will cover its work and sessions. On this occasion, we would like to wish all the success for this major event and all endeavors to develop the health sectors in our Arab world. The Publisher

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

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

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

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Clemenceau Medical Center in Dubai

NEWS 16 SEHA cements its commitment to matching UAE healthcare with international standards 18 Looking toward a healthier Abu Dhabi for current and future generations with Malaffi 30 A new award for LAU Medical Center-Rizk Hospital 46 8th Pan Arab Human Genetics Conference Hosts a public lecture by Prof. Rana Dajani 54 WCM-Q explores law and ethics of stem cells and AI in medicine

FEATURES 74 CONGENITAL AND ACQUIRED HEART DISEASE IN

86 Outpatient Medication Dispensing 62 GE Healthcare Receives FDA Clearance of First Artificial Intelligence Algorithms 70 Increasing marketing value with a sharper focus on medical imaging 80 A Global Destination for Advanced Pediatric Care 84 Safe Time for Patients: Increase the Quality of Care with the LINET SafetyMonitor 88 Every bed in view with Stiegelmeyer Blue Bridge 90 Obstetrics & Gynecology Department at Al Ahli Hospital 92 Sysmex joins the fight against AMR 104 Sleep Disorders and Their Treatments at Hôtel-Dieu de France 116 HPV Vaccine

CHILDREN 86 Smart Beds 94 Cancer 102 sleep apnea 106 Artificial Intelligence 112 Internet of Healthcare Things 120 DEEP BRAIN STIMULATION

INTERVIEWS

ARTICLES

MEDICAL INSTITUTIONS

48 UAE Ministry of Health: Leading on Automation in

58 Acıbadem Healthcare Group Turkey

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32 Dr. Mounes Kalaawi 42 Andre Daoud 64 Mark Stoesz 66 Carine Haddad 82 Jitka Stranska 98 Professor Marwan Ghosn


An upstart on the global stage. A consistent leader in the U.S. We know children deserve the best possible care, in a safe and welcoming environment. Here in Columbus, Ohio, we have it all: world-class cultural attractions, cuisine and entertainment and — most importantly — pediatric specialty care that makes us a leading destination for patients from around the world. Our innovative research and dedicated health care team develop internationally recognized programs. From hosting a worldwide clinical trial consortium for childhood neuroblastoma to renowned gene therapy research aimed at making neuromuscular disorders a thing of the past, we aim to provide the highest level of expertise and care for our patients. Reach out to our Global Patient Services team to learn more about our unique combination of a welcoming city and remarkable care. Learn more, refer a patient or plan a trip: NationwideChildrens.org/Global-Patient-Services GlobalPatientServices@NationwideChildrens.org +1 614 362 9127 Nationwide Children’s Hospital, Columbus, Ohio - USA

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AMERICA’S SECOND

LARGEST CHILDREN’S HOSPITAL

* Based on CHA survey of utilization and financial indicators


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CLEMENCEAU MEDICAL CENTER IN DUBAI

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oday Dubai is considered one of the important destinations for investment in healthcare due to the rising medical tourism sales in the UAE which have increased 5.5% year-over-year to reach 12.1 billion in 2018 with growth supported by a number of government-led initiatives and the rising number of medical travelers in the country.

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In addition, key factors are supporting this growth trend including new medical travel initiatives implemented by government entities in support of the 2021 vision and in-

creasing privatization of the sector in the form of investment and the building of state-of-the-art health facilities. Clemenceau Medicine International (CMI) is following a targeted course of

expansions, launching hospitals and medical centers in major regional city centers and destinations to develop a network that delivers accessible quality healthcare to the community.

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“A STATE-OF-THE-ART MEDICAL CENTER DESIGNED TO OFFER PATIENTS THE MOST INNOVATIVE TREATMENTS AND TECHNOLOGIES AVAILABLE IN THE REGION, IN A SAFE AND COMPASSIONATE ENVIRONMENT”

Therefore, Clemenceau Medical Center is set to launch in Dubai by a group of investors composed of Khansaheb Investment, Dubai Investment, and Clemenceau Medical Center Beirut for the ultimate goal of providing quality healthcare services. Clemenceau Medical Center in Dubai is located in Dubai Healthcare City Phase 2 Al Jaddaf and is considered one of the major hubs of the Clemenceau Medicine Network that is currently composed of CMC Beirut, CMC Riyadh and CMC in Dubai Healthcare City (DHCC). CMC in DHCC is a state-of-the-art medical center designed to offer patients the most innovative treatments and technologies available in the region, in a safe and compassionate environment. Our patients will be amongst the first to benefit from avant-garde treatments and technologies within a 100-bed setting that provides all the essential health services required through a person’s lifetime. CMC houses all specialties and Centers of Excellence including but

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not limited to Digestive Disease & Liver Center, Orthopedic Surgery, Eye Center, Mother & Child Center, IVF & Fertility Clinics, Pediatric Unit, Neonatal Intensive Care Unit, Plastic Surgery, and Hematology/Oncology. The hospital is fully equipped with advanced medical technologies at all departmental levels, but it is important to mention the Imaging & Radiology Center that is equipped with the latest digital imaging systems available to provide progressive diagnostic and interventional procedures to our patients with less exposure to radiation and faster results due to the IT systems set in place. Moreover, the Digestive Disease & Liver Center offers comprehensive clinical services in the diagnosis, treatment, and prevention of gastrointestinal tract, pancreatic, and liver disease. The endoscopy suite is designed, equipped and staffed to provide excellent patient care and offer advanced procedures such as Endoscopic Ultrasound. Additionally, a wide range of non-endoscopic and gastrointestinal and liver procedures


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are performed in the unit and is supported by a powerful department of surgery and specialists for surgical treatment of digestive and gastroenterological, liver, gallbladder, and colorectal diseases and cancer. In addition, CMC in Dubai has built and equipped the most modern Operating Theaters in the world, complemented by advanced laparoscopy and OR automation systems, which in turn provide real time video teleconferencing from any operating theater with the rest of the CMC hospitals that compose the Clemenceau Medicine Network.

technologies developed for diagnostic and interventional procedures and treatments. The center is also supported by the Cardiac Care Unit. Following its mission of providing its patients’ excellence and safety in care, CMC in Dubai has invested in a total laboratory automation system that provides the power and flexibility to meet the needs of the laboratory, both today and in the future. The fully automated lab maximizes efficiency by providing consistent, predictable sample management and helps

improve patient care by minimizing opportunities for error. The Centralized Core Laboratory is supported by comprehensive laboratory IT solutions and diagnostic disciplines such as hematology, biochemistry, immunohematology, serology, microbiology, etc. for the ultimate goal of enhancing patient services and safety. On a pharmaceutical level, the demand for reliable and flexible prescription dispensing services has brought about many improvements in the area of pharmacy automation. By installing

Our doctors, many of which are international experts, have extensive experience in treating every kind of illness including but not limited to Surgical Oncology, Neurospine and Orthopedic Surgery, Urology, Cardiovascular and Thoracic Surgery, Laparoscopic Surgery, Colon & Rectal Surgery, Plastic Surgery, Ophthalmology, and ENT. Furthermore, our Intensive Care Unit (ICU) is equipped with state-of-the-art equipment and intensivists who conduct multidisciplinary rounds to our patients. Our Heart Center offers our patients comprehensive diagnostic and treatment services. This includes our cardiac laboratory that performs a multitude of non-invasive and semi-invasive diagnostic tests, using state-ofthe-art equipment; in addition to the most advanced electrophysiology (EP)

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“ON A PHARMACEUTICAL LEVEL, THE DEMAND FOR RELIABLE AND FLEXIBLE PRESCRIPTION DISPENSING SERVICES HAS BROUGHT ABOUT MANY IMPROVEMENTS IN THE AREA OF PHARMACY AUTOMATION. “

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a customized automated systems, our flexible pharmacy automation solutions combine innovative technology and analytics that easily integrate with our operations to deliver medication accurately, safely, and on time.

the Clemenceau Medicine Network to consult amongst each other and continue their medical education through lectures and joint scientific meetings with Johns Hopkins Medicine International.

Our doctors, many of which are international experts, have extensive experience in treating every kind of illness. CMC supports our doctors by making it easy for them to work together and by providing the best personnel, facilities and technology to help them deliver premium care on a daily basis. CMC’s policy is to foster teamwork, encouraging doctors within

Our patients will be the first to benefit from avant-garde treatments and technologies. Beyond the medical field, our patients enjoy first class services, in a 5-star hotel ambiance with spacious furnished rooms, suites and comfortable waiting areas including 1 Royal Suite, 3 Presidential Suites, and VIP suites. Our International Patient Services offer a complete


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scope of services for patients visiting the hospital from abroad. Our staff is available to coordinate all aspects of a patient’s stay, such as the management of medical consultation and hospital admission, travel and hotel arrangements for the patients and their families, and medical second opinion and remote consultations via telemedicine with all CMC hospitals that compose the network and Johns Hopkins Medicine in the USA. CMC also offers several customized wellness programs for continued health and well –being. The programs are designed to target, reduce and eliminate health risks by early detection and counseling on the person’s lifestyle, where preventive measures can be taken to avoid the progression of any disease. Our Premiere Executive Health Check is planned to help busy executives manage their health and fit a proper healthcare screening program within 1-2 days. Our programs guarantee an experienced team of world-renowned specialist, cutting-edge technology, personal services and strict confidentiality. The importance of CMC in Dubai is in the quality care it provides. In addition to the state-of-the-art facilities, we bring to the healthcare sector 15 years of service excellence and personalized healthcare culture, and access to high quality advanced healthcare and expertise from the Clemenceau Medicine Network.

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Saudi German Hospitals Group named Diriyah Season 2019’s official health partner

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audi German Hospitals (SGH) Group is proud to be the official health partner of Diriyah Season 2019. With this, SGH and its team of experts will look after the wellness and wellbeing of all participants and visitors during the month-long event.

Makarem Sobhi Batterjee, President, SGH Group, said: “We are proud to serve as the official health partner of this year’s Diriyah Season, which demonstrates our commitment towards supporting the efforts of the Saudi Government to hold safe and successful national events. Visitors from all over the region and the world flock to Saudi Arabia to experience Diriyah Season. As SGH, we take the responsibility of providing them with quality medical care to ensure a safe environment.” ” He added: “During this year’s event, we will deploy mobile medical units with modern first-aid facilities to meet the emergency needs of our visitors and participants. Our doctors and medical specialists will be on-hand to provide medical care at these units. Diriyah Season will also be an opportunity for us to promote and increase public awareness about health and safety.”

SGH has been continuously proving itself as a genuine advocate for spreading knowledge and helping individuals lead a healthy life, through its regular participation in local events. With its high industry standing, the Group is considered to be one of the best and largest healthcare networks in Saudi Arabia -- covering various regions in the country such as Jeddah, Riyadh, Aseer, Madina, Hail, and recently Dammam. The SGH Group is also a proud supporter of Jeddah season and Soudah season, which demonstrates the large network that the group has across the kingdom and reflects its strength as key health and medical supporter across all of Saudi Arabia. In choosing the Group as their official health partner, the organizers commended the hospital for its continuous innovation in the medical field and proven track record in health and wellness excellence.

Health Promotion Department in Sharjah reveals health strategy for 2020

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ith 2020 being a year of preparations for the next 50 years, Sharjah has charted out a comprehensive plan that aims to maintain the emirate’s reputation as “an oasis of healthy life”, officials and industry leaders announced. The Health Promotion Department (HPD) of the Supreme Council for Family Affairs, along with its associations, revealed a host of new initiatives that will be implemented this year. Raising awareness to pre-

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vent diseases and encouraging more people to adopt healthy lifestyles are the key focus of activities. “This year’s programmes rely on new, innovative awareness methods to reach all society segments and age groups,” said Iman Rashid Saif, director of the HPD. Strategic efforts will include conducting more field visits and strengthening the health department’s presence in major events and festivals, Saif added. “The department is doing its best to maintain Sharjah’s reputation as an oasis of healthy life.”

Among the initiatives announced were the ‘Hilal Al Seha’ for Ramadan the ‘health and tourism’ drive that will focus on nutrition in partnership with dining outlets. Other events include a ‘walking hour’; a short film competition; a health conference; and a forum where the latest research on joint and bone diseases shall be revealed. Breastfeeding Friends Association will also carry out more than 20 initiatives, including workshops and a ceremony to honour nursing mothers.


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SEHA cements its commitment to matching UAE healthcare with international standards Ten hospitals and 28 primary healthcare centers under the management of SEHA have received Joint Commission International (JCI) Accreditation ing up to welcome the JCI surveyors back for re-accreditation in 2020 as they approach their three-year mark.

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bu Dhabi Health Services Company (SEHA), the largest healthcare network in the United Arab Emirates, has advanced its mission to provide the community with worldclass care by successfully implementing a health system based on the highest international standards and continuing to receive accreditation from global healthcare accreditation organizations, like the Joint Commission International (JCI). SEHA is one

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of the largest healthcare providers in the region, managing 13 hospitals and close to 45 primary health services, almost all of which have received JCI accreditation since 2006. Al Sila Hospital, which launched in 2015 and is situated in the western region of the UAE, is the latest facility managed by SEHA to receive the JCI three-year accreditation. Other accredited SEHA facilities, like Sheikh Khalifa Medical City ,and Al Mafraq Hospital, are gear-

Celebrating the addition of Al Sila Hospital to SEHA’s long list of internationally-recognized facilities and centers, Rashid Al Qubaisi, Deputy CEO of SEHA, said: “Building a safe, sustainable and cohesive community is one of the most important priorities to the government, under which falls the vital role of keeping citizens, residents and visitors healthy and well. We are wholly committed to bringing the world’s highest standards of healthcare to the UAE’s doorstep through the optimum accreditation of all our facilities.” JCI is an accrediting body that aims to improve patient safety and quality of healthcare across the globe by promoting rigorous standards of care and providing solutions for achieving peak performance, focusing on the quality of clinical services, patient safety, and clinical care.


Early Mobilization with LINET Easier patient care for ICU caregivers

Integrating the advanced features of a LINET bed into the Intensive and Critical Care Environment can help simplify an Early Mobilization program. All these features are standard on LINET beds, which can improve utilization and compliance. — ALT therapy

— Lateral Tilt

— Orthopnoeic Chair

— Reverse Trendelenburg

— 30° STOP

— Mobi-Lift®

Discover our solution at Arab Health 2020 in booth H4.G50

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Looking toward a healthier Abu Dhabi for current and future generations with Malaffi

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hether from lifestyle gadgets or medical devices, data is driving healthcare delivery across the world. To utilise this vast amount of healthcare data, the Department of Health - Abu Dhabi (DOH) and Injazat Data Systems launched Malaffi, the region’s first Health Information Exchange (HIE) platform as a Public-Private Partnership. This is a significant milestone for the Emirate and industry, as a patient’s medical information is critical for making well-informed decisions, and ultimately improving quality of care and patient outcomes. Previously, providers recorded patient’s information in their electronic medical records (EMR) systems, which meant patient information remained in silos within the boundaries of each provider’s EMR and were not available to other providers. Malaffi, as an Emirate-wide initiative, will safely and securely connect all public and private healthcare providers in the Emirate of Abu Dhabi, enabling them to meaningfully and in real-time exchange

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important patient health information, ultimately creating a centralised database of unified patient records. Malaffi will connect. Through Malaffi, there are unmatched opportunities for providers and the industry to improve care in a way that has never been feasible on such a scale before. Speaking about Malaffi, H.E Mohammed Hamad Al Hameli, Undersecretary of the Department of Health - Abu Dhabi, said: “We are firmly committed to providing the very best healthcare solutions and technologies to the people of Abu Dhabi. In line with our future-forward vision, we are proud to see a series of milestones for Malaffi in its journey to utilise technology to improve patient outcomes. This is a shared goal across the Emirate, evident through the active participation of leading healthcare providers, both private and public, to adopt the new Malaffi system. We look forward to more milestones in the coming months as we create a better-connect-

ed healthcare system and ultimately a healthier Emirate.”   Atif Al Braiki, the Chief Executive Officer of Abu Dhabi Health Data Services, the operator of Malaffi, added: “As the dynamics of our healthcare landscape continue to evolve - from our growing and aging populations to the rising prevalence of chronic conditions - the needs of our doctors and patients are changing. An HIE platform will allow providers to source crucial healthcare data to ultimately improve care coordination and allocate healthcare resources more efficiently. It has been great to see so many key players come together across the healthcare sector to elevate healthcare quality and patient outcomes across the Emirate. We are looking forward to a more collaborative and technology-focused future to continue to support and drive worldclass care across Abu Dhabi.” To date, more than 1,700 health-


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care facilities have joined Malaffi, out of which around 350 have already onboarded the platform, and approximately 15,500 users from those facilities have access to Malaffi, which contains about 38 million patient records for 3 million patients. Some of the providers that have already onboarded Malaffi include Abu Dhabi Health Services Company (SEHA), United Eastern Medical Services (UEMedical) group, Mediclinic Al Noor Hospital and Kanad Hospital (formerly known as Oasis Hospital). Many other providers are in the onboarding pipeline and will be able to utilise Malaffi very soon. Commenting on Malaffi’s achievements, Dr. Charles Alessi, Chief Clinical Officer, HIMSS International, said: “What Malaffi has achieved to date is both inspiring and impressive. One of the most significant accomplishments has been the speed of implementation and onboarding. Abu Dhabi has established itself as a great example of adopting an HIE platform promptly and successfully to improve patient outcomes.” Malaffi brings together key patient information, including; patient demographic information, medication, allergies, laboratory and radiology results, procedures and all medical interactions, from consultation to emergency treatment. This provides a myriad of benefits to providers, patients and the general public in the following ways.

Empowering providers with data Medical professionals are on the

frontline of delivering healthcare and increased efficiencies can dramatically improve patient outcomes, such as: Reduced medical errors. With 80% of serious medical errors involving miscommunication between healthcare providers during the transfer of patients from one provider to the next1, Malaffi will enable providers to access all the health information they need which can reduce error and misdiagnosis. Reduce duplication. Providers will have more information about their patients than ever before. As such, they are now able to reduce the unnecessary duplication of diagnostic and treatment procedures. Increased efficiency. Better communication and reduced duplication increase efficiency, patient experience and satisfaction. For example, in the US, the implementation of a HIE system resulted in a 12% reduction in consultations by multiple physicians, a 7% reduction in the emergency department length of stay, 4.5% reduction in readmission odds within 30 days2, and a 25% decrease in the odds of imaging procedures being repeated3. Workforce satisfaction. By empowering providers through access to comprehensive and timely health information, Malaffi will assist in reducing stress and the time spent on administrative tasks so that doctors can have more face time with their patients.

Enhancing the patient experience Visiting a doctor can be physically and emotionally challenging for many patients. Patients often have to

undertake unnecessary tests, multiple doctor visits and repeat procedures for the same health issue. This is often due to the non-availability of past patient health information such as test results or diagnoses, which are not shared between healthcare providers and remain inaccessible to the attending doctor and care team. Through Malaffi, patients can rest assured that their provider has all their necessary health information, which will ultimately reduce stress for patients and their loved ones, and importantly improve their patient experience from the start to the end of their journey. Malaffi will also improve patient safety by reducing the risk of medical and medication errors. It will enhance the patient journey for those with chronic or malignant diseases who need to see multiple doctors regularly by ensuring providers have access to all the data necessary to best coordinate care.

Providing access to patients To help patients better manage their health, soon, Malaffi will be launching a patient mobile application. Through the app, patients will have access to their medical information at their fingertips and check their Malaffi file anytime, anywhere, even if they are travelling. Thanks to its patient-friendly interface, the app will engage patients in their care, support prevention and ultimately increase patients’ health literacy. Malaffi will be providing a sneak peek of the app at this year’s edition of Arab Health, exhibited at Malaffi’s stand which is located within the DOH stand (Hall 5, H5.B10).

REFERENCES 1. Joint Commission - https://www.jointcommission.org/assets/1/6/tst_hoc_persp_08_12.pdf 2. Janakiraman, R. et al. (2017) The Effects of Health Information Exchange Access on Healthcare Quality and Efficiency: An Empirical Investigation. Mays Business School Research Paper No. 2915190. 3. Vest, et al (2014), Health Information Exchange and the frequency of repeat medical imaging, Am. Journal of Managed Care, 20: 16 –24

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Sultan Bin Abdulaziz Humanitarian City State-of-the-art services in medical rehabilitation according to the latest medical devices and equipment "Helping people to help themselves" Sultan Bin Abdulaziz Humanitarian City is the largest medical facility in providing all specialized services in the field of rehabilitation in the Middle East region. It spreads over 1,200,000 square meters and is located in Banban, north of Riyadh. It was officially inaugurated on October 30, 2002.

gram, the Amputee Rehabilitation Program, the Pediatric Rehabilitation Program, the Spinal Cord Injury Rehabilitation Program, the Brain Injury Rehabilitation Program, the Outpatient Rehabilitation Program and the Integrated and Comprehensive Rehabilitation Hypnosis Programs.

City Mission

Treatment Program By Riding Horses

The medical City’s noble mission is “Helping people…To help themselves”; it has succeeded in serving the people and has made numerous accomplishments on the medical level. Many patients were able to return to their normal life thanks to Allah, then the medical care and treatment plans carried out by the City’s multidisciplinary medical rehabilitation team.

A treatment program by riding horse is used as a way to help improve muscle movement and increase blood circulation. It is based on teaching children sensory-motor skills in order to acquire torso control, prevent tensile damage to the muscle tendons, improve balance and strengthen muscles in the body, boost self-confidence and the ability to feel the risks.

City Vision

Home Healthcare Program

To be a well-known organization in rehabilitation, and to contribute and spread the medical care in Saudi Arabia to achieve the excellence of the global level.

The Home Healthcare Program works to meet the increasing need for treatment and specialized care that takes place in the patient’s home. It was specially designed for patients who need continuous home care, and was developed in order for those patients to have access to home care coupled with long-term rehabilitation medical needs. It also provides an opportunity to provide a highly developed rehabilitation to the patient in his home.

City Services The City provides state-of-the-art services in medical rehabilitation using the latest medical devices and equipment for children and adults. It has a capacity of more than 511 beds providing excellent medical care for patients under the supervision of highly experienced medical staff as more than one million case benefited from the City’s programs.

Rehabilitation Programs The specialized rehabilitation programs implemented by the Sultan Bin Abdulaziz Humanitarian City have been accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF) since 2008 and include the Stroke Rehabilitation Pro-

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Child Development Center Child Development Center aims to meet the developmental and health needs of children with special needs. The three pillars of services provided by the Child Development Center are medical, rehabilitation and developmental services. The Medical services are essential for providing assessment, diagnosis and consultation, while rehabilitation services focus on reducing disability and increasing functional independence.


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Prince Sultan Bin Abdulaziz Center for Artificial Extremities Prince Sultan Bin Abdulaziz Center for Artificial Extremities, specializes in the preparation, manufacture and maintenance of prosthesis and orthosis, in cooperation with the leading German company Ottobock.

Advanced Surgery Center • • • • • • • • • • • •

Bone surgery and joints Joint and knee replacement Replacement surgery for pelvic joints Spinal surgery Shoulder surgery Foot surgery Neurosurgery Obesity surgery Otorhinolaryngology Urinary surgery Surgery for sports injuries Dental and Orthognathic Surgery

International Awards Sultan Bin Abdulaziz Humanitarian City has won several international accreditations and awards, including CARF and JCI since 2008 to date as well as HIMSS Stage 6 for the application of quality standards in electronic health information systems. The City received the “Best Work Environment” award on December 14, 2014, the Excellence in Patient Safety Award - Arab Health 2011, the Best Healing Environment Award – Al Binaa Hospital 2010, Best Education Initiatives Award - Arab Health 2009, Best External Design Award - Hospital Build Exhibition 2009, annual organization of international conferences, and the Saudi Central Board for Accreditation of Healthcare Institution (CBAHI).

Sultan City Medical Center Sultan City Medical Center provides the highest health standards of medical care and rehabilitation services with the help of highly qualified multidisciplinary team. The center aims to create a different and distinctive patient experience from the start of the treatment to its end. Sultan City Medical Center is considered an extension to Sultan Bin Abdulaziz Humanitarian City’s mission which is helping people to help themselves. The Center also provides a comfortable and safe environment for patients by providing medical, surgical and rehabilitation services to all segments of the society. The Center is located in Riyadh, covers 3,025 square meters and consists of four floors.

It includes the following clinics and specialties: 1. Physical Medicine and Rehabilitation. 2. Surgery (obesity, orthopedic, spine). 3. Dental clinic. 4. Audiology Clinic. 5. Optics Clinic. 6. ENT Clinic. 7. Cardiology Clinic.

8. Neurology Clinic. 9. Psychiatry Clinic. 10. Gastroenterology Clinic. 11. Internal Medicine Clinic 12. Physiotherapy and rehabilitation GYM for adults & children. 13. Radiology Department. 14. Emergency Department.

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Opened by HE Sheikh Nahayan Mabarak Al Nahayan, UAE Minister of Tolerance:

IVF Conference concludes in Abu Dhabi on a high note with over 350 experts gaining insights into the latest in Reproductive Medicine

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old Certification for Excellence in Person-Centered Care represents the highest level of achievement The 5th Annual In-Vitro Fertilization (IVF) Conference was opened (November 15th) in Abu Dhabi by HE Sheikh Nahayan Mabarak Al Nahayan, UAE Minister of Tolerance. Top regional and global fertility experts came together at the Bab Al Qasr, Abu Dhabi for this world-class conference organized by the world leaders in Reproductive Medicine – IVI Fertility. The conference is the largest, one of its kind in the Middle East and focuses on showcasing the latest in the Assisted Reproductive Technology (ART) treatments and how these innovations and scientific breakthroughs can help address the growing problem of infertility. Titled the ‘Latest Advancements in Enhancing Success Rates in ART, Anno 2019,’ the event hosted by IVI Middle East Fertility Clinic, witnessed participation from over 350 OB-GYN specialists, embryologists, nurses and IVF technicians. Fourteen international speakers from various countries presented the latest advancements in several areas of Reproductive Medicine, including Pre-implantation Genetic Testing, Gene Editing, Ovarian Stimu-

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lation, Impact of Vitamin D deficiency and Intracytoplasmic Sperm Injection. Addressing the conference, His Excellency Sheikh Nahayan Mabarak Al Nahayan said: “I endorse your premise that physicians in the field of fertility and human reproduction must practise their profession at the highest international standards of skill and knowledge and that continuing education is essential in view of the rapid advances in the field.” “I admire your conviction that your success depends on superior medical personnel and first-rate health facilities, as well as on knowledge and awareness of the latest research developments and treatments in addition to building national, global and international alliances and partnerships,” he added. “I am confident that your conference will prove to be a major regional and international venue for advancing knowledge of cutting-edge practices in IVF/ART. And I must say that Abu Dhabi provides a highly supportive environment for your work. Under the leadership of the president, His Highness Sheikh Khalifa bin Zayed Al Nahayan, and with the guidance and strong support of His Highness Sheikh Mohammed bin Zayed Al Nahayan, Crown Prince of Abu Dhabi and the

Deputy Supreme Commander of the Armed Forces, Abu Dhabi has a worldclass health care system, with a clear focus on diagnosis, treatment, and public education. Regarding fertility treatments, Abu Dhabi is committed to having the most advanced technologies, and to implementing the most effective treatments and cures. Your conference is an important indication of the strength of the commitment of the United Arab Emirates to excellence in health care.” “I am pleased that your conference has a clear sense of purpose and a high quality of presentations, discussions and professional activities. It is my sincere hope that you will be successful in achieving all your goals and objectives,” HE Sheikh Nahayan concluded. Prof. Dr. Human Fatemi, Subspecialist in Reproductive Medicine and Medical Director of IVI Middle East Fertility Clinics, welcomed the attendees at the conference and gave a short introduction. “During the conference, we examined the major studies and breakthroughs of infertility treatments globally. The attendees also took the opportunity to seek knowledge on the best industry practices in Reproductive Medicine, engage with the distinguished speakers and network with some of the world’s best specialists in the fertility health landscape. Apart from studying the latest industry trends and developments, especially in relevant technological innovations, we also looked into the opportunities and challenges in this field. The idea is to gather enough knowledge in the hope of helping couples who are struggling to conceive,” Prof. Dr. Fatemi said.


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A new award for LAU Medical Center-Rizk Hospital The World Allergy Organization (WAO) awards Dr. Fares H Zaitoun a Special Recognition Award for his “outstanding contribution to the field of allergy, asthma and immunology”

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AU Medical Center-Rizk Hospital announces that Dr. Fares H. Zaitoun Clinical Assistant Professor, Allergy/Immunology has received a Special Recognition Award from the World Allergy Organization (WAO) during its annual World Allergy Conference on December 11-14, 2019 in Lyon, France. This award is in recognition of his “outstanding contribution to the field of allergy, asthma and immunology”. Receiving this award, further confirms and reinforces the mission of LAU Medical Center-Rizk Hospital to pursue high-quality medical practice, research and innovation.

Dr. Fares H. Zaitoun declared being “truly honored and humbled by this recognition and privileged to represent Lebanon and the academic excellence of Lebanese institutions such as LAU Medical Center-Rizk Hospital”. The annual World Allergy Conference attracts between 2,000 and 5,000 experts and scientists working and interested in the fields of allergy, immunology and other related fields. This award truly raises the name of Lebanon and LAU Medical Center-Rizk Hospital in the medical fields.

LAU Medical Center – Rizk Hospital performs the first-of-a-kind “iStent inject®” procedure in Lebanon!

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s part of its mission to heal with compassion and its constant pursuit to always provide its patients with the latest advances and

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technologies in the world of medicine, and with the best health and medical services, the LAU Medical Center Rizk Hospital Ophthalmology department

is proud to announce that it has performed for the first time in Lebanon a one-of-a-kind eye procedure. The procedure performed by Dr. Roland Seif, faculty member at the LAU Gilbert and Rose-Marie Chagoury School of Medicine, consisted of placing the first iStent inject® device for the treatment of glaucoma which was very successful. iStent inject® includes two tiny implants, which are the world’s smallest medical devices known to be implanted in the human body. Implanted during the cataract surgery, iStent inject® helps to restore the natural fluid flow on the patient eye and safely lowers the eye pressure, one of the most important risk factors of glaucoma, which may eventually reduce patient’s reliance on glaucoma medication.


INTERVIEW

CEO of Clemenceau Medical Center Chairman and CEO of Clemenceau Medicine International

Dr. Mounes Kalaawi “We provide an exceptional experience for comprehensive medical care”

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INTERVIEW

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lemenceau Medical Center (CMC) affiliated with Johns Hopkins Medicine International, is a state-of-the-art ultra-modern medical center located in the heart of Beirut that provides quality healthcare services within a supportive and compassionate environment. Shedding light on the main developments and accomplishments achieved by CMC in 2019, Dr. Mounes Kalaawi, CEO of Clemenceau Medical Center, Chairman and CEO of Clemenceau Medicine International, conducted an interview with Arab Hospital Magazine during which he explained the vision for 2020.

In light of the hospital’s developments and achievements, what is the new standard of excellence in medicine that CMC offers? Would you tell us about your vision for 2020? What are the main centers of excellence within the hospital? What business strategy are you adopting? Since its inception to date, Clemenceau Medical Center (CMC) strives to improve the patient’s quality of life by providing the highest levels of care. CMC has introduced a new concept of excellence in health care focused on the patient’s comfort and improving his/her hospital experience by providing advanced treatments by world class physicians within a healing hospital environment and hotelier services. Moreover, integrated patientcentered care is the foundation upon which CMC was envisioned. We focus on value and treating patients as members with the main goal of keeping them healthy. Within this model of care, multidisciplinary teams bring together the expertise and skills of different professionals to asses, plan and manage care

jointly. By providing a holistic approach to care, it enables CMC to deliver comprehensive, continuous & seamless care services across different settings. This includes enhancing patient safety, reducing medical errors, reducing patient recovery time, and providing minimally-invasive alternatives. At CMC, progressive development comes hand in hand with new technologies. And here history has shown that CMC has a long list of firsts, from being the first to introduce Robotic Surgery to Lebanon to maturing our centers of excellence; such as expanding our Heart Center to include an interventional unit with 2 cardiac catherization labs as well as expanding the Cancer Center to include Radiation, Surgical, and Medical Oncological services. In addition, to expanding our radiology department to include an interventional radiology unit that diagnoses and treats a wide variety of diseases in a minimally invasive manner. We ensure that the newest technologies are available and used by world-renowned physicians from all specialties, and fully supported

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by a strong team of nurses, technicians, and administratives as we substantially believe in team work. In addition to adopting new technologies on a medical level, we are always looking to advance our service-related technological capabilities. For instance, we continually seek new solutions that automate daily duties of physicians and clinicians in order to give them more time to practice medicine and focus on patients. By being early adopters of technologies like the Electronic Health records and Hospital Information Systems, we can improve connectivity and

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engagement amongst health partakers, health systems, health plans, and patients and families. Finally, we believe that knowledge and continuous education of our doctors and staff play a vital role in improving our services. Therefore, we actively hold conferences, workshops and training in cooperation with local hospitals and Johns Hopkins Medicine International as transfer of knowhow and knowledge are the key to sustainability.

What is the latest news at the level of global awards?

We, at CMC, take pride in the achievements we have attained, which have earned us numerous regional and international awards and certifications. This year, CMC was awarded the Language of Caring Award at the annual Johns Hopkins Partner’s Forum at Baltimore. The hospital was also ranked the number one hospital for medical travelers by MTQUA in 2019. In addition CMC was awarded the Excellence in Patient Service and Care Award for the 4th consecutive year at the IMTJ Medical Travel Summit held in Berlin. Also CMC was shortlisted


INTERVIEW

for Best Quality Initiative, Best use of Technology in Medical Travel, International Cancer Center of the Year, and International Eye Clinic of the Year.

We would like to talk about CMC’s newly installed fully automated laboratory. What is its importance? And to what extent will it provide advanced efficiency in dealing with laboratory samples?

“WE, AT CMC, TAKE PRIDE IN THE ACHIEVEMENTS WE HAVE ATTAINED, WHICH HAVE EARNED US NUMEROUS REGIONAL AND INTERNATIONAL AWARDS AND CERTIFICATIONS.”

Following its mission of providing its patients’ excellence and safety in care, CMC has invested in a total laboratory automation system that provides the power and flexibility to meet the needs of the laboratory, both today and in the future. Combined with informatics and lean principles, the fully automated lab at CMC maximizes efficiency by providing consistent, predictable sample management and helps improve patient care by minimizing opportunities for error. In an effort to reduce overall laboratory costs and improve overall laboratory efficiencies, CMC has established and implemented a centralized Core Laboratory that includes the main modalities and supported by comprehensive laboratory IT solutions to perform the laboratory testing throughout the system in a timely and costeffective fashion for the ultimate goal of enhancing patient services and safety.

What about the new EP Lab technology? The electrophysiology (EP) lab has become highly specialized over the past years, leading to the subspecialty emerging as one of the fastest growing within the cardiovascular service line. At CMC Heart Center, we introduced the most advanced EP technologies developed for diagnostic and interventional procedures, including catheter ablation, electrophysiology studies, cardiac device implantations, 3D mapping, device implantation for rhythm management, and transcatheter therapy of structural heart disease. By pairing this technology with specialized electrophysiologists and technicians, we are able to provide to our patients high quality cardiovascular care, improve clinical outcomes, reduce procedural time, and provide safe and minimally invasive solutions.

The expansion of the Radiology department is one of the most important expansions you made in 2019. What are the latest developments in medical imaging technology? What about specialists/ proficiency in the diagnosis and treatment, especially with the use of catheters and microneedles? CMC has expanded its radiology department to focus more on interventional radiology by providing the latest advances in

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imaging technology and specialists to diagnose and treat a variety of conditions using small catheters and needles. With this technology, CMC provides a range of services, including: Biopsy, Uterine fibroid treatment, hemorrhoid treatment, Kidney and liver cancer treatment, and so on. CMC’s interventional radiologists are leaders in this imageguided therapeutic revolution. With miniaturized tools and tiny catheters, they deliver precisely targeted treatment anywhere inside the body — without the need for open surgery. By doing so, they are able to destroy malignant tumors with extreme heat

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or cold, without harming healthy tissue, block the blood supply to harmful growths such as uterine fibroids, eliminating the need for hysterectomies in many women, open blocked blood vessels in peripheral disease and diabetes, biopsy tissue in areas that once required exploratory surgery, drain blockages in the liver, gallbladder, kidney and other organs. For patients, this can mean less pain and scarring, as well as a recovery measured in days instead of weeks.

Within the framework of modern treatment standards, the cancer patient receives the

latest technology and treatment methods. Would you please tell us about the importance of your cancer center in terms of treatment methods and healthcare providers? Due to the increase in the number of cancer patients in Lebanon and the region, we found it important to expand on our oncological services to offer a full-fledged cancer center. The CMC Cancer Center offers oncological treatment services with unmatched patient care and safety measures, dedicated towards meeting every step required to successfully carry out treatment all


INTERVIEW

under one roof. The center provides medical, surgical, and radiation oncology services and treatments in a state-of-the-art facility with the most advanced technologies. We also thrive to provide our patients with a compassionate and personalized care by providing all support services including but not limited to pain management and palliative care, multidisciplinary organ specialists, tumor board reviews, continuous education and research, etc.

The latest treatments provided by the CMC Cancer Center:

“CLEMENCEAU MEDICINE INTERNATIONAL IS WORKING TO ESTABLISH A NETWORK OF TOPNOTCH MEDICAL CENTERS FROM RIYADH AND DUBAI TO OTHER REGIONAL AND INTERNATIONAL CITIES, WITH THE AIM OF GATHERING EXPERTISE, HUMAN RESOURCES AND OUTSTANDING HEALTHCARE FROM ALL OVER THE REGION.”

Ocular Oncology Service: We are proud to announce that we successfully established the first adult ocular oncology service in Lebanon. In the past, removal of the eye was the only available treatment for choroidal melanoma in Lebanon. Today at CMC, we offer up-to-date treatment for choroidal melanoma and other intraocular tumors such as brachytherapy (radioactive plaques) which is used to preserve the eye and vision of our patients. Brachytherapy entails placing a radioactive plaque on the surface of the eye to directly treat the underlying tumor with minimal damage to the surrounding ocular tissues. Immunotherapy to treat advanced Breast Cancer: We use the same modern treatments that are being used in Europe and USA. At the beginning of 2019, the FDA approved the use of immunomodulators that are effective in treating patients

with triple-negative breast cancer. During that same month, we started using this highly effective treatment in Beirut which has mild side effects and enhances the patient’s immunity against cancer cells and is more effective than conventional chemotherapy. Stereotactic Body Radiation Therapy (SBRT): SBRT administers very high doses of radiation, using several beams of various intensities aimed at different angles to precisely target the tumor. SBRT begins with one or more sessions of treatment planning with advanced imaging techniques to precisely map the position of the tumor. The images are used to design a four-dimensional, customized treatment plan that determines beam intensity and positioning. The goal is to deliver the highest possible dose to kill the cancer while minimizing exposure to healthy organs.

We must talk about the regional expansions of CMC carried out by Clemenceau Medicine International. What is the reason for choosing Dubai and Riyadh? Clemenceau Medicine International (CMI) is launching hospitals in major regional city centers and destinations around the Middle East to create a network of state-of-the-art medical centers, and bring together expertise from all across the region, hence making quality healthcare accessible to the

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entire community. The network, which now consists of CMC Beirut, CMC Dubai, and CMC Riyadh and will expand to other international cities, will deliver value-based care across the region. The Clemenceau Medicine network will provide patients access to internationally accredited facilities designed to support, facilitate stateof-the-art medicine, technology, patient safety, quality patient care, as well as embrace the patient, family and caregivers in a psychosocially supportive and therapeutic environment. In addition, our patients will have access to specialized physicians and experts and will be

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able to exchange experiences and know-how via telemedicine and Medical Second Opinions without the patient having to travel. Overall, this network provides patients with greater accessibility to quality patient-centered care to help diagnose and deliver treatment. By sharing expertise, medical know-how will rapidly reach new heights, helping patients and their families’ access better treatments and improve their quality of life. Today, Dubai is becoming a new hub for medical travelers. Medical tourism sales in the UAE are increasing with growth supported by a number of government-led

initiatives of 2021 and the rising number of medical travelers in the country. Based on that, it was important for us to have a medical center in Dubai. Clemenceau Medical Center in Dubai Healthcare City is a 100bed State-of-the-Art Medical Center designed to offer patients the most innovative treatments and technologies available in the region, in a safe and compassionate environment. Our patients will benefit from avant-garde treatments and technologies since CMC in Dubai Healthcare City is fully equipped with the most modern and advanced


INTERVIEW

medical equipment. In addition, CMC will offer its patients a diversified medical team of physicians and staff with international expertise to deliver the best clinical practice under one roof. The medical center will officially start operating at the beginning of 2020. As for Clemenceau Medical Center Riyadh, the 180-bed hospital provides all the essential health services required through a person’s lifetime. The hospital will also offer patients with the most innovative treatments and technologies within a first class service, in a 5 star hotel ambiance with spacious furnished suites and VIP services. Our professional clinical staff will be trained to deliver high quality standards of care to ensure a positive patient experience at its finest. Moreover, the medical education and availability of skilled and leading Saudi Doctors will add to the appeal of the hospital and will be further enriched with the transfer of knowledge amongst the network. To summarize, what Clemenceau Medicine offers is 15 years of service excellence and personalized healthcare culture. We are bringing a decade of experience and know-how. Our patients in this region will have access to high quality advanced healthcare and share expertise from Beirut, Dubai, Riyadh and beyond through our network as well as our international affiliation with the best.

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27-30 January 2020 Dubai, United Arab Emirates

Where the healthcare world comes to do business 4,250

55,000

159

14 CME

exhibiting companies

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healthcare professional

conferences

Start planning your participation at the MENA region’s largest medical event.

arabhealthonline.com Together for a healthier world


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INTERVIEW

CEO of Medcare Hospitals and Medical Centres

Andre Daoud “Our vision for 2020 is to take Medcare Hospitals & Medical Centres to greater heights by keeping abreast of the top standards”

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edcare Hospitals and Medical Centres are always striving to improve the quality of life of patients by increasing access to professional support and cutting-edge treatment. 2019 was an exciting year full of achievements and expansions that continue in 2020 according to a vision that keeps pace with medical developments. CEO of Medcare Hospitals and Medical Centres Mr. Andre Daoud, through a comprehensive interview with ‘Hospitals’, shedded the light on the achievements as well as the future vision of Medcare Hospitals and Medical Centres.

As the new year is starting, we would like to know your vision for 2020? How will the Group keep up with the evolving developments in the medical field to provide the highest quality healthcare services? Our vision for 2020 is to take Medcare Hospitals & Medical Centres to greater heights by keeping abreast of the top standards in preventive, curative and rehabilitative healthcare, regionally and internationally. There is no doubt that digital transformation seems to have touched everything, including patient registration, smart diagnosis, self-care tools and a lot more. For many of us, the entire healthcare sector seems to be something which

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is magical; value-based care and filled with positive outcomes. Most of the technologies such as telemedicine, artificial intelligence, chatbots and data science are nowadays used across the globe. Their adoption and mainstreaming in this space will no doubt continue to increase. One can witnesses how more and more such applications are seamlessly integrating into preventive medicine to improve the overall well-being of patients in times to come. This might lead to new surgical and pharmaceutical treatments and genetic engineering to create solutions and cures for conditions which were thought to be untreatable in the past. As healthcare providers, we can feel the satisfaction of creating effective,

lasting and customised solutions for the utmost care of our valued patients.

Please highlight the latest achievements and expansions that you made in the year 2019? Medcare is always striving to improve the quality of life of its patients by increasing access to professional support and cuttingedge treatment, and 2019 was an exciting year for us. We have developed three speciality centres of excellence. The Medcare Pain Management Centre in Dubai, specialising in the management of acute and chronic pain; the Weight Management Centre in Dubai and Sharjah, supporting patients to regain control of


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their weight by following tailored weight management plans; and the Colorectal Surgery Centre, dedicated to treating patients with complex colorectal conditions using state-ofthe-art techniques. Disease management was another major highlight for our patients. In a bid to help the UAE population take better control of their lives, Medcare Hospitals and Medical Centres have adopted a Disease Management Programme, a comprehensive 12-month course that offers customised care plan for better health and well-being. The program is not just dedicated to those suffering from chronic diseases such as diabetes, but it is also aimed to prevent the development of health risks. The Medcare Disease Management Program is positioned to be a gateway to living healthier, complete with tools to improve health status and support patients in making positive lifestyle changes. Medcare has added a few medical centres to its portfolio, the flagship of which is our new paediatric centre in Dubai. It is a state-of-the-art multi-speciality paediatric clinic that is loved by children and parents alike. Our young patients will receive excellent medical treatment through some of the most popular and highly qualified doctors in the region and using the advanced technology that ensures the right diagnosis with the least time and pain. Every treatment room is created to be super fun and comfortable and tailored for

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the child’s age, and the attitude of every single staff member who loves working with children is phenomenal.

You’ve had an innovative approach and distinct skills in teamwork since you’ve been appointed in 2018. How did this reflect on business strategies and administrative processes within the group? By leveraging our teamwork skills, we managed to harness the power of synergy and engage people for exponential performance and results, which were clearly reflected in our business strategies and administrative processes. One enduring truth is that people want to make a difference. Sometimes organisations stop them. That is why facilitating a strong culture will always be the determining factor in how successful strategies perform. This is because times change, but values don’t. As a values-based organisation, everything we do at Medcare is conducted in line with our core values of integrity, passion, respect, excellence, compassion and unity.

Innovation and digitisation are what distinguish Medcare Group regionally. What are the elements of excellence in this field? And how does this affect patients in terms of prevention, treatment, or rehabilitation? Innovation and digitisation have always been a priority for us. The future of premium healthcare is

digital. We have been digitalising several aspects of our facilities, yet always keeping patient care on top of our mind. In fact, integrity is one of our top values, we embrace a higher standard of conduct, and always strive to do the right thing without any compromises. To give you an example, we have recently launched an innovative chatbot platform to engage patients and optimise access to premium healthcare. Overall wellbeing must be what we as healthcare providers should seek to achieve, with an always-on but respectful use of data and working together more collaboratively across functions to enable new realities in treatment (genome-based), proactive intervention, and improved understanding of disease progression. This new future will also be characterised by reduced delivery costs and several disease morbidities shrunk and perhaps even wiped out entirely. We at Medcare will seek to ensure that we are well-positioned to be a leading force in such a future where there are greater points of access to ensure and sustain overall patient wellbeing and to provide seamless service at the touchpoints of the patient’s choosing both infacility and on personal devices.

What about the latest diagnostic technologies? How did Medcare Group benefit from the technological development to ensure the highest levels

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of effective treatment to its patients? In today’s world, technology plays an important role in every industry as well as in our personal lives. Out of all of the industries that technology plays a crucial role in, healthcare is definitely one of the most important. This merger is responsible for improving and saving countless lives all around the world. Medical technology is a broad field where innovation plays a crucial role in sustaining health. Areas like biotechnology, pharmaceuticals, information technology, the development of medical devices and equipment, and more have all made significant contributions to improving the health of people all around the world. At Medcare, the dependence on medical technology cannot be overstated, and as a result of the development of these brilliant innovations, our healthcare practitioners can continue to find ways to improve their practice – from better diagnosis, surgical procedures, and improved patient care.

What is the extent of Medcare Group spread across the UAE? We currently have 18 establishments under Medcare in the UAE, with over 300 outstanding doctors. With extensive expansion plans in the pipeline, we aspire to make Medcare hospitals & Medical Centres a preferred referral hub for people in the UAE as well as in the MENA region.

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How does the Group guarantee the provision of integrated health services in accordance with the highest quality? Medcare is dedicated to offering premium integrated health services in accordance with the highest quality. When we say premium healthcare, we mean premium in every aspect. From talent to technology to facilities and treatment, we maintain the highest possible standards in healthcare delivery. All Medcare hospitals and medical centres are accredited by the Joint Commission International (JCI), which is considered the gold standard in global healthcare. Apart from this, our facilities have won several certifications.

“INNOVATION AND DIGITIZATION HAVE ALWAYS BEEN OUR PRIORITY.” What about the most prominent centres of excellence in the group and the high-level medical services provided by the work teams? What sets Medcare apart is its exceptional multi-cultural, multilingual team of doctors who have received extensive training from some of the top-notch medical institutes in the United States, United Kingdom, India, France, Greece, Australia, Africa and the Middle East. They take the time to listen to patients, understand their medical problems holistically, and recommend the best way to proceed.

Using a multidisciplinary approach, our team provides optimal, guideline-based treatment to patients, with the support of trained nurses, dieticians, rehabilitation therapists and technologists. Living by its simple promise “We’ll Treat You Well”, Medcare’s team is fully committed to providing high-quality, personalised medical care to every patient.

How do you evaluate the healthcare sector in the UAE? What about the government’s role in supporting this sector? The healthcare sector in the UAE has been growing and rapidly evolving over the last decade, and today it offers an extensive range of new specialised services and stateof-the-art treatments for residents. Going forward, the healthcare sector is expected to witness even stronger growth, as it is being driven and supported by government funding too. The key factors that will shape the evolution of the healthcare sector in the future are the supply/ demand dynamics, as well as regulatory changes and shifting market conditions. It’s also important to mention the growing emergence of medical tourism here in the UAE. The country is increasingly attracting international patients seeking an array of treatments from major surgery to rehabilitation and cosmetic corrections, which is considerably contributing to the growth of the sector.


NEWS

8th Pan Arab Human Genetics Conference Hosts a public lecture by Prof. Rana Dajani

Dr. Rana Al-Dajani

HE Abdullah bin Souqat

Dr. Mahmoud Taleb Al-Ali

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ers and geneticists from within the Arab World not only to network and forge collaborations with each other, but also to review and exchange information with the broader international community. It also provides constructive cooperation between the various scientists in the field of human genetics in the Arab world, which ultimately helps to promote scientific research in the Arab world”, he added.

with the progress made in the health field and to use modern technologies in order to enhance the delivery of information to workers in the medical sector within the framework of working to improve community services in the health aspect”, he added.

he Center for Arab Genomics Studies (CAGS), a division of the Sheikh Hamdan bin Rashid Al Maktoum Award for Medical Sciences, has announced the hosting of a public lecture by Dr. Rana Al-Dajani entitled: “To see what everyone sees but think what no one has thought”. The lecture will be a part of the activities of the 8th Pan Arab Human Genetics Conference (PAHGC), which will be held from 19th to 2th January 2020 at the Roda Al Bustan Hotel - Dubai. Dr. Mahmoud Taleb Al-Ali, Director of CAGS and the Chairperson of the Scientific Committee of the conference, said, “We are very glad to be organizing this public lecture on the sidelines of the 8th Pan Arab Human Genetics Conference. I believe that these sorts of lectures are vital for advancing knowledge, stimulating debate and initiating connections. We aim to make this the first in a series of public lectures aimed at popularising the field of human genetics and genomics and we are extremely fortunate to have someone as charismatic and dynamic as Prof. Rana Dajani starting this series off.” “The conference allows research-

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On his part HE Abdullah bin Souqat, Executive Director of Sheikh Hamdan bin Rashid Award for Medical Sciences conveyed his sincere thanks and gratitude to H.H. Sheikh Hamdan bin Rashid Al Maktoum Deputy Ruler of Dubai, UAE Minister of Finance and the Patron of the Award for his consistent follow-up and keenness to support the events of this major scientific forum. He also stressed that the Conference over the past seven sessions has become a unique platform for exchanging experiences between specialists in the field of human genetics. “The Award has supported CAGS since its establishment in 2003 in all its activities, according to the directives of His Highness Sheikh Hamdan bin Rashid Al Maktoum, to keep up

It is worth mention that the theme of the conference in its 8th edition is “Clinical Genomics”, and the main topics to be discussed in the conference include, next generation sequencing, neurodevelopmental disorders, metabolic disorders, dysmorphology, as well as population genomics and human disorders. The conference will be preceded by a 2-day workshop on genomic data analysis for gene discovery and variant interpretation. This workshop is being organized by CAGS in association with the European School of Genetic Medicine, and will take place at the Mohammed Bin Rashid University of Medicine and Health Science. The course will see instructors from around the world offering handson training to a limited number of genetics and genomics professionals working in human genetics within the research or clinical diagnostic setting.


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UAE Ministry of Health: Leading on Automation in Outpatient Medication Dispensing Dr. Abdalla Ahmed Alnaqbi. MD. United Arab Emirates, Ministry of Health and Prevention. Dr. Amin El-Shamy. PhD researcher in Health Economics, MSc in Health Economics, MPA, B Pharm, Health Technology Assessment Office, United Arab Emirates, Ministry of Health and Prevention. James Waterson. RN, M.Med.Ed. Associate Member, Infusion Nurses Society.

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n article submitted to the American journal of hospital pharmacy long ago in 1967 identified how ‘outpatient visits are increasing at a rapid rate and administrative adjustments will be needed to handle larger outpatient prescription volumes’. The author laid out how, ‘new methods and procedures must be developed to reduce patient waiting time, provide the physician and the pharmacist with information pertinent to drug therapy and increase productivity through the

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elimination of administrative detail which can be handled better through automation’.1 The situation remains not dissimilar in 2019, some fifty-two years later. Outpatient visits continue to rise yearon-year, with increasingly complex patients being handled by these departments. Globally there has been a drive towards automation in healthcare to help handle the constantly increasing workload, and to allow for the

redeployment of our limited numbers of highly qualified staff away from routine tasks and towards more constructive engagement with patients. There is also considerable political and financial pressure on healthcare decision-makers to optimize the utilization of resources and to improve services for patients, whilst ensuring that any automation and technology that is deployed definitively adds quantifiable health-economic value. The size of any initial investment in


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health technology and automation is inevitably significant and requires substantial decisions to be taken about funding, the need for change, and required re-engineering of a facility’s infrastructure and established hospital and department procedures, policies and workflows. 2 The remit of the Health Technology Assessment Office to the UAE Ministry of Health and Prevention (MOHAP) is to act as a guide on the introduction of new Health Technology to MOHAP in an efficient, equitable, transparent and explicit manner. The priority of the office is the welfare of the UAE’s population and to act always with the highest economic, ethical, legal, social and organizational standards regarding patient care. With the above in mind, the Health Technology Assessment Office embarked on a two-site head-to-head comparison between an automated

and a ‘traditional’ outpatient pharmacy to assess possible cost-benefits of extending pharmacy automation across multiple MOHAP outpatient facilities in the UAE. Output from an automated outpatient hospital pharmacy hospital and the conventionally managed outpatient pharmacy of a hospital acting as a control was collected over 12 months. During this period 11,646 patients were served by the traditional pharmacy with 33,782 prescriptions and 12,739 patients were served by the automated pharmacy with 37,754 prescriptions. See Table 1. Metrics collected from both pharmacies were average time from prescription order to dispensing, completeness of medications dispensed versus prescriptions, expired inventory, average inventory stock levels, turnaround of unused or uncollected medications into circulation, number of mislabelling or prescription dis-

crepancy events caught, time taken in completing regular inventory, and percentage of missing medications identified. The study took place over 12 months in 2018. The automated pharmacy served 9.4% more patients than the traditional pharmacy in this period and dispensed 11.8% more prescriptions. Overall the automated pharmacy showed a 28.8% lead over the traditional unit in correctly dispensed prescriptions. The time to fill a received prescription was also an impressive 95.7% less than in the traditional pharmacy. Maximum turnaround times for dispensed complete prescriptions was also reduced by 81.4%. The improvement in the number of completely filled prescriptions was perhaps partly due to the increased numbers of individual medication types that the automated pharmacy can store. These increased

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to 114,262 individual medication types, up 1.3% from the 112,814 held in the traditional pharmacy’s storage. This is not an uncommon finding in automated pharmacies; robots are simply better than humans at mundane tasks like constantly calculating the optimum way of stacking and placing medications on shelves, this ensures that more items can be stored without increasing the overall volume of stock. Up to 4,000 medication packs/metre of shelving can be stored by advanced robotic systems. Pharmacy robots even use ‘down-time’, when they are not dispensing or adding stock, making minute adjustments to existing stock on shelves and cleaning the storage area. An increase in line-item storage without a concurrent growth in stock level overall would generally be responsible for less bound capital, the reduction of expired stock loss, and a higher value to the organisation in the stock held as more prescriptions could be serviced and completed. When adding stock pharmacy

robots can also read expiry dates on drug packages, and thereby reduce waste from out of date medications, and also automatically recognise medications that require refrigeration. Some automated pharmacies have internal refrigerated storage units within them and their entire stock area is temperature controlled. The large increase in speed of dispensing by the automated pharmacy seen in the head-to-head study is probably due to the nature of ‘picking’ by the pharmacy robot; rapid barcode identification of ordered medications and multi-picking of up to 8 medication packages per move makes for a speedy pick up and conveyor belts and automated gates leading to spiral chutes can deliver these picked medications directly to the patient service point. Regular inventory is a labour-heavy task in a manual pharmacy. Automated pharmacies can maintain a consistent inventory count as each of the actions, direct loading into the robotic-managed storage with

Table 1: 2018 results for each pharmacy.

“Experience automated pharmacy technologies LIVE with BD at Arab Health Hall 3, booth S3/D50. BD, advancing the world of health.”

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barcode reading for medication stockup and automatic item deduction from stock level upon dispensing is under its control. This means that the inventory balance is a constant and dynamic process. From what has been seen in this head-to-head study the time savings and accuracy of automated dispensing for outpatients are both impressive. Further efficiencies are perhaps also possible if workflow bottlenecks, such as that between prescription and the commencement of dispensing can be resolved. Studies generally seem to indicate that the fuller the integration between systems such as Computerised Practitioner Order Entry, Electronic Medication Administration Record, and the patient’s Electronic Medical Record and automated dispensing systems the greater the gains for the organisation.

Our experience of automation, integration and e-prescribing in our MOH pharmacy can also be seen here: https://www.youtube.com/ watch?v=dSjQ8QdiIDo

References. 1. Hynniman C and Lamy P. Outpatient pharmacy automation. American Journal of Hospital Pharmacy 1967; 24. 18-21. 2. Sng Y, Ong C, Lai Y. Approaches to Outpatient Pharmacy Automation: A Systematic Review European Journal of Hospital Pharmacy 2019; 26:157-162.


NEWS

IHF Awards 2019 Winners Announced Kaohsiung Veterans General Hospital bags the prestigious IHF/Dr. Kwang Tae Kim Grand Award This year, we’ve come up with what I believe to be the best set of winners from a good spread of countries. That said, some countries are definitely doing better than others. My heartiest congratulations to the UAE for winning 5 out of the 27 awards this year.”

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he IHF Awards 2019 winners were announced in an awards ceremony last 8 November during the 43rd World Hospital Congress in the Oman Convention and Exhibition Centre. Kaohsiung Veterans General Hospital from Taiwan won the most coveted Gold Award for the IHF/Dr. Kwang Tae Kim Grand Award for their project “A comprehensive and sequential solution enhancing the quality care of acute myocardial infarction”.

The winners were selected by an international jury of renowned healthcare industry leaders chaired by Dr. Lawrence Lai, Honorary Member of the International Hospital Federation (IHF). Commenting on the winners, Dr. Lai said “Choosing the winners this year has been particularly difficult because of the very high standards and quality of all submitted entries.

The IHF Awards, now on its fifth year, celebrates and recognizes hospitals and healthcare organizations with demonstrable excellence, innovations, and outstanding achievements in the healthcare industry. This year, it attracted 121 entries from 34 countries. Twenty-seven entries came out on top and were selected as finalists from which the eventual winners and merit awardees were chosen in the IHF / Dr. Kwang Tae Kim Grand Award and Excellence Awards in Corporate Social Responsibility, Leadership and Management in Healthcare, and Quality & Safety and Patient-centered Care.

Saudi Healthcare Exhibition 2020 Healthy Nutrition & Safety - Physical Activity - Smoking – Sleeping - Communication

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nder the patronage of the Ministry of Health in the Kingdom of Saudi Arabia, the Saudi Healthcare Exhibition (SHCE2020) is set to be held from 22 – 24 March 2020 at the Riyadh Hilton Hotel. The event will be the epitome of a better Healthy Lifestyle in the Kingdom.

In the recent years, Saudi Arabia has become an epicenter of medical innovation and with that; the Saudi Healthcare 2020 Exhibition marks the celebration to the ever-growing health and Medical industry of the Kingdom. The healthcare and social services sector has been allocated 15% (US$ 39.2 million) of the total KSA’s 2018 budgeted expenditures, up from actual spend of US$ 35.5 million during 2017. This 10.5% increase in the allocation reflects a strong indication of potential demand as well as the Government’s readiness to expand growth and improvement within the sector. Currently, the healthcare market in the Kingdom is driven by public expenditure at 74.2% (2016) and 25.8% by private sector, which is expected to increase to 28.1% by 2025.

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#1 in Saudi Arabia King Faisal Specialist Hospital and Research Centre

SMART ROOM

CANCER SCREENING

FLU VACCINE

Transforming the patient and clinician experience

Enabling early detection for better outcomes

Increasing vaccination rates to keep populations safe

King Faisal Specialist Hospital and Research Centre becomes the first organization in Saudi Arabia to win the HIMSS Davies Enterprise Award. Cerner is proud to work alongside KFSH&RC, and we look forward to collaborating with you as you enjoy further success in the future. Congratulations!

kfshrc.edu.sa cerner.me |

@KFSHRC @CernerMEA


NEWS

WCM-Q explores law and ethics of stem cells and AI in medicine to consider how lawyers can help to develop laws to ensure that science advances and that it does so in ways that protect everyone involved.”

he legal and ethical implications of using stem cells and artificial intelligence (AI) in medicine were discussed at the latest installment of Weill Cornell Medicine-Qatar’s (WCM-Q) Intersection of Law & Medicine series.

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into many different cell types to become tissue- or organ-specific cells with special functions.” The central ethical dilemma of stem cell science arises from the fact that embryonic stem cells are derived from human embryos or by cloning, she explained.

Expert speakers at the event discussed the impact of recent advances in stem cell science and AI on the practice of medicine in Qatar and explored how new legal frameworks could be developed to protect the rights and safety of patients in the MENA region. The day-long event was organized by WCM-Q in collaboration with Hamad Bin Khalifa University and the University of Malaya of Kuala Lumpur, Malaysia. Stem cells are an exciting area for medical researchers because they have the potential to repair damaged or diseased tissues in people with conditions such as Parkinson’s disease, type 1 diabetes, stroke, cancer, and Alzheimer’s disease, among many others. Stem cells can also be used by researchers to test new drugs for safety and effectiveness.

Visiting bioethics expert Dr. Jeremy Sugarman of Johns Hopkins University in Baltimore, US said that the public image of stem cell research had been damaged by a small number of high-profile cases in which scientists had behaved unethically. The field had also been hampered by different countries applying different laws to stem cell research, making international collaboration problematic, he said. Meanwhile, the use of AI in healthcare has the potential to leverage analysis of large amounts of data to improve patient outcomes, but poses ethical concerns regarding privacy, the diversity of data sources, biases and relying on non-human entities for potentially life-changing decisions.

The event, which was co-directed by Dr. Solaiman and Dr. Thurayya Arayssi, professor of clinical medicine and senior associate dean for medical education and continuing professional development at WCM-Q, also featured other expert speakers. Dr. Mohammad Firdaus Bin Abdul Aziz of the Faculty of Law at the University of Malaya, who spoke about stem cell regulations around the world, Dr. Faisal Farooq of Qatar Computing Research Institute, who spoke about AI in healthcare, Dr. Effy Vayena of the Swiss Institute of Technology on the ethical challenges of using machine learning in healthcare, Dr. Sharon Kaur of the Faculty of Law at the University of Malaya on global regulation of AI, and Dr. Mohammed Ghaly of Qatar Faculty of Islamic Studies on Islamic perspectives of bioethics in stem cell research. The visiting experts also engaged in two panel discussions, one examining the law and ethics of stem cell science, chaired by Dr. Adeeba Kamarulzaman, dean of medicine at the University of Malaya, and one on AI in healthcare chaired by Dr. Thurayya Arayssi, professor of clinical medicine and senior associate dean for medical education and continuing professional development at WCM-Q.

Dr. Barry Solaiman, assistant professor of law in the College of Law and Public Policy at HBKU said: “It’s very important that we bridge that gap between the professions of law and medicine, and that we understand the fundamental importance of ethicists to the advance of science. We need

Dr. Arayssi said: “I am very grateful that our expert speakers joined us to explore how legal frameworks can be developed to maximize the benefits of advances in stem cell research and AI for patients, while also respecting the rights, safety and cultural traditions of the everyone in the community.”

WCM-Q’s Dr. Amal Robay, WCM-Q assistant professor in genetic medicine and director of research compliance, said: “Stem cells have the capacity for unlimited or prolonged self-renewal, and they can differentiate themselves

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NEWS

‫ْﺑﻂ اﻟﺼﺤﺔ‬ ‫َر‬ ‫واﻟﺘﻌﻠﻴﻢ‬ ‫واﻟﺒﺤﻮث‬ Linking health, education and research

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

www.hamad.qa 55


NEWS

WCM-Q researcher offers advice for pregnant women who have undergone bariatric surgery substantial weight loss. The procedure is increasingly carried out in women who are of childbearing age. Twenty experts from across the world have now conducted a systematic review of the available research papers to offer guidance on a range of issues which may affect bariatric surgery patients who are pregnant or trying to conceive, including contraception, diet, nutrient levels, gestational weight gain, and breast feeding.

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aculty at Weill Cornell Medicine – Qatar (WCM-Q) have contributed to new guidelines to advise on the care of pregnant women who have had bariatric surgery. Bariatric surgery is used to treat obesity with the majority of operations carried out to reduce the capacity of the stomach which in turn reduces food intake and results in

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Dr. Shahrad Taheri, professor of medicine and director of clinical research at WCM-Q, was one of experts to contribute to the paper, entitled ‘Pregnancy after bariatric surgery: Consensus recommendations for periconception, antenatal and postnatal care.’ Dr. Taheri said: “Bariatric procedures are increasingly available and cause physiological changes in the body that change processes like energy balance and fat metabolism. Pregnancy is a major physiological and nutritional challenge so the health of pregnant women who have undergone bariatric surgery. There needs to be careful monitoring to ensure that women receive sufficient nutrients to allow them and the fetus to grow and remain healthy.” Global obesity almost tripled between 1975 and 2016, with 650 million people now classified as being clinically obese. For women, obesity increases the possibility of complications during pregnancy, and

poor maternal nutrition can have a long-lasting impact on the infant, so it is recommended that women try to lose weight before conceiving. In addition, the report states that men should also lose weight if they and their partner are trying to have children. Other guidance includes the advice that women who have undergone bariatric surgery should postpone pregnancy until their weight has stabilized and that quickly absorbed carbohydrates should be avoided; meals should instead comprise protein and low-glycemic index alternatives. As with standard pregnancies, expectant mothers should take a variety of supplements, and their levels of micronutrients monitored before they conceive and then during each trimester. But the systematic review found that breast milk is not compromised after bariatric surgery and that breastfeeding should be encouraged. Dr. Taheri said: “Pregnancy can be a confusing time for all first-time mothers with a lot of information to absorb about optimal nutrition, supplements and exercise alongside the fact that the body is physically changing and has different requirements. This confusion can be compounded for pregnant women who have undergone weight-loss surgery, and by contributing to this first international guideline, I and my colleagues hope that we can simplify the messages being delivered and offer some reassurance to expectant mothers.”


NEWS

MORE THAN JUST A MEDICAL SCHOOL At Weill Cornell Medicine-Qatar, we are so much more than just a medical school; we are a world-renowned institution and network of influential partners that combines groundbreaking research, world-class medical education, and best-in-class care to put patients at the center of everything we do.

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MEDICAL INSTITUTIONS

Welcoming Hall Ac覺badem Maslak Hospital

Ac覺badem Healthcare Group Turkey offers a best-in-class medical services with its breakthrough technology and expert medical team

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edical tourism is a flourishing field - after all,according to reports, a whopping 14 millionpeople went abroad to receive medical carein 2017. The idea of receiving medical care,but in the lap of luxury, is holding more sway today. Striking a perfect balance between medicaland wellness needs is Ac覺badem Healthcare Group that was established in 1991, and is today the leading institutionin Turkey, in the niche of private healthcare services. After having tasted success in Turkey, the group with its partner IHH Healthcare Berhad, one of the largest groups in the Far East has

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King Suit & Standard Patient Room Ac覺badem Maslak Hospital


MEDICAL INSTITUTIONS

spread its wings all over the world. Today, it has 21 hospitals and 14 medical centers under its belt, in Turkey,Bulgaria, Macedonia and Netherlands, and is part of the world’s second-largest healthcare chain. Medical tourism hubs are developing in different parts of the world, but with Acıbadem’s credibility and reputation of providing the highest quality of services using advanced technologies, large footfalls of patients are witnessed in Turkey. In addition, the team boasts experts who meet international quality standards. Enhancing its solid reputation are the certifications received by independent institutions like Joint Commission International (JCI) and ISO 15189 Clinical Laboratory Accreditation Certificate. All the hospitals under the aegis of the group meet global standards and have their own centers of excellence. There are 16 Heart Care Centers (pediatric and adult cardiology and cardiac surgery), 13 In Vitro Fertilization Centers(infertility - IVF), 11 Cancer Centers (surgery, radiotherapy,chemotherapy), 10 Organ and Tissue Transplantation Centers(liver, kidney, bone marrow), 9 Spine and Neurosurgery Centers, 6 Robotic-assisted surgery centers and a single Sports Medicine Center accredited by FIFA. Another area that Acıbadem Healthcare Group specializes in Aesthetic, Plastic and Reconstructive Surgery that helps patients to look the way they want to, with the able help of specialist physicians and the support of an experienced team. These centers offer a range of services- from rhinoplasty to stem cell rejuvenation therapy, from abdominoplasty to breast augmentation, so that all your

Patient room Acıbadem Healthcare Group, Turkey

requirements are taken care of! Each of these centers are nationally and internationally accredited due to their advanced technology equipment and the qualified team of experts they offer. Since there is a surge in the number of international patients who visit for different healthcare needs, the International Patient Services Center at Acıbadem Healthcare Group, Turkey, provides a range of services to keep them safe and comfortable. Consultations, diagnostic procedures,billing and insurance, travel and accommodation, as well as translation,

is taken care of, thereby making it a ‘one-stop’service center for international patients. The team at the Center includes patient service specialists and physicians who help patients through their “Healthcare Journey”, and in accordance with their needs and expectations. The International Patient Services Center is segregated into three units, and includes over 150 multilingual service executives. With this unwavering commitment towards healthcare, the Center provides thehighest and most reliable quality of services.

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MEDICAL INSTITUTIONS

Children Clinic & Examination Room Acıbadem Maslak Hospital

ACIBADEM’S FORAY INTO EDUCATION AND RESEARCH Acıbadem Healthcare Group has set a global benchmark for an integrated special healthcare system model, and various healthcare support institutions. The Group has set up at hematic university specializing in medical sciences - Acıbadem University - that establishes the scientific infrastructure of healthcare services provided within the various centers,with the help of its experienced academic faculty and the international research studies it has conducted. The Advanced Simulation Center CASE, established under the university, is one of the most comprehensive three centers worldwide, with all the departments and technological infrastructure that it embodies. The center comprises two sections - Clinical Simulation Training Center and an Advanced Endoscopic, and Robotic Surgical Training Center.

Check-up Department Acıbadem Maslak Hospital

from planning, application, control and consultancy services in project management.

MEDICAL SERVICES WITH A TOUCH OF LUXURY A-Plus Hospital and Accommodation Services revolve around the principle “a hospital is a hotel where healthcare services are provided”. With this thought in mind, there are a range of facilities available to keep the patient in pure comfort - there’s patient catering, staff catering, cafeteria operation, cleaning, housekeeping and laundry. In addition, Acıbadem Mobile Healthcare Services provides all-integrated mobile healthcare services for both urgent and non-urgent pre and

post-hospital healthcare processes at the highest level.

A STRONG NETWORK OF LABORATORIES Acıbadem Labvital, Acıbadem Labcell Cell Laboratory and Cord Blood Bank, Pathology and Acıbadem Labgen, which are parts of a strong web of laboratories, are all equipped with new generation technological infrastructure, and offer globally-recognized services in many fields. These include food control, cellular therapy, preparation and storage of peripheral stem cells and bone marrow stem cells, intraoperative pathology consultation (frozen section), macroscopic examination, sample evaluation, genetic diagnosis and personalized medicine options.

PROJECT MANAGEMENT AT ITS BEST Acıbadem Project Management, which embodies planning, application, control and consultancy in project management, enables large projects like hospitals to taste success by providing ‘turnkey’ services. The organization offers all kinds of services - right

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Hybrid Operation Rooms, which are connected to three different diagnostic units (3 Tesla MR, 128 section Sliding CT, Robotic Arm Angiography


ARTICLE

GE Healthcare Receives FDA Clearance of First Artificial Intelligence Algorithms Embedded On-Device to Prioritize Critical Chest X-ray Review

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E Healthcare announced the U.S. Food and Drug Administration’s 510(k) clearance of Critical Care Suite, an industry-first collection of artificial intelligence (AI) algorithms embedded on a mobile X-ray device for triage. Built in collaboration with the University of California San Francisco (UCSF), using GE Healthcare’s Edison platform, the AI algorithms help to reduce the turnaround time it can take for radiologists to review a suspected pneumothorax, a type of collapsed lung.

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“X-ray – the world’s oldest form of medical imaging – just got a whole lot smarter, and soon, the rest of our offerings will too,” says Kieran Murphy, President & CEO, GE Healthcare. “GE Healthcare is leading the way in the creation of AI applications for diagnostic imaging and taking what was once a promise and turning it into a reality. By integrating AI into every aspect of care, we will ultimately improve patient outcomes, reduce waste and inefficiencies, and eliminate costly errors. Critical Care Suite is just the beginning.”

A prioritized “STAT” X-ray can sit waiting for up to eight hours for a radiologist’s review1. However, when a patient is scanned on a device with Critical Care Suite, the system automatically analyzes the images, searching for a pneumothorax. If a pneumothorax is suspected, an alert – along with the original chest X-ray – is sent directly to the radiologist for review via picture archiving and communication systems (PACS). The technologist also receives a subsequent on-device notification to give awareness of the


ARTICLE

prioritized cases. Quality-focused AI algorithms simultaneously analyze and flag protocol and field of view errors as well as auto rotate the images on-device. Critical Care Suite and the quality algorithms were developed using GE Healthcare’s Edison platform – which helps deploy AI algorithms quickly and securely – and deployed on the company’s Optima XR240amx system. “Clinicians are always looking for clinically proven methods to increase outcomes and improve the patient experience,” says Dr. Rachael Callcut, Associate Professor of Surgery at UCSF, a surgeon at UCSF Health and Director of Data Science for the Center for Digital Health Innovation, who partnered in the development of Critical Care Suite. “When a patient X-ray is taken, the minutes and hours it takes to process and interpret the image can impact the outcome in either direction. AI gives us an opportunity to speed up diagnosis, and change the way we care for patients, which could ultimately save lives and improve outcomes.”

To further assist technologists and radiologists, four additional features are also available, including: •

On-Device Pneumothorax Alert2 is flagged as soon as the X-ray image is acquired, if a PTX is detected. AI Score3 from 0 to 100 is presented in which the higher the score, the more confident the

algorithm is that a pneumothorax is detected. Image Overlay4 can be seen on-device (as well as on the Secondary Capture image sent to PACS) and accurately localized 96% of positive pneumothorax findings. Customization of preferences5 allows users to set an AI operating point (5 setting options) in order to tune the performance of the system to preferred sensitivity or specificity.

future of healthcare will be driven by digital technologies. It is applying AI and analytics to healthcare data in order to unearth timely insights that improve patient outcomes. Critical Care Suite was developed and deployed on the X-ray device using GE Healthcare’s Edison platform, which helps deploy AI algorithms quickly and securely.

“Sixty-two percent of exams are marked ‘STAT’ or for urgent reading, but they aren’t all critical6. Critical Care Suite helps cut through the clutter to flag critical cases and reduce delays in turnaround, which can be a serious issue,” said Scott Schubert, President & CEO, X-ray, GE Healthcare. “In addition to flagging images with a suspected pneumothorax with impressive accuracy7 and helping radiologists prioritize those cases immediately, Critical Care Suite also helps improve technologist’s day-to-day workflow, flagging protocol and patient positioning errors to help reduce patient callback rates.”

Critical Care Suite is just the beginning GE Healthcare believes that the

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INTERVIEW

Imaging General Manager, Eastern Growth Markets at GE Healthcare

Mark Stoesz “Critical Care Suite automatically analyzes the images by simultaneously searching for a pneumothorax, reviewing and flagging protocol and field of view errors, and automatically rotating the images”

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OSPITALS Magazine spoke with Mark Stoesz, Imaging General Manager, Eastern Growth Markets, to learn more about this first-of-its-kind technology.

How did you develop and test this technology? We worked closely with our partners at UC San Francisco, St. Luke’s University Health Network, Humber River Hospital, and CARING - Mahajan Imaging – India to develop embedded AI solutions that help radiologists and technologists’ expedite diagnoses and improve quality. Critical Care Suite’s pneumothorax AI Algorithm alone was trained on thousands of unique patient images, from 6 data sources, across 3 countries, from 11 different x-ray detector manufacturers.

How does Critical Care Suite work? Critical Care Suite automatically analyzes the images by simultaneously searching for a pneumothorax, reviewing and flagging protocol and field of view errors, and automatically rotating the images. If a pneumothorax

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is detected, an alert – along with the original chest X-rays – is sent directly to the radiologist for review via picture archiving and communication systems (PACS). The technologist also receives an on-device notification to provide awareness of the prioritized cases.

to the radiologist, helping to decrease the likelihood of miscommunication

What is the significance of having these algorithms “on device” versus having it run on a server or in the Cloud?

Why does it matter the technologist receives a subsequent notification on the device for awareness of flagged cases? Technologists and radiologists work closely together in the department to ensure diagnostic images are being acquired and read in a timely manner. They commonly will communicate throughout the day about particular patients, especially if additional imaging or image processing modifications are needed. Critical Care Suite facilitates awareness so technologists are aware of the cases AI is prioritizing

SC_wout_disclaimers


INTERVIEW

Heat Map on device

There are many advantages for on-device AI: • It enables technologists to prioritize critical findings, automatically flagging images of exams that are suspicious of critical findings and in need of urgent attention by a radiologist8; • It increases workflow efficiency by leveraging artificial intelligence to reduce the number of clicks needed by

No Status bar and Real Time Alert

the technologists to complete an exam; and It allows technologists the opportunity to improve quality and fix errors before sending images to PACS – all from the patient’s bedside.

Furthermore, on-device AI offers a fast and reliable way to ensure AI results for critical findings are generated within seconds of image acquisition without any dependency on internet

connectivity. The AI results are sent to the PACS/radiologist at the same time that the device sends the original diagnostic image, ensuring no additional processing delay. It also offers a low barrier to entry for hospitals wanting to try AI without making financial or resource investments into additional infrastructure or security assessments/precautions for routing images offsite. AI built into the X-ray system, is essentially AI out of the box.

REFERENCES 1. Rachh, Pratik et al. “Reducing STAT Portable Chest Radiograph Turnaround Times: A Pilot Study.” Current Problems in Diagnostic Radiology Vol. 47, No. 3 (n.d.): 156–60. https://www.sciencedirect.com/science/article/abs/pii/S0363018817300312?via=ihub. 2. Not available in the United States. 3. Not available in the United States. 4. Not available in the United States. 5. Not available in the United States 6. Rachh, Pratik et al. “Reducing STAT Portable Chest Radiograph Turnaround Times: A Pilot Study.” Current Problems in Diagnostic Radiology Vol. 47, No. 3 (n.d.): 156–60. https://www.sciencedirect.com/science/article/abs/pii/S0363018817300312?via=ihub. 7. Critical Care Suite’s overall Area Under the Curve (AUC) for detecting a pneumothorax is 0.96. Large PTXs are detected with extremely high accuracy (AUC = 0.99). Small PTXs are detected with high accuracy (AUC = 0.94). GE Healthcare 510k K183182. 8. Not available in the United States.

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INTERVIEW

Healthcare Manager for OKI - MEIT

Carine Haddad “We present the first Laser-LED printers with embedded DICOM protocol worldwide”

O

KI is a pioneer in innovative print technologies from digital LED to High Definition Colour. It delivers unbeatable accuracy and precision printing for the medical industry. ‘Hospitals’ magazine had a comprehensive interview with Carine Haddad, Healthcare Manager for OKI in the Middle East, India and Turkey.

It’s well known that OKI Europe delivers unbeatable accuracy and precision printing for the medical industry. Can we have a brief about the company’s history? Its portfolio? And how it was integrated into the healthcare sector?

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OKI is one of Japan’s pioneering manufacturer of telecommunication equipment, we started back in 1881 when its founder Kibataro Oki manufactured and established Japan’s first telecommunications equipment and made the nation’s first telephone. The long heritage of


DICOM Medical Printers A First in Digital Printer Technology Explore our pathbreaking DICOM integrated printing solutions

Visit our stand at Arab Health 2020 to discover world-leading LED print technology specially designed for ultrasound and digital imaging

Stand # S3.F50 30 - 27 January 2020 Dubai World Trade Centre

The DICOM range makes it possible to print directly from your medical equipment in high-definition colour or mono-chrome on a variety of media. Witness OKI's high-definition near-diagnostic printing capabilities in action and learn ways to enhance patient experience through personalised A4/A3 leaflets and brochures DICOM printers can be used for both medical imaging and regular office printing, helping you save time and money.

Learn more about OKI's DICOM medical printers: www.okime.ae/dicom


DICOM Medical Printers Specially designed for dental printing Explore our pathbreaking DICOM integrated printing solutions

Visit our stand at Arab Health 2020 to discover world-leading LED print technology specially designed for ultrasound and digital imaging

ltra fast and ith po erful engines, the I O range of printers equipped ith I enhancement it, offer a ne standard of print quality to doctors and medical practitioners. DICOM printers are compact in size and offer a wide range of printing solutions for various examinations including one eam , ental adiology and ental anoramic.

Stand # S3.F50

igh reliability, e ceptional print quality and incredible digital imaging capabilities, ma e I O printers an indispensable tool for all dental practitioners.

30 - 27 January 2020 Dubai World Trade Centre

Learn more about OKI's DICOM medical printers: www.okime.ae/dicom


INTERVIEW

over 130 years makes us immensely proud and gives us considerable stability. OKI produced the world’s first digital LED printer in 1981, amongst other key innovations that continue till this day. OKI has a portfolio of A3 and A4 office printers and multifunction printers for every size of business and workgroup, to expand beyond the 4 walls of the office, and to be a one-stop shop for different sectors. Our vision is to address the individual concerns and challenges of our customers, transform their businesses and enable new streamlined digital processes for greater efficiency and productivity. As OKI takes the printing solutions deeper into verticals, we have a unique range of specialist products; including Retail, Graphics and the first LED DICOM-embedded (DMe) A4 and A3 printers which enables direct printing from the medical equipment and machines without software or hardware. The medical printers can also be used for the general admin use, so can save having two separate devices.

What is the medical equipment’s offered by OKI Europe? OKI presents the first Laser-LED printers with embedded DICOM protocol worldwide, offering fully specialized printing solutions targeted at the healthcare market. The DICOM (Digital Imaging and Communications in Medicine) protocol is used worldwide for the management, storage, transmission and printing of medical material. OKI’s A4 and A3 printers fully incorporate the DICOM protocol, and require no further installation of external drivers or print servers.

OKI’s DICOM series consists of one A4 (ES6410DMe) and two A3 (ES8431DMe and Pro9431DMe) colour printers. Robust, flexible and easy to use, they are ideal for hospitals and clinics, as well as for dental and veterinarian clinics. They can print medical files including X-rays, MRIs, ultrasound scans, etc., in High Definition, for uses such as patient records kept by doctors, or for the patient’s own copy of their medical records, and other near-diagnostic purposes. At the same time, they are suitable for ordinary office use, facilitating medical and ordinary printouts from a single device, saving space and reducing the cost of maintenance and supplies.

medical prints from the risk of deterioration due to exposure to the sun or to moisture. The value-added feature which created a difference at our most digitized customers and helped them to consider and invest in our DICOM products is when technology fails in case of an emergency. Because in case of PACS system failure, it is not possible to view the radiological investigations, internet access is required to utilize web-based PACS systems and the need for specialized personnel for its installation and maintenance. OKI printers provide the solution with the high-definition print outs directly from the machines.

The healthcare sector is one of the fastest-growing industries in the world, can you tell us about the services and solutions that you offer in this field?

OKI Europe Limited will Showcase DICOM Medical Printers at Arab Health 2020. Can you brief our readers about this digital printer technology and what sets it apart from other similar technologies?

The healthcare industry is becoming increasingly complex, with providers being asked to deliver quality care, ensure patient safety and improve operations at a time when budgets are under pressure. We are offering a cost-effective printing output that can now help the customers to save up to 70% less than traditional medical images, with added color capacity and warranty for 3 years. Paper can be annotated which allows the radiologist to write his own comments and print directly from the modality or PACS. In addition, paper as a printing material, compared to the materials previously used in medical printing, is more environmentally friendly and more easily stored and archived. Because of its durability, it protects

Combing the quality of an LED printer with integrated DICOM software is a key feature that sets our products apart from other printers, so printing can be done directly from medical equipment without the need for conversion software or external print servers. This also enables printers to be conveniently placed directly at the image source. OKI printers print in highdefinition color and are ideal for “neardiagnostic’ printing of X-rays, nuclear medicine images and scans from CT, MRI and ultrasound. As well as printing medical images, OKI printers can also be used for standard office printing, which reduces the need for multiple printers and cuts down on the cost of consumables. The printers can be connected to several

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INTERVIEW

imaging modalities simultaneously and can print in A3 or A4 paper format. Another feature is that the printer can also deliver 1.2m long banners to enable printing an image with a ratio of 1:1. This is particularly useful for posters and educational materials.

What is the importance of Arab Health event for OKI Europe? Arab Health is the largest healthcare business platform in the MENA region, and as a leader in innovative print technologies with more than 30 years of innovation, particularly in healthcare, the show is the perfect avenue to showcase our latest revolution in printing, increase OKI brand exposure, and network with industry leaders in MENA healthcare region.

Can you inform us about your expansion in the GCC countries and the Middle east? As per IDC Report, we have a momentum growth in the Middle East region and particularly in Levant, which was clearly reflected in our sales figures. We have seen continued growth and an increase in DICOM printer demand in 2018/2019, we at OKI expect more future growth in 2020 in the region.

What are the strategies considered by the company to succeed globally? OKI is founded upon the principal of delivering products and solutions that are dedicated to business customers through a consultative and innovative approach to service, design, manufacture and implementation. We are pioneers in innovative print technologies from digital LED

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to High Definition Colour, we have a portfolio of award-winning products and solutions enabling businesses to achieve both image focused, vibrant, quality print communications and budget flexibility. Much of the success of OKI can be attributed to the OKI family made up of highly experienced, innovative, dedicated and customer-focused professionals across the EMEA region.

What about your social contributions and environmental protection plans? OKI values making a wider contribution to society by supporting environmental initiatives for better future generations. Starting from

using 100% recyclable packaging, till extending the life of our products and consumables; OKI promotes to save energy and conserve global resources from production till waste management. For example, OKI’s digital LED technology reduces the amount of plastic used in printers and makes them more compact. It also generates ample light on very little power, thus saving energy and supporting environmental protection. With many other practices and production features, OKI will actively proceed with its Environmental Programme of 2020 Vision; realisation of low-carbon societies, prevention of pollution, resource circulation, and biodiversity conservation.


3-6 February 2020 Dubai, United Arab Emirates

Transforming tomorrow’s diagnostics Where the world of laboratory medicine meets

600+

lab manufacturers

80+

product categories

35+

exhibiting countries

Attend for free +971 (0) 4 407 2601 medlabmemarketing.com medlabme.com/visit Together for a healthier world


ARTICLE

Increasing marketing value with a sharper focus on medical imaging Article by Javier Lopez, General Manager, Vertical Solutions, OKI Europe Ltd

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or medical organizations and businesses that center around radiology-based offerings, ensuring the right information is being provided in a clear, effective and personalized manner is essential to gaining trust

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and increasing satisfaction. From general surgeries to cosmetic surgeries, veterinary surgeries, dental surgeries and orthopaedists, clear and accurate medical imaging is vital to both correctly understanding patient issues

and communicating the issues and the available treatments to the patients. With accurate information presented in a clear fashion, medical businesses and organizations can


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Tangible Assets

ensure that patients are getting the right treatment, checking visually its progress on print-outs and are satisfied with the services that they are receiving. This has created an opportunity for medical imaging manufacturers to assist medical organizations and businesses in boosting trust and confidence. This can be achieved by providing them with the latest technology that can deliver clear imaging available in a wide variety of print formats.

State-of-the-art DICOM-embedded printing equipment and DICOM RIP printing technology can provide doctors, veterinarians, surgeons and consultants with a tangible and easy-to-understand way to examine x-ray, nuclear medicine, MRI, CT and ultrasound scans and explain the results to their patients. In orthopaedics for example, the provision of banner images printed to life-size scale from a DICOM device will allow faster diagnoses through greater image clarity. Studies have shown that it takes only 150 milliseconds for people to process images that are shown to them, and then another 100 milliseconds for them to attach meaning to it. The entire process takes less time than the blink of an eye whereas words can take up to twice as long to process and recognize. A more recent MIT study suggests that we can understand the meaning of an image in only 13 milliseconds – ten times faster than the blink of an eye. Further studies have found that adding colour to important documents has been shown to increase recall of that technical information by up to 82 percent. For medical organizations, DICOM printing will reduce the amount of time it takes for medical staff to explain medical conditions to their patients from printed scans and results, and minimizes the opportunity for the wrong misinterpretation to be given thanks to the clarity of the printed images. DICOM printing will increase patient satisfaction through the businesses ability to track course of treatments (for example, dental aesthetics progress to improve smiles,

rehabilitation progress) to patients more clearly and easily through the use of sharp, large format images that are easy for patients and their loved ones to understand. In policing and law, DICOM print outs can provide high-quality forensic evidence, not only allowing law enforcement to accurately understand how crimes have taken place but also helping courts to apply the most suitable sentences to the correct suspects. From a marketing perspective, DICOM printed forensic evidence also allows police forces to share clear and accurate details through relevant media channels, informing the public about closed cases and helping to gather valuable information from the public about open cases.

A Personalized Offering Presenting patients with personalized booklets will increase satisfaction and boost confidence by providing them with a referenceable source of information including detailed, high-quality images that they can take home. Printed booklets should include relevant medical record information

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DICOM printed images have not been experienced by patients, or clients of private medical businesses.

alongside the images to maximize their marketing value by explaining the findings of the scan or X-Ray, or detailing proposed surgery in booklets that present visual renderings of potential cosmetic procedures. Presenting a patient requiring surgery with an A3 colour booklet could help them make an informed decision during the consultancy stage, and help the business to drive patient satisfaction. Including a detailed proposal of treatment in the booklet as well as the course of surgery, will increase the patient’s confidence in the weeks or months prior to the surgery as they will be able to quickly reference and familiarize themselves with the medical procedures. This confidence can be further supported by the inclusion of ‘after treatment’ renderings as well as details of any potential follow-up treatments. For university hospitals, providing patients and students alike with their own personal copies of medical imaging is equally important. Attracting students to enroll relies heavily upon the quality of learning resources provided by the institution. Not only

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does a personalized copy for each student improve the learning experience, but holding on to a copy for reference will contribute to a high pass rate by providing students with high-quality study material.

State-of-the-Art Simplicity The ease of integration between medical imaging equipment and DICOM-embedded printers, and the continuous evolution this communication standard has experienced over the years, has achieved a nearly universal level of acceptance among vendors of radiological equipment. However, the benefits of DICOM are only recognized by medical imaging manufacturers and medical staff. While this means that patients receive correct diagnoses and treatments, the benefits of actually being able to keep or reference

This has traditionally been due to the fact that DICOM image files are not easy to share with patients. While other image file formats such as JPEG, PNG or TIFF files are recognized and easily read by personal computers, DICOM files are not recognized by the standard home PC or laptop running Windows or iOS operating systems. While medical organizations could explore the option of sharing the images via email, the patient would require additional software in the form of a DICOM viewer to access the file, and even then, the patient would need additional information in the email content or in a separate text file to explain the findings in the image. There are clear opportunities for surgery-based medial businesses to simplify the consultation process for both patients and staff, making it easier for both parties to understand treatments and injuries. In turn, this creates a clear opportunity for medical imaging manufacturers to provide the equipment that can cost-effectively print tangible assets such as high quality personalized booklets in a flexible range of formats and sizes including sharp, colourful images that will inform and placate medical patients in an age of increasingly high expectations.


ARTICLE FEATURES . Children’s Health

Therapeutic and surgical developments gave children a glimmer of hope

CONGENITAL AND ACQUIRED HEART DISEASE IN CHILDREN JAN.FEB 2020

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ARTICLE FEATURES . Children’s Health

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here are many children suffering from heart disease, some are congenital while others are acquired, meaning that the child suffers from it due to certain factors. Medical advances in pediatric cardiology have been remarkable in recent years thanks to the medical progress achieved at the level of surgery or treatments in addition to the availability of many specialized children’s hospitals given the sensitivity of dealing with this age group and the importance of receiving quality healthcare. The heart is divided into four hollow chambers, two on the right and two on the left. To pump blood throughout the body, the heart uses its left and right sides for different tasks. The right side of the heart moves blood to the lungs through vessels called pulmonary arteries. In the lungs, blood picks up oxygen then returns to the heart’s left side through the pulmonary veins. The left side of the heart then pumps the blood through the aorta and out to the rest of the body. A baby’s heart starts to develop at conception, but is completely formed by 8 weeks into the pregnancy. Congenital heart defects happen during this important first 8 weeks of the baby’s development. Acquired heart disease may occur after months or years. Researchers aren’t sure exactly what causes most of these defects, but they think genetics, certain medical conditions, some medications and environmental factors, such as smoking, may play a role. One of the main causes that can lead to congenital heart disease is the advanced age of the mother at conception, or maternal diabetes, where congenital heart defects accounted for about 50% of defects and deformities that affect the fetus due to maternal diabetes because of high blood sugar levels and the consequent chemical changes. Maternal thyroid dysfunction is associated with increased risk for congenital heart disease, causing a decrease in fetal growth and may lead to preterm birth. It also has a strong impact on the fetal heart because they cause increased heart rate. Women with lupus are more than twice as likely to have a child with a congenital heart defect. Lupus is an autoimmune disease that can cause a number of health issues, affecting joints, organs, and/or blood vessels. Congenital heart disease can have a range of symptoms, because the condition refers to several different types of heart defect. General signs of congenital heart disease can include a blue tinge to the skin (cyanosis), rapid breathing and rapid heartbeat, swelling in the legs, tummy and around the eyes, shortness of breath in babies during feeding and in older children and adults during exercise.

A NEW LEVEL OF VERSATILITY. THE AMPLATZER PICCOLO™ OCCLUDER IS THE ONLY PDA CLOSURE SOLUTION INDICATED FOR PREMATURE INFANTS (≥700G + ≥3 DAYS OLD), PROVEN TO DELIVER SAFE AND EFFECTIVE CLOSURE. IT OFFERS NEW OPPORTUNITIES TO CONFIDENTLY CARE FOR A WIDER RANGE OF NEONATES AND INFANTS THAN EVER BEFORE. IT IS THE WORLD’S FIRST MEDICAL DEVICE THAT CAN BE IMPLANTED IN THE TINIEST BABIES. THE DEVICE, DEVELOPED BY ABBOTT, IS SMALLER THAN A SMALL PEA. IT OFFERS HOPE TO PREMATURE INFANTS AND NEWBORNS WHO NEED CORRECTIVE TREATMENT, AND WHO MAY BE NONRESPONSIVE TO MEDICAL MANAGEMENT AND AT HIGH RISK TO UNDERGO CORRECTIVE SURGERY.

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Congenital Heart Defects in Children In such cases, the problem is in the structure of the heart where the baby is born. The heart is formed in the first weeks of pregnancy to begin the process of pulse and the formation of large blood vessels passing to and from the heart, and may begin the development of birth defect in the heart. Most congenital heart defects result from problems early in your child’s heart development, the cause of which is unknown. However, certain environmental and genetic risk factors may play a role. Congenital heart defects sometimes run in families and may be associated with a genetic syndrome. Smoking during pregnancy increases the likelihood of a congenital heart defect in the baby. Certain medications taken during pregnancy may cause birth defects, including congenital heart defects. Give your doctor a complete list of medications you take before attempting to become pregnant.

cient oxygen can cause your child’s skin or fingernails to appear blue or possibly lead to congestive heart failure. A ventricular septal defect is a hole in the wall between the right and left chambers on the lower half of the heart (ventricles). An atrial septal defect occurs when there’s a hole between the upper heart chambers (atria).

Obstructed blood flow: When blood vessels or heart valves are narrow because of a heart defect, the heart must work harder to pump blood through them. Eventually, this leads to enlarging of the heart and thickening of the heart muscle. Examples of this type of defect are pulmonary stenosis or aortic stenosis. Abnormal blood vessels: Several congenital heart

There are many different types of congenital heart defects, falling mainly into these categories:

defects happen when blood vessels going to and from the heart don’t form correctly, or they’re not positioned the way they’re supposed to be. A defect called transposition of the great arteries occurs when the pulmonary artery and the aorta are on the wrong sides of the heart.

Holes in the heart: Holes can form in the walls between heart chambers or between major blood vessels leaving the heart. In certain situations, these holes allow oxygen-poor blood to mix with oxygen-rich blood, resulting in less oxygen being carried to your child’s body. Depending on the size of the hole, this lack of suffi-

Heart valve abnormalities: If the heart valves can’t open and close correctly, blood can’t flow smoothly. One example of this type of defect is called Ebstein's anomaly. In Ebstein's anomaly, the tricuspid valve — which is located between the right atrium and the right ventri-

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ARTICLE FEATURES . Children’s Health

cle — is malformed and often leaks. Another example is pulmonary atresia, in which the pulmonary valve is missing, causing abnormal blood flow to the lungs.

An underdeveloped heart: Sometimes, a major portion of the heart fails to develop properly. For example, in hypoplastic left heart syndrome, the left side of the heart hasn’t developed enough to effectively pump enough blood to the body. A combination of defects: Some infants are born with several heart defects. Tetralogy of Fallot is a combination of four defects: a hole in the wall between the heart’s ventricles, a narrowed passage between the right ventricle and pulmonary artery, a shift in the connection of the aorta to the heart, and thickened muscle in the right ventricle. Some congenital heart defects cause no signs or symptoms. For some people, signs or symptoms occur later in life. They can recur years after you’ve had treatment for a heart defect. Common congenital heart disease symptoms you might have as an adult include abnormal heart rhythms (arrhythmias), a bluish tint to the skin, lips and fingernails (cyanosis), shortness of breath, tiring quickly upon exertion and swelling of body tissue or organs (edema). Some congenital heart defects can be repaired using catheterization techniques, which allow the repair to be done without surgically opening the chest and heart. Some mild congenital heart defects can be treated with medications that help the heart work more efficiently. You might also need medications to prevent blood clots or to control an irregular heartbeat.

Heart Arrhythmia Heart arrhythmia is a congenital disease in children or newborns accompanied with congenital heart defects. It can be serious and even life-threatening. If your child’s heart beats too fast or too slow, it might affect the heart’s ability to pump blood efficiently to the rest of the body. Irregular blood flow can damage organs, including the kidneys, liver, heart, and brain. Some cases may pose a risk to the health of the child, requiring immediate medical intervention through drug therapy. S ome tachycardias are life-threatening or significantly interfere with a child’s normal activities. Radiofrequency catheter ablation, is done with several catheters in the heart. One is positioned right over the area that’s causing the tachycardia. Then its tip is heated and that small area of the heart is altered so electrical current won’t pass through the tissue.

A RECENT STUDY USING THE AMPLATZER PICCOLO™ OCCLUDER FOR PDA CLOSURE DEMONSTRATED SAFETY AND EFFECTIVENESS WITH A LOW RATE OF MAJOR COMPLICATIONS AND A HIGH RATE OF PDA CLOSURE. THE VERSATILE DESIGN AND PREDICTABLE PERFORMANCE OF THE DEVICE MAKE IT IDEAL FOR A VARIETY OF MORPHOLOGIES, FROM “CONICAL” DUCTUS TO “FETAL TYPE” DUCTUS.

TIGHTLY WOVEN SINGLE-LAYER MESH

ENGINEERED FOR STRUCTURE AND STRENGTH

INTAGLIO WIRE TREATMENT

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Sometimes surgery that interrupts the abnormal connection in the heart is required to permanently stop the tachycardia. A variety of rhythm disorders can be controlled with a pacemaker. Slow heart rates, such as heart block, are the most common reason to use a pacemaker. It works by sending small, painless amounts of electricity to the heart to make it beat. Some cases appear immediately after birth while others appear after the age of five years.

Pericarditis The pericardium is a thin sac that surrounds your heart. It protects and lubricates your heart and keeps it in place within your chest. Problems can occur when the pericardium becomes enflamed or fills with fluid. The swelling can damage your heart and affect its function. The pericardium has a few important roles: It keeps your heart fixed in place within your chest cavity. It prevents your heart from stretching too much and overfilling with blood. It lubricates your heart to prevent friction with the tissues around it as it beats. Pericarditis is an inflammation or infection of the pericardium, the thin sac (membrane) that surrounds the heart. There is a small amount of fluid between the inner and outer layers of the pericardium. When the pericardium becomes inflamed, the amount of fluid between its two layers increases, compressing the heart and interfering with the heart’s ability to function properly. In children, pericarditis is most likely to occur following surgery to repair congenital (present at birth) heart defects or acquired heart disease. However, other causes

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may include infection (viral, bacterial, fungal, parasitic), chest trauma or injury or connective tissue disorders such as systemic lupus erythematosus (lupus). The following are the most common symptoms of pericarditis. However, each child may experience symptoms differently. Symptoms may include chest pain that can be felt especially behind the breastbone, and sometimes beneath the clavicle (collarbone), neck, and left shoulder, chest pain that is a sharp, piercing pain over the center or left side of the chest that increases as the child takes a deep breath, a low-grade fever, irritability, fatigue, loss of appetite and irregular heartbeat. Treatment may include medication (i.e., analgesics and anti-inflammatory drugs), aspiration (removal) of excess fluid and surgery.

Rheumatic Heart Disease Rheumatic fever is an inflammatory disease that can affect many connective tissues, especially in the heart. Untreated or under-treated strep infections put a person at increased risk. Children who get repeated strep throat infections are at the most risk for rheumatic fever and rheumatic heart disease. This disease can seriously cause permanent damage to the heart valves and heart muscle, by causing myocarditis, requiring immediate medical intervention to reduce the risks and complications that can affect the child. The onset of rheumatic fever usually occurs about two to four weeks after a strep throat infection. Rheumatic fever signs and symptoms, which result from inflammation in the heart, joints, skin or central nervous


ARTICLE FEATURES . Children’s Health

system, can include fever, painful and tender joints, red, hot or swollen joints, chest pain, fatigue, flat or slightly raised, painless rash with a ragged edge, jerky, uncontrollable body movements most often in the hands, feet and face and outbursts of unusual behavior, such as crying or inappropriate laughing. The goals of treatment for rheumatic fever are to destroy remaining group A streptococcal bacteria, relieve symptoms, control inflammation and prevent the condition from returning. Your child’s doctor will prescribe penicillin or another antibiotic to eliminate remaining strep bacteria. Our doctor will prescribe a pain reliever, such as aspirin or naproxen to reduce inflammation, fever and pain. If symptoms are severe or your child isn’t responding to the anti-inflammatory drugs, your doctor might prescribe a corticosteroid.

Advanced Treatments There is no doubt that the medical development in the field of heart disease has significantly reflected on the treatments and we can say that heart disease and its treatments have benefited the most from the medical development in recent decades, whether at the level of drug treatments or surgery. Diagnosis has witnessed great development as well and pregnant women are now more aware of fetal monitoring as well as postpartum follow-up with a specialized doctor. Your child’s healthcare provider may prescribe antibiotics to treat the acute strep infection, long-term antibiotics to prevent recurrent strep infection, steroids or nonsteroidal anti-inflammatory medicines to ease inflammation in the heart and in other parts of the body, water pills (diuretics) if heart failure develops and/or anti-inflammatory medicine for the management of fever and arthritis symptoms. Your child may also need other medicines. Some children need surgery to fix or replace damaged heart valves. Surgical treatment has witnessed remarkable developments; 30% of children used to die during open heart surgery in the 1970s, while today this rate is less than 5%. Most often the valve leak caused by the disease is mild and does not need treatment. If the leak is severe enough to strain and enlarge the heart, surgery may be needed to eliminate the leak. This surgery may involve repair of the damaged valve. Sometimes the valve is too badly damaged to repair, in which case it must be replaced by an artificial valve. Proper nutrition is key in the treatment of rheumatic heart disease after consulting a pediatrician and a nutritionist to provide advice and guidance that aim to strengthen the child’s body. Weak bodies or malnutrition have a negative impact on the child’s health and may delay corrective surgeries.

• • • • • •

PICCOLO™ OCCLUDER:

TIGHTLY WOVEN SINGLE-LAYER MESH ENGINEERED FOR STRUCTURE AND STRENGTH INTAGLIO WIRE TREATMENT PREDICTABLE PLACEMENT DELIVERABLE IN 4 FRENCH SYSTEM PROCEDURAL FLEXIBILITY

DELIVERABLE IN 4 FRENCH SYSTEM

PREDICTABLE PLACEMENT

PROCEDURAL FLEXIBILITY

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A Global Destination for Advanced Pediatric Care

WITH MORE THAN 1.5 MILLION PATIENT VISITS PER YEAR, NATIONWIDE CHILDREN’S HOSPITAL HAS BECOME AMERICA’S SECOND LARGEST CHILDREN’S HOSPITAL.

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ationwide Children’s Hospital has a history of leadership in high-quality care across numerous disciplines in the U.S. The hospital aims to unite clinical expertise with technical innovation and compassionate care. This has resulted in steady, rapid growth, the development of many unique clinical programs, and an ever-increasing number of families from around the world choosing to make Nationwide Children’s Hospital the destination for their specialized healthcare services.

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Did you know? •

Nationwide Children’s Hospital is consistently ranked on U.S. News & World Report’s prestigious Honor Roll, a distinction awarded to only 10 children’s centers in the United States. U.S. News & World Report has also ranked Nationwide Children’s Hospital as a Best Children’s Hospital in all 10 evaluated specialties for nine consecutive years.

With more than 1.5 million patient visits per year, Nationwide Children’s Hospital is the second largest children’s hospital in the U.S. National Institutes of Health (NIH) research funding for Nationwide Children’s Hospital ranks 6th among all U.S. children’s hospitals. Nationwide Children’s Hospital is a Magnet™ facility – the highest achievement in nursing excellence – de-


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termined by the American Nurses Credentialing Center and awarded to only seven percent of all U.S. hospitals. The group of leading physicians and researchers has also made tremendous advancements in pediatric care, including:

Leading the Way in Neuroblastoma Care and Research Ranked 4th in the U.S. for pediatric cancer, Nationwide Children’s Hospital has one of the largest pediatric hematology/oncology/blood and marrow transplant programs in the country. As a member of the Children’s Oncology Group and location of its North American biobank, the hospital is optimizing cancer care and surgical oncology for young patients. It is also host to the worldwide Head Start 4 clinical trial via the NEXT Consortium, under the leadership of renowned neuro-oncologist Jonathan Finlay, MB, ChB, FRCP. The trial aims to improve survival and cure rates for childhood brain tumors by bringing evidence-based treatment protocols to children in need as quickly as possible.

Helping Kids Breathe Life into

Transplanted Lungs The Pulmonary Medicine program (ranked in the top 10 in the U.S.) offers a lung and heart-lung transplant program with special care options for even the most fragile patients. The Mechanical Cardiopulmonary Assist program extends the time children and adults can wait for a transplant without organ damage. Similarly, our ambulatory ECMO treatment offers the chance for patients to be active, receiving rehabilitation and, in some cases eating, to improve their strength while awaiting transplant. This unique approach to ECMO also enables patient transport, even in cases of acute respiratory decompensation and advanced lung disease.

Groundbreaking Neurosurgical and Neuromuscular Treatments Ranked 7th in the U.S. in Neurology and Neurosurgery, Nationwide Children’s one of only a few hospitals in the United States offering selective dorsal rhizotomy (SDR), a specialized procedure for children with spasticity to reduce pain and improve mobility. We are also home to groundbreaking clinical trials, one of which led to a first-of-its-kind gene therapy that is now giving hope to

infants with spinal muscular atrophy type1.

Dramatically Improving and Even Curing Medically Intractable Epilepsy Neurology and Neurosurgery (ranked 7th in the U.S.) offer access to innovative therapies, some of which are only offered by a handful of programs in the U.S. The interdisciplinary team of pediatric neurologists and neurosurgeons includes some of the world’s top experts providing a wide range of advanced treatment options for children with medically intractable epilepsy – treatments to not only lessen seizure severity, but may cure the child’s epilepsy entirely. The program has achieved 100 percent surgical survival and post-surgery (Engle class) outcomes significantly higher than national averages.

For more information, contact Global Patient Services at Nationwide Children’s Hospital via email at GlobalPatientServices@ NationwideChildrens.org, call +1 614 362 9127 or visit NationwideChildrens.org/International. Nationwide Children’s Hospital, Columbus, Ohio – USA

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INTERVIEW

Managing Director of LINET MEA

Jitka Stranska “We are Ready to Face Future Trends”

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INET is celebrating its 30th anniversary this year, since its beginning, this European manufacturer has grown to become a global company that ranks among the 4 world leaders in the field of hospital beds. LINET has been operating in the Middle East and Africa for many years, and the strategy of being as close to customers as possible led to the establishment of LINET MEA in Dubai 5 years ago. Its managing director Jitka Stranska spoke to us about the importance of mutual interaction with customers and about current trends and innovations.

What do you think is the most significant trend in the field of hospital beds? There are many trends and it depends on which angle you look at and what you need. Certainly one of the most important is the digitization and integration of information in the online environment. This is another step in the development of hospital beds, which are currently an active factor in the recovery and therapy of patients. Our beds are now equipped with sensors that monitor, for example, safety parameters or the patient’s presence in the bed. Everything at risk is immediately reported to staff, records are evaluated and directly exported to hospital systems.

Who benefits from beds that are connected online?

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Definitely everyone involved. The patient is safer with a reduced risk of falls and injuries. Nurses and doctors have online information about all patients clearly available on the monitor, tablet or mobile. Their work is more efficient, they can better schedule and organize time, and they are not overloaded. Data analysis and evaluation is essential for good management and service.

Is there a demand for smart technologies? How do you determine what healthcare professionals need the most? Our system was developed by direct interaction with the clinical environment. The new generation of SafetyMonitor has completed field tests and pilot installations with positive feedback. Being in close contact with our customers – doctors,

nurses and biomedical engineers – gives us the advantage of anticipating their needs and providing them with the products and services they really need. Our goal is also to transmit information and teach them how to use innovation effectively. We are convinced that this is not very commonplace. That is why we place great emphasis on special workshops and training sessions. Our team of clinical coaches has the opportunity to explain products from a user perspective as well as their clinical benefits while training nurses about correct ergonomics to help create better work habits.

How do you think a bed can improve work habits and the quality of care? We don’t just bring online applications to healthcare, there are


INTERVIEW

features such as lateral tilt, which helps to manipulate the patient in a completely revolutionary way. The rotation of the mattress platform allows patients to turn on their side by themselves under the supervision of a clinician. The nurse has the ability to position patients effortlessly, which is essential for hygiene and effectively preventing pressure injuries, and lateral tilt also helps with bedding and mobilization. By choosing our beds, you can influence the length of stay in the hospital, the number of work-related injuries and the overall quality of care, as the occurrence of falls or pressure injuries are considered indicators of the quality of nursing care.

And how does the patient benefit from a bed equipped with electronics and special features? Are they aware of what they are lying on? The patient is key. In addition to simplifying the work of nurses and doctors, for whom patient care is the primary mission, the bed is comfortable for the patient. It is designed to be self-controlled, which increases self-reliance and the design feels pleasant and trustworthy, which is very important in stressful situations during treatment. The bed is not only positive for the psyche, but there are also functions that actively enter the treatment process, for example, automatic lateral therapy is used in the ICU environment to prevent VAP.

Can you explain it? Simple programming of

Automatic Lateral Therapy – ALT function allows patients to rotate up to 30 degrees for continuous therapy and can be used to reduce pleural and transpulmonary pressure. Thanks to further technological development and cooperation with the manufacturer of Electrical Impedance Tomography we now have a platform that enables precise ventilation management that is individualized, continuous, safe and radiation-free. This project is one of our priorities for the coming period and I believe it will be possible to implement this revolutionary method as soon as possible into the therapeutic processes.

How difficult is it to participate actively and at such a level in highly professional projects? This is possible because of the diverse team working for LINET Group. We have three development centers in Europe and a team of clinical coaches and other professionals who are actively working at the LINET Academy training center and are also engaged in professional activities such as the development of the new method of individualized pulmonary ventilation. Thanks to them we have also developed the Early Mobilization with LINET program aimed at mobilizing and activating ICU patients. Also, our own Moving and Handling concept, which is based on ergonomic patient positioning using bed functions and simple aids is very positively accepted. We manage to be a part of current events and we are invited

as specialists for professional gatherings. After all, we take part in conferences and congresses on a regular basis because it is a great opportunity to share and explain details about our innovations to the professional audience of various specializations and focuses.

What specializations are they? In addition to the core segment of intensive and acute care, we have an overlap with the pediatric field. Because of a relatively recent acquisition, we have been able to enter the field of obstetrics and gynecology with premium products. We have expanded our portfolio to include the unique AVE 2 birthing bed that is primarily associated with maximum support for natural births. Gracie is a unique gynecological workplace that provides connectivity, efficient use of space and time, and of course high patient comfort. Another trend area is One Day Care and One Day Surgery. Statistics say that more than 60% of interventions in the US are currently outpatient. The structure and concept of healthcare is changing rapidly, and we are ready for it.

How do you respond to changes and trends in healthcare in the MEA region? Here we follow the same trends as in Europe, the USA, and other developed economies. People expect the highest quality of care, our advantage is that we can offer innovations for nursing procedures in connection with our beds.

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SAFE TIME FOR PATIENTS Increase the Quality of Care with the LINET SafetyMonitor

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ccording to the WHO, 1 in 10 patients are harmed during hospitalization1 – they fall out of bed, contract an infection, are given the wrong medication or are even misdiagnosed. The elimination of risks is one of the priorities for healthcare and is also a top concern for LINET Group, the European leader in the segment of hospital beds and other equipment. That’s why LINET Group created SafetyMonitor, the next generation of its own digital platform, whose main mission is to increase patient

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bed safety. The unique SafetyMonitor can be integrated into the hospital information system and it´s compatible with the Eleganza 5 and the new Eleganza 4 beds. This unique monitoring system represents an entry into a completely new segment. “For LINET, the launch of SafetyMonitor is an important milestone, because this is the first time we are entering the digital business and healthcare services,” says Zbyněk Frolík, founder and owner of LINET.

Safety First Despite all of the progress, the

issue of falls remains a ubiquitous problem and 50–70% of these incidents are related to beds2. Using integrated sensors, SafetyMonitor is set to monitor key safety parameters such as patient bed position, sideboard position, brake condition, bed height and back tilt. In addition, it continuously monitors and evaluates the patient’s weight. These parameters are monitored on all beds in the ward and, if necessary, the system emits a warning that there is a risk situation. An alert or alarm is displayed at the nurses’ station or on mobile devices and the


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staff has the opportunity to intervene quickly and effectively.

Application for the Future The intuitive user interface is clear and visible from a distance and allows you to view the status of up to 50 beds (and patients) on a single screen. While SafetyMonitor can monitor different types of data, the system displays only the most useful information. This means SafetyMonitor is ready for further expansion, especially towards extending the life of the bed and

ensuring its overall safe condition. One of the enhancements of SafetyMonitor is the bed location function. SafetyMonitor allows you to monitor the movement of the bed and determines its exact position using its location tag. If a bed is moved to another location, it automatically connects to the system and displays its current position within the user interface. Digital transformation affects our lives more and more. In line with the trends, LINET Group is developing its SmartCare system to create a friendly,

safe and trouble-free hospital operation. It is focused on the patient, quick recovery, and safety and comfort, which is the main goal of quality hospital care. At the same time, the system is designed to facilitate the work of medical staff and to prevent burnout, which results from longterm overload. REFERENCES 1. WHO global report on evidence on patient safety 2008, WHO 10 facts for patient safety accessed 2015 2. * Oliver D, Healey F, Haines TP. (2010). Falls and fall-related injuries in hospitals. Clinics in Geriatric Medicine

Smile with TOM the Bear

Complete, modern and playful beds for the best pediatric care

MiMi newborn baby cot

Tom 2 pediatric bed Specialized room equipment for small patients is becoming a symbol of quality pediatric care. In this respect, LINET Group is a unique brand that provides products developed and manufactured in Europe for the full range of pediatric care.

Discover our solution at Arab Health 2020 in booth H4.G50

Eleganza Smart Junior bed

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ARTICLE FEATURES . Smart Beds

SMART BEDS‌ A New Concept for Healthcare

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odern hospitals pay great attention to providing a comfortable environment for the patient by being in a comfortable room, contributing to improving his movement and helping healthcare providers through the availability of high-performance smart bed systems that help the doctor and the nursing staff by obtaining the most accurate details of the disease and reading the vital functions of the patient remotely.

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Smart hospital rooms provide the patient in bed with the possibility of communicating with the doctor via video calling. Moreover, the smart and sophisticated hospital beds provided an innovative concept through the advantages of contacting the medical team in addition to the ability of collecting data and sending it to the hospital’s main information center. Smart beds are among the stateof-the-art technologies deployed in hospitals and medical centers in the

Gulf countries and the Middle East region, as they played an important role in raising their efficiency and improving the level of services in them, as well as helping medical staff and healthcare providers to perform the tasks assigned to them to the fullest extent, contributing to the reduction of medical errors in hospitals. Smart beds are also designed to facilitate the patient’s movement and help him regain his normal movement faster given its active role in restoring


ARTICLE FEATURES . Smart Beds

the patient’s wellness, health and activity. Beds are very important for this purpose according to studies that have shown that the patient’s movement during his stay in the intensive care rooms contribute to the speed of recovery and early discharge from the hospital. These beds depend on the principle of computing to access data accurately, directly and efficiently through an innovative and smart system that comply with the needs of the medical facility and its work patterns in order to provide the best health and treatment services using smart technology, applying the best standards and protocols adopted globally. Through the presence of sensitive sensors that monitor the patient’s vital functions while in bed such as the heartbeat, temperature, breathing, etc., the medical staff in the doctor’s room receives the patient information through the personal computer with a full data clarification; it also sends an alert in the event of a sudden deterioration of the condition such as having a stroke, heart attack, and other urgent cases that require immediate medical intervention. Smart beds can also determine whether the bed is vacant, or if the patient is trying to get up. They can also

adjust themselves to ensure proper pressure and provide support to the patient. Sensors can also monitor the medical condition of the elderly, and other wireless devices can encourage the user to lead a healthy life such as wearable heart rhythm monitors. Also,

many modern hospital beds are able to feature a bed exit alarm whereby a pressure pad on or in the mattress arms an audible alert when a weight such as a patient is placed on it, and activating the full alarm once this weight is removed.

Smart Room A new concept dominates healthcare in hospitals, which is the concept of comprehensive and smart rooms in an advanced hospital environment that guarantees the patient’s safety and his access to accurate medical care in addition to improving the workflow for the medical staff. Smart patient rooms electronically connect medical devices with the medical file in the patient’s room, which contributes to raising the level of healthcare provided to patients in terms of providing smart ways to communicate with service providers and other parties. One of the advantages of smart patient rooms is the automatic connection of medical devices with the electronic health information system and vital signs devices, i.e. devices for measuring weight and the patient’s vital functions, devices for pumping drugs, and breathing devices; everything is automatically registered in the system without the intervention of the nursing staff. Each bed is equipped with an iPad so that alert signs and medical status indicators are displayed on a special electronic screen for each patient, allowing healthcare staff to monitor the patient’s condition remotely. Modern communication systems and information technology had a major role in the development of the health system in general, thus, hospitals worked to develop their systems to keep pace with this development in order to serve more patients with greater accuracy and quality. Smart health applications have made it possible to store data directly from the patient’s room with the possibility of processing it at a high speed, and help provide medical care that suits the patient’s needs, ensuring that he gets the best services based on quality, trust and accuracy.

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Beds equipped with an Out-of-Bed system, for example, can indicate when a fall-prone patient gets out of bed.

EVERY BED IN VIEW WITH STIEGELMEYER BLUE BRIDGE Dashboard with current status information reduces the workload of nursing staff

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he safety of patients and the protection of valuable equipment are a high priority in every hospital and nursing home. But in everyday work situations, keeping all the rooms in a ward under constant supervision is scarcely possible. Stiegelmeyer’s new Blue Bridge system reduces this burden dramatically. Blue Bridge supplies important status information about the beds in the ward, at a glance.

Network-connected hospital beds and care beds from Stiegelmeyer send data wirelessly to a dashboard – a graphic overview of all the beds using easily understandable symbols.

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Network-connected hospital beds and care beds from Stiegelmeyer send data wirelessly to a dashboard – a graphic overview of all the beds


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using easily understandable symbols. Staff can view this dashboard on their smartphones or tablets as well as on the ward’s computer screen.

A great help in preventing falls If a symbol on the dashboard turns red, the nursing staff can respond immediately if action is required. Beds equipped with an Out-of-Bed system, for example, can indicate when a resident gets out of bed. If the resident is particularly at risk of falling, prompt assistance will be required. For fall prevention purposes, it is also important to be notified if the bed is not at its lowest position. At night, in particular, this position, close to the floor, protects the resident from fall injuries. It is also helpful to be notified if the bed is not connected to the power supply. An accidentally dis-

connected power plug will affect the functions of the bed. Without a battery, no adjustments can be made using the handset. A decreasing battery charge can also result in unnecessary error messages. With the dashboard, such problems can be avoided. Blue Bridge also reports if the mains power plug is plugged in although the bed brakes have not been applied. Steps can then be taken to prevent damage to the cable and power socket caused by the unintended movement of the bed. At the same time, patients are also protected from fall injuries caused by leaning against an unbraked bed.

Live location tracking saves time With Stiegelmeyer Blue Bridge, many daily processes can be optimized thanks to the live data collect-

For fall prevention purposes, it is also important to be notified if the bed is not at its lowest position. At night, in particular, this position, close to the floor, protects the patient from serious fall-related injuries.

Blue Bridge also reports if the mains power plug is plugged in although the bed brakes have not been applied. Steps can then be taken to prevent damage to the cable and power socket caused by unintended movement of the bed.

ed from the beds. This includes real-time location tracking – searching for beds is a thing of the past thanks to precise, room-specific information. Staff have more time to devote to caring and the care facility has greater legal certainty. Stiegelmeyer adapts its connectivity solutions optimally to the existing infrastructure and develops the concepts in close cooperation with those responsible on-site. Hospitals and nursing homes thus benefit from digitization that brings tangible benefits to people, without overtaxing them, and saves valuable resources.

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Obstetrics & Gynecology Department at Al Ahli Hospital

Full Range of Services By Dr Mazen Bishtawi Director at the Obstetrics and Gynecology Department at Al Ahli Hospital

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bstetrics and Gynecology Department at Al Ahli Hospital provides a holistic approach and has a full range of services for women throughout every stage of their life. Highly qualified and dedicated medical team is available to guide and support women through prenatal care, pregnancy and delivery, including high-risk pregnancies. It provides comprehensive gynecologic services including care for adolescent girls, urogynecology, cancer prevention, infertility, sterilization, advanced laparoscopic surgery , endometriosis and pelvic masses.

“OBSTETRICS AND GYNECOLOGY DEPARTMENT, AIMS TO PROVIDE HIGHQUALITY AND APPROPRIATE SERVICES.� To ensure the best condition of the expectant moms and their babies, an antenatal clinic is available for high-risk cases like diabetes with pregnancy, anemia, high blood pressure, previous pregnancy loss, previous Caesarian section, multiple pregnancies, breech presentation, growth restriction babies and premature labors. Dr Bishtawi, who is a Fellow of the Royal College of Obstetrician and

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Gynaecologists, UK (FRCOG), Fellow of the American College of Obstetrician and Gynaecologists (FACOG) has a European Diploma in Operative Endoscopy (France) and specialized in Gynecological Oncology (RCOG) United Kingdom has brought handful of experience to the Al-Ahli Hospital. “We have expanded and appointed new consultants to improve the services. We have diversity among the consultants because we live in a diverse country with people coming from different parts of the world. Services now available at the Ahli hospital is all aspects of Obstetrics and Gynecology,” said Dr Bishtawi. “We do have a fully integrated laparoscopic surgery. We have a group of laparoscopic surgeons and we are able to do the most advanced surgical procedures in gynecology, removal of cysts of ovary, management of endometriosis, remove fibroids , hysterectomy through keyhole surgery,” he added. Obstetrics and Gynecology Department at Al Ahli Hospital provides services to prevent and early detect gynecology-related problems. A programme has been established for prevention of cervical cancer and offer fast-track route for women who have abnormal pap smears and the colposcopy procedure. Colposcopy is a procedure to closely examine cervix, vagina and vulva for signs of disease. During colposcopy, your doctor uses a special instrument called a colposcope. The doctor may recommend colposcopy if Pap test result is abnormal. “We are proud to offer our patients a co- testing with high-risk HPV virus alongside the conventional pap smear test to improve the cervical

cancer screening efficiency. HPV vaccination will be available shortly in the hospital,” said Dr Bishtawi “We also have a programme specially aimed at women after the age of 50. We do screenings for women with high risk of ovarian cancer. We follow them closely with ultrasound

scan and blood tests”. He added Obstetrics and Gynecology Department at Al Ahli Hospital has a team of 13 consultants and 11 specialists to address all needs of patients. We aim to improve patents satisfaction and offering a state-ofthe-art services to our community.

Services at Al Ahli Hospital

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Sysmex joins the fight against AMR AMR knows no boundaries. It can affect anyone, of any age, in any country

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he phrase ‘survival of the fittest’ also applies to microbiology. Bacteria, viruses and parasites are constantly evolving and improving their strategies to make us their hosts. They can outsmart our medical advancements, and if we don’t take action, these microorganisms will become harder and harder to treat, or may even become untreatable. Antimicrobial resistance (AMR) is an ever-growing concern in the healthcare community. AMR is the ability of a microorganism such as bacteria, viruses and parasites to stop an antimicrobial (e.g. antibiotics) from working against it. Because this is already happening, more and more patients require very strong solutions, which can have harmful side effects

on the body. AMR can also lead to treatments becoming ineffective and accelerate the spread of infections. The United Nations has declared that AMR is a global health crisis and if we don’t act now, annual deaths related to AMR could surpass annual cancer fatalities.1 The World Health Organization created a global action plan to tackle AMR.2 The plan includes five strategic objectives, several of which we can directly support with our expertise at Sysmex.

The fight starts with diagnostics Specific diagnostic information can lead to more accurate diagnoses, thereby leaving fewer antimicrobial prescriptions to chance. That means

giving microorganisms fewer opportunities to evolve and outsmart antimicrobials. As an in-vitro diagnostics company, we offer innovative solutions to combat AMR because comprehensive UTI screening, malaria detection and finding the root cause of infections can help slow it down. Sysmex Middle East joined the World Antibiotic Awareness Week from 18-24 November to improve awareness and understanding of AMR, as well as learn about how Sysmex can support the optimal use of antimicrobials now and in the future. We invite you to participate and join the fight against AMR by spreading awareness with friends, family and colleagues. Follow us on social media for updates and use the hashtag #AMRfighter when sharing!

SOURCES 1 https://news.un.org/en/node/1025511/antimicrobial-resistance-a-global-health-emergency-un-ahead-of-awareness-week-2 2 https://www.who.int/antimicrobial-resistance/global-action-plan/en/

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Urinary tract infection (UTI)

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UTI is an infection which is often caused by bacteria in the urinary system. Urine is normally sterile, but an infection can occur when foreign bacteria are introduced into the urinary system. In most cases, bacteria travel up the urethra to the bladder. It is estimated that 150 million UTIs occur yearly on a global basis, making it one of the most frequent bacterial infections worldwide1. This is just one source contributing to the spread of antimicrobial resistance. There are countries in many parts of the world where treatment for UTIs with fluoroquinolone antibiotics is now ineffective in more than half of patients2.

The World Health Organization created a global action plan to tackle AMR.2 The plan includes five strategic objectives, several of which we can directly support with our expertise at Sysmex.

Affecting many more women than men, UTIs account for nearly 25% of all infections3 The first step in diagnosing a UTI is typically a simple dipstick test using a urine sample, which tests for nitrite-producing bacteria as well as the presence of white and red blood cells. It’s quick, but not the most accu-

rate or reliable method because it can result in a false negative4. Lab analysis of the urine can also consist of a urine culture, which can tell the physician of the presence of bacteria that may be causing the infection and lead the way for follow-up testing to identify the most effective medication. In an ideal situation, all samples that are suspected of UTI would be sent to the microbiology lab to have a culture created. This is not the case as it requires a lot of time and resources, so only the dipstick text is used. Even then, many of the samples that are sent for a culture are negative in the end. However, the result is only avail-

able after 12 to 24 hours which can sometimes lead to unnecessary antibiotic prescriptions on suspicion. In the Unispital ZĂźrich, for example, around 80% of cultures prepared on suspicion of UTI are negative, therefore the ability to rule UTI negative samples early on can save a lot of hassle5.

Imagine being able to rule out UTI negative samples in <1 minute If you would like to know more about how Sysmex solutions can help you optimise your laboratory workflow, check out our UN-Series. #AMRfighter

SOURCES 1 Flores-Mireles, A. L., Walker, J. N., Caparon, M., & Hultgren, S. J. (2015). Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nature reviews microbiology, 13(5), 269-284. 2 World Health Organization. (2018) Antimicrobial Resistance. https://www.who.int/en/news-room/fact-sheets/detail/antimicrobial-resistance 3 Foxman, B. (2002). Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. The American journal of medicine, 113(1), 5-13. 4 Mambatta, A. K., Jayalakshmi Jayarajan, V. L. R., Harini, S., Menon, S., & Kuppusamy, J. (2015). Reliability of dipstick assay in predicting urinary tract infection. Journal of family medicine and primary care, 4(2), 265. 5 Fischer, V. (2019). Ein neuer Schritt zur schnelleren Urinanalytik. xtra, 50-52.

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ARTICLE FEATURES . Cancer

Cancer A ray of hope that marked a turning point in the journey of eradicating it

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reating and eliminating cancer is the focus of scientists and those interested in medicine, as countries allocate huge budgets in order to find treatments to control this pernicious disease that kills millions of people around the world, according to statistics. Recent years have led to the emergence of a new generation of advanced treatments that have sparked hope, and can even be described as a turning point in the journey of eradicating cancer, while research that are in full swing today promises more results in the coming years.

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ARTICLE FEATURES . Cancer

In addition to modern and advanced treatments that have emerged, such as immunotherapy or targeted therapy, the combination of treatments has a significant positive impact with fewer side effects. In addition to the developments of traditional treatments such as chemotherapy and radiotherapy have in turn extended patients’ lives while reducing complications that the patient suffers from during his medical journey. It is also necessary to shed light on modern diagnostic methods and their ability to detect the presence of cancer while it is still in the formative stage. Four-dimensional imaging devices, accurate blood tests, genetic tests and DNA testing are all diagnostic methods that contributed to early detection of the disease, which increases the chances of treatment, in light of the increased awareness among societies of the need for regular follow-up and visiting the doctor once a year in order to perform some diagnostic tests that will contribute to monitoring and tracking the disease during its early stages.

Immunotherapy… A turning point in the process of fighting cancer Immunotherapy is treatment that uses certain parts of a person’s immune system to fight diseases such as cancer. This can be done by stimulating your own immune system to work harder or smarter to attack cancer cells and giving you immune system components, such as manmade immune system proteins. Among the most common cancers in which immunotherapy is used are skin cancer, lung cancer, breast cancer, colorectal cancer, Hodgkin lymphoma, urinary tract cancers, etc., at a time when research continues to reach promising results in the coming

period. Immunotherapy for cancer in the advanced stages has yielded positive results in terms of reducing the risk of disease recurrence after treatment and prolonging life, while many patients were permanently cured from cancer. This advanced treatment gave hope to patients who were condemned to death, especially skin and lung cancer patients, who had little chance of recovery, especially in advanced cases. Immunotherapy works better for some types of cancer than for others. It’s used by itself for some of these cancers, but for others it seems to work better when used with other types of treatment.

Combination Treatments Today, of the treatment protocols that led to amazing results is the combination of two types of treatments. Research has shown that immunotherapy-chemotherapy combinations double the survival rate while reducing the side effects that patients often feel when undergoing chemotherapy sessions. It is mainly important to develop a viable treatment strategy in accordance with international principles and protocols depending on the type of disease, its location and the general patient condition, provided that immunotherapy is the first line of defense alone or with chemotherapy. After the success of the combination, doctors began mixing immunotherapy and targeted therapy, which contributed to controlling several metastatic tumors, which were difficult to treat and eliminate in the past.

Targeted therapy… Kills only cancer cells Cancer-directed treatment is used in the patient’s body to eliminate the cancerous cell and preserve the normal cell while reducing the need for chemotherapy. This treatment pro-

vides effective results with less side effects compared to other treatments as it enters the affected cells, reduces and stops their spread, helping the cancer patient lead a normal life. Oncologists resort to this treatment for many types of cancer such as lung cancer, liver cancer, colon cancer, kidney cancer, breast cancer, ovarian cancer, among others. One of the advantages of this treatment is that it not only finds and destroys rapidly spreading cancer cells, but also keeps healthy cells without destroying them such as white blood cells, digestive cells and hair follicles, but not everyone suffering from cancer is a candidate for targeted therapy. This is the optimal type of cancer treatment, but the doctor must determine the extent of response to it. Before starting treatment sessions, several tests must be performed to determine the type of appropriate drugs that give the best results with the fewest side effects. The genetic nature of the detected cancer cells is also evaluated to know the nature of their growth and reproduction, which allows determining the use of targeted therapy that can change the nature of the work of the cancer cells and thus reduce the chances of cancer recurrence. As a result, this treatment is effective in advanced cases of cancer. This type of treatment has been extensively used in breast, colon, head and neck tumors, skin, kidney and ovarian tumors as well as lymphoma and the most important results have been skin tumors known as melanoma and liver cancer. Perhaps the patients that benefit from targeted therapy the most are breast cancer patients, as its use contributed to increasing the success of treatment and getting rid of the disease without its recurrence. Targeted therapy works by targeting

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the cancerâ&#x20AC;&#x2122;s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival.

Radiation Therapy Radiation therapy is a type of cancer treatment that uses beams of intense energy to kill cancer cells. Radiation therapy most often uses X-rays, but protons or other types of energy also can be used. Radiation therapy damages cells by destroying the genetic material that controls how cells grow and divide. While both healthy and cancerous cells are damaged by radiation therapy, the goal of radiation therapy is to destroy as few normal, healthy cells as possible. Normal cells can often repair much of the damage caused by radiation. Radiation therapy side effects depend on which part of your body is being exposed to radiation and how much radiation is used. You may experience no side effects, or you may experience several. Most side effects are temporary, can be controlled and generally disappear over time once

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treatment has ended. Your doctor may suggest radiation therapy as an option at different times during your cancer treatment and for different reasons, including as the only (primary) treatment for cancer, before surgery, to shrink a cancerous tumor (neoadjuvant therapy), after surgery, to stop the growth of any remaining cancer cells (adjuvant therapy), in combination with other treatments, such as chemotherapy, to destroy cancer cells or in advanced cancer to alleviate symptoms caused by the cancer. Cobalt radiation, or cobalt-60 therapy, is a specific type of radiation therapy that uses gamma rays from cobalt-60 radioisotopes to treat conditions such as cancer.

Chemotherapy Chemotherapy is a drug treatment that uses powerful chemicals to kill fast-growing cells in your body. It is most often used to treat cancer, since cancer cells grow and multiply much more quickly than most cells in the body. Many different chemo-

therapy drugs are available. Chemotherapy drugs can be used alone or in combination to treat a wide variety of cancers. Though chemotherapy is an effective way to treat many types of cancer, chemotherapy treatment also carries a risk of side effects. Some chemotherapy side effects are mild and treatable, while others can cause serious complications. Chemotherapy is used to kill cancer cells in people with cancer. There are a variety of settings in which chemotherapy may be used in people with cancer - to cure the cancer without other treatments, after other treatments, to kill hidden cancer cells, to prepare you for other treatments or to ease signs and symptoms. Chemotherapy drugs can also cause side effects that donâ&#x20AC;&#x2122;t become evident until months or years after treatment. Late side effects vary depending on the chemotherapy drug but can include damage to lung tissue, heart problems, infertility, kidney problems, nerve damage (peripheral neuropathy) and risk of a second cancer.


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SHEDDING LIGHT ON 2019 ACHIEVEMENTS IN THE JOURNEY TO FIGHT CANCER Cancer Center Director at Clemenceau Medical Center (CMC) affiliated with Johns Hopkins International

Professor Marwan Ghosn “We are witnessing a revolution at the level of early diagnosis and advanced treatments”

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he year 2019 complemented the previous years that recorded unprecedented medical achievements in the fight against cancer, described by Professor Marwan Ghosn, Cancer Center Director at Clemenceau Medical Center (CMC) affiliated with Johns Hopkins International as a “revolution” that affected the advanced diagnosis, the multiple treatments and patient monitoring with the importance of helping him return to his normal and productive life. In an interview with “Hospitals” magazine, Professor Ghosn says that this revolution is based on a remarkable discovery: the human genome and DNA analysis, which urged us to think of new methods for early diagnosis.

In highlighting the 2019 achievements in the fight against cancer, Professor Ghosn says that recent breakthrough in research will soon launch an early diagnosis examination for cancer cells before the formation of the tumor in the organ, which does not appear in the imaging devices despite their development, and it will be applied to about six types of cancer including breast, lung and colon cancer. This examination is a revolution in the diagnosis field; it is a blood test that captures the DNA sequence. After analyzing it in specialized laboratories, there are certain breaks that warn that cancer cells have started to nidate in a specific place in the human body, which means that cancer will appear in the coming period. Professor Ghosn confirms that

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the idea of this test is based on the principle of early diagnosis, which cannot appear on imaging devices that detect the disease. “When confirming the presence of the beginning of cancer cell formation somewhere in the human body, then we move to regular follow-up with the patient so that he is placed under observation according to a specific diagnostic program every two months until the disease appears, then we kill it off while it is still in the development stage.” In this context, Professor Ghosn confirms that this advanced test has nothing to do with hereditary or genetic tests; and the revolution in this test stems from the principle of detecting the formation of the cancer or its nidation before it appears on imaging devices such as MRI, CT-Scan, colonoscopy, and others. Professor Ghosn asserts that the

doctor must see the tumor in order to be able to kill it, which hasn’t been achieved by medicine until today, but the future promises further medical accomplishments.

Advanced Treatments and Artificial Intelligence We are still in the context of developments, and regarding the development of diagnostic tools, Professor Ghosn spoke about the revolution, but this time in the framework of diagnostic devices, whether at the level of imaging devices or blood tests but most importantly at the level of data management and building a computerized database where the medical sector benefited from the amazing progress of IT science and artificial intelligence. Although it was late in entering the world of medicine, but it was the latest qualitative


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shift that contributed to helping the doctor reach further discoveries after collecting the necessary information about the patient as well as his detailed medical history. In regard to the treatments and the extent of their development, Professor Ghosn discussed the astounding development of treatments, which have a very active role in destroying cancer. “When there is cancer, we rely on basic matters to treat it after diagnosis. The first step is to destroy the disease in its location and the second step is the possibility of a microscopic spread of cancer in another part of the body that must be also destroyed, hence, we must destroy the disease in situ in addition to its spread to other organs in the body,” he says. Killing the primary disease depends on three methods of treatment. The first is surgery, as this field witnessed a major surgical revolution, mainly the use of robotic surgery given its active role in helping the surgeon reach more accurate places in the body through the highly accurate robotic arms. In addition to robotic surgery, Professor Ghosn says that the world of surgery has witnessed amazing developments, whether at the level of surgical work or anesthesiology, in addition to the possibility of controlling post-operative complications such as bleeding, etc. “We resort to radiotherapy in order to control the tumor. This field has witnessed many amazing

developments. The state-of-the-art radiology equipment available today allow the doctor to perform targeted radiology sessions and X-rays can now be used on specific places only, and with the help of medical imaging technology and three-dimensional images that enable us to see the patient’s body very precisely and from several directions, so the doctor can reach his goal accurately without damaging other places,” said Professor Ghosn regarding the treatments.

Medical Treatments What about the medical treatments and developments in this field? In order to kill the disease locally and in all places in the body, we have medical treatments that enter the patient’s body whether orally or intravenously; it is neither radiotherapy nor surgery. Medical treatments have seen many developments, including: 1. Chemotherapy, which has witnessed significant development after scientific laboratories worked to create a new more sophisticated generation with fewer side effects. This modern formula makes chemotherapy more targeted towards the cancerous cell, meaning that it attracts it without the other parts of the body and is called “liposomal”.

2. The second medical treatment is targeted therapy, where receptors are present on the cancer cell

membrane, and some types of cancer have reached treatments that target them directly. The situation here is similar to the runway designated to receive the plane when landing, as is the case with targeted therapy that degrades the cell and prevents any spread or proliferation of the cancerous cell, but rather destroys and kills it.This treatment is available in the form of pills and injections, and there is a major development in order to find all types of receptors for the cancerous cell. Research is still underway to find a targeted therapy to every change in the DNA that leads to cancer. If we have targeted therapy to the change in the DNA sequence, the cancer will be destroyed and killed off. The problem is that there are some cancers that we treat successfully with targeted therapy such as chronic blood cancers, but sometimes the cancer cell reappears because it learns how to resist treatment such as lung cancer, which calls for regular check-ups and continuous monitoring. Talking about targeted therapy prompts us to mention the term “personalized medicine” because we do not treat all patients in the same way; it is another word to tell the patient that we have analyzed the DNA to look for a transformation or change in it that led to the emergence of cancer and treat it accordingly.

3. The third type of medical treatment is the one that gives

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orders to the immune system to work on destroying cancer; we mean immunotherapy, which caused a massive revolution in the journey of medical and scientific research to fight this malignant disease. There are some types of tumors that work on idling the immune system in order to multiply and spread randomly. This mechanism works according to a specific code called PD1- PDL1, a system in which cells communicate with one another. This treatment is very effective for some types of cancer such as skin and lung cancers and a certain number of breast, stomach and colon cancers, while work is underway to find more treatments. I would like to shed light on combination therapy and its benefits, as the combination of two types of treatments in a specific way such as chemotherapy and immunotherapy or targeted therapy has proven highly effective

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in fighting cancer. Research promises further developments at the level of combination therapy.

4. The fourth medical treatment is hormonal therapy, where some types of cancer can be killed off through hormonal change, mainly breast cancer through female hormones and prostate cancer through male hormones. There is a tremendous development in this field in recent years and we expect further development in the future. What about post-treatment, rehabilitation and prevention? After carrying out early diagnosis, treatment and recovery, we start focusing on two issues. The first is to prevent a new relapse by regularly monitoring the patient and performing accurate diagnostic tests and images in order to monitor any change or nidation of cancer cells because

early detection enables us to better kill off the disease. The second issue is the return of the patient to his normal productive life as it was before the disease, and it is a very important issue because the psychological aspect is key to the success of any treatment.

Despite this medical revolution, cancer cases are still on the rise. Today there is a higher life expectancy as the person is expected to live longer than he used to in the past, and this will certainly increase the presence of cancer cases because it is known that this disease increases with age. Second, we should not separate the person from his surrounding environment or external factors, mainly smoking and passive smoking, and the health risks that may arise as a result, whether cancer or other diseases, in addition to pollution and other factors.


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ARTICLE FEATURES . Sleep Apnea

Snoring is the first sign & has serious health consequences

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leep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts. If you snore loudly and feel tired even after a full nightâ&#x20AC;&#x2122;s sleep, you might have sleep apnea. The main types of sleep apnea are obstructive sleep apnea, the more common form that occurs when throat muscles relax Central sleep apnea, which occurs when your brain doesnâ&#x20AC;&#x2122;t send proper signals to the muscles that control breathing and complex sleep apnea syndrome, also known as treatment-emergent central sleep apnea, which occurs when someone has both obstructive sleep apnea and central sleep apnea.

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ARTICLE FEATURES . Sleep Apnea

The signs and symptoms of obstructive and central sleep apneas overlap, sometimes making it difficult to determine which type you have. The most common signs and symptoms of obstructive and central sleep apneas include loud snoring, episodes in which you stop breathing during sleep — which would be reported by another person, gasping for air during sleep, awakening with a dry mouth, morning headache, difficulty staying asleep, excessive daytime sleepiness (hypersomnia), difficulty paying attention while awake and irritability. Factors that increase the risk of this form of sleep apnea include excess weight, neck circumference, a narrowed airway, family history, use of alcohol, sedatives and tranquilizers, smoking and nasal congestion. Sleep apnea is a serious medical condition. Complications can include daytime fatigue, hypertension or heart problems, type 2 diabetes, metabolic syndrome, complications with medications and surgery and liver problems.

Diseases caused by sleep apnea There’s a wealth of research suggesting that sleep apnea and high blood pressure are a dangerous pair. Obstructive sleep apnea, which occurs when breathing is briefly and repeatedly interrupted during sleep, has been shown to increase risk for high blood pressure. Research also shows that high blood pressure, often referred to as the “silent killer,” can cause sleep apnea or worsen breathing in patients already affected by sleep apnea. Sleep apnea and high blood pressure have both been linked to significantly increased risk for serious complications, such as stroke and heart attack.

Research suggests that anywhere from 30–50% of patients with high blood pressure have sleep apnea. However, sleep apnea is much more common in patients with resistant hypertension, who have tried a variety of high blood pressure treatments but can’t get their condition under control. Patients with sleep apnea had a significantly higher prevalence of atrial fibrillation and ventricular arrhythmias. Sudden drops in blood oxygen levels that occur during sleep apnea increase blood pressure and strain the cardiovascular system. Researchers from the Sleep Heart Health Study (SHHS) report that the risk of stroke appears in men with mild sleep apnea and rises with the severity of sleep apnea. Men with moderate to severe sleep apnea were nearly three times more likely to have a stroke than men without sleep apnea or with mild sleep apnea.

Treatment Options Losing excess weight could be a good first step in treating obstructive sleep apnea. In addition to lifestyle changes that promote weight loss, other health changes could help a person reduce the symptoms of sleep apnea. Some examples of healthful lifestyle changes include refraining from smoking, which can lead to swelling in the upper airways, resulting in sleep apnea, refraining from drinking alcohol as it can relax the throat muscles and increase the likelihood of snoring and taking over-the-counter allergy medications or nasal decongestants to increase airflow by reducing swelling and fluid buildup in the nasal passages. Sleep apnea can be a serious condition. When a person stops breathing, the heart works overtime to pump

blood through the body to provide the oxygen that the body does not get during apnea episodes. This extra work can damage the heart and lead to high blood pressure and heart rhythm problems. Traditionally, doctors treat sleep apnea by having a person wear a special device called a continuous positive airway pressure (CPAP) machine. This machine fits over the mouth or nose and provides extra positive airway pressure to keep the airways from collapsing while a person sleeps, preventing apnea and snoring. An oral appliance, often called a mandibular repositioning device (MRD), is an effective additional therapy option and can be considered a first-line* of therapy for patients with mild to moderate sleep apnea. It is a custom-made, adjustable oral appliance available from a dentist that holds the lower jaw in a forward position during sleep. This mechanical protrusion expands the space behind the tongue, puts tension on the pharyngeal walls to reduce collapse of the airway and diminishes palate vibration. Another option is wearing an oral appliance designed to keep your throat open. CPAP is more reliably effective than oral appliances, but oral appliances might be easier to use. Some are designed to open your throat by bringing your jaw forward, which can sometimes relieve snoring and mild obstructive sleep apnea. A number of devices are available from your dentist. You might need to try different devices before finding one that works for you. Once you find the right fit, you’ll need to follow up with your dentist repeatedly during the first year and then regularly after that to ensure that the fit is still good and to reassess your signs and symptoms.

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Sleep Disorders and Their Treatments at Hôtel-Dieu de France

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eople spend about a third of their life asleep, which roughly equals 25 to 30 years of an average lifespan. Scientific studies have shown how vital it is to understand sleep and its disorders. About twenty years ago, the rapid development of this field led to a new medical specialization called sleep medicine. Doctors began to understand the importance of sleep in human life, how to conduct necessary sleep tests and research, as well as sleep’s effects, both positive and negative, on existing problems and diseases. The Sleep Center at Hôtel-Dieu de France was established more than ten years ago and has since registered around 4,000 cases. Today, it includes three rooms endowed with the latest equipment to study, treat and monitor sleep disorders.

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The center consists of four doctors specialized in sleep medicine in addition to their main specialties (the lungs and the nervous system), and of four technicians working nights to accompany patients and days to help the medical staff read results, as well

as nurses and administrators. “The Sleep Center at Hôtel-Dieu de France examines two types of problems: first, sleep-related problems, and second, health problems that increase sleep disturbances such as nervous system diseases, heart


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diseases, or respiratory diseases,” explained Professor Moussa Riachy, specialist in lung diseases and cardiopulmonary resuscitation and Director of the Sleep Center at Hôtel-Dieu de France. “The symptoms of sleep disturbances are numerous, but those sought out by doctors and suspected to be symptoms of sleep apnea are excessive daytime drowsiness and fatigue, difficulty concentrating and memory loss, high blood pressure problems without any prior cause, obesity in the neck, snoring and stopped breathing at night.”

Today, sleep apnea is the most common sleep disease as it affects 4% of men and 2% of women. It occurs during sleep through stopped or slowed breathing. With the medical and scientific progress made in recent years, it was found that sleep apnea causes many health problems such as heart attacks, strokes, diabetes and high blood pressure. The Sleep Center will diagnose the disease and determine its cause, pattern, severity and effects on the body upon waking up. Other diseases are studied and treated at the Sleep Center such as: respiratory failure due to airway or lung obstruction (especially among smokers who suffer from a decrease in oxygen

levels), rib cage contractions that limit the lungs’ functions, high pCO2 levels in the body, heart diseases, in addition to problems of sleep itself, such as excessive sleep, insomnia, sleepwalking or other disorders. “The Sleep Center conducts numerous studies; however they are mainly divided into four levels. The first is a comprehensive sleeping exam that includes a spirometry test, an electrocardiogram (ECG), an electroencephalogram (EEG) through up to 32 channels to determine the patient’s stage of sleep, monitoring of the sleep position, snoring and oxygen levels, in addition to being accompanied by a technician throughout the night. The second level of testing is often held outside the Center at the patient’s residency, which is why results between this test and the first one may differ from 15 to 20%. The third level includes tests to record sleep without an EEG. As for the fourth, it is a mere test to observe oxygen level fluctuations during the night”, explained Prof. Riachy. The Sleep Center at Hôtel-Dieu de France is endowed with the latest equipment enabling it to carry out numerous studies, including: a five-stage daytime exam to study the patient’s sleepiness degrees after spending a night at the Center, the BiPAP and Ventilation exams which test the Bi-

level Positive Airway Pressure as well as the ventilation pressure, or the Splitnight exam involving two stages, the first to get a diagnosis and the second to come up with a treatment, both conducted under the medical staff’s supervision who will determine the correct treatment doses. Sleep disorders are still new in the medical field, although they are very common and considered one of the main causes of many diseases including high blood pressure and heart diseases; however, the Lebanese society lacks awareness when it comes to sleep disorders. As studies increase, sleep disorders become more and more important as we understand their impact on our lives and health. After years of experience and treating many cases, the specialized team at Hôtel-Dieu de France is capable of identifying those who need to refer to the Sleep Center. “Fatigue during the day or after a meal is not normal,” advised Prof. Riachy stressing that, “Fatigue during the day, lack of concentration, memory loss, failing to wake up energized and well rested or failing to wake up at all are all indications that your body is not sleeping or resting enough, even if you slept for more than six hours. If your partner is suffering from agitated sleep, snoring or stopped breathing, they should also consider visiting the Sleep Center.”

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ARTICLE FEATURES . Artificial Intelligence

ARTIFICIAL INTELLIGENCE & ROBOTS IN MEDICINE The highest standards of technology and digital transformation

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rtificial intelligence in the healthcare sector has become an irreplaceable reality after it has proven its effectiveness thanks to the added value it provides, which positively reflected on the quality and efficiency of health services.

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Artificial intelligence techniques have significantly contributed to raising the quality of the health sector in the Gulf countries, and they allow early detection or prediction of diseases before they occur, in addition to exploring highly effective methods

of treatment and providing the best healthcare to patients with extreme accuracy. Artificial intelligence refers to systems or machines that mimic human intelligence to perform tasks and can iteratively improve themselves based on the information they collect.


ARTICLE FEATURES . Artificial Intelligence

It also enables the medical sector to harness this achievement in the field of medical diagnosis and reduce medical errors, which is considered one of the most complicated and difficult fields by healthcare providers. Doctors and healthcare providers agree that the introduction of artificial intelligence and robotics in the health sector will contribute significantly to reducing medical errors in addition to providing greater precision in surgical

work. Relying on artificial intelligence and robots in the health field will remarkably reduce medical errors and contribute to performing surgeries with almost 100% accuracy. The principle of patient healthcare is no longer confined to the hospital halls and patient rooms. Rather, it is today hypothetically supported by artificial intelligence and innovations that have reconsidered the concept of health benefits away from the traditional con-

cept. The medical sector in particular is one of the fields that have witnessed achievements and changes thanks to modern technology in accordance with the highest standards in the artificial intelligence field, which has proven highly effective in several areas that help the doctor in making the appropriate decision for the medical condition and raising work efficiency. These technologies have become one of the main pillars of the healthcare sector.

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Main Applications The medical sector is one of the fields that have been witnessing radical achievements and changes thanks to modern technology and artificial intelligence in accordance with the highest technological standards and digital transformation. The applications of artificial intelligence in the health sector came to serve humanity in general and patients in particular. There are multiple and various applications of artificial intelligence in the healthcare sector. Perhaps the most important fields that have benefited from this development are medical imaging, radiology, the pharmaceutical industry, and the research field, especially those related to cancer, methods of diagnosis and treatment. In addition, the field of artificial intelligence in the medical sector is characterized by raising the quality of health services and discovering diseases early or anticipating their occurrence, thus exploring methods of treatment and increasing their effectiveness due to early detection as well as providing the best and most accurate healthcare to patients. AI helps clinicians in terms of following a more comprehensive approach to disease management, better coordination of healthcare plans and helping patients to manage and comply with long-term treatment programs in a better way. The use of modern technologies and artificial intelligence contributes greatly to providing high-quality healthcare, as modern devices and technologies can diagnose many diseases in addition to their effective role in terms of reducing the spread of infection. Robotic surgery, digital pills and other artificial intelligence technologies have contributed to reshaping the healthcare industry

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while improving the quality of patient care and reducing healthcare costs. Artificial intelligence is also used to accurately detect some diseases, especially early-stage cancer. In addition, early medical diagnosis of diseases that may afflict a person is considered a future challenge, but with the introduction of artificial intelligence in the field of early medical diagnosis, it may have successful results; which is what we began to see by diagnosing some serious and incurable diseases by having the opportunity to discover an illness at an early stage. Advanced medical computers can also analyze CT scans and ultrasound, to provide conclusions in the fields of cancer and osteoporosis. On the other

hand, it is noteworthy that the presence of doctors is fundamental, but artificial intelligence techniques can be an additional tool that facilitates the doctor’s work to treat patients and detect many types of diseases at an early stage. These state-of-the-art technologies will serve as a doctor’s consultant who makes the treatment decision without replacing him, but the future of doctors depends on knowing its techniques and being familiar with them to the fullest extent. The use of modern technologies and artificial intelligence contributes to providing high-quality healthcare, through the possible diagnosis of many diseases in addition to reducing the spread of infection.

Robots and delicate surgeries The medical sector can significantly benefit from artificial intelligence that simulates the human mind. A robot, for instance, is a machine that acts like a human, responds to some of the sound effects and stores information. Robots are also used during surgery, called “robotic surgery”. It is an advanced form of minimally invasive or laparoscopic (small incision) surgery where surgeons use a computer-controlled robot to assist them in certain surgical procedures. The robot’s “hands” have a high degree of dexterity, allowing surgeons the ability to operate in very tight spaces in the body that would otherwise only be accessible through open surgery. Successful robotic surgery requires extensive training, experience and skill. Without a talented surgeon controlling the equipment, robot is just a sophisticated tool. Robotic surgeons should have a wealth of experience performing hundreds of complex procedures because they will manipulate the robot’s four arms by maneuvering two master controls that provide fingertip precision of movement. The use of high-definition 3D cameras allows surgeons close-up views of areas they aren’t able to see during open surgery. Fully articulating robotic arms mimic the movement of hands, allowing surgeons to have greater dexterity and control than is possible with conventional laparoscopic instruments. Robots cannot function without human intervention in any way. This high-tech tool is used by qualified surgeons who are highly qualified and trained. Robotic surgery provides an accurate diagnosis of the medical condition during surgery so the doctor can remove tissues as required while ensuring that the tumor is completely eradicated. Robotic surgery offers many benefits to patients compared to open surgery, including shorter hospitalization, reduced pain and discomfort, faster recovery time and return to normal activities, smaller incisions, resulting in reduced risk of infection, reduced blood loss and transfusions and minimal scarring.


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Artificial Intelligence Is Transforming Healthcare

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rtificial intelligence (AI) is revolutionizing healthcare. The primary aim of AI applications in healthcare is to analyze links between prevention or treatment approaches and patient outcomes. AI applications can save cost and time for the diagnosis and management of disease states, thus making healthcare more effective and efficient. AI enables fast and comprehensive analysis of huge data sets to effectively enable decision-making with speed and accuracy. AI is largely described to be of 2 types: virtual and physical. Virtual AI includes informatics from deep learning applications, such as electronic health records (EHRs) and image processing, to assist physicians with diagnosis and management of disease states. Physical AI includes mechanical advances, such as robotics in surgery and physical rehabilitation. Algorithms have been developed to train data sets for statistical applications to enable data processing with accuracy. These principles underlie machine learning (ML), which enables computers to make successful predictions using past experiences.

Concept of Artificial Intelligence

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AI in HealthCare In healthcare, AI is defined as the mimicking of human cognitive functions by computers. AI has been inspired by the functioning of biological neurons and includes the basics of sensing, recognition, and object recognition to enable machines to perform as good as or even better than humans. However, with the inherent lack of articulation and generation of insights, AI cannot replace physicians in healthcare. With no universally applicable rules in healthcare, AI must be supplemented with physician judgment in many instances. An extensive correlation of history and clinical findings is needed for the diagnosis or monitoring of any disease state. The physicianâ&#x20AC;&#x201C;patient relationship is guided by associative and lateral thinking and can influence management decisions. Machines can be more precise, reliable, and comprehensive and have relatively lower risk of bias; however, they still lack the elements of trust and empathy. There is a growing concern that AI systems learn by doing and, with repeat training, can outperform humans. AI holds a promising fu-

ture in health care but only when used with diligence for the right purposes.

Opportunities of AI in the HealthCare Context AI is already in healthcare and itâ&#x20AC;&#x2122;s fundamentally changing medicine. AI in healthcare mainly refers to caregivers and organizations accessing vast data sets of potentially life-saving information. This includes treatment methods and their outcomes, survival rates, and speed of care gathered across millions of patients, geographical locations, and innumerable and sometimes interconnected health conditions. New computing power can detect and analyze large and small trends from the data and even make predictions through machine learning thatâ&#x20AC;&#x2122;s designed to identify potential health outcomes.AI plays an important role in augmenting knowledge and improving outcomes in healthcare. AI has widespread applications for the prediction and diagnosis of disease, handling of large quantities of data and synthesis of insights, and maximizing efficiency and outcomes in medical management of disease states. Benefits of AI have been described for various diseases


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and outcomes; for example, in the prediction of sepsis in intensive care and diagnosis and classification of malignant lesions, retinal diseases, and pneumonia, among others. Principles of AI have been deployed in precision medicine to build precise, safe, and targeted therapies. There are enormous benefits to utilizing AI in healthcare. AI can be a great assist in routine clinical practice and research. Quick and easy access to information, increased outreach, and reduction of errors in diagnosis and treatment of disease are the key benefits of AI. Predictive diagnosis, precision medicine, and delivery of targeted therapies are some key areas in which AI has introduced significant improvements. Virtual follow-up and consultations provide effectiveness in terms of costs and time. For instance, AI-based telemedicine applications provide quality of care and reduce wait times and chances of infection acquired during hospital visits to patients. This ultimately results in high patient satisfaction during treatment. AI has several applications in diagnosis and decision support. AI enables decision-makers to access the right and up-to-date information to help make better decisions in real time. Application of AI has brought about an evolutionary change in radiological diagnosis by improving the value and accuracy of image analysis. Designs based on deep learning have enabled digital image analysis for the early detection of breast pathologies with precision. In another example, an ML software library has been trained to detect changes in Parkinsonâ&#x20AC;&#x2122;s disease by DaTscan image analysis. This library can be a useful adjunct to clinical diagnosis. AI also finds an application

in patient triage. Wearable devices have been designed to enable remote monitoring and analysis of vital signs and consciousness index. Algorithms have been trained to classify disease conditions based on severity. Models have been developed to triage patients and predict survival in the pre-hospital environment. Electronic triage (e-triage) finds utility in emergency departments. In a multicenter, retrospective, cross-sectional study of 172 726 emergency visits in urban and community emergency departments, e-triage was more accurate than the Emergency Severity Index (ESI) for triage. When compared to ESI, e-triage identified more than 10% (14 326 patients) of ESI level 3 patients who needed critical care or an emergency procedure and were up-triaged (6.2% e-triage vs 1.7% ESI) and needed hospitalization (45.4% e-triage vs 18.9% ESI).

Samer Ellahham MD,FACC,CPHQ Cleveland Clinic Abu Dhabi Al Falah Street Abu Dhabi, United Arab Emirates Mobile: 971508113142 ellahas@clevelandclinicabudhabi.ae

Conclusions Artificial intelligence (AI) in healthcare is the use of complex algorithms and software to emulate human cognition in the analysis of complicated medical data. Specifically, AI is the ability for computer algorithms to approximate conclusions without direct human input.The application of AI ranges from hospital administration to therapeutic decisions. AI is changing the medical landscape. Healthcare generates humongous data, which may be structured, unstructured and semi-structured. These data will be redundant unless it is interpreted and integrated into various algorithms, especially to predict outcomes. In AI, the algorithms are created in such a way that they can not only modify themselves in response to patterns in data set, they can also derive infer-

ences when applied to new data. In lieu of availability of humongous data, several predictive models have been developed in the context of healthcare administration and operations; clinical decision support; predictions in healthcare; patient monitoring; and healthcare interventions. AI seems to be an ideal tool for several practical applications in healthcare. A wide range of AI algorithms are available for managing and predicting healthcare processes into the various departments of a healthcare organization. Despite available evidence on the use of AI in patient flow management, the application is still in infancy. AI has the potential to radically change healthcare. In the future, AI has the potential to shift the focus away from disease to how to stay healthy.

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ARTICLE FEATURES . IoT healthcare wearable devices

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ARTICLE FEATURES . IoT healthcare wearable devices

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oday, the world is more prepared to use wearable devices in the healthcare field due to the technological development and digitization of the health sector on the one hand and because of people’s awareness about the importance of this type of devices and their important use as they simulate their daily needs; the devices have become smaller as well as more connected and linked to networks and other devices with the multiple and diverse tasks they perform. Internet of Healthcare Things (IoHT) has emerged in hospitals and has contributed to improving daily work and patient care, in addition to enhancing patient experience; there are endless benefits to the Internet of Healthcare Things in the medical sector. The wearable devices can be used efficiently as health monitoring system during daily routines in many places and situations. Wearable technology can assess patient heart activity outside of a laboratory or clinical environment. Wearable technologies enable the continuous monitoring of human physical activities and behaviors, as well as physiological and biochemical parameters during daily life. The most commonly measured data include vital signs such as heart rate, blood pressure, and body temperature, as well as blood oxygen saturation, posture, and physical activities through the use of electrocardiogram (ECG), ballistocardiogram (BCG) and other devices. Wearable devices have had a major impact in bringing about a shift at the personal healthcare level in light of the increasing dependence on modern technologies as they are considered an effective way to get rid of bad health habits and maintain a

healthy life. Whereas continuous monitoring helps to manage health better, and provides its user with an active and comfortable life experience. The GCC countries were among the leading countries that invested in the Internet of Healthcare Things with no less than two billion dollars, according to a report issued by Ardent Consulting for financial analyses entitled “Governmental Focus Areas in the HealthCare Sector in the Gulf Cooperation Council Countries.” Today, many companies specialized in medical technology have entered into the wearable medical devices industry as they contribute to reducing doctor’s or physiotherapist’s visits, especially post-surgery, and monitoring vital activities. There are many wearable devices frequently used in societies, including smart watches that measure vital functions in the body and give an alert if a sudden event occurred. There are also sports apparel that teach the user to exercise properly in order to avoid injuries, while other devices are placed on the back to indicate a poor posture that damages the spine. Such devices would encourage community members to adopt a healthy behavior and better manage their lives while controlling their health condition in the case of chronic diseases. The spread of consumer wearable devices and other medical devices is also applied along with artificial intelligence in order to control some heart disease in its early stages, as the treating doctor can better monitor the disease to detect heart attacks that may be life-threatening in the early and more treatable stages. Benefiting from wearable devices and collecting patient information continuously and regularly helps the patient to receive better care at any

time and place because they are no longer restricted to visiting a doctor or a health institution. These developments have contributed effectively to providing a new opportunity to improve treatment outcomes in hospitals and clinics, even in relation to patients caring for themselves through these state-of-the-art wearable technologies and the Internet of things that allow them to control their surroundings and monitor their vital functions through solutions that include mobile applications that the patient can control. By relying on the appropriate technology, doctors can closely monitor your blood pressure over a few days and weeks. Cardiologists can also find evidence faster for arrhythmias through the data collected by wearable technologies and its associated applications; while diabetics can regularly check their blood sugar levels, and record them automatically. These devices collect data to be presented to the doctor when needed in order to determine the patient’s health status. The set of readings and data collected by the device worn by the patient give a clearer picture of the health condition so the doctor can diagnose it more accurately with the ability to monitor the patient continuously. These advanced devices will strengthen the concept of preventive medicine, as prevention has become a major area of focus where healthcare expenditures are expected to grow in the future.

Internet of Things Internet of Healthcare Things (IoHT) are used via remote monitoring technologies, smart sensors, activity trackers, wearable biometric sensors, glucose and blood pressure monitors, medication dispensers and smart beds. These technologies will improve

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every aspect of healthcare and change the way it is managed. The Internet of Things and wearable devices are also used to improve patientsâ&#x20AC;&#x2122; health. They report when there is arrhythmia or if the patient failed to take care of himself and share that information on other devices used while working. By updating the patientsâ&#x20AC;&#x2122; personal health data, these devices ensure that every fine detail is taken into account in order to make the most beneficial decisions to patients. Moreover, they can be used as a tool for medical commitment and patient home monitoring. The Internet of Things can also enable healthcare teams to collect millions of data points and connect them to personal fitness through wearable devices such as heart rate, sleep, sweat, temperature and activity; therefore, the information fed by the sensors can send alerts to patients and caregivers in real time, so they can obtain alerts and stimuli to increase the

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heart rate and other vital functions. This will not only improve the workflow process but also ensure that you can manage your health from home.

Smart Watches Watches are no longer used for showing the time or date, but today they have become a body movement sensor through which the number of steps and calories burned can be tracked while the heart rate, blood pressure and blood sugar levels can be monitored. The smart watch allows to track and monitor health indicators and vital functions in the body through the variety of accurate readings of body indicators during physical activities. Smart health watches monitor the health status around the clock, seven days a week, and have the ability to smartly read body indicators in order to provide a detailed analysis, which contributes to improving the patientâ&#x20AC;&#x2122;s fitness. The heart rate as well

as sleep patterns can be closely monitored while data collection can be used to improve overall sleep quality and track fitness levels, among others. In addition, some medical companies working in the medical devices field have developed smart watches for those suffering from the risk of developing chronic diseases such as high blood pressure through the availability of a technology that monitors blood pressure and the heart rate while warning the patient in the event of tachycardia, in addition to tracking the number of steps and calories, as well as monitoring respiration, resting time, activity and sleep. Smart bands focus on fitness through its features that help maintain health. Other features include meters, heart rate monitors screens, sleep screens etc. For everyone exercising outdoors or at the gym, they can track their physical activity and monitor their health condition as well


ARTICLE FEATURES . IoT healthcare wearable devices

as their sleep cycles, deep sleep analysis and quality while monitoring their heart rate, respiration among others.

Smartphonesâ&#x20AC;&#x2122; effective role Smartphones have had an effective role in the era of technology, as they provided many facilities, including easy data and medical files transfer among doctors, which means that the doctor, through his mobile phone, can view the patientâ&#x20AC;&#x2122;s exams or diagnostic images with the possibility of easily ending them to other doctors inside or outside the country. On the other hand, many health applications that help the patient monitor his vital functions such as heart beat, blood pressure and blood

sugar levels, while reminding him of when to take his medication, eat food and others. It is true that some of these applications may not have the necessary accuracy, but they urge the patient to monitor their health condition more before going to the specialist doctor. Mobile health applications are similar to medical devices built into a mobile phone, which turns into an electronic medical platform for monitoring vital health signals such as weight, cholesterol levels, etc.; however, some warn against the consequences of relying only on these applications due to its possibility of containing inaccurate information and does not meet the health requirements of some health conditions,

especially if the person suffers from some health problems and health disorders that require regular follow-up with his doctor. Among the useful applications in this regard are those that document information such as the number of hours of sleep, the timing and type of food whether it is healthy or not in addition to exercise, as it contributes to collecting and archiving health information while helping to reach a specific goal by tracking progress gradually. Some of these health applications have had a positive role for their user in terms of losing weight and reducing blood pressure, which means that they can contribute to improving the lifestyle and daily routine.

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Anti cancer vaccine By Dr. Asmaa Abdulsalam Consultant of Obstetrics and Gynecology at Al Ahli Hospital

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t is well known and for a long time that vaccines can be used to protect against many infectious diseases.

But does this apply to cancer prevention? Yes, the HPV vaccine can be used to prevent infection with the Human Papilloma Virus which is the main cause of cervical cancer in women. However, it should be clear that the HPV vaccine cannot treat already existing HPV infection either existing cervical pathology.HPV virus is a DNA virus that once enters the cell will look for the nucleus, occupying it and multiply inside using E6 and E7 oncoproteins to dysregulate the host cell cycle control and abrogating the host cells antiproliferative response. HPV types 16 and 18 are the most common oncogenic types found in cervical cancer. HPV is sexually transmitted, full penetration during the sexual relationship is not a requirement to get the infection as condoms will provide only partial protection, anecdotal reports of transmission by fingers or fomites are available.Risk of acquiring HPV

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infection increases by increasing the number of sexual partners.Smoking, HIV infection, long-term use of oral contraception, and high parity will influence progress from HPV infection to advanced high-grade intraepithelial lesions and cancer.Cervical cancer is a late complication of Persistent HPV infection. HPV infection control in cervical neoplasia can be achieved by natural immunity HPV vaccine has been proved to be very effective in the prevention of type 16 and 18 associated CIN in women aged 24 to 45 years old provided that they are free of HPV virus 16 &18, however, the optimal age to receive the vaccine is a pre-adolescent period. There are 2 types of the vaccine the BIVALENT AND QUADRIVALENT, there is evidence that the bivalent vaccine provides significant cross-protection against CIN2 associated with HPV virus types 31,33, 45 and the quadrivalent vaccine against CIN 2 associated with type 31. The need for booster dose vaccination to maintain protection to be determined by further follow-up research. But what if the infection already exists? Here comes the PAP

smear as a second line of protection as it detects any changes in the cells of the cervix before it changes into cancer by many long years with subsequent allows medical intervention at the proper time. Cancer cervix is unique among other cancers in that there are screening tests that can predict it before it happens, and once tissue changes detected it could be eradicated effectively by different methods like cryotherapy, Elecrtodiathermy, laser and,  cone biopsy up to hysterectomy. Cervix cancer has almost disappeared from the list of women cancers in developed countries which apply strict screening program for cervix cancer meanwhile cancer cervix remains on the top of the list of women cancers in less developed countries which lack such preventive prophylactic programs.In conclusion, there are many strong effective methods to protect against cancer cervix including HPV vaccine and screening test, So every woman during the reproductive age group should seek regular checkups and follow screening programs regularly.


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Coccygodynia Tailbone pain

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ailbone pain is a debilitating condition whose incidence is rising due to our increasingly sedentary lifestyles. Though this condition is rare, it can be quite painful and unpleasant socially. The terms coccydynia, coccygodynia and coxalgia are synonyms. Simpson introduced the term coccygodynia in 1859, though the condition was known since the 16th century. Women are five times more predisposed to this condition and so are obese people.

Causes: •

• •

Anatomy and function The term coccyx originates from the Greek work kokkyx, which means the cuckoo bird as its beak is shaped like the coccyx. (Figure 1) The coccyx is a triangular bone that consists of 3 to 5 fused segments, the largest of which articulates with the lowest sacral segment. Despite its small size, the coccyx has several important functions. Along with being the insertion site for multiple muscles, ligaments, and tendons, it also serves as one leg of the tripod— along with the ischial tuberosities (the bones on which we sit)—that provides weight-bearing support to a person in the seated position. The coccyx also provides support to the anus.

Trauma- direct falls or hits can cause fractures, subluxations or hypermobility of the coccyx .Trauma during delivery is also a common cause. Prolonged sitting on hard surfaces is a common cause. Obesity has a direct bearing on this condition because the coccyx juts out posteriorly due to the weight. Ironically rapid weight loss can also cause coccygodynia due to loss of cushioning effect. Non-traumatic coccygodynia can be due to infective causes like pilonidal sinus, degenerative disc disease and very rarely tumours. Usually the pain is related to prolonged sitting especially with a poor posture (television disease as described by Shapiro in 1950).The pain is aggravated by sitting on hard surfaces or during defecation.

Investigations: Investigations are not always required. However, x-rays (static and dynamic) are done to rule out fractures, subluxations or instability. MRI may be helpful to diagnose inflammation, which suggests hypermobility and to diagnose tumours.

Management

Figure 1

Conservative or non-interventional treatment is usually successful in more than 90 percent of cases. This involves anti-inflammatory medication orally or

Dr. Sumukh Khandekar Department of Trauma and Orthopaedics at Al Ahli Hospital

Figure 2 topically. Avoiding pressure on the coccyx by using modified wedge-shaped cushions is beneficial.(Figure 2) Physiotherapy including TENS (transcutaneous electrical stimulation) and manipulation may help in refractory cases. Injections of local anaesthetic with or without steroids are usually done under image guidance (fluoroscopy) due to the proximity of the rectum and anal canal. Caudal epidural injections and ganglion impar (of Walther) blocks may help. The current literature suggests that a coccygectomy may provide relief in an appropriate subset of patients who have failed all other treatments. A multidisciplinary approach employing physical therapy, ergonomic adaptations, medications (NSAIDs), injections, and, possibly, psychotherapy leads to the greatest chance of success in these patients.

References: 1. Lirette, Lesley Smallwood et al. “Coccydynia: an overview of the anatomy, etiology, and treatment of coccyx pain.” The Ochsner journal vol. 14, 1 (2014): 84-7. 2. Maigne JY, Doursounian L, Chatellier G. Causes and mechanisms of common coccydynia: Role of body mass index and coccygeal trauma. Spine. 2000; 25:3072–9 3. Nathan S. T., Fisher B. E., and Roberts C. S. Coccydynia The Journal of Bone and Joint Surgery. British volume 2010 92-B:12, 1622-1627

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Facts about Obesity What is obesity? Obesity is a chronic condition defined by an excess amount of body fat.

What are the health risks associated with obesity? Obesity is not just a cosmetic consideration; it is harmful to one’s health as it increases the risk of developing a number of chronic diseases, including the following: • Insulin resistance and Type 2 diabetes. • Hypertension • Hypercholesterolemia • Stroke (cerebrovascular accidents) • Heart attack. • Congestive heart failure • Gallstones

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• •

• •

Gout and gouty arthritis Osteoarthritis (degenerative arthritis) of the knees, hips, and the lower back Sleep apnea Cancer. Obesity is a risk factor for cancer of the colon in men and women, cancer of the rectum and prostate in men, and cancer of the gallbladder and uterus in women. Obesity may also be associated with breast cancer, particularly in postmenopausal women.

What causes obesity? The balance between calorie intake and energy expenditure determines a person’s weight. If a person eats more calories than he or she burns (metabolizes), the person gains weight (the body will store the excess energy as fat). Ultimately, bodyweight is the result of genetics, metabolism, environment, behavior, and culture. • Genetics. A person is more likely to develop obesity if one or both parents are obese. • Overeating, especially if the diet is high in fat or sugar. • A diet high in simple carbohydrates. • Frequency of eating. • Physical inactivity. Sedentary people burn fewer calories than people who are active. • Medications. Medications associated with weight gain include certain antidepressants, anticonvulsants, some diabetes medications, certain hormones, and most corticosteroids. Some high blood pres-

• •

sure medications and antihistamines cause weight gain. Psychological factors. Diseases such as hypothyroidism, insulin resistance, polycystic ovary syndrome, and Cushing’s syndrome are also contributors to obesity. Social issues

What is the body mass index (BMI)? The body mass index (BMI) is now the measurement of choice for physicians and researchers studying obesity. The body mass index (BMI) equals a person’s weight in kilograms (kg) divided by their height in meters (m) squared. The World Health Organization uses a classification system using the BMI to define overweight and obesity. • A BMI of 25 to 29.9 is defined as a “pre-obese.” • A BMI of 30 to 34.99 is defined as “obese class I.” • A BMI of 35 to 39.99 is defined as “obese class II.” • A BMI of or greater than 40.00 is defined as “obese class III.”

What is the role of physical activity and exercise in obesity? Physical activity and exercise help burn calories. The amount of calories burned depends on the type, duration, and intensity of the activity. It also depends on the weight of the person. But exercise as a treatment for obesity is most effective when combined with a diet and weight-loss program. Other benefits of exercise include • Improved blood sugar control and increased insulin sensitivity (decreased insulin resis-


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• • • •

tance) Reduced triglyceride levels and increased "good" HDL cholesterol levels Lowered blood pressure a reduction in abdominal fat Reduced risk of heart disease release of endorphins that make people feel good.

What is the role of diet in the treatment of obesity? The first goal of dieting is to stop further weight gain. The next goal is to establish realistic weight-loss goals. General diet guidelines for achieving and maintaining a healthy weight • A safe and effective long-term weight reduction and maintenance diet have to contain balanced, nutritious foods to avoid vitamin deficiencies and other diseases of malnutrition. • Eat more nutritious foods that have “low energy density.” Low energy-dense foods contain relatively few calories per unit weight (fewer calories in a large amount of food). Examples include vegetables, fruits, lean meat, fish, grains, and beans. • Eat less “energy-dense foods.” Energy-dense foods are high in fats and simple sugars. They generally have a high-calorie value in a small amount of food. Examples include red meat, egg yolks, fried foods, high fat/sugar fast foods, sweets, pastries, butter, and high-fat salad dressings. • About 55% of calories in the diet should be from complex carbohydrates. Eat more complex carbohydrates such

as brown rice, whole-grain bread, fruits, and vegetables. Avoid simple carbohydrates such as table sugars, sweets, doughnuts, cakes, and muffins.

What is the role of medication in the treatment of obesity? Medication treatment of obesity should be used only in patients who have health risks related to obesity. Medications should be used in patients with a BMI greater than 30 or in those with a BMI of greater than 27 who have other medical conditions (such as high blood pressure, diabetes, high blood cholesterol) that put them at risk for developing heart disease. Medications should not be used for cosmetic reasons. Medications should only be used as an adjunct to diet modifications and an exercise program.

Dr. Bakhos Alhaddad Specialist General Surgeon at Al Ahli Hospital

What is the role of weight loss surgery in the treatment of obesity?

The National Institute of Health consensus has suggested the following guidelines for weight loss surgery in obese patients: • Patients with a BMI of greater than 40 (morbid obesity) • Patients with a BMI of greater than 35 who have serious medical problems such as sleep apnea that would improve with weight loss

strict the size of the stomach but also bypass or remove part of your digestive system to decrease the absorption of food/calories. The Common Surgical Bariatric Procedures: Laparoscopic Adjustable Gastric Banding, Laparoscopic Sleeve Gastrectomy, Laparoscopic Gastric Bypass, and Laparoscopic Gastric Mini Bypass. The Common Endoscopic Bariatric Procedures: Intra-Gastric Balloons, Intra-Gastric Botox Injection, and POSE Procedure.

Conclusion: Currently, there are basically two types of bariatric surgery: • Restrictive surgeries: These surgeries restrict the size of the stomach and slow down digestion. • Malabsorptive/restrictive surgeries: These surgeries re-

Maintaining your ideal body weight is a balancing act between food consumption and calories needed by the body for energy. You are what you eat. The kinds and amounts of food you eat affect your ability to maintain your ideal weight and to lose weight.

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ARTICLE FEATURES . Deep Brain Stimulation

DEEP BRAIN STIMULATION A globally recognized surgical procedure JAN.FEB 2020

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ARTICLE FEATURES . Deep Brain Stimulation

D

eep brain stimulation (DBS) is a surgery that involves implanting electrodes within certain areas of your brain. These electrodes produce electrical impulses that regulate abnormal impulses. Or the electrical impulses can affect certain cells and chemicals within the brain. The amount of stimulation in deep brain stimulation is controlled by a pacemaker-like device placed under the skin in your upper chest. A wire that travels under your skin connects this device to the electrodes in your brain. This advanced treatment is now widely used especially for the treatment of epilepsy and Parkinson’s disease. DBS can help reduce the symptoms of tremor, slowness, stiffness, and walking problems caused by Parkinson’s disease, dystonia, or essential tremor. Successful DBS allows people to potentially reduce their medications and improve their quality of life. Today there are sophisticated devices that are effectively implanted and the patient does not need more surgical interventions due to the external programming and maintenance of the device, which prevents the side effects of surgery and unnecessary costs, and more importantly, the tangible improvement of the condition after the patients had lost hope of recovery. In deep brain stimulation, electrodes are placed in a specific area of the brain depending on the symptoms being treated. The electrodes are placed on both the left and right sides of the brain through small holes made at the top of the skull. The electrodes are connected by long wires that travel under the skin and down the neck to a battery-powered stimulator under the skin of the chest. When turned on, the stimulator sends electrical pulses to block the faulty nerve signals causing

tremors, rigidity, and other symptoms. The patient uses a handheld controller to turn the DBS system on and off. The doctor programs the stimulator settings with a wireless device. The stimulation settings can be adjusted as a patient’s condition changes over time. Unlike other surgeries, DBS does not damage the brain tissue. Thus, if better treatments develop in the future, the DBS procedure can be reversed. One of the advantages of brain stimulation is to improve the motor function so that the patient is able to accomplish his daily activities, return to work and reduce the symptoms of the disease over time, which was proved a year after the transplant procedure, especially if accompanied with drug therapy. In addition, patients can stop or reduce their oral medications intake over time, which reduces the side effects of these treatments. This modern method has also contributed to improving the quality of sleep in patients, reducing the intensity of involuntary movements in addition to enhancing motor function.

How is DBS performed? Deep brain stimulation is a serious and potentially risky procedure. Even if you might be eligible for deep brain stimulation, you and your doctors must carefully weigh the risks and potential benefits of the procedure. Before surgery, you’ll need medical tests to make sure that deep brain stimulation is a safe and appropriate option for you. You’ll also need brain-imaging studies, such as an MRI, before the surgery, to map the areas of your brain to implant the electrodes. For the brain surgery portion, your care team fits you with a special head frame to keep your head still during the procedure. Then, team members

use magnetic resonance imaging (MRI) to map your brain and identify the area in your brain where they’ll place the electrodes. Surgery can be done with you awake and alert and you’ll be given a local anesthetic to numb your scalp before the procedure, but you won’t need an anesthetic in your brain itself because the brain has no pain receptors. Your surgeon implants a thin wire lead with a number of contacts (electrodes) at the tips into a specific area of your brain. Or one lead is implanted into each side of the brain (for a total of two leads). A wire runs under your skin to a pulse generator (neurostimulator) implanted near your collarbone. During surgery, both the neurologist and surgeon carefully monitor your brain to help ensure correct electrode placement. During the second portion of the surgery, the surgeon implants the part of the device that contains the batteries (pulse generator) under the skin in your chest, near your collarbone. General anesthesia is used during this procedure. Wires from the brain electrodes are placed under your skin and guided down to the battery-operated pulse generator. The generator is programmed to send continuous electrical pulses to your brain. You control the generator, and you can turn it on or off using a special remote control. Stimulation may be constant, 24 hours a day, or your doctor may advise you to turn your pulse generator off at night and back on in the morning, depending on your condition. You can turn stimulation on and off with a special remote control that you’ll take home with you. In some cases, your doctor may program the pulse generator to let you make minor adjustments at home. The battery life of your generator varies with usage and

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settings. When the battery needs to be replaced, your surgeon will replace the generator during an outpatient procedure.

Parkinson’s Disease For people living with Parkinson’s disease and essential tremor, deep brain stimulation can be a revelation as they manage complex medical conditions, transforming their lives for the better. Deep brain stimulation is one of the most important modern methods in the treatment of Parkinson’s disease, especially in the early stages of the disease. In recent years, a new and advanced generation of deep brain stimulation has emerged, thanks to studies and research by specialized companies that have led to the emergence of these innovative treatments for Parkinson’s disease. Parkinson’s disease is a progressive nervous system disorder that affects movement. Symptoms start gradually, sometimes starting with a barely noticeable tremor in just one hand. Tremors are common, but the disorder also commonly causes stiffness or slowing of movement. In the early stages of Parkinson’s disease, your face may show little or no expression. Your arms may not swing when you walk. Your speech may become soft or slurred. Parkinson’s disease symptoms worsen as your condition progresses over time. DBS won’t cure your disease, but it may help lessen your symptoms. If deep brain stimulation works, your symptoms will improve significantly, but they usually don’t go away completely. In some cases, medications may still be needed for certain conditions. Parkinson’s signs and symptoms may include tremor, slowed movement, rigid muscles, impaired posture and balance, loss of

automatic movements, speech and writing changes. Deep brain stimulation is a process that sends electrical impulses to parts of your brain that aren’t working properly, enabling the currents to realign. A DBS system helps to restore the stability of brain circuits that have been disturbed so your brain activity returns to normal. To target symptoms of Parkinson’s disease, doctors first implant a medical device called a neurostimulator. The device, operated by a battery, sends electrical stimulation to the directional lead. This lead delivers these stimulation pulses to a certain area of your brain that controls movements. The electrical stimulation halts abnormal

nerve signals that trigger the most debilitating Parkinson’s effects. For example, DBS helps control tremor, rigidity, stiffness, slowed movement, and walking problems that often come with PD. DBS is also a highly effective medical therapy for people with essential tremor, a common movement disorder that causes people’s hands or arms to shake while doing daily activities such as eating, drinking, or writing. An essential tremor may impact your head, vocal cords and tongue and worsen with stress, fatigue or stimulant medications. DBS can block the abnormal nerve signals in your brain that cause these hand and arm tremors, restoring your natural balance.

Patients with Epilepsy Epilepsy is a central nervous system disorder in which brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations, and sometimes loss of awareness. If your epilepsy isn’t getting better with the treatments you get now, you may want to try deep brain stimulation. In this treatment, your doctor places small electrodes into your brain to help control your seizures. These electrodes deliver an electric current. This interrupts the abnormal electrical signals and helps prevent seizures.

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IHTF’19, Jordan presents broader outlook in medical tourism Review by Dr Prem Jagyasi

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he International Healthcare Travel Forum (IHTF’19) held from 26th -28th October in Jordan marked another great event of the MENA medical tourism sector. It was a meticulously planned event organized by the PHA (Private Hospitals Association) in coordination with the Arab Health Foundation and GHTC under the royal patronage of His Majesty King Abdullah II Ibn Al Hussein.

and organizing efforts of Dr. Fauzi Al Hammouri, the Chairman of PHA and the honorary president of GHTC ensured the best level of comfort for every guest. Jordan leads in healthcare tourism in the MENA region for its excellence in healthcare services, affordable treatment costs and great patient experience. It also holds a significant position in the global medical tourism sector.

The forum was aimed at developing coordination among all medical tourism destinations and stakeholders. Extraordinary planning

The Meet

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The forum welcomed more than 700 participants including renowned personalities and professionals of the

global medical tourism sector from 48 countries and 38 exhibitors. Of all, the presence of Jordan’s honorable Prime Minister Mr. H.E. Dr.OmarAl Razzaz was of immense significance. His statement on continued support from the government in expanding Jordan’s healthcare tourism was cheered. The fascinating 3-day meet witnessed insightful presentations and panel discussions on various development aspects of healthcare tourism development in view of the current and future trends. Dr Prem Jagyasi, the award-winning globally recognized speaker presented the keynote


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speech on ‘The Future of Global Healthcare’, a relevant subject given the objective of the meet. It was encouraging to see leading decision-makers active in information and experience-sharing to uplift healthcare tourism in this region. Special awards were presented to many international dignitaries and Arab ministers. The exhibition pavilion, inaugurated on the opening day, caught everybody’s attention mainly due to the honorable prime minister’s interest in it. It was a great networking opportunity for the exhibitors from reputed organizations and institutions having a stake in the medical tourism business.

Medical tourism in Jordan Jordan’s healthcare is founded on high-quality standards. It attracts more than 200,000 patients from 62 countries every year. Each patient is accompanied by one or more than one family member or friend. In every 3 patients treated in the out-patient setting, 1 patient is treated in the in-patient setting. Healthcare tourism in Jordan fetches nearly $1.2 billion in

revenue annually contributing 3.7% to the country’s GDP. Jordan, despite a small country, has great medical achievements to its credit. It is the first country in the Arab region to conduct kidney and cardiac transplant. It is also the first country to conduct laparoscopic surgery, liver and bone marrow transplant and IVF treatment successfully in this region. Jordan has several JCI accredited

hospitals. The King Hussein Medical Center is a well-known center of excellence. The King Hussein Cancer Center is the first center outside the US to achieve JCI accreditation. It is recognized as one of the best cancer treatment centers in the world. The King Hussein Medical Center is also working on advanced stem cell treatments under the patronization of his Majesty King Abdullah II Ibn Al Hussein. Jordan receives appreciable participation from the public and private sectors in establishing state-ofthe-art medical facilities the latest one being the Abdali Medical Center.

The Agenda IHTF’19 agenda was based on the following: 1. Expansion of Healthcare Travel – Ministerial Summit 2. Healthcare Excellence in Jordan 3. Legislation, Regulations and Accreditations 4. Implementing the Amman Declaration, The 8 Healthcare Travel Segments 5. Media and Digital Trends in

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Healthcare Healthcare Marketing and Branding 7. Patient’s Experience Prominent personalities/professionals from ministries, healthcare institutions, medical tourism facilitators, healthcare companies, travel organizations, print and media persons, wellness and spa service providers and insurance companies shared their opinions from different viewpoints. 6.

The ministerial summit was impressive. The government’s intent was clear in expanding healthcare travel to meet the growing demands of healthcare travelers. It focused on expand-

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ing the eight segments as adopted in the Amman Declaration couple of years before. Several investment opportunities were promoted that is sure to bring in quick returns.

ing technology, precision medicine, blockchain technology and telemedicine in improving treatment outcome and reducing healthcare cost. The audience acknowledged with great applause.

Dr Prem on the future of global healthcare

Healthcare excellence in Jordan

As the keynote speaker, Dr Prem’s speech on the future of global healthcare was very stimulating. The healthcare delivery is witnessing a revolutionary change driven by tech disruptors and cutting-edge treatments. He discussed about the potential of AI, AR/VR, Mobile health, IoT, wearable, genomics, regenerative medicine, immunotherapy, 3D print-

It was another important session highly absorbing. A great platform to showcase Jordon’s healthcare excellence and the speakers did it very well. There were discussions on treatment developments in different facilities. Special reference was of excellence in cardiac and cancer treatments. Pain management and palliative care was also featured in the discussions.


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Legislation, Regulations and Accreditations This session saw some thought-provoking presentations from recognized healthcare tourism personalities. Few case studies were referred that supported the importance of legislation, regulations and accreditations in healthcare beneficial both for domestic and foreign patients. Healthcare regulations are stringent in Jordan. The country has well-framed malpractice laws that help in confidence-building among foreign patients. Presentations from the Jordan Medical Association also highlighted its valuable contribution to the growth of this sector.

Implementation of the Amman Declaration Medical tourism is spreading out its arms. Strategies were discussed to build other sectors of health and wellness in Jordan with special emphasis on spa services, thermal springs and the Dead Sea. Other segments considered for discussion included Dental Tourism, Culinary Tourism, Sports Tourism, Accessible Tourism and Assisted Residential Tourism.

The only cons - high cost and doesn’t reach fast to consumers. She drew a fair comparison between the print and digital media. Healthcare digitalization and the role of enterprise resource planning and its effective application in healthcare systems were also given due attention. Dr Prem discussed on Developing Sustainable Healthcare Marketing and Branding for Global Outreach. He also underscored the impact of social media on medical travel. Organizers did not miss a session on Patient experience, the much talked about subject in today’s global medical tourism. Presenters shared the experiences of Sudanese patients in Jordan that said a lot about Jordan’s care and hospitality. The 3-day meet provided a great networking platform with meaningful participation from all sides. Such a quality conference helped Jordan

present its further potential in healthcare tourism to the world.

About Dr Prem Jagyasi Dr Prem Jagyasi is a Times award-winning global speaker, publisher, global consultant and a bestseller author. Dr Prem has been to 65 countries to deliver keynote speeches and conduct focused workshops. As an entrepreneur, he runs Dr Prem and Associates – a boutique consulting and training firm with associates based in 35+ countries. He is also the founder of Dr Prem Web Magazine network – a thriving publication with 50+ websites on life improvement topics, with the patronage of 5 million loyal readers from across the globe. He is an authority in the field of Medical Tourism, Global Healthcare and Wellness Tourism. Dr Prem also takes great delight in travel photography. More at DrPrem.com

Print media gets reaffirmed Print or digital media, which is more important? Ms. Mirna Chammas, the Editor of the Arab Hospital Magazine says nobody is the winner. In the dominative era of digital media, information can be quickly accessed through smartphones but print media is tangible and have longer shelf-life, she asserts. Attention span is more; readers get more engaged in print media owing to the featured content written by genuine writers. Print media is a credible source of information, so lesser chances of fake news which is crucial in healthcare.

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EXHIBITIONS

Arab Health to address the exacerbation of asthma in the MENA region as currently only 30% of people are treated in a controlled environment

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rab Health, the largest exhibition for healthcare and trade professionals in the MENA region, will address the growing prevalence of asthma in the Middle East and North Africa (MENA) region as part of the 4th annual Emergency Medicine Conference, which takes place on the opening day of the trade show on 27 January 2020. According to research from the Global Asthma Network, some 339 million people, or one in 20 globally, are affected by the condition. Often referred to as a Chronic Respiratory Disease (CRD), it causes airways to restrict and often results in coughing, wheezing, tightening of the chest, shortness of breath and generally difficulty breathing. In the UAE, approximately 14% of the population is impacted, equating to 1.3 million residents.

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Speaking ahead of the Emergency Medicine conference, Dr.Saleh Fares, Consultant of Emergency Medicine, EMS and Disaster Medicine, Founder and President, Emirates Society of Emergency Medicine (ESEM), Dubai, and moderator of the respirology session, said: “CRDs are increasing in prevalence in the Middle East and, unfortunately, are often left undiagnosed and untreated. This is having huge social and economic consequences and, in some instances, is resulting in death. With the correct diagnosis and treatment, the number of deaths can be dramatically reduced, and the impact of the condition lessoned.” “We need to ensure there is better access to treatment and educate both frontline medical staff, as well as the patient, about the symptoms and the best course of action to take to remedy the condition,” he added. The UAE’s above-average number of asthma cases is often attributed to the UAE’s dusty conditions due to the desert environment as well as seasonal changes and the resulting increase and decrease in temperature and humidity. A reliance on air conditioning in the home and office, if not properly cleaned, can also become the ideal breeding ground for mould and dust which can act as a trigger for some sufferers. According to Dr. Danish Sami, Consultant, Emergency Medicine, Sheikh Shakhbout Medical City (SSMC), Abu Dhabi, who will outline the factors contributing to the region’s asthma problems as part of his session

titled Asthma Exacerbation in 2020: “The issue we face is that only 30% of asthma sufferers are treated in a controlled environment. Similarly, only 30% are either partially controlled, and 40% have no diagnosis and therefore no treatment. There is still a need for education, particularly with children, who we need to encourage to exercise more to help negate the impact of asthma, however steps taken within the education system and health authorities are helping to address these issues.” According to the latest research from UN Comtrade 2019, the UAE has seen a Compound Annual Growth Rate (CAGR) increase of 14.92% from US$19.6 million in 2015 to US$34.1 million in 2018 in the product categories of therapeutic respiration apparatus, ozone, oxygen and aerosol therapy apparatus; and artificial respiration or other therapeutic respiration apparatus. The bulk of therapeutic respiration apparatus imports by the UAE come from the United States, China, Japan and Germany – all countries that will be present at Arab Health 2020 and showcasing their latest technology in this field. Ross Williams, Exhibition Director of Arab Health, said: “As part of our commitment to providing access and information about the most up-todate solutions and medical devices to the region, we will host over 250 companies who will be showcasing the latest technologies related to respiratory and life support. Products and services will include ventilation


EXHIBITIONS

solutions, oxygen and nebuliser masks as well as ventilation units and ICU ventilation from companies including Drager, Hamilton and Polybond India.” In addition to the Emergency Medicine Conference, a total of 13 Continuing Medical Education (CME) conferences and one educational forum will take place during the four-day Arab Health Congress. More than 5,000 delegates are expected to attend popular returning tracks including Obs & Gyne, Diabetes and Total Radiology, as well as eight new conferences that include; Midwifery, Patient Experience, Physical Medicine, Rehabilitation & Sports Medicine, and a Healthcare Investment Forum, amongst others. Organised by Informa Markets, an anticipated 4,250+ exhibitors from

more than 64 countries and 55,000 visitors are expected to attend the 2020 edition of the show which takes

place from 27 – 30 January 2020 at the Dubai World Trade Centre and Conrad Dubai Hotel.

Value of the Internet of Medical Things (IoMT) in the MENA region to top US$9 billion by 2022, says Arab Health report

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rab Health, the MENA region’s largest exhibition for healthcare and trade professionals, will showcase the vital role technology has on improving the speed and accuracy of diagnosis and treatment in the healthcare industry, when the event returns to the Dubai World Trade Centre and Conrad Dubai Hotel from 27 – 30 January 2020. A report by Arab Health titled: “The Future Of Health Information Technology and The Internet Of Medical Things” highlights that the value of the Internet of Medical Things (IoMT) global market was valued at US$41.2 billion in 2017 and is expected to increase to US$158.1 billion in 2022, according to ‘Markets

& Markets’. In the MENA region, the figure is expected to increase from US$2 billion to US$9 billion during

the same period, representing a Compound Annual Growth Rate (CAGR) of 35%.

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“The IoMT refers to connected infrastructure of medical devices, software applications and health systems services which have grown in the prominence of supporting clinical decisions, reducing incorrect diagnosis, and improving quality of services through the management of chronic diseases and monitoring of hospitalised patients”, said Ross Williams, Exhibition Director of Arab Health.

Showcasing Disruptive Technologies at the Innovation Hub As part of the 2020 edition of Arab Health, the much-lauded Innovation Hub will return after its successful inauguration at last year’s show. It will showcase several of the disruptive technologies in the IoMT ecosystem including Artificial Intelligence (AI), Augmented and Virtual Reality (AR/VR), mobile device accessories, smart watches, fitness trackers and applications, disease management devices, health monitors, home care devices and telemedicine devices, to name a few. The Innovation hub will also feature a startup zone, providing local and international startups the opportunity to display and demonstrate new products and innovations that are shaping the future of healthcare. Over 35 companies have already confirmed their participation in this segment of the show, and include Sharjah-based Nabta Health, a tech-driven company that address gaps in women’s health by integrating digital health components into traditional care pathways to improve clinical outcomes; Balsam United, a Hospital Management Information System (HMIS) provider based in Saudi Arabia; and Seers Technology, a remote patient monitoring solution provider for the global digital health markets, with headquarters in South

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Korea. This year will also see the return of the Innov8 Talks segment, where eight SME’s and entrepreneurs for each day of the show will have eight minutes to present their latest groundbreaking healthcare ideas. The final day of the exhibition will see winners from each day ‘pitch off’ to investors, with Amazon, Raiven Capital and Microsoft already confirmed.

Digitalising the Patient Experience Patient experience towards ‘digitalisation in healthcare and enhancing the patient experience through digital health’ will form the basis of discussion at the newly launched Patient Experience conference, with a focus on empowering the patient to make better decisions, and in turn, implementation of an efficient and stronger healthcare system. The sessions will be delivered by Dr Ramadan Alblooshi, Chief Regulatory Office, Dubai Health Authority (DHA) and Dr Tamara Sunbul, Strategic Planning, Performance Mgmt. & Business Development Office, Johns Hopkins Aramco Healthcare based in Saudi Arabia.

Health Technology Breakthroughs in 2019 Several breakthrough technolo-

gies have taken place in 2019, with the World Economic Forum (WEF) identifying the prominent role IoMT has played in the healthcare industry. It gives an example of a pill with a tiny sensor, that transmits information to a patch on the patients arm when taken, with the resulting information then relayed to a mobile phone which is monitored by a doctor to ensure medication is taken at the correct frequency and time. Similarly, the MIT Technology Review has identified several groundbreaking technologies this year, such as a revolutionary blood test to predict premature births; a swallowable probe making it easier to screen for gut disease; personalised cancer vaccines which can reprogram the body to attack cancerous cells; EKG-enabled smartwatches; and voice assistants in clinics. “A future where data is secure, aggregated and easily analysed will be a crucial enabler for the digital transformation of healthcare and the health and well-being of people on an individual, national, and global scale,” added Williams. Organised by Informa Markets, an anticipated 4,250+ exhibitors from more than 64 countries and 55,000 visitors are expected to attend the 2020 edition of Arab Health.


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WELCOME TO MALAFFI CONNECTING HEALTHCARE

Malaffi, the Abu Dhabi Health Information Exchange, will connect all public and private healthcare providers in the Emirate of Abu Dhabi, to create a unified patient file and to improve healthcare quality and patient outcomes.

Visit us at Arab Health Stand of the Department of Health-Abu Dhabi Hall 5, H5.B10 27 - 30 January 2020, Dubai World Trade Centre

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www.malaffi.ae /Malaffi

Profile for The Arab Hospital Magazine

HOSPITALS Magazine issue 50  

HOSPITALS Magazine issue 50