UHS Medical times April 2017

UHS Medical Times 1

Newsletter |April 2017

DEPRESSION The theme for World Health Organization’s (WHO), World Health Day campaign in 2017 is “Depression: Let’s Talk”, which aims to ensure that more people with depression, both seek and get help. It aims to make people, more aware of depression and the fact that it can be prevented and treated, to have people with depression seek help; and family, friends and colleagues of people living with depression able to provide support.

1 in 4

adults live with a mental or neurological disorder and nearly According to the WHO, two-thirds do not seek treatment. And since we cannot see mental illness in someone the same way that we can identify a bad cough, there may not be an immediate way for anyone else to identify it.

Depression a disorder as old as the history of humankind. Already Hippocrates (460-377 BC) described melancholia, a condition very similar to today’s depression.

Depression is a serious medical illness that causes a persistent feeling of sadness and/or loss of interest. More than 350 million people globally are affected by depression and it can affect anyone – from young people to old. It is different from usual mood fluctuations and short-lived emotional responses to challenges in everyday life. Especially when long-lasting and with moderate or severe intensity, depression may become a serious health condition. It can cause the affected person to suffer greatly and function poorly at work, at school and in the family. At its worst, depression can lead to suicide. Suicide is the second leading cause of death in 15-29 year olds.

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e-newsletter | October September 2016 Newsletter |April 20172016

KEY FACTS Depression is a common mental disorder. Globally, more than 300 million people of all ages

suffer from depression.

Depression is the leading cause of disability worldwide, and is a major contributor to the

overall global burden of disease.

More women are affected by depression than men.

At its worst, depression can lead to suicide.

And the best part is Depression is treatable.

DEPRESSION IN UAE Mental illness knows no borders. So here in the UAE, things are no different to the rest of the world. In fact, in this region, two of the top three causes of ill health are anxiety and depression.

Figures suggest that as much as 4% of the population could be clinically depressed, while mild depression may be affecting up to 15% of the country.

4% could be clinically Depressed

Rising Affect on School Kids and Young Ages

15% affected by mild Depression

Are You DEPRESSED?

High-Stress a major factor for Depression

But depression is not a natural disease. It is not an inevitable part of being human like many diseases; depression is a disease of civilization. It’s a disease caused by a high-stress, industrialized, modern lifestyle that is incompatible with our genetic evolution.

Feeling helpless, hopeless, tiredness, losing interest in friends and other things, behaving aggressively, short-temperedness, change in sleep patterns, getting irritated quickly and thinking negatively are some of the signs of depression. When someone suffers from depression, it becomes difďŹ cult for the person to perform daily activities and it seriously affects their productivity at work. In order to overcome depression, it is necessary that the symptoms and causes are understood.

There is an alarming rise in the number of school children suffering from depression. The number of children and young people turning up with a psychiatric condition has more than doubled in last few years

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Newsletter |April 2017

WHAT IS DEPRESSION? Everyone feels sad or low sometimes, but these feelings usually pass with a little time.

Depression—also called “Clinical Depression” or a “Depressive Disorder”—is a mood disorder that causes distressing symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working. To be diagnosed with depression, symptoms must be present most of the day, nearly every day for at least 2 weeks.

A Feel of

LONELINESS TYPES OF DEPRESSION There are many different types of depression. Events in your life cause some, and chemical changes in your brain cause others. Depending on the number and severity of symptoms, a depressive episode can be categorized as mild, moderate, or severe.

Severe Depression: Severe symptoms that interfere with the ability to work, sleep, study, eat, and enjoy life. An episode can occur only once in a person’s lifetime, but more often, a person has several episodes.

Persistent Depressive Disorder: A depressed mood that lasts for at least 2 years. A person diagnosed with persistent depressive disorder may have episodes of major depression along with periods of less severe symptoms, but symptoms must last for 2 years.

Some forms of depression are slightly different, or they may develop under unique circumstances. They include:

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Newsletter |April 2017

Psychotic Depression, which occurs when a person has severe depression plus some form of psychosis, such as having disturbing false beliefs or a break with reality (delusions), or hearing or seeing upsetting things that others cannot hear or see (hallucinations).

Postpartum Depression, which is much more serious than the “baby blues” that many women experience after giving birth, when hormonal and physical changes and the new responsibility of caring for a newborn can be overwhelming. It is estimated that 10 to 15 percent of women experience postpartum depression after giving birth.

10 to 15

Percent of Women Experience Postpartum Depression After Giving Birth.

Seasonal Affective Disorder (SAD), which is characterized by the onset of depression during the winter months, when there is less natural sunlight. The depression generally lifts during spring and summer. SAD may be effectively treated with light therapy, but nearly half of those with SAD do not get better with light therapy alone. Antidepressant medication and psychotherapy can reduce SAD symptoms, either alone or in combination with light therapy.

Bipolar Disorder is different from depression. The reason it is included in this list is because someone with bipolar disorder experiences episodes of extreme low moods (depression). But a person with bipolar disorder also experiences extreme high moods (called “mania”).

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Newsletter |April 2017

WHAT ARE THE SIGNS AND SYMPTOMS OF DEPRESSION? Sadness is only one small part of depression and some people with depression may not feel sadness at all. Different people have different symptoms.

Clinical depression is characterized by the presence of the majority of these symptoms:

Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feeling sad or empty) or observation made by others (e.g., appears tearful). (In children and adolescents, this may be characterized as an irritable mood.)

Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day.

Insomnia or hypersomnia nearly every day Psychomotor agitation or retardation nearly every day Fatigue or loss of energy nearly every day Feelings of worthlessness or excessive or inappropriate guilt nearly every day Diminished ability to think or concentrate, or indecisiveness, nearly every day Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide DEPRESSED MOOD DIMINISHED INTEREST OR PLEASURE DECREASE OR INCREASE IN APPETITE

S E

PSYCHOMOTOR AGITATION FATIGUE OR LOSS OF ENERGY FEELINGS OF WORTHLESSNESS INDECISIVENESS RECURRENT THOUGHTS OF DEATH

E D

R P

N O

I S

INSOMNIA OR HYPERSOMNIA

In addition, for a diagnosis of major depression to be made, the symptoms must not be better accounted for by Bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.

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Newsletter |April 2017

CAUSES OF DEPRESSION Depression results from a complex interaction of social, psychological and biological factors. People who have gone through adverse life events (unemployment, bereavement, psychological trauma) are more likely to develop depression. Depression can, in turn, lead to more stress and dysfunction and worsen the affected person’s life situation and depression itself.

First-degree biological relatives of individuals with Major this disorder are 1.5 - 3 times more likely to develop Major Depressive Disorder. They also have an increased risk of having Alcohol Dependence, Anxiety Disorder (e.g., Panic Disorder, Social Phobia), and Attention-DeďŹ cit/ Hyperactivity Disorder compared with the general population.

There are interrelationships between depression and physical health. For example, cardiovascular disease can lead to depression and vice versa.

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Newsletter |April 2017

DIAGNOSIS OF DEPRESSION Although there are known, effective treatments for depression, fewer than half of those affected in the world (in many countries, fewer than 10%) receive such treatments. Barriers to effective care include a lack of resources, lack of trained health-care providers, and social stigma associated with mental disorders. Another barrier to effective care is inaccurate assessment. In countries of all income levels, people who are depressed are often not correctly diagnosed, and others who do not have the disorder are too often misdiagnosed and prescribed antidepressants.

This disorder may begin at any age, with an average age at onset in the mid-20s.

Some individuals have isolated episodes that are separated by many years without any depressive symptoms, whereas others have clusters of episodes, and still others have increasingly frequent episodes as they grow older. After the ďŹ rst episode of this disorder, there is a 60% chance of having a second episode.

After the second episode, there is a 70% chance of having a third, and after the third episode, there is a 90% chance of having a fourth. About 5%-10% of individuals with this disorder subsequently develop Bipolar I Disorder.

The acute onset of severe depression, especially with psychotic features and psychomotor retardation, in a young person without prepubertal psychopathology is more likely to predict a bipolar course. A family history of Bipolar Disorder may also be suggestive of subsequent development of Bipolar Disorder.

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Newsletter |April 2017

DEPRESSION IS A TREATABLE ILLNESS There are effective treatments for moderate and severe depression. In two-thirds of cases, the Major Depressive Episode ends with complete recovery. For individuals that have only a partial recovery, there is a greater likelihood of developing additional episodes of this disorder and of continuing the pattern of partial inter-episode recovery. Individuals that have pre-existing Dysthymic Disorder prior to the onset of this disorder are more likely to have additional Major Depressive Episodes, have poorer interepisode recovery, and have more difďŹ cult to treat Major Depressive Episodes. One year after the diagnosis of this disorder, 40% have no mood disorder; 20% are partially recovered; and 40% still have symptoms that are sufďŹ ciently severe to meet the criteria for a full Major Depressive Episode. The severity of the initial Major Depressive Episode appears to predict persistence. Chronic general medical conditions are also a risk factor for more persistent episodes. Among those with an onset of depression in later life; there is evidence of subcortical white matter hyper intensities associated with cerebrovascular disease.

These vascular depressions are associated with greater neuropsychological impairments and poorer responses to standard therapies.

YES,

IT IS TREATABLE

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Newsletter |April 2017

Health-care providers may offer psychological treatments (such as behavioural activation, cognitive behavioural therapy [CBT], and interpersonal psychotherapy [IPT]) or antidepressant medication (such as selective serotonin reuptake inhibitors [SSRIs] and tricyclic antidepressants [TCAs]). Health-care providers should keep in mind the possible adverse effects associated with antidepressant medication, the ability to deliver either intervention (in terms of expertise, and/or treatment availability), and individual preferences. Different psychological treatment formats for consideration include individual and/or group face-to-face psychological treatments delivered by professionals and supervised lay therapists.

Psychosocial and Antidepressants are effective treatments for depression. Prevention programmes have been shown to reduce depression. Effective community approaches to prevent depression include school-based programmes to enhance a pattern of positive thinking in children and adolescents. Interventions for parents of children with behavioural problems may reduce parental depressive symptoms and improve outcomes for their children. Exercise programmes for the elderly can also be effective in depression prevention.

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Newsletter |April 2017

TEAM AT UHS

QUALIFICATIONS Dr. Sajedah Shaltoni is a Jordanian Board Certified Family Medicine Consultant. Following her graduation from the University of Punjab in Pakistan, she obtained a high specialty degree in Family Medicine from Jordan and later earned a Master’s Degree in Geriatric Medicine after which she earned a fellowship in teaching from the Society of Teachers of Family Medicine (STFM) in the USA.

EXPERIENCE Dr. Sajedah has a 16 year experience being a Family Medicine practitioner handling both acute and chronic cases. She provides care in all aspects of family healthcare from children to elderly and from diagnosis to treatment and management.

Therefore, she addresses symptoms in a holistic approach and interprets the causes, as per age group, into either psychological or physiological. She is keen on encouraging preventive medicine and on early detection of illnesses.

Dr. Sajedah M. Shaltoni High Specialty Degree in Family Medicine, Jordanian Board Certified Master’s Degree in Geriatric Medicine Consultant Family Medicine

She has a special interest in geriatric and mental health care.

She not only cares for the common chronic diseases that the elderly face such as diabetes, hypertension, and early cognitive impairment (including Alzheimer’s), but she also cares for the mental illnesses that the general population endure including stresses related to work and family conflicts, depression and anxiety. She has a way with words and a way of looking at the symptoms first and then relating them to the bodily system involved.

Academically, Dr. Sajedah was an Assistant Professor of Family Medicine in Clinical Medicine at Weill Cornell Medical College in Qatar. She was also a lecturer for the Mental Health Foundation course directed for primary health care doctors, an instructor in the course of Pediatrics given by Sick Kids Hospital in Canada, and a lecturer in Dubai Medical College for students during their clinical rotations. She is a Fellow of the Society of Teachers of Family Medicine (STFM), USA. Dr. Sajedah is an active member of various professional organizations like World Organization of Family Doctors (WONCA) and Middle East Academy for Medicine of Ageing (MEAMA). She has also presented in many local and international conferences and symposia in relevance in her area of expertise. She is a public speaker running workshops and lectures for the community’s awareness and health education.

SPECIAL INTEREST

Family Counseling Cognitive Behavioral Therapy Youth Health Women Health Geriatric Medicine Mental Health Preventive Medicine

LANGUAGE KNOWN English, Arabic, Urdu

QUALIFICATIONS Dr. John Ferguson is a UK Board Certified physician. He has a Diploma in Aviation Medicine and also a Master’s Degree in Occupational Medicine which he graduated with merit from the University of Manchester.

LANGUAGE KNOWN English and French

EXPERIENCE Dr. John Ferguson is a Consultant Family Medicine with experience in UK, Australia and UAE. Since 2005, Dr. John has established his interest in Occupational Medicine focusing on Aviation Medicine. He was appointed as a UAE General Civil Aviation Authority Aeromedical Examiner in 2004, Senior Aeromedical Examiner in year 2010 and Medical Review Officer a year after.

Dr. John Douglas Ferguson

Prior to joining UHS, Dr. John worked with the 2 biggest airlines in UAE - as an Aviation Medicine Specialist in Dubai and Head of Aviation Medicine in Abu Dhabi. He was also appointed as an Accountable Manager of the first GCAA approved Aeromedical Centre in the country. As a Senior Aviation Medicine Examiner, he has a great deal of experience dealing with aeromedical certification of professional pilots, cabin crew and air traffic controllers.

MBChB, Diploma in Aviation Medicine, MSc Occupational Medicine

SPECIAL INTEREST

Consultant Family Medicine and Senior Aeromedical Examiner

Occupational Medicine

Aviation Medicine

Family Medicine

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Newsletter |April 2017

TEAM AT UHS

QUALIFICATIONS Dr. Lulwa Khairi Sultan, graduated medical degree from Arabian Gulf University in Bahrain. She is also a board certified in Family Practice accredited by Irish College of General Practitioners (ICGP) and Royal College of Surgeons in Ireland (RCSI) and further went on to complete her Arab Board in Family Practice in Bahrain.

EXPERIENCE Dr. Lulwa, an Arab Board certified Consultant Family Medicine physician with 16 years of clinical practice. Before joining University Hospital Sharjah, Dr. Lulwa had worked extensively in Bahrain and United Arab Emirates.

Dr. Lulwa attended several training program in various sub specialties related to family medicine.

SPECIAL INTEREST

Dr. Lulwa Khairi Sultan Sultan MD, Arab Board Certificate in Family Medicine Consultant Family Medicine

Acute and Chronic Illness Women’s Health Emergency Electro-cautery Cryotherapy Psychology Family Counseling Skin Diseases

LANGUAGE KNOWN Arabic, English, Urdu

QUALIFICATIONS

LANGUAGE KNOWN

Dr. Sridevi Parvathareddy is an alumnus of the distinguished Royal Free Hospital, Hampstead London and graduated with a merit award. Prior to that, she completed her Bachelor’s Degree in Psychology from University College London. Most recently, she has been qualified to be an Aeromedical Examiner.

English, Telugu, British Sign Language Stage 1

She is a member of the Royal College of Physicians (MRCP), UK and Royal College of General Practitioners (MRCGP), UK.

EXPERIENCE Dr. Sridevi is a UK board certified Consultant in Family Medicine, with extensive training in the United Kingdom. She was associated as Family Medicine Specialist in the areas of Harrow and Northwood in London before relocating to United Arab Emirates in 2015. During her tenure in UK, she was appointed as a Child Protection Lead in Charlton Medical Centre for 1 year.

Dr. Sridevi Parvathareddy

SPECIAL INTEREST

MBBS (UK), BSc Psychology (UK), MRCGP (UK), MRCP (UK)

Chronic Disease Management

Consultant Family Medicine and Aeromedical Examiner

Women’s Health

Preventive Medicine Aesthetic Dermatology

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Newsletter |April 2017

TEAM AT UHS

QUALIFICATIONS Dr. Sana Kausar a Family Medicine Specialist, graduated as MBChB from the University of Glasgow in Scotland. She also finished her postgraduate training in Glasgow, Scotland. In 2008, she gained certification and passed the Royal College of General Practitioner or MRCGP. Dr. Sana completed her Diploma of the Royal College of Obstetrics and Gynecology (DRCOG) in London, year 2011. Most recently, she has been qualified to be an Aeromedical Examiner.

EXPERIENCE Dr. Sana Kausar has trained in the West of Scotland after graduating in 1998. She was a partner at a private clinic in Glasgow between 2003 to 2007. She then immigrated to Dubai where she worked in clinical practice in Dubai Health Care City including as an ER physician over the last 3 years.

She now joined us in our department of Family Medicine in UHS.

SPECIAL INTEREST Dr. Sana Kausar MBChB, MRCGP (Scotland), DRCOG (London) Family Medicine Specialist and Aeromedical Examiner

Dermatology

Emergency Medicine

Obstetrics and Gynecology

LANGUAGE KNOWN English, Hindi, Punjabi & Urdu

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Newsletter |April 2017

SCOPE OF SERVICES AT UHS MEDICAL SERVICES

SURGICAL SERVICES

CARDIOLOGY

NEUROPHYSIOLOGY

Anesthesiology

Bariatric Surgery

24-Hour BP Monitoring

Electroencephalogram (EEG)

Aviation Medicine

Ears, Nose and Throat Surgery

24-Hour Holter Monitoring

Electromyography (EMG)

Cardiology

General Surgery

2D/3D Echo

Evoked Potential Test

Critical Care

Neurological Surgery

3D Transesophageal Echo

Brain Auditory Evoked Potential

Dermatology

Obstetrics and Gynecologic Surgery

CT coronary Angiography

(BAEP)

Emergency Medicine

Ophthalmic Surgery

Somato Sensory Evoked Potential

Endocrinology

Orthopedic Surgery

Dobutamine Stress Echo for Ischemia and Viability Studies

Family Medicine

Pediatric Surgery

Gastroenterology

Plastic and Reconstructive Surgery

Internal Medicine

Urologic Surgery

Medical Oncology

Vascular Surgery

Neonatology Nephrology Neurology Pediatrics Psychiatry Pulmonology Rheumatology MEDICAL DIAGNOSTICS IMAGING (MDI) 128 Channel CT Scan with Coronary and Cardiac Facility

PATHOLOGY & LABORATORY MEDICINE

Interventional Cardiology Stress Test

(SSEP) Visual Evoked Potential ( VEP) Nerve Conduction Studies (NCS)

Treadmill Stress Test

AUDIOLOGY

OTHER SPECIALTY SERVICES

Biochemistry

Acoustic Reflex Threshold

24/7 Emergency Services

Blood Transfusion Medicine

Auditory Brainstem Response

Ambulance

Cytology

Auditory Steady State Response

Hemodialysis

Hematology

Cochlear Implant Mapping

Physiotherapy

Histology

Electrocochleography

Pharmacy

Immunology

Free Field Audiometry

Sharjah Breast Centre

Microbiology

Hearing Aid Fitting and Programming

Phlebotomy

Newborn Hearing Screening

Bone Densitometry

Otoacoustic Emission

Digital X-Ray and Fluoroscopy

Pure Tone Audiometry (PTA)

Mammography and Guided Breast Intervention

Speech Audiometry

MRI 1.5 TESLA

Tinnitus Evaluation

Ultrasound

Tympanometry

Vascular Interventional Lab

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