HOSPITALS Magazine issue 44 by The Arab Hospital Magazine

Issue 44/ 148 JAN - FEB 2019

THE ARAB HOSPITAL APPLICATION IS AVAILABLE

Engineer Sobhi Batterjee President of the Saudi German Hospitals Group

NEWS

Publisher Arab Health Media Communication

TO NEW MEDICAL ACHIEVEMENTS IN THE NEW YEAR

General Manager Simon Chammas schammas@tahmag.com Creative Department Roula Haddad - Georges Habka Creative Director: Jessy E. Hajj Photographer Hanna Nehme

After a year full of health activities and successes, the year 2019 begins with a richer agenda in the healthcare sector, led by the Arab Health Exhibition and Congress. The exhibition, held in Dubai at the end of January, offers a unique opportunity for health professionals and specialists to share experiences, technologies and developments. It is the largest medical exhibition and conferences in the Middle East, providing several accredited conferences where medical and clinical topics are addressed by international specialists. Another major conference is the HIMSS Global Conference & Exhibition, held before the end of last year in Riyadh. It addressed current challenges, future plans and possible solutions in the healthcare field. It also reviewed the latest developments in health information technology and highlighted the vital role of e-health. In Qatar, in addition to the well-known medical conferences, the conferences were dedicated to building modern hospitals. The issue of healthcare spending and the promising opportunities for international drug manufacturers have also taken part in these conferences. This rising movement in the medical and healthcare conferences promises to bring further successes in 2019 as well as a brighter future in the medical field. So to many new achievements in the new year… The Publisher

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

JANUARY . FEBRUARY 2019

COVER

FEATURES

28 Engineer Sobhi Batterjee

78 Artificial intelligence in healthcare 90 Telemedicine for wound care management 96 Alzheimer’s disease 108 Medical Imaging Technology 120 Immunotherapy 122 Wearable Technology

President of the Saudi German Hospitals Group

NEWS 4 Hill-Rom expands digital health capabilities in new global collaboration with Microsoft 12 Sysmex Launches their First Subsidiary in Egypt and North Africa 52 The Saudi Ministry of Health organized its annual meeting for Obesity Surgery Program at King Saud Medical City (KSMC) Riyadh 54 MEDLAB explores “Lab of the Future” 62 Al-Ahli Hospital’s Participation in the World Innovation Summit for Health (WISH)

MEDICAL INSTITUTIONS 14 Nationwide Children’s Hospital 40 The University of Nicosia Medical School 42 Health Care Accreditation Council - Jordan 44 The American Accreditation Commission International 56 Acibadem Healthcare Group Turkey 64 NMG Modular Design-Build Turnkey Solutions 82 MEDSBLA

INTERVIEWS 68 Andre Daoud, Chief Executive Officer, Medcare 72 Curtis Laitinen, Associate Director For Healthcare, AECOM Middle East: King Hussein Medical City

JANUARY.FEBRUARY 2019

ARTICLES 98 Hearing loss can be temporary or permanent 102 Teratoma 104 Bleeding Gums 106 Unexplained infertility

NEWS

Hill-Rom expands digital health capabilities in new global collaboration with Microsoft Hill-Rom (NYSE: HRC), a global medical technology company, announced on January 8, a collaboration with Microsoft to bring advanced, actionable point-of-care data and solutions to caregivers and healthcare provider organizations.

he combined offerings, using Microsoft Azure®, are intended to dynamically analyze real-time sensing data from medical devices and historical medical record information, and communicate potential patient risk and hospital protocol actions directly to caregivers at the point of care. The solutions combine Hill-Rom’s deep clinical knowledge and streaming operational data from medical devices, and Microsoft’s cloud, including Azure® IoT and Azure® Machine Learning, to help drive enhanced patient outcomes. The Hill-Rom® digital solution offerings will be available to hospitals beginning later in 2019. “Information and connectivity are critical to providing quality healthcare, reducing length of stay, driving efficiencies across the healthcare continuum and providing clinical and economic value,” said Hill-Rom President and CEO John Groetelaars. “Our collaboration with Microsoft will help clinicians identify, communicate and mitigate patient risk in real-time, advancing our vision of connected care to address customer challenges and enhance patient outcomes.” Hill-Rom’s connected solutions will integrate data from the company’s medical devices (including smart hospital bed systems, vital signs monitors and other connected devices) and hospitals’ electronic medical records through a common gateway infrastructure. The combination of medical device data and Azure Machine Learning will help assess and analyze critical and secure information at the bedside, delivering actionable insights to clinicians that can help reduce costly complications and enhance efficiency and patient outcomes. In addition to localized and cloud-based patient risk identification and communications, the collaboration with Microsoft offers hospitals simplified installation, integration, information security and support while enabling scalability and flexibility for IT departments across the globe. “Microsoft’s AI capabilities make Azure an ideal platform for Hill-Rom’s new digital offerings. The powerful combination of Hill-Rom’s proven applications with Azure will help empower organizations across all industries, and especially in the health market,” Chris Sakalosky, Vice President, US Health & Life Sciences, Microsoft Corp.

JANUARY.FEBRUARY 2019

NEWS

King Hussein Cancer Center Wins Sheikh Hamdan Bin Rashid Al Maktoum Award in the Category of Best Arab Medical Center

is Highness Sheikh Hamdan Bin Rashid Al Maktoum, Deputy Ruler of Dubai, Minister of Finance and patron of the Sheikh Hamdan Bin Rashid Al Maktoum Award for Medical Sciences, honored the King Hussein Cancer Center (KHCC) for winning the prestigious Sheikh Hamdan Bin Rashid Al Maktoum Award for Medical Sciences for Best Medical College, institute or center in the Arab World, further commending the Center’s dedicated efforts to providing the highest levels of comprehensive care to cancer patients across the region. KHCC Director General Dr. Asem Mansour received the award on behalf of KHCC at a ceremony held in the United Arab Emirates, stating: “This award is the culmination of our combined efforts over the years, and a manifestation of our success in promoting comprehensive cancer care in the Arab World.” Dr. Mansour continued, “KHCC is now among the most sought-after centers in the world, offering cancer patients the most advanced treatment plans.” The Sheikh Hamdan Bin Rashid Al Maktoum Award for Medical Sciences includes the following three categories:

the International Awards, the Arab World Awards and the UAE Awards, all of which aim to recognize individuals, universities, institutions and research centers around the world for their outstanding achievements in the field of medicine.

Princess Dina inaugurates cancer awareness ‘Success Path’ initiative University, the Jordan News Agency, Petra, reported. The projects aims to raise public awareness of cancer, preventive methods and the importance of early diagnosis, in addition to providing psychological and social support to patients.

RH Princess Dina Mired, president of the Union for International Cancer Control, inaugurated the launch of the “Success Path” initiative. The initiative is organised by the World Islamic Sciences and Education

JANUARY.FEBRUARY 2019

Princess Dina said that their meeting focused on methods for combating cancer and sending a message of hope and determination to cancer patients all over the world. She also said that noncommunicable diseases kill around 41 million people each year, pointing out that 70 per cent of these cases take place in developing countries. For his part, University President Salman Bdour voiced his appreciation for the princess’s regional and international efforts in combating cancer.

NEW ERA IN HEALTHCARE SERVICES • 4 Countries: Turkey, Bulgaria, Macedonia, Netherlands • 21 Hospitals, 16 Outpatient Clinics • Multidisciplinary Centers of Excellence: 16 Heartcare Centers, 13 In Vitro Fertilization Centers, 11 Cancer Centers, 10 Organ & Tissue Transplantation Centers (liver, kidney, bone marrow), 9 Spine & Neurosurgery Centers, 6 Robotic-assisted Surgery Centers and 1 Sports Medicine Center accredited by FIFA.

• 2.300 Physicians, 4.000 Nurses • 5.000.000 patient visits in 2017

acibademinternational.com

+90 216 544 46 64

MEDICAL INNOVATIONS

Cleveland Clinic unveils top 10 medical innovations for 2019

lternate therapies for pain. The use of artificial intelligence in healthcare. Expanded window to treat stroke patients. These are some of the innovations that will enhance healing and change healthcare in the coming year, according to a distinguished panel of doctors and researchers. The list of up-and-coming technologies was selected by a panel of Cleveland Clinic physicians and scientists, led by Michael Roizen, M.D., Chief Wellness Officer at the Ohio-headquartered organization. “Healthcare is ever changing and we anticipate that innovations such as cancer immunotherapy and pharmacogenomics will significantly transform the medical field and improve care for patients at Cleveland Clinic and throughout the world,” said Dr. Roizen. Here, in order of anticipated importance, are the Top 10 Medical Innovations of 2019:

1. Alternative Therapy for Pain: Fighting the Opioid Crisis The opioid crisis has been declared a public health emergency. Today, chronic pain is the leading cause of opioid prescription. Though several clinically validated alternative therapies for chronic pain exist, none have curtailed the crisis. Now, innovation and potential for hope comes by way of pharmacogenomic testing, which uses a patient’s genetic makeup to predict an individual’s metabolism of drugs, including some opiate-based drug. Pharmacogenomic testing can be used to avoid adverse reactions and eliminate unnecessary and ineffective prescriptions, replacing them with more effective medications. Phar-

JANUARY.FEBRUARY 2019

macogenomics can also be used to predict who may have little or no pain relief to some opiate-based analgesics. Such patients might otherwise finish their prescription quickly and return for a new prescription earlier than expected. Pharmacogenomics can reduce or eliminate the stigma of “drug-seeking” that might be unfairly ascribed to such patients and provide the opportunity to tailor medication therapy. In 2019, with increased access to genetic testing, pharmacogenomics is poised to make significant inroads into precision medicine and potentially an end to the crisis.

2. The Advent of AI in Healthcare Once thought as a futuristic threat to humankind, artificial intelligence is now a part of everyday life. In healthcare, AI is changing the game with its applications in decision support, image analysis and patient triage. Today, artificial intelligence is helping physicians make smarter decisions at the point of care, improving the ease and accuracy of viewing patient scans and reducing physician burnout. For instance, machine learning algorithms have the ability to highlight problem areas on images, aiding in the screening process and quickly making sense of the mountains of data within a physician’s EMR system. With AI’s continued integration into healthcare, caring for patients has become a matter of working smarter, not harder.

3. Expanded Window for Acute Stroke Intervention When it comes to stroke intervention, a timely response is critical. Prolonged lack of blood flow following a stroke can cause irreversible de-

struction, often resulting in disability. In many cases of stroke, intervention methods can be deployed to save tissue. But until now, intervention of a stroke has only been recommended within a limited window of time. Released this past year, new guidelines suggest an expanded window for treatment. This lengthened timeframe is anticipated to lower the risk of disability and provide opportunity for recovery to an increased number of future stroke patients.

4. Advances in Immunotherapy for Cancer Treatment Cancer immunotherapy, or biologic therapy, is a technique that uses the body’s own immune system to fight cancer. While immunotherapies for cancer have existed for some time, the worldwide work toward a cure for cancer continues to highlight new and novel immunotherapeutic targets. Scientists are creating life-changing new cancer treatments through the concepts of joint therapy and engineered T-cells. With the near daily discovery of new immunotherapeutic targets and biomarkers, it is the hope that effective therapies will soon exist for all tumor profiles.

5. Patient-Specific Products Achieved with 3D Printing Utilizing 3D printing technology, medical devices can now be matched to the exact specifications of a patient. Designed to be more compatible with an individual’s natural anatomy, devices modeled from patient-specific dimensions have shown greater acceptance by the body, increased comfort and improved performance outcomes. The versatility provided by 3D printing gives medical practitioners the

WHEN A TUMOR ATTACKS THE BODY, THAT’S

CANCER

WHEN THE BODY ATTACKS THE TUMOR, THAT’S A

REVOLUTION Long Live the Immunorevolution. For cancer patients, it’s a living prescription. Modified immune cells roaming the body, hunting for cancer cells, and living on in the body long after the cancer is gone. Today, we’re creating immunotherapies to fight leukemia, glioblastoma and pancreatic cancer. And one day soon, we’ll do the same for Alzheimer’s, Parkinson’s and HIV. It’s all part of the largest cellular immunotherapy program in the world. And one more reason why your life is worth Penn Medicine.

Discover more at ImmunoRevolution.org

MEDICAL INNOVATIONS

ability to provide patients the most advanced care, while simultaneously minimizing the risk of complication in patients that meet specific medical requirements. Currently, the most significant work in this space includes external prosthetics, cranial/orthopedic implants, and customized airway stents for diseases narrowing the airway. Work in prosthetics and other bodily implants is also gaining speed with some cleared for the commercial market. The technology has also been found helpful in surgical planning. To date, the technology has been used for many complicated heart surgeries, and even the Cleveland Clinic’s most recent total face transplant. With its widening healthcare applications, 3D printing is increasing the attention to detail in patient care.

6. Virtual and Mixed Reality for Medical Education Virtual and mixed reality involve the use of computer technology to create simulated and hybrid environments. Popular for their gaming applications, virtual and mixed reality, with their futuristic affect, never fail to dazzle audiences. But VR/MR technology is much more than a game. These reality systems have recently caught the eye of healthcare professionals eager to sharpen their skills. Now popular for medical education, VR/MR programs provide simulation training that serves to enhance traditional medical schooling. With this immersive style of learning, VR/MR training appeals to all types of learners: audio, visual and kinesthetic. Education via simulation is a productive step toward the system’s most adept and confident healthcare providers.

7. Visor for Prehospital Stroke Diagnosis Though less common than isch-

JANUARY.FEBRUARY 2019

emic strokes, hemorrhagic strokes – during which blood escapes from a ruptured blood vessel in the brain – are responsible for nearly 40 percent of stroke deaths. Rapid diagnosis is necessary for effective treatment, as uncontrolled bleeding can lead to swelling of, and damage to, the brain. To speed diagnosis, healthcare professionals are using new, advanced technologies such as the hemorrhage scanning visor, which can detect bleeding in the brain. An efficient diagnostic tool, the visor for prehospital hemorrhage scanning serves to speed up diagnosis and the ever-important time to treatment.

8. Innovation in Robotic Surgery Most surgeries performed today are the shortest and least invasive that science will allow. This adaptation in surgical methodology is brought about in part by the integration of robotics. Robots in the operating room provide surgeons with guidance for extreme precision in surgery. Today, surgical platforms are highly advanced and are being used anywhere from spine to endovascular procedures. Shortened recovery time and limited pain after surgery are just a few of the patient benefits seen with minimally invasive robotized surgery. Continued advancement in the field has led to more precise and effective surgeries with improved surgical outcomes.

9. Mitral and Tricuspid Valve Percutaneous Replacement and Repair Cardiac surgery today is less invasive and more routine and effective than its historic counterpart. Performed percutaneously – via a catheter through the skin – many cardiac procedures no longer require an open heart surgery approach. Two such procedures performed this way include replace-

ments and repair of both the mitral and tricuspid valves. Hot on the trail of aortic valve percutaneous intervention, recent percutaneous mitral and tricuspid valve intervention has yielded significant positive outcomes while filling a void in the field of heart surgery. The exploration of this technology in a greater patient population is ongoing, but with promising post-op results, the innovation has significant implications for the future of cardiac care.

10. RNA-Based Therapies Akin to DNA-based gene therapies, RNA-based therapies are the newest innovation in labs nationwide and have shown immense potential. Interfering with genetic data at the ribonucleic acid (RNA) level gives scientists the ability to intercept a patient’s genetic abnormality before it is translated into functioning (or nonfunctioning) proteins. Today, the most popular and successful mechanisms of RNA therapy include antisense nucleotides and RNA interference. These new therapies are being explored in a variety of rare genetic diseases such as Huntington’s disease, as well as in cancer and neurologic diseases, with the hope of treatment by way of alternate genetic data. These new mechanisms of action are opening windows for progress and innovation in therapeutics. The Top 10 Medical Innovations of 2019 were announced at the 2018 Medical Innovation Summit. Now in its 16th year, the event is organized by Cleveland Clinic Innovations, the development and commercialization arm of Cleveland Clinic. For more information on the annual Top 10 Medical Innovations list including descriptions, videos, and year-by-year comparisons visit: http://innovations.clevelandclinic. org/Summit/Top-10-Medical-Innovations.aspx.

NMG Modular Design-Build Turnkey Solutions Creating a Future Proof Healing Environment As Technology begins to play a larger role in patient delivery, healthcare facilities must be designed with adaptability in mind. The continuous change in the healthcare industry, driven by technological advancements, requires healthcare operators to constantly reinvent their facilities.

NMG has established itself as the leading force in designing, building and furnishing highly functional, flexible, and sustainable healthcare facilities with focus on operational efficiency, as well as creating a healing environment, promoting enhanced well-being for patients, families, and caregivers alike.

www.nmg.us.com

Visit us at Arab Health 2019 NMG Booth number 4F30 - Hall 4

NEWS

Shaping the future of diagnostics and healthcare in Egypt

Sysmex Launches their First Subsidiary in Egypt and North Africa

ith a vision to advance the diagnostics and healthcare infrastructure in Egypt, Sysmex Corporation, one of the global leaders in vitro diagnostics, launches their first subsidiary in Egypt. Affirming their commitment to bettering the healthcare landscape, Sysmex will provide the Egyptian market with innovative and advanced clinical applications and best-in-class in vitro diagnostic technologies, as well as an excellent training academy that will host and sponsor a plethora of scientific workshops and clinical research studies. With the honorary attendance of reputable policy makers, government officials and top diagnostic medical professionals, inaugurating the launch is Mr Kazuya Obe, Senior Executive Officer, Managing Director of Sysmex Global Marketing, Mr Matthias Voelkel, Managing Director of Sysmex Europe, Mr Saad Kayali, Managing Director of Sysmex Middle East and Mr Ahmed Shawky, General Manager of Sysmex Egypt.

JANUARY.FEBRUARY 2019

Ahmed Shawky, General Manager for Sysmex Egypt says, “Egypt has a population growth rate of 2.2% annually, which puts pressure on the healthcare industry and drives the need for more advanced healthcare solutions. Our main goal is to provide new innovative solutions and the latest diagnostic technology to meet the standards of modern healthcare practices and the growing needs of the Egyptian market. With our investment in a local sales and service organization as well as our drive to advance healthcare, we aspire to be a contributing force to streamline public healthcare budgets and shape the future of scientific research and development in Egypt.” With its advanced technology, Sysmex will contribute in many fields such as urinalysis, oncology, and hemostasis. In addition, Sysmex will offer their market-leading hematology analyzers, which help in diagnosing many diseases such as anemia, cancer, as well as a number of communicable and endemic diseases. The analyzers

will also provide necessary diagnoses for pregnant women, ensuring the health of the mother and fetus. Sysmex will also offer best-in-class after-sales support with a dedicated team of field service engineers, as well as application and scientific support. To further reinforce its educational role as a company interested in elevating the standards of scientific knowledge and clinical research in Egypt, Sysmex’s academy will provide new opportunities for healthcare professionals, by providing both on-ground, practical scientific workshops as well as innovative e-learning methodologies that allow the access of a vast pool of resources anytime, anywhere. The training centre is designed to welcome an average of 200 students per course and to host an average of around twelve courses per year. Mr Saad Kayali adds, “Egypt’s market for medical devices is the second largest in the Middle East, and it is anticipated to grow exponentially over the years. This being said, Sysmex Egypt aims to cultivate its presence in the Egyptian market by providing the latest in clinical research and hosting the best scientific workshops to meet market needs and growth.” He further adds that Sysmex Middle East as the sub- regional management office is aiming to support the Egyptian market with dedicated and talented teams for clinical applications, after-sales support and integrated concept solutions. Sysmex is currently serving over 190 countries around the world, bringing advanced clinical solutions to labs and hospitals. Sysmex Egypt (SEL) will be overseen and supported by Sysmex EMEA (Europe, Middle East and Africa).

MEDICAL INSTITUTIONS

Nationwide Children’s Hospital A global destination for continuous, compassionate innovation

merica’s second largest children’s hospital — performing more than 1.4 million patient visits per year — is also one of its best: Nationwide Children’s Hospital is consistently ranked among the 10 best children’s hospitals in the United States. Founded in 1892, the hospital has a long tradition of serving the residents of Columbus, Ohio as well as families from all 50 states and more than 68 countries.

Pelvic Reconstruction (CCPR). The program offers the most experienced pediatric surgeons in the world — performing nearly 1,000 procedures per year — for conditions such as anorectal and cloacal malformations, Hirschprung disease and gastrointestinal issues. CCPR also offers sacral nerve stimulation and a renowned Bowel Management Bootcamp for children coping with constipation or incontinence.

A Well-Deserved Reputation

Cardiovascular Surgery

The hospital’s prestigious standing results from tireless emphasis on top-quality patient care and a longstanding commitment to being a global driver of clinical innovation and advanced research.

Nationwide Children’s offers the world’s first therapeutic Hybrid Cardiac Operating and Catheterization Suites, compatible with both interventional cardiology and cardiothoracic surgery. The Heart Center also runs the first FDA-approved human study of tissue engineering repair for congenital heart defects.

Key hospital metrics include: •

•

Ranked #7 among U.S. children’s hospitals by U.S. News & World Report. Ranked among the best U.S. children’s hospitals by U.S. News & World Report for all 10 evaluated specialties. National Institutes of Health (NIH) research funding ranked 6th of all U.S. children’s hospitals. Magnet™ facility designation from the American Nurses Credentialing Center, awarded to only two percent of U.S. hospitals.

Colorectal Surgery Experts from 10 disciplines unite to provide the world’s leading colorectal, urologic and gynecologic advanced care in the Center for Colorectal and

Neurodiagnostics & Epilepsy Patients requiring testing of the brain, spinal cord and peripheral nervous system now have access to the Neurodiagnostic Program’s multidisciplinary, innovative evaluation of injury and disease. Epilepsy patients also receive expert care in the hospital’s Epilepsy Monitoring Unit and Level 4 Epilepsy Center, which offers 21 advanced epilepsy treatment procedures and a 100 percent surgical survival record. The Neurology program ranks 7th in the United States.

Muscular Dystrophy and Neuromuscular Disorders Nationwide Children’s is the only center in the world that has carried out clinical trials in all three major

forms of spinal muscular atrophy (SMA), and is hosting the world’s first gene therapy clinical trial for SMA1. Nationwide Children’s was also the first Certified Duchenne Care Center.

Gastroenterology Disorders caused by behavioral concerns or physiological abnormalities receive critical investigation from the nation’s leading experts in intestinal function. The team leads the world in gastric pacemaker experience and offers the country’s only inpatient Rumination Rehabilitation Program.

Hematology, Oncology & Blood and Marrow Transplantation Ranked 5th in the country for oncology, Nationwide Children’s has one of the largest pediatric cancer programs in the United States and offers personalized and unrivalled care for brain tumor resection, blood disorders, immune system deficiencies and more. The hospital hosts the Children’s Oncology Group (COG) North American biobank and is home to the worldwide Head Start 4 clinical trial (led by the hospital’s Director of Neuro-Oncology, Jonathan Finlay, MD) via the National Experimental Therapeutics (NEXT) Consortium, expediting evidence-based treatment protocols for pediatric cancers.

Welcome to Columbus With convenient access to the city’s international airport, downtown food and cultural centers, arena district and more, Nationwide Children’s offers global visitors a comfortable and welcoming place to call home during treatment.

Global Patient Services at Nationwide Children’s Hospital via email at GlobalPatientServices@NationwideChildrens.org call +1 614 362 9127, or visit NationwideChildrens.org/Global-Patient-Services

JANUARY.FEBRUARY 2019

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

W57019

AMERICA’S SECOND

LARGEST CHILDREN’S HOSPITAL

* Based on CHA survey of utilization and financial indicators

MEDICAL EQUIPMENTS

UltraZonic – Belgian pioneers in unique medical data software technology

ltraZonic is a Belgian-based hi-tech R&D and manufacturing company specialized in infection control technologies. Surgical instruments and flexible endoscopes need a professional focus with advanced medical cleaning methods to avoid cross-contamination. Digitalizing data is the future and thanks to the innovative character of the company there is a constant focus on research & development in the technical and medical field to ensure advanced solutions. Operating from that vision, UltraZonic has designed their ENDO machine, which is the very first device worldwide that pre-cleans flexible endoscopes semi-automatically thoroughly thanks to its advanced integrated software data system. “The complexity of flexible endoscopes requires extra attention and accuracy when cleaning to avoid cross-contamination and infections. Our ENDO finally makes cleaning an easy and controlled process where there is no more room for mistakes,” says Nancy, CEO.

Nancy Steenbakkers, CEO of UltraZonic The company has also developed the innovative MED machine that lifts ultrasonic cleaning to a higher level. “Ultrasonic cleaning is a well-known

concept but has seen little innovation in the last 50 years. After years of research, we have been able to fine-tune this technique with a few advanced applications with an easy to use device to clean your medical instruments as a result. “Thanks to our innovative software packet that we implement in our devices, where you can track and trace all data, we are taking patient safety to a whole new level. This is unseen in the current medical sector, but most needed to guarantee a safe outcome. Make sure to give them a visit at H4.H10 and experience the advanced cleaning technology yourself as they will be giving demos of their state-ofthe-art ENDO.

www.ultrazonic.com

JANUARY.FEBRUARY 2019

Commited to the Highest Healthcare Standards

Eq u

Ph a & rma St or cy A ag u e S tom olu a tio tion ns

Ro Infe om ct De ion co Con nt am trol ina & tio n

Sh Ext ok rac wa or ve po So rea lu l tio ns

C m riti en ca t& lC Co are ns um

les

H IT ealt So hc lu ar tio e ns

rg ica lO So pht lut alm ion o log s

S Su urgi rg cal ica Im l In p str lan um ts en ts

ys & ioth Or er th ap op y ae Equ dic ip Br me ac nt es

1. Quality

2. Reliability

3. Expertise

Supplying superior products and solutions in the medical ďŹ eld with advanced functions and technologies.

Extending professional training on equipment and solutions to ensure optimum knowledge and high expertise.

Delivering reliable and prompt after sales service and

Call us at

+974 4411 1960

Email us at

info@ims.qa

Visit us at

www.ims.qa

proďŹ cient technical support.

Ideal Medical Solutions w.l.l. P.O. Box 19176 , Doha, Qatar

NEWS

Dubai Health Authority Healthy practices to maximize your health in 2019

octors from Dubai Health Authority have mapped out a few habits that, if implemented consistently, will help make us healthier and hopefully happier in 2019. Doctors emphasize that the best way to achieve resolutions is to focus on establishing habits and routines that will help you achieve your resolution. “Focus on building habits that will help you achieve your goal,” says Dr Nada Al Mulla, Family Medicine Physician and Head of Nad Al Hammar Health Centre. “If your goal is to read 12 books a year, create an environment that will facilitate that. Make it a habit to carry your book with you at all times. If your goal is to reach a certain weight, focus on exercising three times a week. Also, check your progress regularly. Break your goals into a series of steps, focusing on creating sub-goals, which are concrete, measurable and time-based.”

Yearly screening Dr Mulla says people must opt for comprehensive health screenings. “It sounds so simple and yet people avoid doing this or taking time out for it. I highly recommend that people should undergo a comprehensive health check-up once a year, especially if they have a family-history of certain diseases.

Quit tobacco Even if you have tried to quit several times before and you have been unsuccessful, head to a cessation clinic rather than trying on your own. “Tobacco use is the leading preventable cause of death,” says Dr Al Mulla.

Exercise: a feel-good medicine New research suggests that exercise causes changes in the brain that boost memory and thinking skills. Additionally, let us not forget, exer-

cise reduces the odds of developing a battery of lifestyle diseases: diabetes, blood pressure and stroke.

Cut back on sugar and eat healthily “Decreasing sugar actually increases people’s energy, by minimizing the highs and lows that sweet foods triggers,” explains Dr Al Mulla. “Eat natural sugars in moderation, such as two portions of fruit a day, but keep your portions in control. Follow a balanced healthy diet, do not skip breakfast and stay clear of fast food.”

Be kind to yourself and slow down the pace of life Dr Khawla Ahmed Al Mer, Consultant Psychiatrist at Rashid Hospital, says it is time to take a back seat, slow down the pace of life and take time out to do things that bring you genuine happiness.

Prime Healthcare Group Minimally invasive appendectomy saves patient’s life

team of doctors at Prime Healthcare Group recently carried out a rare minimally invasive appendectomy that saved the life of a young woman of Middle Eastern origin, it has been revealed.

Dr Prashant Hombal, general and laparoscopic surgeon from Prime Hospital, said: “On October 31, a 29-year-old woman was rushed into the emergency department with acute appendicitis and severe pain with a pain score of six to seven. A CT scan revealed she had a 1cm stone in the appendix measuring 5cm and this had perforated the appendix. Usually stones are formed by hardened mucous secretions. Normally appendectomies are done with a proper abdominal incision. That is the conventional method. But in this case we decided to opt for a laparoscopic surgery which is more complicated, but it allows for a quicker recovery. We had to conduct the surgery the same day as any delay could have led to the bursting of her appendix.” Acute Appendicitis is the most common acute surgical condition of the abdomen. Perforated appendicitis is associated with higher mortality rate; as high as five per cent. The emergency laparoscopic appendectomy carried out on October 31, resulted in quick recovery as the surgery was carried out through tiny incisions which healed quickly and the patient was on her feet within a week.

JANUARY.FEBRUARY 2019

→ Hospital Accreditation → Clinical Excellence Certification → Medical Web Content Certification

LLENCE CER CE TIF EX

We Know Healthcare.

IT Y

ION AT IC

CLIN ICA L

aacihealthcare.com

& PATIEN T S

NEWS

Diabetes cases in the MENA region expected to increase by 110% to 82 million by 2045 analysis of the key factors impacting the “Diabesity” epidemic - which refers to a twin occurrence of the epidemics of Type 2 diabetes and obesity - with a focus on the MENA region and its future outlook.

Ross Williams

new report by Colliers International titled “Diabesity – Impact on the MENA Region” has revealed that the number of diabetic patients in the Middle East & North Africa (MENA) region is expected to increase by 110% to 82 million by 2045, second only to Africa (156%), significantly impacting mortality, loss of productivity (GDP) and increased healthcare expenditure. The report, which is part of the Arab Health Market Series, also highlighted the economic burden of diabetes in the region which reached US$ 21.3 billion and is expected to jump by 67% to US$ 35.5 billion by 2045. Meanwhile, eight Middle Eastern countries – Kuwait, Qatar, Egypt, KSA, Bahrain, UAE, Jordan and Lebanon – have the highest ratio of obesity among adults globally with 27% to 40% of the total population affected. Published ahead of Arab Health 2019, which takes place from 28 – 31 January at the Dubai World Trade Centre, the latest research from Colliers International provides in-depth

JANUARY.FEBRUARY 2019

Commenting, Ross Williams, Exhibition Director of Arab Health, said: “With health professionals and researchers considering “Diabesity” as potentially the greatest epidemic in human history, the advancement of communication technology, telehealth and application of Artificial Intelligence (AI) is now playing a critical role in management of chronic illnesses such as diabesity and obesity. The economic and societal impact of the epidemic is a catalyst for the entire healthcare industry to come together to offer collective solutions to this global problem.” According to the report, factors contributing to the “Diabesity” epidemic in the Gulf region include altered eating patterns due to increased income and urbanisation (only 38% of the GCC population eats fresh fruit and vegetables), sedentary lifestyles (60% of men and 73% of women are physically inactive), barriers to a healthy diet and lesser emphasis on nutritional education, as well as increased consumption of sugar and sugar substitutes (GCC countries represent a US$ 8.4 billion soft drink market). The report also outlined a number of preventative measures being taken by governments around the region to tackle the growing problem of diabesity. For example, the UAE has developed a clear roadmap for combating

and controlling diabesity. Though the challenges are still being faced in some areas such as lifestyle modification, physical inactivity and diet, government measures have led to a drop in the prevalence of diabetes in the UAE from 19.3% in 2013 to 17.3% in 2017. Some of the current measures being carried out by the UAE government include the Abu Dhabi Children’s Obesity Task Force which plans to reduce obesity by increasing physical activity in children by 15% and reduce the average body mass index by 15% by 2020, as well as the introduction of a 50% “sugar tax” on soda and 100% on energy drinks and tobacco products, in order to lower obesity and diabetes rates. Arab Health, the largest exhibition and congress for healthcare and trade professionals in the MENA region, will host the 5th Diabetes Conference bringing together the region’s foremost experts to measure the prevalence of “Diabesity” in the region and to discuss the latest developments in its prevention, treatment and management. “The Diabetes Conference at Arab Health is the perfect platform to bring together all stakeholders from government authorities to the region’s leading diabetes experts - to assess the various public health measures and technological advances that can be adopted in order to tackle the growing burden of this epidemic,” added Williams. Organized by Informa Life Sciences Exhibitions, the 44th Arab Health Exhibition & Congress will welcome more than 4,150 exhibiting companies from 66 countries and an anticipated 84,500+ attendees from across the globe.

NEWS

Introducing the Centrella™ Smart+ Bed

Because life-altering moments deserve elevated care. The Centrella™ smart+ bed is changing the way care is delivered, using advanced visual and verbal prompts. With caregiver-focused technology, the Centrella™ Smart+ bed is designed to simplify how caregivers work and help keep patients safe. Delivering elevated care through: Optimized patient safety Enhanced patient satisfaction Advanced caregiver-focused technology

.. .

Visit Hill-Rom. Saeed Hall 3 – S3B30. Explore the Centrella® Smart+ Bed and our portfolio of products and solutions from Hill-Rom, Liko, Welch Allyn, Mortara, Aspen Surgical, Allen Medical, and Trumpf Medical. ©2019 Hill-Rom Services, Inc. ALL RIGHTS RESERVED. 45 l 201 9 08-JAN-2019 ENG – US 207383 rev 2

NEWS

Baylor St. Luke’s liver transplant team gives maksim more miles How a Liver Transplant Put Maksim Koloskov Back in the Race

ver a decade ago, Maksim Koloskov was diagnosed with primary biliary cirrhosis (PBC), a chronic disease that causes the liver to slowly deteriorate. As his condition progressed, he went from running daily to not being able to cross the street within a matter of months.

cover. Maksim is extremely grateful for the gift of life he received from his donor and their family as well as the care he received during his time at Baylor St. Luke’s. “Baylor St. Luke’s has the best specialists in the country, and I am thankful for the entire liver team,” said Maksim. “I have tremendous appreciation for everyone at the hospital that

took care of me.” Since his transplant, Maksim is back to his morning runs. He competed in the 2016 Transplant Games of America and recently ran in the 2018 New York City Marathon. His goal is to help bring awareness to the importance of organ donation through his running and prove that in the marathon of life, compassion is everything.

A consultation landed him at Baylor St. Luke’s Medical Center. After a meeting with the team of specialists, they determined Maksim would need a liver transplant. He was placed on the transplant waiting list in February of 2014, and after six months of waiting, he received the news he had a donor. On July 30, 2014, Maksim underwent a successful liver transplant at Baylor St. Luke’s. After spending three days in the ICU, he went home to reFOR MORE INFORMATION CONTACT INTERNATIONAL SERVICES AT BAYLOR ST LUKE’S MEDICAL CENTER Via email at international@stlukeshealth.org or call +1 832 355 3350 or visit StLukesInternational.org Texas Medical Center, Houston, Texas - USA

JANUARY.FEBRUARY 2019

NEWS

We offer personalized medicine where specialists use your genetic makeup to help select the best course of therapy, targeting the specific characteristics unique to the cancer. Our experts at the NCI-designated Dan L Duncan Comprehensive Cancer Center at Baylor St. Luke’s Medical Center offer the latest innovations in cancer treatment—many of which stem from our own internationally recognized research. That’s our answer to cancer.

Tel: 1.800.670.3924 Email: International@stlukeshealth.org StLukesInternational.org Texas Medical Center, Houston, Texas – U.S.A.

Baylor St. Luke’s Medical Center

COVER

JANUARY.FEBRUARY 2019

COVER

President of the Saudi German Hospitals Group

Engineer Sobhi Batterjee “We hope to expand our global reach, after developing a solid presence in the Gulf and the Arab World”

ng. Sobhi Batterjee, the renowned Saudi businessman and President of the Saudi German Hospitals Group, has received numerous titles and awards in recognition of his achievements and accomplishments in the Middle East for his contributions to the construction of the Saudi German Hospitals and the great success it has achieved. He began his career as an electrical engineer after receiving a master’s degree with honors from the University of Colorado, USA in 1973, and a bachelor’s degree in electrical engineering from the University of Kansas in the United States as well in 1972. Today, he is one of the pioneering leaders in the private health sector in the Middle East, and is dedicated to establishing a strong medical system that contributes to the development of medical services in the region. In a candid and comprehensive interview with “Hospitals” magazine, Eng. Batterjee spoke openly and transparently about his beginnings as an engineer in the world of health and hospitals, and the major challenges facing the health sector. He stressed the importance of focusing on medical tourism in the Gulf and activating it by ensuring all the requirements for its success compared to active countries in this field such as Taiwan, India and others. He pointed out that he has several developmental factors and conditions that he can offer to officials in the Gulf countries and the Arab world to make medical tourism accessible to everybody. He also stressed that the Saudi German Hospitals Group aspires to have a global reach after the spread of the Group’s hospitals in the Gulf and Arab countries. Below is the full interview:

COVER

Can you go back to the starting point of your professional path, and how your family influenced your career? It is true that we are a family with a long-standing history in hospital work. My grandfather was the first to bring medicines into Saudi Arabia. It was in the 1940s, when Batterjee National Pharmacies spread and were the first and sole provider of medicine in Saudi Arabia at the time. I grew up in a family culture of alleviating people’s pain. After my brothers, cousins and I studied abroad, my parents, brothers and I decided to add patient service and hospital building to the family business. We succeeded because we have a strong determination and ambitions and we work 24 hours a day. If you go to our hospitals anywhere, you will find my phone number at the entrance to the reception areas, in the elevators and in patients’ rooms. We advised inpatients and outpatients to contact the numbers mentioned (including my number, hospital manager, medical director and clinic manager numbers) should they have any comment on the service or if they were uncomfortable for any reason. This is what patients don’t find in other hospitals. The sincere desire to serve people is our main motivation and drive that make me wake up at 5 am to this day to follow up on my work in the Group.

Where are the Saoudi german hospitals currently located? Tell us about the story behind your first hospital construction? The operating hospitals of the Saudi German Hospitals Group are in Jeddah, Aseer, Riyadh, Madinah, Hail, Sana’a, Dubai, Cairo and Sharjah. Soon we will be in Ajman. The story of building the Group’s first hospital begins with my mother’s desire that

JANUARY.FEBRUARY 2019

we become doctors, while I had studied and graduated as an engineer. Then I worked at Juffali company as a site engineer with a salary of 2200 riyals. After that, I established my own company in electrical contracting and air conditioning from 1975 to 1985. When my brother Khalid graduated from Germany, the idea of working in the field of medical services, to fulfil our mother’s wishes, as well as building a hospital began to develop. Then I challenged the reality and was determined to fulfill my mother’s wish. I decided to embark on this adventure and built the Jeddah Hospital, although oil prices plummeted from $ 40 to $ 8 a barrel, people believed, out of ignorance, that Saudi Arabia had gone bankrupt, and investors started leaving the country. At that time in 1985, we started digging the foundation for the first project in the middle of the desert, the Saudi German Hospital in Jeddah, and they said that Batterjee had gone insane. Then he built a large hospital away from the center of Jeddah and thank God we succeeded in the operation and construction of a large hospital in the city of Jeddah - the Saudi German Hospital in Jeddah.

What about your book “Road to Success”? When I attended a conference in the United States entitled “Hyper Competition” in 1996, I learned about things I had not known before that inspired me to think about building a chain of hospitals. Then, I returned from that conference and started building and operating a chain of five hospitals by 2005. We started in Aseer, Riyadh, Madinah and Sanaa and soon in 2019 we will be in Ajman and Dammam and in 2020 in Mecca and Alexandria to complete the construction of 30

hospitals, on the basis of which I published my book “Road to Success” which benefits the reader a lot. In the Arabic library, they talk about success stories mostly about foreigners. Even most of the successful local entrepreneurs who had time to write their own success stories, wrote an biography of what they had accomplished. My book is different; it is not about a success story but the road to success. It is aimed at small investors and those who want to build a future in a company or in an investment that benefits them. Therefore, I think that my book would be very useful because it includes a work system and talks about 6 steps; if anyone follows them they can reach their goals. Here is an example: An Arab journalist came to me years ago and interviewed me, I asked her what her goal in life was and she answered that she aspired to be the editor of the magazine she represented, then I offered her my book. After a certain period of time, she came back and told me that she had bought the magazine. In my book “Road to Success”, I put my own recipe that I experienced and adopted throughout my journey to achieve success and excellence. This process began since I was one of the top ten students in high school in the Kingdom of Saudi Arabia. To sum this recipe up, I can say that all ideas and goals can be transformed into reality no matter how great and disparate they were.

What is the added value of the Saudi German Hospitals Group for the health sector? The Saudi German Hospitals Group has proven that providing medical services is not exclusive to doctor, we have even introduced new concepts to this industry. We are the first to introduce the term

COVER

Engineer Sobhi Batterjee currently holds the following positions: Chairman of Middle East Healthcare Company (Saudi German Hospitals Group) Founder and CEO of Saudi German Hospitals Group Chairman of Bait Al Batterjee Medical Company (Holding Co.) Chairman of the Board of Directors of Batterjee Medical College for Science and Technology.

COVER

“Corporate Health” into hospital work, and hospitals are now owned by companies, not individuals. It is also worth noting that we are the first to introduce IT to our hospitals.

What about Saudi German Hospitals Group being the first group to introduce the IT concept into its business? IT has invaded all economy sectors and has brought about profound changes. The Saudi German Hospitals Group is the first group to introduce the concept of information technology into its business. We have stopped using papers and paper files and are now adopting electronic archiving, thus our hospitals are now paperless. Everything related to the patient is done electronically, and we do not have paper files for patients. This way, we saved outpatients a lot of time and the loss of their medical files. We also save a lot of money that would have been spent on employees who transferred the files and that would have been spent on purchasing and printing files and papers, etc. We also saved storage costs, paper accumulation and preservation for long periods of time in addition to the cost of storage space. On top of that, we saved a lot of our doctors’ time, and provided them with quick and easy access to the information. This is reflected positively on the quality, speed and excellence of health services.

Where are you now from achieving your goal of building thirty hospitals? I am still convinced of the vision, and my mission is to keep urging and motivating the team so we don’t fail. Therefore, we have adopted two steps that will increase the chances of success: the first is to become a public

JANUARY.FEBRUARY 2019

shareholding company and enter the capital market and the second step is to launch charitable hospital projects.

for all hospitals, and we started a unified procurement process for the whole group.

You have high management skills. How did you acquire them?

You have a solid theory in the concept of willpower, how do you explain it?

Experience is key as well as the constant pursuit of the best in addition to the management skills I learned from conferences and lectures that I participate in, especially a lecture in Philadelphia that has enlightened me about several issues and made me see things more accurately, thus, I learned the Power of Network concept. A man alone is not like a man who has ten sons, each one of them in a different city providing him with opportunities and information. If an organization grows and expands its branches, it will have an added power. I also attended a four-day lecture series entitled “Hyper Competition” and learned that the purchasing power of an individual is not similar to the purchasing power of a group where you can get cheaper prices because you buy in larger quantities. In addition, I learned about the concept of market share, as the share of a group of hospitals is a big force in the market that cannot be compared to one hospital share. Insurance companies, for instance, do not deal with me as they do with other hospitals. We have a group of branches, therefore, insurance companies cannot impose their price on us. Based on this principle, I set my goal to build five hospitals in 2005, and many considered that this step was not calculated. However, we were able, thanks to God, to achieve this goal a year ahead of schedule. My brother Dr. Khaled has formed a Total Quality Management team. We have adopted a unified computer program

A human being is not bound by anything, he was blessed with the Spirit of God. So there is no room to say: I do not know, I cannot do. I do not believe in these terms. “I cannot” is not in my dictionary at all. If a man wants and is determined to achieve something, he will achieve what he wants. I have a famous saying in this regard: “What man wants, man gets; it’s a matter of passion and persistence”.

What is your comment when they describe you as an assertive leader? Besides being the head of the Group and the final decision-maker, I am very democratic, and I backtrack on any decision that is proven to be wrong or if there is a better one to be taken. This is known to everyone around me. I am also a very good listener to the opinions of others and they even come before my personal one. I never impose my opinion, but in return I am very disciplined and firm.

How do you maintain the success of the follow-up system that you created? Business follow-up is originally my lifestyle, and if the institution did not have a business follow-up system, it will not operate well. Anyone who does not have in his life and in his office a business follow-up system, they will not accomplish anything at all. Many people spend a lot of time theorizing and planning and then when the time of implementation comes, they do nothing. Many things

COVER

are lost with the numerous tasks and burdens of implementation, due to the lack of a follow-up system. Therefore, we were the pioneers in connecting hospitals technically: audio, video and information (computational, patient information, meetings...) from 2003, and we were the first to launch an interactive website with patients to answer their questions and follow up on their affairs.

What is the adopted policy of the Saudi German Hospitals Group to achieve success? My personal philosophy is that anyone wishing to work within the hospital sector must have a specific culture. Hospital work is not only a matter of money or investment, but a mixture of culture and investment. It means that if someone has money but has no desire to serve people “they must forget about it” because it would be a heavy burden on them and would require great effort. Investing in the service of people, medical care, and patient care requires a great deal of effort, because you will be dealing

with people’s most valuable asset (father, mother, brother, child...). Therefore, there is no success if the work culture is not unified among the management department and employees. Therefore, it is best not to invest in this industry, and serve people as in real estate, hotels and tourism, but not in health.

The most important awards he received in his career •

•

Engineer Sobhi Batterjee’s main achievements: •

•

Designing, financing, establishing, equipping and operating an international multidisciplinary hospital group. Establishment of faculties for medical sciences in various specialties. Awareness and education of health and medical management. Community development (through non-profit organizations). Establishment of charitable hospitals to serve the poor.

•

The 2003 Investment Pioneer Award in 25 Islamic countries, awarded to him by the Islamic Corporation for the Development of the Private Sector of the Islamic Development Bank. Best Hospital Developer in the Middle East for 2004, awarded to him by the Gulf Medical Journal and the ECRI, Inc. Sheikh Mohammed bin Rashid Al Maktoum Award for Arab Management in the category of “Best Arab Management Personality” in 2006; it is one of the most prestigious awards that recognize outstanding Arab management figures and their achievements in the region. Best Executive Director in Healthcare Award by the Middle East Excellence Awards Institute and

COVER

•

JANUARY.FEBRUARY 2019

presented to him by Mr. Dominique de Villepin, former Prime Minister of France in 2008. He was named Ernst & Young Middle East Entrepreneur of the year Award for 2008 after being selected from among sixteen active and talented regional business leaders. Engineer Sobhi Batterjee received the award in recognition for his hard work and determination to build a successful institution in a short period of time and contribute significantly to the promotion of healthcare standards in the region. Saudi Achievement Award for Corporate Social Responsibility (CSR) by Arabian Business in 2007 for the Saudi business sector in 2007 where he was honored by His Royal Highness Prince Sattam bin Abdulaziz, Deputy Governor of Riyadh Province. National Medal of Cedar – Grade Knight awarded to him in Lebanon by the former President of Lebanon in 2007 Emile Lahoud; it is the highest state order of Lebanon granted to non-Lebanese, in recognition for their efforts and support for Arab health. Eng. Sobhi Batterjee has been selected amongst an elite group of YPO-WPO members as an award recipient for the SEN Corporate Social Responsibility (CSR) Leadership Award in midMarch in 2009 at Miami, USA. Eng. Sobhi Batterjee received Arab Takreem Award in the category of Outstanding Corporate Leader in 2010.

COVER

Saudi German Hospitals Group’s Main Awards •

• • • • • •

Best Training and Educational Hospital Award by the International Arbitration Committee formed on the sidelines of the Arab Health Exhibition and Congress in Dubai, the second largest medical event in the world visited by about 100 thousand specialized visitors and more than 4,000 exhibitors from more than 49 countries. Saudi Achievement Award 2007 for Corporate Social Responsibility (CSR) by Arabian Business Magazine. United Nations Millennium Development Goals Award and Arab-African Initiatives in Cairo in 2007. Saudi German Hospitals Group was selected among the 50 most impressive companies in the GCC region, according to the field survey conducted by Arabian Business (the first company in the list in the healthcare field). SGH Group won an award in Arab Health Dubai 2014 by Orthopedic Department of SGH Jeddah for the Excellence in Surgery Services Award. Saudi German Hospitals Group has been selected and honored as a Global Growth Company 2014 by the World Economic Forum. Best Education Project in the Middle East and North Africa for Batterjee Medical College for Science and Technology for year 2010.

NEWS

JANUARY.FEBRUARY 2019

NEWS NEWS

MEDICAL INSTITUTIONS

The University of Nicosia Medical School Pioneering Medical Education in Cyprus and the Region

he University of Nicosia has pioneered medical education in Cyprus, establishing the first Medical School in the country in 2011. Seven years on, the Medical School has become renowned in Cyprus and abroad for its innovative and quality education. It has more than 740 students from 58 countries, 132 academic and administrative staff, and 496 clinical part-time teaching staff. Its programmes include not only medical degree but also postgraduate courses aimed at working professionals that are delivered entirely online.

Postgraduate Online Programmes in Healthcare Administration & Public Health Ideal for working professionals and new graduates The Master of Science in Health Services Administration prepares students for a leadership position in this rapidly growing and ever-changing field, with a multi-disciplinary curriculum accommodating individual professional advancement goals. The Master Public Health addresses critical policy issues and public health challenges in developed and developing countries,

JANUARY.FEBRUARY 2019

with an opportunity to specialize in a broad range of public health topics • Fully online degrees from the first university in the European Union to earn a 5-Star rating for online/distance learning. • Study full-time or part-time. • Opportunity to sample the programme through a free 1-week trial. • Scholarships available.

Two medical degrees and a postgraduate course for Family Doctors: MBBS – 4-year graduate-entry British medical degree awarded by St George’s, University of London, quality assured by the UK General Medical Council. MD – 6-year medical degree for high school graduates, certified and quality approved by the Cyprus Ministry of Education and Culture. PG / MSc in Family Medicine – Postgraduate Programme offered online for practising doctors. The Postgraduate Diploma has received educational accreditation from the UK Royal College of General Practi-

tioners (RCGP), and students with the requisite clinical experience can take the examinations in Cyprus to become International Members of the RCGP.

Tracking the Career Advancement of our Graduates The success of a medical school’s graduates reflects that institution’s quality of education. Of the Medical School’s 255 graduates so far (2015 – 2018), 252 or 99% have already been offered positions at over 200 medical centres around the world for residency training and research. These include medical centres such as John Radcliffe Hospital in Oxford, Addenbrooke’s Hospital in Cambridge, St Mary’s Hospital, King’s College Hospital and the University College Hospital in London, Massachusetts General Hospital in Boston (Harvard University affiliated), Thomas Jefferson University Hospital in Philadelphia, Mount Sinai in New York, and the University of Toronto and Dalhousie University in Canada. This recognition by the global medical community is a testament to the high-quality education offered by the first and largest Medical School in Cyprus.

Tel: +35722471999

Email: admissions@med.unic.ac.cy

Website: med.unic.ac.cy

MEDICAL INSTITUTIONS

Health Care Accreditation Council, a national body driving continuous improvement of quality inhealthcare

alking through the heavily congested primary healthcare center, you admire the team work and patient flow. You wonder after just checking another one what’s different? Then, you hear an older lady saying: “It’s been really special here lately; I’ve been coming to pick up my medication every month for the past 3 years, but for the past months, the pharmacist has been really rechecking if I am taking any additional medication, instructing me and guiding me on how to take my regular meds with food and before bed time, and explaining side effects I may feel.” In another setting, while in the hospital, a younger male was describing his surgical experience in a hospital: “It’s different this time, I wasn’t worried about my medical

JANUARY.FEBRUARY 2019

status during my surgical procedure! All healthcare providers explained my case to me in a detailed manner from physicians, nurses as well as nutritionists.Their plan of care was based on accurate diagnostic results provided by calibrated devices, interpreted, and explained to me by qualified staff. My privacy was respected the whole time, and my comfort was ensured continuously. I was protected from potential errors when my surgical site was marked and my ID was documented and presented on a bracelet stating my full name. What brought me further comfort, while I was being prepped for my imaging procedure prior to the surgery, my pregnant wife was promptly instructed to avoid the radiation area. And all staff members were wearing gloves and disinfecting their hands and tools consistently, and for all of that I was really impressed”.

MEDICAL INSTITUTIONS

In both places, you look up at the wall and you see the shining bright golden star on the certificate that says: Accredited since May 2018 till April 2020 by the Health Care accreditation council (HCAC). This is the kind of impact that the HCAC thrives forâ€Ś to bring safer care to each and every patient while empowering healthcare professionals and ensuring systems are in place for continuous quality improvement. To be able to give such a stamp, the Health Care Accreditation Council, a locally grown internationally renowned organization, has achieved the International Society for Quality in Health Care (ISQua) triple accreditation, ensuring that its standards, surveyor mechanism and awarding are patient centered and adhering to evidence-based best practices. We are the first Arab and 13th institution in the world to receive this prestigious recognition. Today, the Health Care accreditation Council provides services for healthcare institutions to improve their quality and patient safety through consultation, training and accreditation. The six sets of standards for hospitals, primary healthcare, ambulatory care, medical laboratories, breast imaging units, diabetes and cardiac programs are the basis for building quality management systems that ensure cross-cutting patient safety issues from infection control, to continuity of care, human resources, medication management and environmental safety. HCAC consultants design tools to ensure the implementation of standards and support healthcare organizations to be able to adhere to them for continuous quality improvement. The HCAC boasts especially its 5 flagship courses in risk management, infections control, leadership, occupational health and quality among a yearly calendar of workshops tailored to the needs of healthcare providers to ensure quality improvement. From Jordan to the region, HCAC has been able to expand its services to support government and individuals in understanding and developing accreditation systems. The aim is to find the ways and means to ensure that every

healthcare institution and individual are taking a step forward towards better care. It could be through call for pledges during Change Day where healthcare professionals undertake at least one initiative to support patient rights flow or experience or through the National quality and Safety Goals to address national challenges and call for improvement. HCAC has also been instrumental in influencing policy and raising the bar in Jordan and regionally. Although, HCAC does not measure its success by the numbers of accredited organizations, we have accredited more than 150 institutions and trained more than 5000 professionals over the past 10 years. Studies that compared accredited and non-accredited institutions have showed increased time of encounter between provider and patient in accredited primary healthcare centers, improved diabetes and hypertension control and increased in employee satisfaction, because they work in an organized workplace and their health and rights are taken into account, also the studies showed an improvement in the workplace environment and a decrease in turnover. HCAC is there for you to help you choose your way for improving quality and patient safety. Join the move and empower your healthcare professionals with systems, tools and skills and distinguish your organization with the HCAC Star Stamp.

MEDICAL INSTITUTIONS

The American Accreditation Commission International One of the world’s most experienced organizations in the provision of healthcare organization accreditation and clinical excellence certification

Dr. John Davis Bell President AACI

he American Accreditation Commission International (AACI) is one of the world’s most experienced organizations in the provision of healthcare organization accreditation and clinical excellence certification. Rule Risk and Save Lives is our Mission at AACI. This concept serves to guide us in our efforts to improve healthcare services and the safety, well-being, and quality of life of all customers with whom we engage. Driven by our mission, we support governments and healthcare organizations, as well as partners and healthcare professionals to improve the quality of healthcare, patient safety, and excellence of service delivery worldwide. We also help healthcare organizations manage risk and increase their reliance on achieving the intended results of patient care processes throughout their scope of services.

We offer 3 areas of service: 1.

Accreditation Program for

JANUARY.FEBRUARY 2019

2. 3.

Healthcare Organizations. Clinical Excellence Certification Web-based Medical Content Certification.

Accreditation program Our Accreditation program is not just another compliance survey. We work to change the “culture of accreditation” by creating an association with our healthcare organizations so as to collaboratively work together to focus on continual improvement, development of innovative methods for compliance, patient safety, and promotion of quality care for their patients. It is a journey with our clients towards continual improvement and patient satisfaction. Our Clinical Excellence Programs elevate participating institutions to a much higher category of care delivery than those who offer similar, “compliant level” services. AACI’s approaches to accreditation and clinical excellence certification

Mr. Kresimir Antonio Paliska Senior Vice President & CEO AACI are designed to allow healthcare organizations to be innovative, as the standards are not prescriptive or rigid. AACI takes a different stance. You must comply with the AACI Accreditation Standards, but how an institution accomplishes this requirement is left up to the individual healthcare organization. The framework for processes control and how to design, improve, monitor, and measure their performance lies within the AACI standard requirements of compliance. However, compliance methodology often depends on the resources of a given healthcare organization. Flexible, best practice philosophy is encouraged at AACI. Accordingly, AACI doesn’t prescribe a specific way to meet a requirement. Your leadership team determines the best way of accomplishing the goal and ensuring consistent methodology, thus accomplishing the intended outcome. We ensure that our client organizations make a transitional change in their quality

MEDICAL INSTITUTIONS

Clinical Excellence Certification programs Clinical Excellence Certification programs highlight disease specific healthcare delivery. They establish a consistent high level of quality, using effective data-driven performance improvement. Clinical Excellence Standards and their emphasis on spe-

Web Content Medical Certification Web Content Medical Certification has been developed to encourage the dissemination of quality health information for patients and professionals and the general public. It is designed to promote reliable and relevant medical data via the internet. Medical Content Certification is a service provided to website producers so that their customers may have a high

Our services Our services are delivered by healthcare practitioners and executives who offer constructive and pertinent advice to our international customers. AACI’s team of experts includes physicians, nurses, health administrators, physical environment experts, and allied healthcare professionals with a wealth of hands-on expertise and experience in the health services field. AACI experts offer objective perspectives of care and assist clients to measure performance in keeping with international best practices and standards of care. They know the business you are in and are trained to understand the challenges and risks you face. Our staff undergoes extensive, stringent, and continual training and qualification programs in their area of expertise. Our surveyors know your local needs, rules, and regulations. We know how to help you solve your compliance obligations in a way satisfactory to your institution and method of healthcare delivery. We do not tell you what to do…we help you do it your way.

WE KNOW HEALTHCARE!

aacihealthcare.com

ION AT IC

LLENCE CER CE TIF EX

AACI provides a unique program not provided by other accreditation organizations: Our Integrated Management system, provides accreditation survey and ISO 9001:2015 certification in a single package, with no additional charges. Accrediting and Certifying your organization systems simultaneously, saves your time, effort and investment, while increasing the effectiveness of your organization’s management system. Perhaps a new approach to accreditation is just what you need. Achieving compliance with ISO 9001:2015 will enable you to examine your structure and processes for directing and improving your healthcare organization.

level of confidence and assurance that the content of their URL is valid. In this way, we help to ensure trustworthy, objective, and transparent medical information for internet users.

IT Y

Integrated Management system

cific clinical practice help healthcare organizations establish a consistent approach to quality of care, reduction of risk, and minimization of error. This maintains a consistently high level of quality by using a “feedback- loop” of management reviewed, data-driven performance improvement methodology. Our Clinical Excellence Certification service portfolio is designed to meet the requirements of any organization wishing to demonstrate not only compliance, but top-tier excellence in the specific fields of: • Maternity Services Certification. • Acute Stroke Certification. • Endoscopy Services Certification. • Pathology Services Certification. • Stroke Shield Certification for Senior Living Facilities and LTAC Facilities.

CLIN ICA L

management system and improve the communication between leaders, staff, and physicians. Because flexibility is allowed in achieving compliance over time, they avoid designing poor processes that are not sustainable.

& PATIEN T S

NEWS

Dr Manoj Menon receives top accolade at Smart Health Dubai Awards for “Spotcheck” and government organizations from across the Middle East with researchers and investors in order to share knowledge and build alliances. The two-day event took place at Raffles Hotel and was attended by over 200 individuals.

he co-founder of Spotcheck, a technology-driven health and wellness services provider, which offers an 8 minutes non-invasive health screening and a digital platform, has been awarded as one of the top 50 leaders in the healthcare sector in the region. Dr Manoj Menon was given the award at the Smart Health Dubai conference, a platform held in Dubai once a year which brings together decision-makers from corporates

The pioneering Spotcheck ecosystem incorporates a non-invasive health assessment kiosk and a digital platform, ENHAPP, which provides the user with a personalized condition specific wellness program comprising fitness routines, meal programs, engagement with lifestyle coaches and tele-consulting sessions. The kiosk uses FDA and CE approved health assessment technology and is being introduced to corporate and government organizations that have a strong internal focus on employee wellbeing. Dr Menon carries 27 years’ experience and expertise in strategic informational technology planning with special emphasis on the healthcare sector. Along with his team, he began developing the Spotcheck kiosk and

the wellness ecosystem in 2015. The system is geared towards corporates, government organizations, hospitals and clinics. Spotcheck has successfully completed 6,500 health assessments with an accuracy rate of 98.5%. Dr Menon comments: “It’s a true honour to be recognized in this way by Smart Health Dubai, a highly regarded event in the healthcare technology space. Receiving this accolade coincides with the launch of the ENHAPP digital platform for our valued customers in the corporate and government sector. “We are working closely with the HR Managers and the Health & Safety Managers to build a sustained wellness program for their employees. Over the past 12 months we have also introduced the kiosk into wellness and diagnostic centers where the feedback has been very positive. Considering individual’s data privacy, the platform provides an aggregate corporate health analysis, highlighting top health concerns, hydration levels and other metrics which lead to the overall health score.”

Dubai Blood Donation Centre, 63,735 blood donors in 2018

ubai Health Authority’s Dubai Blood Donation Centre, which is part of the medical support services and nursing sector, received 63,735 blood donors in 2018, the director of the centre revealed. Dubai Blood Donation Centre is the only blood donation centre in the emirate. It accounts for about 50 per cent of the total blood collected throughout the UAE. Dr Mai Raouf, Director of Dubai Blood Donation Centre, said that

JANUARY.FEBRUARY 2019

50,456 blood units and 1,117 pooled platelets were collected in 2018, while 4,741 platelets and 480 concentrated blood units were collected through the apheresis system. Dr Raouf also revealed that 635 blood donation campaigns were launched last year and that 11,118 blood units were distributed to private sector hospitals. “We at Dubai Blood Donation Centre are committed to providing a safe and adequate supply of blood to all DHA hospitals and private hospitals in the emirate to save the lives

of patients who require blood transfusions by ensuring that the services we provide are up to internationals standards,” said Dr Raouf. Dr Raouf also revealed that 38 per cent of the blood collected was supplied to the Thalassaemia Centre, 16 per cent was supplied to Dubai Hospital, 14 per cent was supplied to Rashid Hospital, 8 per cent was supplied to Latifa Hospital, 3 per cent was supplied to Hatta Hospital and 21 per cent was supplied to private sector hospitals.

NEWS

360 care around you

Early Mobilization with LINET Improve Early Mobility in your unit

Level 1

Many ICU patients suffer from orthostatic hypotension. This hemodynamic instability may cause a delay in turning and repositioning, and may contribute to the formation of pressure ulcers and higher risk of VAP. Micro-shifting and Automatic Lateral Therapy can assist in reducing these complications.

Level 2

Immobile ICU patients can experience trunk or core weakness, reducing their ability to support themselves in an upright position. The full chair and reverse Trendelenburg positions help with muscle strengthening exercises as well as hemodynamic and orthostatic training.

Level 3

Sitting on the side of the bed is an important part of the mobilization process. It can help to assess muscle strength and hemodynamic stability before ambulating patients.

Join us at booth #S1.G30

Level 4

On average, there is a 2â€“3% daily loss of muscle mass over the first 10Â days. The Mobi-LiftÂŽ and Lateral Tilt provide safe and effective support in mobilization. This may help to prevent an adverse event such as orthostatic hypotension or patient falls.

www.linet.ae

NEWS

Cardiovascular disease is the number one cause of death in Saudi Arabia

MSD discusses the relation between Cholesterol & heart disease

ardiovascular disease is the number one cause of death in Saudi Arabia. Atherscerosis disease accounts for 45 per cent of all cardiovascular deaths. Atherscerosis occurs when there high levels of cholesterol in the blood which can damage the arteries that carry blood from the heart to the rest of the body. Once the damage starts, the LDL-C builds up in the artery walls as plaque, which starts to block the flow of blood. This blockage may result in a heart attack if not detected early on. MSD, a leading global biopharmaceutical company, recently held an event with regional medical professionals to focus on the relationship between cholesterol and cardiovascular diseases across Saudi Arabia, and the wider region. During the event, leading cardiologists from the region focused on the increased prevalence of heart disease that results from high cholesterol and the importance of managing low-density lipoprotein cholesterol or LDL-C. Prominent speakers noted that in Saudi Arabia, cardiovascular diseases represent a major health challenge across the Saudi population. Programmed community-based screening is needed for all cardiovascular risk factors in the Kingdom. Professor Mohammed Rudwan Arafah, President of Saudi Heart Association and Consultant Cardiologist at the King Khalid University Hospital in Riyadh noted, “High cholesterol and other fat producing products in the blood can put a person at risk of developing heart disease, blood-vessel disease and circulation problems.

JANUARY.FEBRUARY 2019

Extra fat in the blood accumulates in the walls of the blood vessels. This can lead to the formation of clots in the arteries that can cause heart attacks, strokes and narrowing of the blood vessels into the limbs. Early diagnosis and treatment of high cholesterol can decrease the risk for CVDs.” “Excess weight may modestly increase your LDL (bad) cholesterol level therefore, losing weight may subsequently lower LDL-C and raise HDL cholesterol levels. Cholesterol is raising higher prevalence rates in KSA. The overall prevalence of high cholesterol is 54 per cent of the total adult Saudi population. Urgent public health measures such as education, case finding and further screening programs are required. “The high prevalence of diabetes, obesity and high cholesterol in Saudi Arabia and the region increases the risk of heart attacks in younger patients and controlling weight, blood sugar and cholesterol are critical in prevention of heart disease,” Professor Arafah added. Dr Abdulrahman Al Shaikh, consultant Internal Medicine at Soliman Fakeeh Hospital said, “Education and awareness are key components to understanding how cholesterol is directly associated with the rise of CVDs – not only in Saudi Arabia, but across the region as a whole. High cholesterol itself does not cause any symptoms, so many people are unaware that their cholesterol levels are too high. Therefore, it is important to regularly check your cholesterol (LDL-C) especially if you have other risk factors that can lead to cardiovascular diseases. The risk factors that may lead to develop-

ing elevated cholesterol are family history, diabetes, obesity, unhealthy diets, lack of exercise, smoking, kidney disease, or hypothyroidism”. “Maintaining low levels of cholesterol decreases the risk for developing heart disease which may lead to death, therefore it is crucial for patients to adhere to their medication,” added Dr. Al Shaikh. The WHO projects that cardiovascular diseases will remain the leading cause of death worldwide in future years, with deaths estimated to increase 23.6 million by 2030. Globally, a third of ischaemic heart disease is attributable to high cholesterol. Overall, elevated cholesterol is estimated to cause 2.6 million deaths (4.5 per cent of total). Elevated total cholesterol is a major cause of disease burden in both the developed and developing world as a risk factor for ischemic heart disease and stroke.

NEWS

The new tube holder from Greiner Bio-One impresses thanks to its versatility

Organ donor registry set to come into force

he new VACUETTE® branded SAFELINK tube holder facilitates quick and easy blood collection. The tube can be used in combination with all medical products that have a standard female luer lock connection, such as winged cannulae. Above all, it stands out thanks to its simple handling.

Tube holder with potential The luer lock feature sets the VACUETTE® SAFELINK apart from the conventional Greiner Bio- One tube holders and makes it particularly suitable for blood collection from venous access devices according to guideline recommendations. Furthermore, tests show that the secure connection withstands pressures of up to 185mmHg. This, along with the functional design and practical handling could make a significant contribution to efficiency in everyday healthcare situations.

Secure screw connection between holder and collection product The simple screw connection ensures safe and successful blood collection. With a controlled threading movement, the single-use product connects safely and smoothly to the respective medical device. The VACUETTE® SAFELINK is manufactured from unbreakable plastic, and does not contain natural rubber latex.

Regular improvements and innovations at Greiner Bio-One Greiner Bio-One uses targeted market monitoring as the basis for implementing ongoing en- hancements, so its product portfolio is regularly optimized and expanded. The range of accessories already includes various tube holders, from the standard holder through to the safety version. The VACUETTE® SAFELINK holder is a perfect addition to the product line with its screw system for a secure connection.

JANUARY.FEBRUARY 2019

he groundbreaking procedures marked the biggest strides in health care in the emirate of Abu Dhabi. This year will continue to build on those achievements, just as a raft of regulations introduced by the healthcare regulator, the Department of Health, should help improve standards in the sector. The UAE had long allowed organ transplants. Kidneys had been transplanted between living donors for nearly a decade. In addition, the first solid organ transplant from a deceased donor — that of a kidney — was performed in 2013. A heart from a deceased donor was transplanted in 2017 after a presidential decree clarifying the concept of brain death came into effect. But it was 2018 that transformed the field of organ transplantation in the country. In total, more than 25 ailing people in the UAE benefited last year alone after receiving organs from deceased donors. In most cases, multiple organs were harvested from the deceased and transplanted into more than one ailing patient. Successful transplants at the Cleveland Clinic Abu Dhabi, including the first transplant of a liver from a deceased donor and a lung from a deceased donor, meant that the country gained its first multi-organ transplant centre. Surgeons at the renowned hospital also went on to perform a double-lung transplant, a complex five-and-a half-hour procedure that gave a 45-year-old Arab woman a new lease on life. Meanwhile, the Department of Health’s focus on tackling childhood obesity in Abu Dhabi is expected to push for new initiatives to tackle the problem.

NEWS

The Saudi Ministry of Health organized its annual meeting for Obesity Surgery Program at King Saud Medical City (KSMC) Riyadh

Dr. Haitham Al-Falah

uring the meeting, accreditation certificates were distributed by the deputy minister of health for therapeutic services to 14

obesity centers across the Kingdom. Dr. Haitham Al-Falah, director of the obesity center at KSMC, said he was pleased to have reached this number of accreditation in the Kingdom and is looking forward to having six more accreditations in the near future. Dr. Al-Falah stated that enormous efforts are being made to increase the quality of these centers and facilitate its services according to patient safety standards. Dr. Al-Falah indicated that the obesity surgery program is considered to be the largest in the Middle East in terms of its distribution and conducted operations for all types of categories within the community. Obesity, said Dr. Al-Falah, is set to

be one of the major healthcare challenges in the Kingdom and worldwide according to recent statistics. He also stressed that the massive number of obese individuals in the community are exposed to chronic diseases such as diabetes, hypertension, arteriosclerosis and others. Therefore, this makes a serious indicator for healthcare stakeholders to find effective solutions to reduce such phenomenon. The Obesity Center at KSMC is certified by the International Society for Obesity Surgery as an accredited international center. It is also considered to be the first center under the Ministry of Health that is recognized globally.

King Salman bin Abdulaziz decisions to improve healthcare in KSA

ustodian of the Two Holy Mosques King Salman bin Abdulaziz approved a number of decisions taken by the Saudi Health Council including the establishment of the National Center for Evidence-based Health Practice to improve healthcare services in the Kingdom. The center will work to consolidate an evidence-based work culture in the Saudi health sector. The decisions are aimed at improving the quality of health services and raising the standard of the Saudi health sector. It has been decided to unify codes for lab measurement units across the Kingdom. The executive plan of the program will be implemented in cooperation with all

JANUARY.FEBRUARY 2019

stakeholders to develop an integrated system of rules and regulations. The secretary-general of the Saudi Health Council, Dr. Nahar Al-Azimi, thanked King Salman for approving the decisions of the council. He said the approval reflects King Salman and Crown Prince Mohammed bin Salman’s keenness to improve the quality of life of the people of Saudi Arabia. Dr. Al-Azimi also thanked Saudi Health Minister Dr. Tawfiq Al-Rabiah, who is also president of the council, and other council members for their support and encouragement. Under new rules, hospitals are not allowed to reject heart-related cases transported by the Saudi Red Crescent provided the health facilities are

well-equipped to handle such cases. Dr. Al-Azimi said regarding oncology services in the Kingdom, specialized hospitals and medical cities have been directed to activate a hub-and-spoke cooperation program. He said it will be implemented in two phases: In the first phase, oncology units in Arar, Madinah and Asir regions will be linked to specialized hospitals, and in the second phase, specialized hospitals will provide other health facilities — with the most referrals — with studies and relevant work plans. The health council is also planning to implement a unified referral system to all services’ providers, whether governmental or nongovernmental bodies, to benefit from the referral program (Ihalati).

NEWS

Please join Hill-Rom at our 2019 Arab Health stand Location: World Trade Center Stand: Saeed Hall 3 â€“ S3B30 Date: 28 - 31 January

NEWS

MEDLAB explores “Lab of the Future” as the UAE prepares to adopt the use of Artificial Intelligence in the medical laboratory

EDLAB, the MENA region’s largest medical laboratory exhibition and congress, has announced the launch of its inaugural Artificial Intelligence (AI) conference taking place during the 18th edition of the show, which will run from 4–7 February 2019 at the Dubai World Trade Centre, Dubai, United Arab Emirates. The conference will explore the potential for AI to transform the medical laboratory industry in the UAE through improved efficiencies and how diagnosis can be revolutionized through futuristic technologies such as data robots and “bloodless blood tests”. With AI predicted to add US$182 billion to UAE’s economy by 2035 and the healthcare industry taking a US$22 billion slice of the gains in its gross value added (GVA), medical laboratories across the country are preparing for the “AI lab of the future”. Adding to this, the UAE Strategy for Artificial Intelligence - launched in 2017 – and the appointment of the country’s first UAE Minister of State for Artificial Intelligence, aims to make the country a world leader in the field of AI investments in healthcare in order to minimize chronic and dangerous diseases. Commenting as Chair of the Artificial Intelligence conference

JANUARY.FEBRUARY 2019

at MEDLAB, Dr P. K. Menon, Director and COO of UAE-based Thumbay Labs, said: “The medical laboratory has been one of the earliest to adapt robotics and AI into its workflow. As early as 1984, the EXPERT consultation system-building tool, a knowledge-based AI programme, was developed at Rutgers University for enabling sequential laboratory testing and interpretation. Now, with the staggering increase in the volume of patient healthcare data, a constant increase in patient expectations and scarcity of resources, AI will be the engine driving improvements across the care continuum.” “Today’s clinical labs are already using advanced robotics to test minute volumes of blood, serum and other bodily fluids from thousands of samples in a day to give highly accurate and reproducible answers to clinical questions, in scales almost difficult to emulate humanly. In the future, robots used in the clinical laboratory will be heuristic (self-learning), using inferential processes, with numerous ways to derive the best decision possible - even allowing for missing information. AI programmes will change the way our laboratories generate and display clinical information in the future,” he

added. Globally, a number of transformative advancements are being made by the adoption of revolutionary AI technologies in the medical laboratory. Earlier this year, scientists at the Mayo Clinic submitted a bloodless blood test for approval to the U.S. Food and Drug Administration (FDA) in order to create a test that people could do at home, without drawing blood. The algorithm can determine serum potassium levels in the blood by monitoring small changes in electrocardiogram (ECG) waves. In the UAE, Abu Dhabi-headquartered National Reference Laboratory (NRL) is planning to adopt AI methodologies in the near future as an essential component of NRL’s molecular diagnostic laboratory services, and, with that, be at the forefront of using advanced technology to improve patient outcomes in the UAE and the region. “It is anticipated that with the aid of AI, there will be an acceleration in novel gene discovery, therefore ending the diagnostic odyssey for many undiagnosed genetic diseases. AI will have a pivotal role in translating genomic research into actionable bedside applications that will benefit both providers and patients, and help in the fulfillment of the promise of precision medicine in the region,” said Dr Val Zvereff, Technical Director of Molecular Genetics at NRL. Along with the Artificial Intelligence conference, the 2019 edition of MEDLAB will see the introduction of two more new tracks - Immunology and Cytogenetics & IVF - bringing the total number of CME-accredited conferences to 11.

4-7 FEB 2019 DWTC, DUBAI

Further your knowledge by attending up to 11 CME accredited conferences 4 February

5 February

6 February

7 February

Laboratory Management

Clinical Chemistry

Microbiology

Haematology & Blood Transfusion

Artificial Intelligence

Histopathology & Cytology

Molecular Diagnostics & Genetics

Point of Care Testing

Immunology

Laboratory Informatics

Cytogenetics & IVF

Hear from internationally acclaimed laboratory champions

Dr Patrick Godbey Brunswick Georgia, USA

Glen Fine Wayne Pennsylvania, USA

Dr Ali Hajeer King Abdulaziz Medical City Riyadh, KSA

Prof Martin L.Olsson Lund University Lund, Sweden

Dr Harpreet S Sood University College Hospital London, United Kingdom

medlabcongress@informa.com medlabme.com/congress

In compliance with:

Supported by:

Upload by:

alizzy.deviantart.com

Organised by:

NEWS INSTITUTIONS MEDICAL

ACIBADEM HEALTHCARE GROUP TURKEY An ECOSYSTEM that sets an example for the world in healthcare service…

eveloping rapidly since 1991, Acıbadem Healthcare Group became one of the leading institutions in Turkey in the field of private healthcare services, and now moves forward globally with its partner IHH Healthcare Berhad, one of the biggest groups in the Far East, in 2012. Comprised of 21 hospitals and 16 medical centers, Acıbadem has become a part of the world’s second largest Healthcare Chain with this agreement under the auspices of IHH Healthcare Berhad. Each year, many patients from different parts of the world choose Turkey to receive treatment, and they prefer Acıbadem which provides services using the most advanced technology worldwide featuring an expert team meeting international quality standards. Its quality of the services also supported by independent institutions; Joint Commission International (JCI) and “ISO 15189 Clinical Laboratory Accreditation Certificate”.

Globally competitive integrated healthcare services in Healthcare Apart from hospitals and medical centers, Acıbadem Healthcare Group offers a worldwide example setting integrated special healthcare system model, and includes various healthcare support institutions.

JANUARY.FEBRUARY 2019

MEDICAL INSTITUTIONS NEWS

Multidisciplinary Centers of Excellence

All of the hospitals within ACIBADEM Group that meet the global standards, also stand out with the Centers of Excellence: 16 Heartcare Centers (pediatric and adult cardiology and cardiac surgery), 13 In Vitro Fertilization Centers (infertility - IVF), 11 Cancer Centers (surgery, radiotherapy, chemotherapy), 10 Organ & Tissue Transplantation Centers (liver, kidney, bone marrow), 9 Spine & Neurosurgery Centers, 6 Robotic-assisted Surgery Centers and 1 Sports Medicine Center accredited by FIFA are all among the nationally and internationally accredited and qualified centers due to their advanced technology equipment and experts that have significant experience in their own fields.

NEWS INSTITUTIONS MEDICAL

Acibadem Maslak Hospital in Turkey introduces next generation cancer care with MRIdian MR Image-guided radiation therapy the state-of-the-art radiotherapy device to cancer patients. On table and continuous soft tissue imaging enables plan adaptation to reshape radiation doses based on the anatomical changes which occur from one day of treatment to the next. Using a novel streaming video perspective, the technology also allows oncologists to visualize and automatically control beam delivery based on the real-time position of the tumor and surrounding organs.

MR Linac is the newest technology that combined MRI and Linac for the first time in the world and Acibadem Maslak Hospital in Istanbul in Turkey has begun treating patients with it. With this technology, radiation oncologist can treat the patient as a surgeon, because this device enables the physicians to see tumour precisely, even in soft tissues. Acıbadem Maslak Hospital is the ninth MR Linac center in the world. MRIdian, MRI-guided radiotherapy, presents

JANUARY.FEBRUARY 2019

We are pleased to have commenced Turkey’s first MRI-guided radiation therapy program and believe it offers cancer patients in Turkey a number of distinct benefits over traditional radiation therapy,” said Prof. Enis Ozyar, M.D., the Chief of Acibadem Mehmet Ali Aydınlar University, School of Medicine, Department of Radiation Oncology. “Most importantly, MRIdian allows for clinical improvements in visualization and precision daily plan adaptation, and it provides us with the tools to deliver higher and potentially more effective radiation doses.” Turkey is currently one of the leading countries in health tourism due to the country’s advanced diagnostic and treatment services offered.

MEDICAL INSTITUTIONS NEWS

9th CENTER IN THE WORLD 3rd CENTER IN EUROPE

With MRIdian

SEE THE INVISIBLE

NEW ERA IN CANCER TREATMENT

MRIdian, the newest smart radiotherapy, can deliver precise and accurate radiation to cancerous tumors. Combined MRI, provides real time and continuous imaging and is spares surrounding tissues from radiation beams.

+90 216 5 44 46 64

acibademinternational.com

NEWS

Changing face of healthcare placed in expert focus through qf’s ‘Education City Speaker Series’ Its talks, which are free to attend and open to all, reflect QF’s commitment to encouraging dialogue, discourse, social interaction, and critical thinking. During his career, US physician Zeiger has developed the Google Flu Trends service and ‘Smart Patients’, which enables patients and carers to share their healthcare experiences and knowledge, and has also served as a clinical instructor of medicine at Stanford University School of Medicine.

ey themes surrounding the impact of technology on global healthcare have been explored by US physician and innovator Roni Zeiger through the ‘Education City Speaker Series’, launched by Qatar Foundation (QF) as a platform for knowledge-sharing and public interaction with experts. The former Chief Health Strategist at Google spoke to members of QF’s

JANUARY.FEBRUARY 2019

community and the wider public about ‘How Technology Is Changing Healthcare’ during the event at Qatar National Library (QNL), at Education City, before answering questions posed by the audience. The Education City Speaker Series is designed to provide the community in Qatar with an opportunity to benefit from the perspectives of experts and thought-leaders across a range of fields, while sharing their own views and opening up discussions.

“This is the most exciting time to be in healthcare,” Zeiger said. “Advances in robotic surgery, targeted therapy, and the use of AI to analyze medical data are all transforming healthcare. “We still have much to do. Not only do we have to continue to conduct biomedical research and look for breakthroughs, we must also do the basics, which means designing healthcare systems holistically so they best serve society.” Further talks in the Education City Speaker Series will be announced in due course.

NEWS

Al-Ahli Hospital’s Participation in the World Innovation Summit for Health (WISH)

s an official sponsor, Al-Ahli Hospital participated in the 2-day WISH 2018. Through its location at WISH’s exhibition, Al-Ahli Hospital reached out to representatives of the WHO and representatives of other health sectors from all over the world. The Summit aimed at highlighting the importance of overcoming the healthcare challenges by promoting international relations with local and international organizations by the medical sector in Qatar. As a representative of the private sector in Qatar, Mr. Khaled Al-Emadi, Chief Executive Officer of Medicare Group and Al-Ahli Hospital, participated in the summit and addressed the role of the private sector in health care. This Summit focused on the method of establishing more effective and extensive cooperation between the public and private sectors to provide the required comprehensive health care services. It focused on the importance of developing

JANUARY.FEBRUARY 2019

the work of private healthcare service provider. The private sector provides substantial services in the health sector, but more effort for the development of performance is anticipated. The second part of this Summit addressed how can governments promote a conducive and enabling environment for providers of the ready “comprehensive health coverage” by meeting the leaders of 6 major governmental bodies in the countries which provide comprehensive health coverage. “As the public sector provides a free comprehensive healthcare in rich countries, such as Qatar; hence, for the purpose of providing a better service for the patient, the private sector should invest in the health sector to cope with the (governmental) public sector without limits” added Mr. Al-Emadi in praise of the role of the private sector. Al-Ahli Hospital organized awareness events under the umbrella of

WISH. Such events included awareness raising of the nursing profession and the legal midwifery profession and their importance. The nursing section was visited by school students for encouraging them to abide by the various healthy practices and for raising the awareness of the students. Al-Ahli Hospital targets 2 age groups: from 4 to 5 years and from 14 to 15 years. Nurses tried to raise the awareness of the students about the negative effects of social media compared to their positive effects. They explained that they are considered double-edged weapons; when abused and addicted, social media cause isolation and loneliness. They also adversely affect school performance and cause poor language and pronunciation, in addition to sleep disorders arising out of usages of electronic devices, such as mobile phones, tablets, and laptops. Furthermore, social media may expose people to a violation of privacy.

NEWS

MEDICAL INSTITUTIONS

NMG Modular Design-Build Turnkey Solutions Pre-manufactured

The NMG Modular Design-Build Concept

All necessary mechanical, electrical, plumbing, and medical gas is integrated into the modular walls.

NMG is an American based design-build company that is at the forefront when it comes to modular interior design and construction. We have established ourselves as the leading force in designing and building highly functional, flexible, and sustainable healthcare facilities with focus on operational efficiency, as well as creating a healing environment, promoting enhanced well-being for patients, families and caregivers alike. Our passion and dedication is to change the way healthcare facilities are designed and built, including complete modular ICU, PICU & NICU departments, customized head-walls and foot-walls for patient rooms, dialysis suites, outpatient clinics, waiting areas & interactive pediatric departments.

Future flexibility Installed tiles are simply clicked on and off the structure, without any fixed drilling needed, allowing for future inspection and maintenance to be done within minutes.

Integrated technology Technology is integrated into the system for quality assurance and infection control, while contributing to the appealing environment.

Fast Installation Fast installation is ensured as the system arrives on site ready to be assembled, saving both time and cost during construction.

JANUARY.FEBRUARY 2019

MEDICAL INSTITUTIONS

The Future-Proof Facility As technology begins to play a larger role in patient care delivery, healthcare facilities must be designed with adaptability in mind. The continuous change in the healthcare industry, driven by technological advancements, requires healthcare operators to constantly reinvent and renovate their facilities. Over the next few years, the healthcare industry will experience a significant change, with more emphasis on utilizing technology such as the internet of things and artificial intelligence. Our modular system allows new technology to be easily integrated into the overall solution, providing complete sustainability. Allowing facility managers and engineers to access the cavities of the wall system for necessary inspection and maintenance, in addition to incorporating new technology in the future, within matter of minutes and with minimum disruption for the facility, will result in enhanced efficiency and better operational outcome. Only the most advanced and true future-proof modular system, where the ultimate flexibility is provided, a system that is designed to ensure adaptability for future needs, allows healthcare operators to be prepared for the forthcoming facility requirements. This is what we, at NMG, provide for our clients.

The Healing Environment The healthcare research literature has demonstrated how properly designed facilities can impact patients’ recovery and general well-being. Yet healthcare facilities tend to be designed and built in a relatively cold and raw manner, adding to the already uncomfortable and stressful experi-

ence for patients and their families. It is highly important to utilize what research has shown when it comes to healthcare design. Using evidence-based design principles, from neuroscience and psychology to architecture and behavioral economics, will enhance the patient experience and satisfaction and lead to faster recovery. This includes elements such as choosing the relevant color hues for different areas, ensuring exposure to natural light, incorporating contact with nature and positive distractions. Our modular system is designed with elements to enhance the infection prevention and control where technology is integrated behind back-painted glass and highly advanced medical fillers are used to seal extrusions, leading to reduced rate of infection for patients during their stay. Our highly experienced designers are dedicated to creating the perfect patient-family centered healing environment. The extensive range of advanced and appealing solutions contribute to the patients’ well-being, exceed visitors’ expectations, and results in higher satisfaction among patients, their families, and caregivers alike.

The Bottom Line There is no better return on investment than a quickly and accurately built hospital with sustainable, highly functional, and charming environment. This can only be accomplished with our state-of-the-art solutions. Over the course of only few years of operation, the financial benefits of investing in NMG’s solutions are evident.

www.nmg.us.com

NEWS

Project Communications at Messe Düsseldorf Readjust: Dietmar Thomas appointed Head of Trade Fair Press Department Messe Düsseldorf: 1 January 2019 saw Dietmar Thomas take office as the new head of the trade fair press department. In this role Thomas will be in charge of communications for all trade fair projects. He will strengthen the standing of the individual trade fairs in the mediascape and their perception in their relevant target groups and drive digital transformation of the project and trade fair communication. Dietmar Thomas reports to Dr. Christian Plenge, Division Director of Digital Strategy and Communication.

January 2019 saw Dietmar Thomas (51) take the helm in Messe Düsseldorf’s trade fair press department – which, alongside Corporate Communications and Marketing Services, forms one of the three communication pillars of the company. In this post Thomas will be in charge of trade fair communications for the individual projects. The mediascape will now have a new main contact for the events of

Wolfram Diener, operative Managing Director responsible in charge of Digital Strategy and Communication at Messe Düsseldorf, delights at filling this key position: “Our trade fairs are the global hubs and hinge points for their respective industries. In times of digital change it is all the more important to reach the sectors’ target groups in an up-to-date, effective way and strengthen trade fairs as their first point of contact – also beyond the duration of the trade fairs proper.” Dietmar Thomas, he adds, is the right person to do so as an experienced expert in communications.

Thomas comes to this new role from the Publicis group of agencies where he has established and managed the editorial department focused on content marketing in Düsseldorf since 2016. Prior to this position, he served as a press spokesman in charge of marketing for brand companies and taking care of global product communications and held several executive positions at magazines and agencies in Germany and abroad. Thomas studied modern communication and learnt script and creative writing for film and TV at the “School of Theater, Film and Television” of the University of California in Los Angeles. “I look forward to using my 30 years of communication experience for Messe Düsseldorf, a company that organizes numerous exciting and successful global No. 1 trade fairs. One of my key aims is to strategically develop further its project communication as part of digital transformation,” says Dietmar Thomas, who follows on from Eva Rugenstein. In December 2018, this former head of the trade press department retired after serving in this role for 25 years at Messe Düsseldorf.

Tanzanian Conjoined Twins separated in Riyadh

he separation surgery of Tanzanian conjoined twins Anishia and Milanese has been successful, said Dr. Abdullah Al-Rabeeah, supervisor general of King Salman Humanitarian Aid and Relief Center and an adviser to the royal court. The procedure was carried out at the King Abdullah Specialist Children’s

JANUARY.FEBRUARY 2019

Hospital in King Abdul Aziz Medical City in Riyadh. The decision to go ahead and operate was taken after a meeting chaired by team leader Dr. Al-Rabeeah. It followed extensive examination of the twins, and of their suitability for the procedure. He thanked King Salman and

Crown Prince Mohammed bin Salman for their humanitarian initiative and wished his team every success for the operation. The procedure made Anishia and Milanese the 48th set of conjoined twins to be separated in the Kingdom. Their mother has been with the twins in Riyadh since before their operation.

NEWS

INTERVIEW

Chief Executive Officer, Medcare

Andre Daoud “Medcare is a very strong premium brand that is easily expandable and as we continue to provide high-quality and patientcentric healthcare, expansion will always be part of our future plans”

ith more than 15 years of experience in the healthcare field, Andre Daoud has been appointed as the new CEO for Medcare Group. “Hospitals” magazine had the chance to meet with Mr. Daoud to discuss the future of Medcare and his role on how to implement new strategies for further business growth and development. Also, how his passion in delivering the highest standard in patient care will lead to a world-class healthcare delivery.

You have extensive experience spanning over 15 years in the healthcare field, can you please give us an overview about your professional life? How will your expertise benefit Medcare? Prior to being part of the healthcare sector, I had the chance to work in various fields such as e-commerce, finance and digital solutions. I shifted to the healthcare industry specifically in the insurance field 15 years ago with a focus on technical, operations, strategy and business development.

JANUARY.FEBRUARY 2019

INTERVIEW

I worked in the public and private sectors delivering healthcare solutions in various countries at different levels ranging from strategic partnerships, international patient services to establishing national healthcare schemes. A major milestone was working with Dubai Heath Authority on creating, implementing and managing the Dubai National Health Scheme “Saada” and enabling, for the first time in the region, the introduction of the national ID as a primary means of accessing healthcare. My professional journey has been quite an exciting one so far, filled with learnings and discovery of the complex healthcare ecosystem from its different perspectives. Having combined all this experience, I come to put it into practice from the side of healthcare providers. This experience gives me a great edge and enables me to create a different experience for the Medcare patient, one that is quite unique, seamless and digitally driven. Along with the organization’s vision which primarily focuses on clinical excellence and patient safety, I am confident I will be able to further digitalize the patient experience and create a sustainable model that enables the highest possible standards of care delivery to patients who need it.

You have recently taken the role of Group CEO at Medcare, what are the steps you are taking to further the strategic planning for the Group? In my current capacity, I bring to Medcare an integrated cultural understanding and a strong digital focus with the aim of enhancing customer experience and supporting operational efficiency. This includes managing day-to-day operations, working with a superb team of healthcare professionals to deliver optimum patient

care support across a number of medical practices. Innovation is a core component of our daily activities, and we continue to leverage the power of digital and health technologies to streamline our operations.

What are the initiatives you will be putting in place to provide premium healthcare of international standards in the UAE? Quality healthcare is more than just a popular phrase in our Medcare culture. We are committed to providing high-quality, personalized medical care to every patient no matter what their medical need is. Quality in healthcare means providing the care the patient needs when the patient needs it, in a safe and effective manner. Quality healthcare also means engaging and involving the patient, so he takes ownership in preventive care and in the treatment of diagnosed conditions. We find it to be a collaborative effort that involves the patient, the physician, the patient’s family, and the community as a whole. Medcare is a premium healthcare network, and part of the wider Aster DM Healthcare, a global healthcare group with 317 medical establishments across 9 countries, including the GCC, India and Africa. Our aim at Medcare is to leverage international medical practices across a number of areas that add value to the overall care delivery process. We have been successful in bringing an exceptional multi-cultural, multi-lingual team of doctors who have received extensive training from some of the top medical institutes in the United States, United Kingdom, India, France, Greece, Australia, Africa and the Middle East.

How many hospitals and medical centres does Medcare

operate? Do you have any expansion plans in the future? We have three multi-specialty hospitals, Medcare Hospital Safa Park Dubai and Medcare Hospital Sharjah, one facility that is exclusively for women and children and another hospital that is uniquely dedicated for orthopedics and spine care. Under the Medcare brand, we operate three specialty centers and 12 multi-specialty centers in key locations across Dubai and Sharjah. Medcare is a very strong premium brand that is easily expandable and as we continue to provide high-quality and patient-centric healthcare, expansion will always be part of our future plans. This will help us further provide what is expected from us as an organization that strives to meet the future healthcare needs in the best way possible and provide the most advanced possible care to our patients.

Medcare is a major healthcare provider in the UAE. What are the specialties that you pride yourself on offering? How do you evaluate the quality of these specialties? Medcare is a group of multi-specialty facilities, offering an extensive range of healthcare that aims to add more value to patients across the UAE. Some of the specialties we treat include cardiology, orthopedics, general and specialized surgery, dentistry, emergency, gastroenterology, neonatology, audiology, endocrinology, hematology, neurosurgery, pediatrics, urology, pulmonology, obstetrics and gynecology and many more. Medcare Orthopedic & Spine Hospital one of the most technologically advanced facilities of its kind in the UAE. The world-class team of doctors provides specialized, protocol-based care for bones, joints, ligaments,

INTERVIEW

tendons, spine, spinal cord and feet, in both adults and children. Our doctors are capable of handling the most complicated cases, including orthopedic and spine trauma. In addition, the hospital has a fullfledged physiotherapy and rehab wing that provides high-quality inpatient and outpatient physical rehabilitation services. Medcare Women & Children Hospital is an exclusive haven for women and children where they receive exceptional care from experts in pediatric and women’s healthcare, in a modern and state-of-the-art facility that offers a wide range of facilities including obstetrics, gynecology, plastic surgery, breast surgery, neonatal, dermatology and other care services under the same roof. The aim is to deliver a holistic medical service to patients across the UAE through dedicated hospitals and multi-specialty clinics.

Improving patient care has become a priority for all healthcare providers with the overall objective of achieving a high degree of patient satisfaction. What are the strategic steps you are planning to implement to achieve this? Doctors credentials? Advanced technology? Patients are at the core of what we do. Medical excellence is what defines Medcare’s day-to-day operations. Our team of 300 plus expert doctors ensures great care and personalized attention, with the support of our very efficient team of nurses and ancillary staff. Medcare’s doctors take time to listen to patients, understand their medical problems holistically and recommend the best way forward. Multidisciplinary in approach, they provide optimal, guideline-based treatment to

JANUARY.FEBRUARY 2019

patients, with the support of trained nurses, dieticians, rehabilitation therapists and technologists.

Being one of the largest providers of healthcare, what is the added value of Medcare to the healthcare industry in the UAE? In today’s world, technology plays an important role in every industry as well as in our personal lives. Out of all 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. Healthcare is one of the fastest-growing sectors in the world and is a key contributor to the UAE economy. The UAE’s healthcare market is expected to reach Dh71.5 billion in 2020 at an average annual growth rate of 12.7 per cent from 2015. We have a role to play in advancing the healthcare field in the UAE, and medical technology will help us sustain health. Moreover, Medcare is a brand that strives to create a new benchmark in healthcare delivery in the UAE, with every new project it comes up with. To begin with, we’ve made sure that our hospitals don’t look like hospitals. Designed with a keen eye for detail, our patient-care spaces are designed to create an ambience that is conducive to healing. Our facilities are world-class in every sense of the word as they combine the best of talent, technology, facilities and care. We have 19 establishments under Medcare right now, with a very strong team of 300 plus doctors. We are passionate about the discovery and development of innovative methods to support patients’ clinical outcomes.

How do you see the healthcare industry evolving in light of the government support in the UAE? How did Medcare benefit from this support? The U.A.E. healthcare sector is expanding rapidly to meet both the evolving needs of a growing population and the nation’s ambition to become a regional medical tourism hub. This rapid expansion is challenging the ability of the UAE to both provide adequate medical personnel and contain costs. However, the government has adopted a series of long-term initiatives, above all Vision 2021, to address these challenges and guide the sustainable growth of this sector. Vision 2021 emphasizes the importance of preventive medicine and seeks to reduce cancer and lifestyle-related diseases such as diabetes and cardiovascular diseases to ensure a longer, healthy life. In addition to adopting ambitious plans to revamp and drive better healthcare infrastructures. We remain committed to maintaining a strong growth trajectory in the region by introducing innovative initiatives that cater to serving patients and achieving better treatment outcomes.

In your opinion, how is technology contributing to a better patient journey? Do you foresee artificial intelligence taking over the role of doctors in the future? And to what extent? The healthcare industry, both across the MENA region and around the world, is experiencing new periods of change that includes disruption and rapid innovation that are driven primarily by the adoption of technology, which has become, as we have witnessed, an integral component in shaping the healthcare industry. Advancements in technology are

INTERVIEW

transforming the entire healthcare industry. From wearable tracking devices to patient-centered care modules to increased data security are all examples of how the healthcare sector is embracing technology to deliver optimum results to patients. There is a clear understanding that AI enhances our general progress and performance on multiple levels.

Its transformative nature means that it will help increase collaboration and drive training programs. The healthcare industry as a whole is adopting integrated approaches that place patients at the heart of their initiatives and services, who now have far more access to data that is used to finding the right care modules tailored to their needs

and overall conditions. There is still a growing need for intelligent solutions to help address major challenges in improving outcomes, simplifying data and insights gathering, lowering the cost of healthcare delivery. The widespread use of technology is also changing the way healthcare professionals provide care and how patients can connect with the industry.

INTERVIEW

Associate Director For Healthcare, AECOM Middle East: King Hussein Medical City

Curtis Laitinen “The legacy companies that joined to form AECOM had a long history of work in the UAE and the Middle East, going back over 50 years, and included healthcare projects”

urtis Laitinen, Associate Director for Healthcare at AECOM in the Middle East, is a highly experienced Medical Planner. He has been leading AECOM’s healthcare design team, based in Abu Dhabi, UAE, for the past five years. During this time, AECOM has established a fully integrated design practice, including architecture, medical planning and interior design with a complete building engineering team as well as fire and life safety, cost consulting, project management, sustainability, and construction services for healthcare. Working with private and government clients, this practice has grown to take on some of the region’s most ambitious healthcare projects, including, most recently, the soon-to-be-tendered King Hussein Hospital, the new centerpiece at King Hussein Medical City, for the Royal Jordanian Armed Forces. Below is the full interview:

What do you mean by, “fully integrated design practice”? The legacy companies that joined to form AECOM had a long history of work in the UAE and the Middle East, going back over 50 years, and includ-

JANUARY.FEBRUARY 2019

ed healthcare projects. Integrating the teams into a single company had already occurred, but taking the lead role in managing design projects and doing the complete design was new for this office. Bringing a world-class team of experts from each discipline, combining them with project managers that had deep knowledge of the local markets, and basing this team in a regional “design hub” was a first. This gives clients the best of both worlds: knowledge of global best practices as well as direct and frequent access to the design team. It also allows them to get a tailored team for their project, with a single point of responsibility for all aspects of the design. Of course, having many of the disciplines sitting near each other, in the same office, also improves communication and collaboration, resulting in faster, more innovative problem solving and more refined, better coordinated buildings.

What changes have you seen in healthcare design? Over my career, I have seen enormous changes in hospital design. Most notably is the application of

evidence-based design (EBD). This is where statistical studies on human behaviour, and the psychological effects of healthcare environments on patient outcomes and staff effectiveness are used to enhance the patient experience . Wayfinding is now an important component of a facility’s design and is considered from the early concept stage. This is a key element of reducing patient stress. There is also an increased emphasis on patient privacy, which has affected the design of public spaces, acoustics, lines-ofsight, and the separation of busier public areas from treatment areas. Infection prevention is better understood, and has become more sophisticated. There are many new products using materials with anti-bacterial properties. Lessons learned from high-tech industries, including pharmaceutical and computer chip manufacturing have led to the introduction of HEPA filters and ultra-clean modular environments such as ceilings that integrate lighting, equipment and utilities. The variety of design options associated with these systems has been rapidly improving, and they are now common in surgery, intensive

INTERVIEW

care and central sterile departments. From the world of commercial office design, manufacturers have been expanding their offerings to include healthcare-specific solutions. Herman Miller and DIRTT for example offer solutions for outpatient clinic examination and treatment rooms. We have planned for these systems in the triage areas of the Emergency Department at King Hussein Medical City, in Amman, Jordan, which is currently being designed. There have also been interesting developments with healthcare designers introducing best practice from the hospitality industry to healthcare. This has affected the organisation of departments, behind the scenes, as well as the more visible and interactive elements of the patient and visitor experience. It has evolved now to the point where hospital interiors are conceived as part of a brand identity and given amenity ratings similar to hotels. Our team has applied this approach with Clemenceau Medical International for two of their hospitals in the region, both of which are currently under construction. Add in computers, electronic medical records, digital imaging and robotic surgery and it’s clear that the pace of change is not slowing down. With gene therapy, bio-technology, nano-technology, 3D printing of tissues and organs, and more, I expect we’ll see even more change over the next 20 years. This constant change and increasing complexity is why it is important to design hospitals to be flexible. This “design for flexibility” means planning a hospital’s infrastructure not just to work with today’s technologies, but for the integration of whatever innovations come next,

even if it means new ways of working and even whole new departments.

What are some other keys to good healthcare design? At a basic level, the first principle of healthcare design is the same as the primary mission for all doctors, with their Hippocratic Oath, which is “First, do no harm”. And in a hospital, where it can be a matter of life and death, that is no small thing. But, there are less obvious ways that this is important. For example, this means having a safe building, keeping things clean, and preventing infections from spreading from one person to another. That starts with each patient, and then takes in the wider context of the caregiving staff, and the patient care environment within the building, and the wider environment. But, in a more positive way, healthcare design is about creating a ‘healing environment’ that promotes wellness and improves the lives of the people who use it. Healthcare facilities are witness to major life moments. Hospitals and

clinics can engage with health education and enhance the surrounding community by providing accessible public spaces, resource stewardship and generally being the central component of healthy cities.

How can a well-designed healthcare centre improve the well-being of patients? The movement towards evidence-based design (EBD) has had a huge influence. It has introduced to the design space statistical studies on human behaviour, and the psychological effects of healthcare environments on patient outcomes and staff effectiveness. This in turn has improved the quality of the hospital environment, making spaces more pleasant and comfortable, and with positive distractions, such as views of nature and uplifting artwork. This reduction in environmental stressors has created what are termed ‘healing environments’, which result in faster recoveries and improved patient outcomes. A well-designed facility also pro-

INTERVIEW

vides a less stressful, more welcoming experience for the patientsâ€™ families and other visitors. The family is an active part of a patientâ€™s care, and an important component of the healing process, so the above strategies can help them too. Family-centred design includes providing adequate spaces, with proper amenities, such as seating, access to Wi-Fi, and a place to get a healthy snack when they are spending many hours in a hospital. These considerations start at the front door continuing all the way to the patient room. In King Hussein Medical City, for example, the public areas include plenty of seating, both indoors and on outdoor rooftop terraces; and a coffee shop and public cafeteria on different levels. All of these will take advantage of the hilltop location to provide what should be some remarkable views of the city of Amman. EBD has also improved the environment for the people who work in these facilities every day, making their work flows more efficient and providing a lower-stress environment. For example, there is evidence that providing healthcare staff with a window in their workroom significantly reduces the number of medical errors. Environments such as the Emergency Department can be high-stress and a coffee break with a view helps staff clear their head and return to work more focused on the task at hand.

Tell us about your current work. You mentioned the new King Hussein Hospital, in Amman Jordan. The current King Hussein Hospital is the general hospital at the centre of King Hussein Medical City, which has several other specialty hospitals

JANUARY.FEBRUARY 2019

INTERVIEW

and outpatient clinics. It is run by the Royal Jordanian Medical Services, and is the largest medical centre for the Royal Jordanian Armed Forces. While primarily serving the armed forces personnel and their families, it is also one of the main public hospitals for the city of Amman. It has a long history and a great reputation in the region. Following their master plan, the new King Hussein Hospital is to be the first of several phases, beginning the transformation of the campus, and ensuring that it remains a leading medical centre into the 21st Century.

What were the biggest challenges in the spatial planning of the new King Hussein Hospital? With any hospital, there are some significant factors: Change: We can’t just think about the day the hospital opens. Technology changes, equipment needs replacing, new treatments are developed and successful organisations grow. All of this means that healthcare planners should think ahead and design the building infrastructure for flexibility, to accommodate change and future-proof the client’s investment. Complexity: Hospitals, as a building type, require a lot of engineering to support all of the equipment, people and activities that occupy them. And those activities mean getting patients, staff, supplies, medications and information to the right place, at the right time, in an efficient way. People: A hospital is not a factory. Aside from the engineering systems, hospitals are about people. The patient is at the centre of every process. The spatial planning of a hospital is about getting patients to where they

need to be, taking them back again, figuring out what’s wrong, providing treatment, and keeping them comfortable and relaxed at every step of the way. That is the essence of healthcare. With King Hussein Hospital, the first challenge is its size. It will have 940 beds, including 144 intensive care beds and a new 16-bed burn unit; 43 operating theatres, and the country’s main Level-1 trauma centre, with 125 treatment/exam rooms. There will be some outpatient services, but most of the clinics are to be in future phases. It is going to be a very large general hospital. Including staff parking, it will cover a little over 330,000 square meters. The next challenge is that it is a very tall hospital. The city of Amman has grown around the campus, so available land is scarce. The replacement hospital had to be high-rise, to free up land on the campus for future phases. With 30 stories up to the helipad, it will be a major change from their current campus, which is mostly two to four stories high. A third challenge was the steeply sloping hilltop site, which provides for fantastic views of the surrounding city, but which creates challenges for arrival and departure of patients who may have limited mobility. We were able to work with the terrain, using it to our advantage, with large drop-off areas running along the hillside, to allow on-grade entry on multiple levels So, what we have is a very urban project, reflecting contemporary Amman: a big general hospital, with very large departments, stacked high. What we had to do was keep it organised, efficient, easy to maintain, easy to navigate, and visitor-friendly.

Visitor-friendly? How so? Please elaborate a bit. Wayfinding is one factor that had to be considered from the early concept design stage. We had to make the organisation of a building’s form and services visually obvious and intuitive to everyone who interacts with it. Good wayfinding is a key element of reducing stress. Examples include: • Good visibility for the approach to the hospital. Of course the tower can be seen at a distance, but also, the large expanses of glass call out the main entry lobby and other public spaces. • Long, covered areas for arrival and drop-off, accommodating many cars for both scheduled and emergency patients. • Straightening out corridors, so the inside of a hospital is less like a maze. • Using views to the outside to help people orient. • Referencing internal landmarks to help people remember their route. • Using multiple visual cues for visitors, such as themes, materials and colour, to define departments and zones. • Avoiding having to go through one department to access another. This also reduces through traffic and noise, and increases patient privacy. • Integrating technology to support wayfinding and patient flow. For example, digital signage, and electronic management of patient movement through the facility.

INTERVIEW

While conveniently located information kiosks are important, incorporating wayfinding into the design of public spaces makes signage almost secondary. How to accommodate the patient’s family is too often overlooked. Typically they are under a lot of stress, and want to be as close to the patient as possible. It is important that the hospital provides places where they can wait, which are nearby and comfortable, but not in the way of the staff. This space may be in the patient’s room, or in nearby family waiting areas, which might have views outside, artworks and other positive distractions.Separating public areas from the hustle and bustle of the “back of house” activities also allows for a more pleasant visitor experience. For family and visitors, waiting areas are one of their primary experiences in the hospital. Durability and cleanliness are certainly necessary. But transport terminal-style hospital waiting areas, with rows of benches or stacking chairs, are long gone thankfully. Today, patients and their families seek divisions of space that offer smaller groupings of seating for better privacy and comfort. There is no single chair or seating type that suits everyone. Also, using the hospitality industry as a design reference, people like choice. As such it was important to create a variety of smaller areas, allowing for a range of options that appeal to different ages, personalities and physical needs. For example, waiting areas include quiet lounge areas. There are also a couple of public spaces with café seating, where parents can have a drink and surf the internet on their laptop, as well as children’s areas, which have playful child-scale furniture and are

JANUARY.FEBRUARY 2019

acoustically separated from the adult spaces but within easy sight of the parents. Technology has also been used to improve convenience. Patient tracking screens will let the patient know when they can expect to be seen. Families can be contacted by mobile phones when a procedure is done. Video screens can provide programmed videos and music to create a calming environment. Part of our challenge as designers is to anticipate the needs of the people that the facility will treat, or is trying to appeal to.

And, what about the patient rooms? What factors in their design contribute to patient wellness? One very nice feature of the existing hospital is that the patient wards are pavilions, surrounded by garden courtyards. Views of nature have been statistically proven to improve patient outcomes. In the new King Hussein Hospital, the idea of patient rooms with views was central. All rooms in the new facility will be single-bed rooms, with a view out over the city, or a rooftop terrace. The single bed rooms also allow for better privacy, are more restful for the patient, and

are better for infection control. In all rooms, there is an area near the windows for family, with seating that is out of the way of the nurses and doctors. 100% of the patient rooms, and their en-suite toilets are accessible, as per the American ADA Guidelines; except for one 24-bed ward, which is specially designed to accommodate very large “Bariatric” patients, who have their own unique requirements. Keeping supplies, equipment, charting areas and waste disposal nearby is part of the planning challenge. Being a military hospital, the finishes need to be very practical, durable and easy to clean. When an exam is being done, a patient room requires high light levels, with colour temperature that gives good colour rendering of the skin. Overall, the interior design of the new KHMC patient room reflects the state-of-the-art healthcare to be delivered, a contemporary international style, incorporating elements and materials that will make patients feel at home; mixing clean, bright materials with natural accents for contrast and depth; and referencing the diverse natural landscape and rich cultural heritage of Jordan.

ARTICLE FEATURES . Artificial Intelligence in Healthcare

ARTIFICIAL INTELLIGENCE IN HEALTHCARE JANUARY.FEBRUARY 2019

ARTICLE FEATURES . Artificial Intelligence in Healthcare

he world has been witnessing radical changes and successive developments in various fields. The medical field is one of the most challenging for doctors and healthcare providers to keep up with year after year. Artificial intelligence in medicine aims to explore the human body and find successful ways to overcome diseases that are still killing people. Artificial intelligence in medicine is a modern concept in the diagnosis and treatment of diseases in a smart manner according to the highest technical standards and the latest technological practices, and is like a revolution in the health sector aiming to serve patients in the health sector according to the highest technological standards in the field of artificial intelligence. However, we should emphasize that artificial intelligence techniques and their use in the medical field will not replace doctors at all, according to recent studies, but they will help in providing accurate diagnosis and clinical care. Of course, doctors are very important because the device cannot provide the psychological support and sympathy provided by the doctor through his ability to relieve tension and anxiety; the machine is also unable to introduce new ideas for a new

disease that has suddenly emerged, or suggest new medicines. AI systems are found to pick up signs of illness that are unknown to doctors, making the AIs more accurate as a result. Fortunately, researchers have found that AI is able to detect cancer and other diseases earlier than possible through standard diagnostic methods, which could be lifesaving for future patients.

Collaboration between doctors and AI techniques According to experts’ expectations, the collaboration between artificial intelligence techniques and physicians will contribute to improving treatment options and health services as well as the possibility of curing some of the most intractable diseases. At the moment, medical companies are developing new technologies that focus on diagnosing certain diseases so that devices recognize the medical image and then determine the type of disease expected according to results and analysis using artificial intelligence techniques, which will help doctors get a faster diagnosis of diseases and thus increase chances of cure. On a related note, artificial intelligence can diagnose diseases from telltale groups of symptoms, strange

patterns in blood tests, and the subtle abnormalities that cells display as a disease begins takes hold. Time and again, AI systems are found to pick up signs of illness that are unknown to doctors, making the AIs more accurate as a result. Earlier this year, researchers at Nottingham University trained several AIs to spot people at risk of heart attack and found that all of them performed better than doctors. Another AI built at Stanford University in California has learned to spot breast cancer in biopsy tissues.

Robot and Artificial Intelligence in Medicine 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

ARTICLE FEATURES . Artificial Intelligence in Healthcare

only be accessible through open (long incision) surgery. Remote surgery (or telesurgery) is the ability for a doctor to perform surgery on a patient even though they are not physically in the same location. It requires the availability of the latest communication technology and the effective exchange of management information systems. Other future applications include the implementation of microprocessors or secondary treatments in the body to perform medical and surgical functions, as well as the use of biological sensors that can read and convert responses to natural and chemical changes for patients with chronic diseases. A China-made AI-based software made its debut in China. After listening to the

JANUARY.FEBRUARY 2019

patient’s symptoms, the robot provides checklists for the patient and medical advice based on the results. Then the therapy will be verified by human doctors. The software consists of diagnostic models involving more than 30 diseases, such as Tuberculosis and depression, which are likely to be misdiagnosed. Based on trial tests in several hospitals, the AI “doctor’s” successful diagnosis rate is 20 percent higher than human doctors. The self-learning AI “doctor” can constantly learn medical knowledge, experience and diagnosis process. It has a big database consisting of tens of millions of clinical cases. It is designed to be a general practitioner. Every one or two weeks, it can learn diagnosing a new disease. The AI doctor

will assist human doctors rather than replace them. For China’s medical institutions especially those in poor areas, AI would be a good assistant. On the other hand, the hospitals’ management and databases benefited greatly from the work organization and improved management by providing the possibility of collecting information about patients and their histories, which helps in having an accurate diagnosis after the doctor gets informed about the medical condition in full details through the patient’s medical file. These advanced systems in hospitals have contributed to enhancing the ability to have an accurate diagnosis and avoid random drug prescription as well as adverse reactions that may occur.

Shaping the industry, keeping the patient first.

A unified voice for the regionâ€™s MedTech industry. Add your voice by joining the Mecomed Medical Technology Association Middle East & Africa

For enquiries please contact: +971 4 513 6977 | info@mecomed.com

www.mecomed.com

MEDICAL INSTITUTIONS

MEDSBLA A communications system for the doctors of the future MedLab Media Group Recently there has been much talk about the new data protection rules. As a doctor, it is in your interests to comply with the ever-changing regulations that may affect your professional life. On the other hand, you may need to quickly exchange information with colleagues. This becomes problematic as you are

JANUARY.FEBRUARY 2019

dealing with private and sensitive information. The modification of the European Data Protection Directive has opened up new ways to ensure the confidentiality and security of the data. Information regarding health and patient diagnosis is particularly sensitive and does not escape the provisions added by the European Data Protection Regulation (RGPD), which

also provides the Act of Transfer and Responsibility of Medical Insurance in the USA (HIPAA). With regulations set in place that guarantee the confidentiality of data and a secure exchange of information, Europe and the United States have taken the initial steps to extend the protection of their citizens and service providers. This initiative to protect citizen information, especially

MEDICAL INSTITUTIONS their own groups. Both share the basic characteristic of a messaging system, as well as multiple tools: a pharmacological guide, medical calculators, a 3D anatomy system (BioDigital), a section of updated medical news by specialty and an online congress that will bring the user closer to the medicine of the future.

in terms of health, has taken hold in the Middle Eastern countries. Like all Western countries, they seek to ensure the security of private information. Despite the spike of conversation in recent months about these regulations, many doctors are not yet aware of the implications of resolving issues through applications that do not work under RGPD and HIPAA.

Best way to communicate In lieu of the recent conversations regarding data protection, the MedsBla platform is about to revolutionize doctor-to-doctor communications. MedsBla is a messaging system that groups together different roles: doctors, health professionals, patients, medical students, and administrators (i.e. all workers within a hospital or clinic who manage private accounts).

The app allows healthcare professionals to separate their personal communications from the professional with a guaranteed secure network. The messaging system is based on a two-pronged approach. Firstly, the global system, in which any user can exchange information with the rest of the medical community. The initial step is the free download of the application on any mobile device, either iOS or Android to register. Additionally, the user can access on the web browser (www.medsbla.com). Secondly, the MedBla’s private license. The private channel is a payment option for hospitals, clinics, medical center of different types of organizations, societies, schools, or foundations, whose members want to communicate privately and create

“We realized that doctors had a very important and unrealized need: to be able to exchange sensitive information with their colleagues. We wanted to create a secure platform and reliable messaging system that would allow them to be agile in the day-to-day professional life. We have achieved it; our app offers them the safe environment they were looking for.” Alberto Cueto, Product Owner of MedsBla

Why should I download MedsBla? Despite being experienced medical professionals, doctors often need second opinions and need to be able to consult with colleagues on highly specific matters. And the most important thing must not be forgotten: the information shared is private and sensitive, needing a secure network to pass along. By downloading and using MedsBla, you can be assured that the law is behind you. The information

MEDICAL INSTITUTIONS allowing health organizations to be more effective and efficient.

â€œIn the United States, hospitals preferred asolated messaging systems to their environment because they did not have a global solution. MedsBla is now the global solution.â€? Oleg Vorontsov, CEO of MMG

you share on MedsBla is protected and complies with current regulations. Simply go to Google Play or Apple App Store, search for MedsBla and download it. Once installed, fill in the required fields. From this point onwards, you can start creating your personal network of contacts. The app facilitates communication with health authorities and establishes a direct chanel of communication between a hospital and other parties (i.e. pharmacies or insurance companies). In addition, users can make video calls 1 to 1 like other communication systems but MedsBla also offers multiple people videocalls (up to 15 users at the same time).

More than a messaging system The app not only makes it easier for you to communicate with others, but it gives you access to a multitude of tools- the MedsBla tools. Once you click on this option, you will find a range of features: DeepAIMed, the intelligent search engine for medical terms; news classified by specialties and updated at lightning

JANUARY.FEBRUARY 2019

speed; medical calculators; BioDigital, a 3D anatomy system which is constantly being updated; or vademecum, a pharmological guide in which you will find information about medications.

MedLab Media Group protects the doctor The Spanish start-up MedLab Media Group (MMG) created MedsBla to democratize the practice and create a more innovative and safe medical practice. As MMG explains, it is about providing the healthcare professional with a secured work space, a way to be in contact with other professionals, exchange knowledge, and guarantee absolute confidentiality and security. MMG satisfies the need expressed by healthcare professionals. With the design of this app, the company responds to the necessity of the sector, which until now has been working in legal helplessness, using tools exposed to possible cyber-attacks. MedsBla protects the healthcare professional and the patient, while

Doctors will remain vulnerable unless there is a firm commitment to the protection of health information. As Kaspersky Laboratory analysts acknowledge, there is currently a high amount of unprotected medical information and patient data stored in the connected healthcare infrastructure. In an investigation carried out by this security company, it was detected that more than 1,500 devices used to process images of patients had their access open. They also identified that a significant amount of medical software and web applications had vulnerabilities for which exploits already existed (i.e. a series of commands or actions that are used to take advantage of security vulnerability in an information system and thus achieve unwanted behavior of it). This same report states that as long as health organizations do not take action in this matter, the unencrypted information that health systems have will continue to attract cybercriminals, interested in intercepting data that circulates unprotected. We all remember the impact of WannaCry, an attack that Kaspersky Laboratory places in the top 5 of the most memorable cyber-attacks. For 4 days, WannaCry managed to disable more than 200,000 computers in 150 countries, including critical infrastructures. In some hospitals, WannaCry encrypted all devices, including medical equipment, and some factories were forced to stop production.

MEDICAL INSTITUTIONS

Sensitive data within the reach of cybercriminals The ease of access to many communication tools not as secure as MedsBla has caused some health professionals to make their consultations through mobile phones and share information with their colleagues without realizing that these systems do not guarantee the security of the data and may have ethical implications. It cannot be denied that the introduction of information and communication technologies has been a great advance for Medicine, but it is advisable to be cautious with the use we make of it. Instantaneous communication systems or messaging services allow immediacy and speed but making a medical consultation through this route lacks a precise assessment judgment and evidences a lack of professional ethics. Juan José Rodríguez Sendín, President of the Deontological Commission of the Organización Médica Colegial de España (OMC), said: “This is a very clear question: Deontology does not make a medium safe or unsafe, but every doctor knows that clinical information is highly sensitive so using tools that do not guarantee the protection of these data is assuming a risk that is condemned. It is not justified deontologically”. Rodríguez Sendín acknowledges that sometimes doctors are unaware that they are

committing an illegal act by sharing sensitive data because they live in past eras. Many of these messaging services are global platforms exposed to a wide variety of computer attacks. Last July, the personal data of at least 1.5 million Singaporeans (more than a quarter of the total population) were “hacked”. Among the pirated information were medication reports from 160,000 patients. The cyberattack managed to access the database of national health institutions and get hold of all this sensitive information. As the Ponemon Institute report reveals, digital medical records are particularly attractive to cybercriminals: they have a black market value 50 times higher than credit card data. The latest report published by this institute confirms that, for the eighth consecutive year, health care organizations had the highest costs associated with data theft, with a cost of $408 per lost or stolen record, nearly three times higher than the industry average of $148. In this context, health organizations should consider the need to join the European and U.S. initiatives, and strengthen the security in the exchange of information, because not to do so the consequences are not only for health professionals or patients, but also affect the management of the organizations themselves generating high additional costs.

As Ricardo de Lorenzo y Aparici, managing partner of the New Technologies Area of De Lorenzo Abogados, explains: “If you want to use an instant messaging service to communicate with other health professionals, when it comes to obtaining the patient’s consent, you must be informed in detail about the possible participants who will have access to personal data, being prohibited the transfer of data to subjects who do not need access to the information depending on the purpose of the provision”. De Lorenzo affirms that applications such as WhatsApp “are highly topical because of the sanctions it is receiving from the Spanish Data Protection Agency (AEPD) due to non-consented transfers of personal data that exist between this tool and Facebook, both owned by the same person responsible”. The AEPD managed more than 10,500 claims in 2017 and has imposed historical sanctions such as the one imposed on Google for 900,000 euros for infringements of the LOPD (law prior to the RGDP) and the one imposed on WhatsApp and Facebook for ceding personal data without consent for 1.2 million euros.

To register, just follow this link:

www.medsbla.com

ARTICLE

Global Healthcare innovations likely to gain ground in 2019 By Dr Prem Jagyasi

018 was exciting for global healthcare with innovations making regular news headlines. So what we can expect in 2019? Will we see a greater acceptance of blockchain technology? Or will AI (Artificial Intelligence) and Machine Learning bring some radical changes in patient-centric care? Consumers are more aware of their health and are engaging in decision-making. The coming year is likely to focus more on value-based care with improved integration of IT and healthcare services ensuring better accessibility and affordability of

JANUARY.FEBRUARY 2019

medical care and support. Following are the anticipated global healthcare innovations in 2019:

1. Stepping up to blockchain technology: This unique peer-to-peer shared ledger technology is set to be the game changer in global healthcare by allowing secured data and information sharing among disparate systems. The system assures transparency in healthcare operations ruling enabling timely medical intervention and substantially reducing healthcare costs. With blockchain technology, the providers would be able to deliver

more value-based care by enhancing patient engagement. This technology is estimated to make a savings of $100-$150 billion per year in almost every aspect of healthcare. Ethereum, a block-chain platform and Viant have already partnered with GSK to increase the pace of blockchain applications.

2. Evolution of Artificial Intelligence (AI) and Machine Learning: Artificial Intelligence has already become an integral part of our daily lives and 2019 global healthcare is poised to witness more of its amazing

ARTICLE

applications. In a recent innovation, AI tools will help in predicting post-surgery infection risks enabling doctors to take pre-emptive measures. For patients with severely restricted mobility, AI integrated Robotic wheelchairs can function with the help of facial recognition. The coming year will see more use of AI-induced robotic assistants that would help them in detecting illness and suggest medications and fix appointments with the physicians. By 2020, the European Union plans to invest $24 billion in AI and cloud-based services. The tech giant Google has launched an AI-based eye-screening program in Thailand to detect diabetic eye disease, one of the major causes of blindness.

3. Innovative remote robotic surgery: Modern healthcare is welcoming minimally invasive surgeries resulting in faster recovery. Robots are perfect solutions to it. They are guiding physicians in performing high-precision surgeries with maximum accuracy involving least procedural time. With high-speed internet and improvement in time-lag, telesurgery or remote robotic surgery is considered viable and absolutely safe. Surgeons can perform operation hundreds and thousands of miles away from the operating room with robots.

4. Customized patient transportation services: In non-emergency medical situations, transporting patients to and from the clinic is a big issue worldwide. Lack of transportation has resulted in missing/ rescheduling doctorâ€™s appointment for 25% low-income group patients costing the US healthcare system $150 billion on an average every year.

Uber and Lyft have partnered with healthcare organizations offering rideshare services through their API platforms Uber Healthcare and Lyft Concierge. Patients can schedule their rides through their smartphones using the Uber dashboard. Even if the patients do not have smartphones, the healthcare providers can schedule the appointment and adjust the billing with the Uber dashboard.

5. Data science and predictive analytics: Data science and predictive analysis is helping healthcare providers in analyzing huge information generated by the growing number of patients. Feeding the information in AI-based systems, physicians can make quicker decisions. Further advancements in predictive analysis will help physicians address ailments endemic to a particular region, families and communities. More integration of data from IoMT is expected to create further detailed models to identify high-risk patients and reduce the chance of negative outcomes.

6. Pre-hospital diagnosis of stroke with Visor: Medical professionals are using Visor, an effective scanning tool to detect hemorrhage in brain before hospitalization for quicker intervention of treatment. Hemorrhagic strokes account for 40% of deaths from stroke. Visor enables a faster diagnosis of hemorrhagic bleeding saving the brain from further damage like uncontrolled bleeding and swelling which may lead to permanent disability or death.

7. Pharmacogenomics and CRISPR: Precision medicine or medicine customized according to the patientâ€™s

genetic is likely to gain more importance as health-conscious consumers would be seeking more effective cost-saving treatments. With enhanced access to genetic testing in 2019, Pharmacogenomics or customized medication is poised to make greater inroads. Significant collaborations among leading biotech companies are on the way to develop new treatments on human genetics. Genome editing tool CRISPR is likely to create new breakthroughs to prevent inheritance of diseases. It is likely to find more applications in cancer immunotherapy, which has recently received the FDA nod.

8. 3D Printing technology: Healthcare sector is poised to be the second largest industry in 3D printing technology. 3D printed devices matching anatomical features of patients are better accepted by the body minimizing the risk of complications. Significant advancements in 3D printing technology have been observed in external prosthetics, orthopedic implants, customized airways for stents, complex cardiac surgeries and even in total face transplant recently conducted in Cleveland Clinic. 3D printed drugs are likely to generate more attention as research is underway to create polypill effective in treating multiple diseases.

9. Biometrics to usher in a new era: Identifying patients with 100% accuracy is imperative in healthcare to prevent duplication of medical records and reduce time-killing redundant tasks. It will help clinicians for correct diagnosis and treatment based on patientsâ€™ previous medical history. The new era of biometrics will enable identities shared in cloud accessible only to the authenticated users.

ARTICLE

12. Advancement of health wearables:

Therefore, whether the patient is at home, in an emergency department or physician’s office, the healthcare provider will be confident of his/her identity and provide treatment based on previous medical records. More biometrics are used more are benefits for organizations and patients leading to high patient satisfaction and healthier outcomes.

hospitalization cost: •

•

10. Improved tools for healthcare record management: •

The EHR (Electronic Health Records) market is estimated to grow at a CAGR of 6% per year from 2018-22. Fragmented patient data existing in silos create obstacles for healthcare providers in improving treatment outcomes. The situation becomes more chaotic if the patient avails both private and public healthcare service. Health App from the tech giant Apple has helped in integrating patient data in the encrypted form in the iphones of the users. Apple has partnered with many leading hospitals and clinics like Johns Hopkins Medicine, UC San Diego Health, Cleveland Clinic, Penn Medicine and others who have implemented this technology. Patients can view their medical records from all the providers from a single platform.

•

11. Smarter home healthcare services to reduce

JANUARY.FEBRUARY 2019

By 2020, about 17% of the American population will turn 65 exponentially shooting up the demand for home healthcare services. Mobile-assisted health devices are offering smart care by remotely monitoring patients’ vital parameters and sharing it real-time with the healthcare providers to take quick actions. Elderly patients will be enabled with Alarm Integration technology installed in their appliances. These sensors can track the activity of patients and send alerts to the caregivers to take necessary action as and when required. Passive sensing technology would find more applications in monitoring deteriorating clinical conditions (DCC) where physiological assessment can be made without touching the patient. Wireless patient-worn solutions in miniature-sized reusable monitors or disposable units similar to band-aid will help in assessing vital parameters like ECG, heart rate, blood pressure, SPO2, temperature and motion.

Health awareness is driving more people to advanced wearables for tracking health status. The advent of Apple Watch Series 4, the first wearable capable of recording ECG has given a new turn in this sector. The device already approved by FDA will not require any prescription for purchase. The leading health wearable player Fit Bit in partnership with Google is exploring the possibility of developing consumer and enterprise health solutions. Its acquisition of Twine Health, a HIPAA-compliant platform has already enhanced its business outcomes with the integration of a coaching platform empowering consumers to access better health outcomes.

13. Internet of Medical Things (IoMT): Internet of Things (IoT) in healthcare is the Internet of Medical Things (IoMT) integrating healthcare tech, wearables, apps and telemedicine. As remote patient monitoring is gaining popularity, IoMT has been experiencing significant growth since last couple of years. In 2019, it is likely to see more innovative features and expanded usage. Leveraging the connected devices, it is also possible to monitor high-risk patients alerting them as required. Patients aware of this continuous monitoring are likely to follow a regulated lifestyle. An estimated 30 billion IoMT devices are likely to be deployed globally by 2020.

14. AR/VR/MR: Augmented Reality, Virtual Reality and Mixed Reality are changing the modes of treatment with innovative therapies for better patient experi-

ARTICLE

ences. Luna, a Virtual Reality Therapist available on VRHealth Platform from early next year would help in reducing hot flashes in women. Improved applications of AR/VR are likely to be in emergency response, prevention and diagnosis, medical education, surgery, elder care and rehabilitation and emotional recovery.

15. Telehealth: Telehealth is growing in leaps and bounds as modern age consumers prefer digitally driven healthcare services for enhanced access to healthcare from a distance. In the recently proposed 2019 Medicare and Medicaid guidelines for Physician Fee Schedule and Qualified Payment Pro-

gram Updates, telemedicine services are given heavy importance to provide different access points to patients. Emergency Department Teletriage, Teleophthalmology, improving population health by preventing low birth-weight babies and expanding access to specialty services are likely to feature more in 2019 telehealth.

About Dr. Prem Jagyasi Dr Prem is an award-winning strategic leader, renowned author, publisher and highly acclaimed global speaker. Aside from publishing a bevy of life-improvement guides, Dr Prem runs a network of 50 niche websites that attracts millions of readers across the globe. Thus far, Dr Prem has traveled to more than 65 countries, addressed numerous international conferences and offered his expert services to more than 150 international organizations. He also owns, operates and leads a web services and technology business, supervised and managed by his eminent team. Dr Prem further takes great delight in travel photography. Please visit him at http://drprem.com/

ARTICLE FEATURES . Telemedicine

TELEMEDICINE FOR WOUND CARE MANAGEMENT What, Why and How of Tele-wound Care Dr Saira Baloch MD

Dr Suhail Chughtai FRCS

Dr Samer Ellahham MD

Medical Director & Physician: Wound Care & Hyperbaric Medicine Clinic, Texas Health Allen Hospital, Dallas USA. Advisory Board Member: Medical City Online, UK

Orthopaedic Surgeon & Medico legal Examiner: M L Professionals, Harley Street Clinic, London, UK. Microsoft Certified Specialist & Telehealth Expert, Chairman: Medical City Online UK

Senior Cardiovascular Consultant: Cleveland Clinic Abu Dhabi, UAE. Regional Chair Middle East: Patient Safety Movement Foundation Cleveland Clinic Care Giver

JANUARY.FEBRUARY 2019

ARTICLE FEATURES . Telemedicine

xamining and treating wounds from distance using a specialized form of Telemedicine is reviewed in this article referring to a portal that meets most the requirements for such clinical practice. The authors using their experience in Wound Care, Telemedicine and Patient Safety, outline the advantages and disadvantages they regard as significant in the light their respective experience. The Tele-wound Care Software design is referred to and compared with one suitable model available.

What is Telehealth? The Telecare Services Association regards Telehealth as “Delivery of Healthcare Services remotely by means of Telecommunications Technology”. Telehealth is defined as “the transmission of data of patients (documents, images, audio, video etc) between separate physical locations to diagnose and monitor suitable medical conditions remotely”. The term is used synonymously for a range of portals working together to facilitate healthcare, promote public health and deliver health education via telecommunications technologies.

What is Telemedicine? Telemedicine is “the process of delivering Healthcare services over one or multiple channels of Telecommunication connecting a healthcare provider (a doctor, therapist or nurse) with a patient without a physical meeting”. In short, it is the process of Virtual Medical Consultation over Internet with care receiver and care giver at two different physical locations.

or smart medical gadgets to record BP, Pulse, Blood Glucose, Single lead EKG etc is carried out via a connected Healthcare system. The recorded findings are interpreted during Virtual or Physical Consultations. Telecare can be a standalone service or be part of Telemedicine portal.

What is the commonest mode of communication for Healthcare over Internet? Nowadays, Two Way Live Online Video is embedded in as much as 72% of all Telehealth Care facilities within web-based solutions. Delivering Healthcare Services using Live Video over internet is one of the most innovative technological revolutions of the current era. It is no longer a question of “if” Telehealth Care Services improve the healthcare outcome since over the last decade, there is a growing evidence to confirm this statement. Telemedicine’s efficacy in bringing a positive change in healthcare quality, patient engagement and cost- effectiveness is well proven in a growing number of medical articles and studies.

TELEMEDICINE FOR WOUND CARE MANAGEMENT (TELE-WOUND CARE) How is Tele-wound Care defined? Tele-wound Care is defined as managing a wound from distance using digital imagery and/or live video technology. Live Video is the means of choice for Tele-wound Care.

What is Telecare?

What are the types of Telewound Care Management?

Telecare is defined as providing healthcare services via remote monitoring utilizing equipment, gadgets and telecommunication technology”. Remote monitoring via modern

Synchronous - Real-Time Wound Care using two-way Live Online Video Interface between the patient & the wound care specialist or nurse where would is examined over live web cam

ARTICLE FEATURES . Telemedicine

or similar device for taking a management decision. Asynchronous - Store & Forward type where the patient uploads Digital Still Images or Video Clips for wound evaluation by the specialist subsequently for taking a management decision and relaying it back to the patient or nurse coordinator. Hybrid - Have features of Synchronous and Asynchronous types such as patients uploading images for evaluation get involved in a Live Teleconsultation for a timely management plan review.

TELE-WOUND CARE ADDING VALUE TO WOUND HEALTHCARE SERVICES

•

• • • •

•

Increases patient access to care. Less effort and pain for patient (ride to appointment, no clinic wait time). Cost effective for patient (no transportation, caregiver escort, no gas money etc). Improves patient satisfaction (one-to-one patient physician interaction, patients feel more engaged in their plan of care). Improves overall quality of

JANUARY.FEBRUARY 2019

• • •

• • • • • • • •

Decreases burden of back and forth correspondence. Provides “Virtual Triage” cover. Helps streamline care plan & delivery. Increases practice volume. Minimizes staff burn out Medical City Online October 2018. Helps monitoring patient in underserved areas. Improves clinical outcomes. Enables them to educate patients effectively via online video clips.

Disadvantages to the Patient •

•

• • •

•

Cost-effective for Hospitals and Insurance Companies.

Broadband Internet and Computer dependency. Getting used to the Software Interface. Limitations posed for patients with disabilities such as vision, hearing impairment or ability to access the wound themselves for displaying through the camera.

Disadvantages to the Wound Care Provider

Advantages to the Wound Care Industry •

Decreases utilization of resources. Minimizes space requirement for expanding practices. Improves patient satisfaction and trust in healthcare system

CHALLENGES AND DIFFICULTIES FACED IN ADOPTING TO TELE-WOUND CARE

•

Advantages to Wound Care Providers

Advantages to Patients needing Wound Care •

care by enabling a timely intervention. Enhanced quality of life by reducing the hassles attached to visiting a clinic. Decreases risk of infections by reducing number of visits Decrease in number of visits to accident department. Proven improved clinical outcomes. Can provide patient education on wound care and self-dressing via videos.

•

Lack of hands-on wound assessment (palpation, depth). Inability to detect odor. Margin of Diagnostic Inaccuracy (decreasing with increasing usage). • Possible learning curve with technology depending up the tech-awareness. Complex wounds still need to be referred for debridement,

ARTICLE FEATURES . Telemedicine

•

procedures, etc. Issue with Fair compensation / reimbursement in a fee for service environment. •

Disadvantages to the Wound Care Industry •

•

Ethical and legal issues (evolving and streamlining due to increasing usage). Enforcement of standards (evolving and streamlining due to increasing usage). Overutilization of service due to convenience offered.

TYPES OF WOUNDS MANAGEABLE VIA TELEWOUND CARE PORTALS Most of the wound which do not need surgical intervention can be managed through a suitable Tele-wound care portal. Having a Nurse Coordinator present at the patient end is not necessary in most situations though for some scenarios, it is a major advantage to have a nurse coordinator work with the patient working along with a wound care specialist calling in from distance, yet in sync with the nurse coordinator to improve outcome. Following wounds can be managed via a suitable Tele-wound Care portal: • Diabetic ulcers. • Venous ulcers. • Pressure ulcers. • Arterial ulcers. • Complicated trauma wounds. • Chronic non-healing surgical wounds. • Burns wound follow-up. • Follow-up after skin graft / flap. • Wounds on negative pressure wound therapy. • Recently discharged patients from hospital.. • Patients with wounds under Home Health Service. • Wounds with urgent concerns

such as infection, blister, changing color of discharge, swelling around the wound etc. Malignant / complex wounds in patients on palliative care.

• • • •

TELE-WOUND CARE METHODOLOGY - HOW Technology requirements of an appropriate Tele-wound Care Software •

•

The software is to be available on Desktop (Windows or Mac), Mobile Handheld devices with inter-platform compatibility. Standard Internet bandwidth used for domestic connections should be sufficient to convey live video. In the absence of Internet connection, a 3-G mobile device data connection should be sufficient for a basic live video consultation. Minimum required upload Internet speed for Live Video should not exceed that of a routinely available domestic Internet connection. Desktop Software is to be cloud-based without needing to download any file. The Tele-wound Care Website must be SSL (Secure Socket Layer) certified. HIPPA and GDPR Compliance to be mandatory depending upon location. Point-to-point Live Video Latency should not exceed 0.5 sec.

CONNECTING VIA A TELEWOUND CARE SOFTWARE The registration and then login process should be simple. Once the doctor and patient login at the portal, the sequence of screens and navigation through the software should remain self-explanatory and jargon free. • Both care receiver and care giver would need to be connected to routinely available Internet connected devices. • A desktop PC, a laptop or a mobile device (smart phone or tablet). • Live two-way video via HD webcam, mic and speakers or mobile device camera.

Patient’s side •

•

Easy to use, without distractions with minimal learning curve. Customizable Templates and

Wound Care Devices are optional, e.g.: Special Light, Dermatoscope etc. Can add a second camera such as a mobile phone to show the wound while staying connected through the web cam. Patients to have access to teaching videos within the software prepared or arranged by the Wound Specialist for providing education on self-dressing.

Wound Care Provider’s side (at a distance)

Other required attributes •

Forms receiving data. Data Mining and Analytics available. Safe, Secure and Scalable. Reliable and Accurate Outcome Tracking. Compliant to regulations.

•

Can engage a local nurse coordinator for wound care in an additional video window to examine the wound together and leave specific instructions. Wound care provider can

ARTICLE FEATURES . Telemedicine

show images or pre-recorded videos during the live consult to illustrate a concept or instruction.

PATIENT’S SIDE - WORK FLOW FOR A TELE-WOUND CARE CONSULTATION The patient after having made an appointment with the care-provider will need to provide information to help the clinician reach a management decision. Such information is best split in relevant forms which are incorporated in the software as customizable templates to match the requirements of the Healthcare System or Service provider. The filling of information is made easy by simple ticks or even voice controlled plugin can be added if required.

Patient History & Bio Form This template gathers information about lifestyle-related to wound care management which is standardized via a form.

Medical Records Such can be directly pulled in from an existing EMR via an API or may be uploaded in the form of pdf or jpg files for situations where connection to EMR is not a requirement.

Lab Results and Radiological Images Similarly, lab results and radiological images can be uploaded as attached files or pulled in from an existing EMR via an API.

Vital Parameters and Observations Recording of arterial pulse, blood pressure, temperature, single lead EKG can be done by the patient using home gadgets. The values are entered into the portal automatically if such gadgets have a bluetooth connection which will then update the patient’s records automatically for the next consultation whether virtual or physical. Entering such information manually also needs to be available in a Tele-wound care portal.

Wound History Form The patient provides information about location, appearance, progress of size, associated symptoms etc while completing the history of the wound.

Comorbidities Form The care provider needs to know about other medical conditions that can have a role in the aetiology or management of the wound.

Wound Images or Short Video Clips Visual information in the form of daily or series of images of the wound is valuable information for the clinician. Having such information archived adds further significance for retrospective review of not only individual case but also as collective data for a given group of patients.

JANUARY.FEBRUARY 2019

SYNCHRONOUS OR ASYNCHRONOUS TELECONSULTATION Once the patient’s data is available including images or a short recorded video of the wound, the Tele-consultation can be Synchronous (via Live Two-way Video) or Asynchronous (Store and Forward). The asynchronous teleconsultation is suitable where patient and doctor cannot match consultation times or there is an issue of internet service otherwise, most patients would prefer a Live Teleconsultation.

CARE PROVIDER’S WORK FLOW DURING A LIVE TELECONSULTATION The Wound Care Specialist or the Nurse Coordinator working from dis-

tance would take the patient through a step-by-step approach while reviewing the gathered information through a shared area on the screen. The pattern of review should be as follows: • Patient & Wound History along with relevant comorbidities via the forms filled by the patient. • Wound images or short video clip uploaded by the patient • Lab results and radiological images uploaded by the patient. • Vital observations or any relevant information recorded by the smart gadgets or manually entered by the patient.

REFLECTION OF THE CARE PROVIDER (WOUND SPECIALIST OR WOUND CARE NURSE) For a non-live or Asynchronous Teleconsultation, the care provider would go straight to set of tools for reflecting on the available information to set up a management plan. For a Live or Synchronous Teleconsultation, the clinician or the nurse after having gathered the uploaded information will now turn to the visual examination. The Live Visual Examination can be done through the Web cam being used in the Teleconsultation or the patient can add an additional camera such as a mobile phone camera to easily show the area of the wound while staying connected on the web cam. The option of having a dermatoscope is practical if a nurse coordinator is present with the patient as she can carry a laptop connected to a dermatoscope with or without special light source. The clinician can now reflect on the information gathered to set up a management plan as the set of tabs available on the screen match his/her care plan template: • Findings of the Wound Exam-

ARTICLE FEATURES . Telemedicine

Medical Literature Support to the article

• • •

•

• •

•

• •

ination via a templated form. • Suggesting a diagnosis with comments. Medical City Online October 2018. Request further Lab investigations or Radiological Images with electronic connectivity direct to the local labs. Prescribe medications with electronic connectivity direct to the local pharmacies. Wound Dressing Instructions added. Surgical procedure recommendation – Referral letter to appropriate center. Follow-up appointment given at the end of the consultation with the Wound Care. Specialist or Nurse Coordinator. Referral to another Specialist if necessary, through the software.

The care provider can review a summary of the Teleconsultation as an auto-generated and downloadable file is created. For an Asynchronous Teleconsultation, patient will not be available in real time though information provided earlier would help the clinician make wound management decisions which will be stored in the system for execution by the patient or the nurse coordinator as they login next time.

Educating the patient Throughout the Live Teleconsultation, the care provider can explain the patient on any of the blocks of information as both are viewing it simultaneously on a shared screen area while talking to each other on Live Video. Moreover, additional information in the form of educational images or short videos should be kept available in the portal which can be either shown during the Live Teleconsultation (permitted time) or can be referred to for subsequent viewing of the patient.

SUMMARY The attributes of a Tele-wound Care Portal are summed up above with a view to simulate as much as possible to a physical consultation. Given the advantages of a virtual consultation, the authors believe that the above laid out attributes would justify use of a Tele-wound Care Portal. A good virtual teleconsultation system for wound care should enable timely review of the wound but will increase the patient satisfaction and confidence into the healthcare system by making a clinician readily available for making effective management decisions. The value of educating a patient using the electronic means has additional value and would also help improve the outcome by increasing patient compliance once they are engaged into the process of management.

1. Treatment of diabetic foot ulcers in the home: video consultations as an alternative to outpatient hospital care, Jane Clemensen, Simon B. Larsen, Marit Kirkevold and Nieles Eiskiaer. International Journal of Telemedicine and Applications and Research Article (6 pages) Article ID 132890, vol 2008 2. L. Kobza and A. Scheurrich, “The impact of telemedicine on outcomes of chronic wounds in the home care setting,” Ostomy//Wound Management, vol. 46 no. 10, pp. 48-53, 2000 3. R. Wootton, “Recent advances: telemedicine, “British Medical Journal, vol. 323, no. 7312, pp. 557- 560, 2011. 4. L. S. Halstead, T. Dang, M. Elrod, R. J. Convit, M. J. Rosen, and S. Woods, “Teleassessment compared with live assessment of pressure ulcers in a wound clinic: a pilot study,” Advances in Skin & wound Care, vol. 16, no. 2, pp. 91-96, 2003. 5. S. E. Gardner, R. A. Frantz, J. K. Specht et al., “How accurate are chronic wound assessments using interactive video technology?” Journal of Gerontological Nursing, vol. 27, no. 1, pp. 15-20, 2001. 6. C. H. Hsieh, H. H. Tsai, J. W. Yin, C. Y. Chen, J. C. Yang and S. F. Jeng, “Teleconsultation with the mobile camera-phone in digital soft-tissue injury: a feasibility study,” Plastic and Reconstructive Surgery, vol. 114, no. 7, pp. 1776-1782, 2004. A. C. Roth, J. C, Reid, and M. Concannon, “Diagnostic quality of low resolution images for tele-wound care,” in Proceedings of the AMIA Symposium, pp. 917-920, Philadelphia, Pa, USA, May 1998. 7. F. Mair and P. Whitten, “Systematic review of studies of patient satisfaction with telemedicine,” British Medical Journal, vol. 320, no. 7248, pp. 1517-1520, 2000. 8. W. A. Wilbright, J. A. Birke, C. A. Patout, M. Varnado, and R. Horswell, “The use of telemedicine in the management of diabetes-related foot ulceration: a pilot study,” Advances in Skin & Wound Care, vol. 17, no. 5, pp. 232-238, 2004. 9. D. C. Visco, T. Shalley, S. J. Wren et al., “Use of telehealth for chronic wound care: a case study,” Journal of Wound, Ostomy and Continence Nursing, vol. 28, no. 2, pp. 89-95, 2001. 10. Do Telemedicine Wound Care Specialist Consults Meet the Needs of the Referring Physician? A Survey of Primary Care Providers, Marek K. Dobke Dhaval Bhavasar, and Fernando Herrera. International Journal of Telemedicine and Applications. Research Articles (6 pages), Article ID 321376, Volume 2011 11. Telemedicine in wound care: a review by Chanussot-Deprez C, et al. Adv Skin Wound Care. 2013 Feb:26(2):78-82. doi: 10.1097/01. ASW.0000426717. 59326.5 Medical City Online October 2018

ARTICLE FEATURES . Alzheimer’s Disease

ALZHEIMER’S DISEASE It destroys memory and other important mental functions

ith the increasing number of people with Alzheimer’s disease, we have seen international efforts from the World Health Organization and communities calling for early detection and prevention of the disease, especially after the WHO stated that last year, around 50 million people have dementia worldwide. The number of dementia patients is increasing rapidly, with increase in life expectancy, according to World Health Organization (WHO). While Alzheimer’s is the 6th leading cause of death worldwide, it affects women more than men because women tend to live longer and the chances of developing Alzheimer’s increases with age. The high number of cases urged communities and medical organizations to intensify their efforts in order to detect and prevent the disease at an early stage, as it destroys memory and other important mental functions. Dementia is a chronic syndrome caused by a variety of brain illnesses that affect memory, thinking, behavior and ability to perform every-

JANUARY.FEBRUARY 2019

day activities. Alzheimer’s disease is the most common cause of dementia and possibly contributes to up to 70% of cases. Dementia can be caused by a number of progressive disorders that affect memory, thinking, behavior and the ability to perform everyday activities. Although doctors have yet to fully understand the causes of Alzheimer’s disease, ongoing research has shown that it is caused by brain cell death. It is a neurodegenerative disease, which means there is progressive brain cell death that happens over a course of time. The total brain size shrinks with Alzheimer’s - the tissue has progressively fewer nerve cells and connections. Alzheimer’s disease is caused by a combination of genetic, lifestyle and environmental factors that affect the brain over time. The formation of amyloid plaques and neurofibrillary tangles are thought to contribute to the degradation of nerve cells in the brain and the subsequent symptoms of Alzheimer’s disease. One of the hallmarks of Alzheimer’s disease is the accumulation of amyloid plaques between the

brain’s nerve cells. In a healthy brain, these protein fragments are broken down and eliminated. In Alzheimer’s disease, the fragments accumulate to form hard, insoluble plaques. Neurofibrillary tangles are insoluble twisted fibers found inside the brain’s cells. These tangles consist primarily of a protein called tau, which forms part of a structure called a microtubule. The microtubule helps transport nutrients and other important substances from one part of the nerve cell to another. In Alzheimer’s disease, however, the tau protein is abnormal and the microtubule structures collapse.

Forgetfulness is the most common symptom of Alzheimer’s At first, increasing forgetfulness or mild confusion may be the only symptoms of Alzheimer’s disease that you notice. But over time, the disease robs you of more of your memory, especially recent memories. The rate at which symptoms worsen varies from person to person. If you have

ARTICLE FEATURES . Alzheimer’s Disease

Alzheimer’s, you may be the first to notice that you’re having unusual difficulty remembering things and organizing your thoughts. Or you may not recognize that anything is wrong, even when changes are noticeable to your family members, close friends or co-workers. Brain changes associated with Alzheimer’s disease lead to growing trouble with memory, disorientation and misinterpreting spatial relationships, speaking and writing, thinking and reasoning, making judgments and decisions, planning and performing familiar tasks and changes in personality and behavior. Changes in brain cells begin long before the onset of symptoms, then, symptoms begin to appear gradually and slowly and worsen over time until the person starts having problems in the ability to perform daily activities. Early signs and symptoms of Alzheimer’s disease can therefore be summarized as follows: • Memory loss. • Trouble focusing and problem solving. • Inability to do simple things and daily chores. • Difficulty to remember times and places. • Changes in vision. • Poor judgment and decision-making. • Difficulty to think of common words during a conversation. • Mood changes such as depression.

Risk factors that increase the risk of developing Alzheimer’s Age: Increasing age is the greatest known risk factor for Alzheimer’s. Alzheimer’s is not a part of normal aging, but your risk increases greatly after you reach age 65. The rate of dementia doubles every decade after age

60. People with rare genetic changes linked to early-onset Alzheimer’s begin experiencing symptoms as early as their 30s. Family history: Your risk of developing Alzheimer’s appears to be somewhat higher if a first-degree relative has the disease. Scientists have identified rare changes (mutations) in three genes that virtually guarantee a person who inherits them will develop Alzheimer’s. But these mutations account for less than 5 percent of Alzheimer’s disease. Down syndrome: Many people with Down syndrome develop Alzheimer’s disease. Signs and symptoms of Alzheimer’s tend to appear 10 to 20 years earlier in people with Down syndrome than they do for the general population. A gene contained in the extra chromosome that causes Down syndrome significantly increases the risk of Alzheimer’s disease. Sex: Women seem to be more likely than are men to develop Alzheimer’s disease, in part because they live longer. Mild cognitive impairment: People with mild cognitive impairment (MCI) have memory problems or other symptoms of cognitive decline that are worse than might be expected for their age, but not severe enough to be diagnosed as dementia. Past head trauma: People who’ve had a severe head trauma seem to have a greater risk of Alzheimer’s disease. Lifestyle and heart health: There’s no lifestyle factor that’s been definitively shown to reduce your risk of Alzheimer’s disease. However, some evidence suggests that the same factors that put you at risk of heart disease also may increase the chance that you’ll develop Alzheimer’s. Examples include lack of exercise, obesity, smoking or exposure to secondhand

smoke, high blood pressure, high blood cholesterol, poorly controlled type 2 diabetes and an unhealthy diet.

Can we prevent it? Certain lifestyle choices, such as physical activity and diet, may help support brain health and prevent Alzheimer’s. Many of these lifestyle changes have been shown to lower the risk of other diseases, like heart disease and diabetes, which have been linked to Alzheimer’s. Some of the effective ways to prevent Alzheimer’s disease include being fit as weight loss is one of the best natural ways to prevent it, as a study has shown that obesity and overweight may lead to Alzheimer’s disease with age. Eating healthy foods rich in nutrients and minerals, especially foods containing omega-3 fatty acids, helps keep your brain cells healthy. Lowering cholesterol levels, when cholesterol level is high, it may accumulate in the arteries, and may reach the brain cells causing damage and leading to Alzheimer’s disease. Controlling blood pressure is a natural way to avoid Alzheimer’s disease as high blood pressure causes damage to the arteries and obstructs blood flow to the brain, damaging nerve cells. Recent study found that learning new things and skills, playing chess and solving puzzles make you less likely to develop Alzheimer’s disease. The treatment of depression and anxiety quickly contributes to the prevention of Alzheimer’s, as mental disorders can rapidly damage brain cells. Not eating too much red meat and trying to avoid it also contributes naturally to the prevention of Alzheimer’s because the amino acid found in them can damage brain cells. Researchers believe that caffeine and coffee may delay the onset of symptoms, thus delaying a diagnosis.

ARTICLE

Dr. Aref Awa / Consultant ENT Surgeon

Hearing loss can be temporary or permanent It often comes on gradually as you get older, but it can sometimes happen suddenly

ee your DR if you notice any problems with your hearing so you can find out the cause and get advice on treatment.

• • •

Signs and symptoms of hearing loss It’s not always easy to tell if you’re losing your hearing. Common signs include: • Difficulty hearing other people clearly, and misunderstanding what they say,

JANUARY.FEBRUARY 2019

especially in noisy places. Asking people to repeat themselves. Listening to music or watching television loudly. Having to concentrate hard to hear what other people are saying, which can be tiring or stressful.

The signs can be slightly different if you only have hearing loss in 1 ear or if a young child has hearing loss.

When to get medical help Your DR can help if you think you’re losing your hearing. • If you or your child suddenly lose hearing (in 1 or both ears), call your DR as soon as possible. • If you think your or your child’s hearing is getting gradually worse, make an appointment to see your DR. Your DR will ask about your symp-

ARTICLE

toms and look inside your ears using a small handheld torch with a magnifying lens. They can also do some simple checks of your hearing.

Hearing loss sometimes gets better on its own or may be treated with medicine or a simple procedure. For example, earwax can be sucked out or softened with eardrops.

Causes of hearing loss Hearing loss can have many different causes. For example: • Sudden hearing loss in 1 ear may be due to earwax, an ear infection, a perforated (burst) eardrum or Ménière’s disease. • Sudden hearing loss in both ears may be due to damage from a very loud noise, or taking certain medicines that can affect hearing. • Gradual hearing loss in 1 ear may be due to something inside the ear, such as fluid (glue ear), a bony growth (otosclerosis) or a build-up of skin cells (cholesteatoma). • Gradual hearing loss in both ears is usually caused by aging or exposure to loud noises over many years.

But other types – such as gradual hearing loss, which often happens as we get older – may be permanent. In these cases, treatment can help make the most of the remaining hearing. This may involve using: • Hearing aids – several different types are available • Implants – devices that are attached to your skull or placed deep inside the ear, if hearing aids aren’t suitable

cochlear implants, auditory brainstem implants and middle ear implants.

Bone-anchored hearing aids A bone-anchored hearing aid (BAHA) may be an option if you have hearing loss caused by sound being unable to reach your inner ear. This type of hearing aid is attached to your skull during a minor operation. It picks up the sound and sends it to the inner ear by vibrating the bones near your ear. It can be clipped on and off – for example, it’s removed at night and when you swim or take a shower. Some newer types are held onto the head with magnets instead of a connector through the skin.

Hearing implants For some people, hearing aids don’t help and instead, they need to have a special device fitted inside or to their skull during an operation. These are known as hearing implants. Common types of the implant include bone-anchored hearing aids,

Cochlear implants A cochlear implant may be an option if you have severe, permanent hearing loss that isn’t helped by hearing aids. They work by turning sound into electrical signals and sending them to part of the inner ear called

Babies have a hearing check in the first few weeks after birth. They may have a problem with their hearing if they: • Aren’t startled by loud noises • Seem to hear some sounds but not others • Notice you when they see you, but not when you call their name • Don’t turn towards voices by 4 months of age • Haven’t started to say any recognizable words by around 15 months

Treatments for hearing loss

ARTICLE

the cochlea. From here, the signals travel to the brain and are heard as sound. The implant has 2 main parts: • A microphone behind the ear that picks up the sound and changes it into electrical signals, which are sent along a wire to a device on the skin • A device placed inside the skull that picks up the electrical signals from the device on the skin and sends them along wires to the cochlea Before having a cochlear implant, you’ll have an assessment to find out if it will help. The implant will only work if the nerve that sends sound to the brain (auditory nerve) is working properly.

cochlea. An ABI won’t usually fully restore your hearing, but it can usually improve it to some degree.

Middle ear implants A middle ear implant (MEI) may be an option if you can’t use a regular hearing aid – for example, because you’re allergic to the materials they’re made from or they don’t fit in your ear correctly. An MEI has 2 main parts: • A device attached to the skin that picks up the sound and turns it into an electrical signal. • A device under the skin that picks up these signals and sends them along a wire to the small hearing bones deep in the ear, which causes them to vibrate.

Auditory brainstem implants An auditory brainstem implant (ABI) may be an option if you have severe, permanent hearing loss and a problem with your auditory nerve. An ABI works in a similar way to a cochlear implant, but the electrical sound signals are sent directly to the brain along wires, instead of the

JANUARY.FEBRUARY 2019

Vibrating the hearing bones means that sound can travel into your inner ear and brain. This won’t fully restore your hearing, but it can help make sounds louder and clearer. • Different ways of communicating – such as sign language or lip reading

100

Preventing hearing loss It’s not always possible to prevent hearing loss, but there are some simple things you can do to reduce the risk of damaging your hearing. These include: • Not having your television, radio or music on too loud. • Using headphones that block out more outside noise, instead of turning up the volume . • Wearing ear protection (such as ear defenders) if you work in a noisy environment, such as a garage workshop or a building site; special vented earplugs that allow some noise in are also available for musicians. • Using ear protection at loud concerts and other events where there are high noise levels. • Not inserting objects into your or your children’s ears – this includes fingers, cotton buds, cotton wool and tissue, • Your doctor is the best person to assess your hearing and decide what to do and when.

ARTICLE

Teratoma A dermoid cyst is a mature cystic Teratoma

eratomas are germ cell tumors with Totipotent cell origin which can differentiate to any ecto, endoad mesoderm, however predominantly ectoderm. The word is derived from the Greek Teras meaning Monster. Benign cystic teratoma are the most frequent occurring neoplasms representing 95% of germ cell tumors and 25%-40% of all ovarian tumours. It is most common in young reproductive age 30 years. Teratoma is usually moderate size and pedunculated. Its surface is a smooth, thick wall, cystic or heterogeneous. Cut section is very offensive when opened, single or multilocular contains sebaceous material+ keratin (fluid at body temperature, solid at room temperature). The wall of the teratoma contains Rokitansky protuberances (embryonic nodules) which is site production of totipotent cells& from which hair taft projects.

JANUARY.FEBRUARY 2019

Hair, bones, teeth, cartilages etc may be found monster-like embryo which is called Fetiform teratoma and fetus in fetu. They are forms of mature teratoma that include one or more components resembling a malformed fetus. Fetus in Fetu has been interpreted as a fetus growing within its twin. This is interpretation assumes a special complication of twinning, one of the several grouped under the term parasitic twin. It is noteworthy that in many cases the fetus in fetu is reported to occupy a fluid-filled cyst within a mature teratoma. Cysts within mature teratoma may have partially developed organ systems : reports include cases of partial cranial bones ,long bones and even rudimentary beating heart Regardless of whether fetus in fetu and fetiform teratoma are one entity, they are distinct from and not to be confused with ectopic pregnancy.

102

Complications of Dermoid cyst The majority 60% of dermoid cysts are symptomatic and cause abdominal pain. However 5-10% may undergo torsion as they are symptomatic, however, 5-10% may undergo torsion as they are pedunculate. Less commonly 1-4% may rupture and cause chemical peritonitis Oleo-Keratin granulomatosis and acure abdomen or slowly causing chronic granulomatous peritonitis. Rarely a mature cystic teratoma can turn malignant commonly to squamous cell carcinoma which has been found in our study at the time of initial surgery or any type of malignancy any tissue can be found.

Diagnosis of Dermoid Cyst Ovarian mature cystic teratomas the most common germ cell tumor accounting for up to 70% of benign ovarian masses in the reproductive years and 20% in postmenopausal

ARTICLE

women. Transvaginal U/s is the imaging modality of choice. Ovarian cystic teratomas have a variety of appearances characterized by echogenic sebaceous material and calcification and typically contain a hypoechoic attenuating component with multiple small homogenous interfaces. Tumor markers as CA125 ans CEA ans alpha-fetoprotein are also done to help in ruling out malignancy and MRI with contrast for abdomen and pelvis are frequently done.

Management of Dermoid Cyst There are Controversies of Surgical Management : 1. Surgical approach: Laparoscopy versus Laparotomy 2. The provedure: OOphorectomy versus Cystectomy 3. The relevance of the spillage of contents and techniques to minimize it 4. The place of ovarian tissue spring techniques 5. Specimen exteriorization: laparoscopic port versus colpotomy 6. The criteria for surveillance (expectant management). 7. Managent of torsion.

Surgical approach The RCOG guidelines recommend that operative laparoscopy is the Gold standard for all benign ovarian masses because it is associated with reduced febrile morbidity, postoperative pain, postoperative complications, overall cost and earlier discharge. Technique used after good endoscopic visualisation of abdominal cavity the dermoid cyst is removed either by atraumatic development of

the plane between the cyst wall and ovarian tissues which was accomplished using hydro dissection. After, the cyst is removed, the base of the capsule is irrigated and coagulated by bipolar diathermy overlap of ovarian edges and leave the defect to heal without suturing to minimize adhesions. With large ovarian dermoids up to 8 to 9 cm the risk of chemical peritonitis is decreased by making a tiny hole and aspirating the contents to minimize its size and use endo-bag or poch to remove it to minimize the spillage some risk factors for laparoscopy which are obesity, age and previous abdominal surgery which can be overcome.

The place of an ovarian tissue-preserving technique The mesial-side ovarian incision for laparoscopic cystectomy as an ovarian tissue-preserving technique. The medial side is the anterior hilar margin of the ovary where the tubal fimbriae are closely applied to the tubal pole of the ovary. The medial side incision technique is associated with higher ovarian reserve in terms of low FSH and less contents spillage.

The criteria of surveillance (expectant management) Ovarian mature cystic teratomas grow over time increasing the risk of pain and ovarian accidents therefore surgical managementâ€™s usually appropriate.

Surveillance during pregnancy The ACOG guidelines stated that adnexal masses diagnosed during pregnancy have a low risk for both malignancy and torsion and other

Dr. Khadija Abbas Hosni Gynecology and Obstetrics Consultant acute complications so for expectant management. In addition, the RCOG guidelines recommend that a surgeon with suitable experience and appropriate equipment should undertake laparoscopic management of benign ovarian cysts.

Conclusion Laparoscopic surgery is the golden technique for management of ovarian dermoid. Thank GOD it is safe and cost-effective the patient is having less morbidity less both intra and postoperative period. Laparoscopy is more cosmetic with smaller skin incision Minimal tissue handling and trauma. Diminish the risk of infection and diminish adhesion formation which permits to preserve fertility of the patient. Of course with less operative pain requiring less analgesia and more guest satisfaction. Resumption of normal activities is earlier and it is mandatory to irrigate the pelvic cavity with a large amount of warm saline till the saline is extracted from the pelvic cavity is clear at the end.

103

ARTICLE

Bleeding Gums Why and How to prevent it?

ave you seen a bit of blood in your sink when you brush your teeth lately? That bleeding can be one of the first warning signs that you’ve got gum disease. The mild variety is called gingivitis. When you have that, only your gums are infected. If you don’t treat it, the infection can travel below your

JANUARY.FEBRUARY 2019

gum line and into your bone. Then it becomes a more serious form of gum disease called periodontitis. Both gingivitis and periodontitis have been shown to raise your risk of things like diabetes. Early detection is your best bet.

Symptoms •

104

You can find and treat the prob-

•

lem before it gets serious if you know what to look for. Take note if you notice: Red, swollen gums: That’s one of the first signs your gums need attention. Gum diseases typically start with inflammation along the gum line, they may also feel tender or painful and bleed easily when you floss or brush.

ARTICLE

•

Bad breath: Your mouth is a nice, warm, and wet home for millions of bacteria. They feed on plaque, so the more of that you have, the bigger the buffet. Bacteria release toxins that can irritate the gums and teeth and have a foul smell. It can also be a symptom of serious gum disease. Your breath usually doesn’t change much if you’ve got gingivitis. Gums that get smaller: If your teeth look longer than they used to, chances are they’re not growing -- your gums are shrinking. When bone starts to break down, the gums start separating from the tooth, creating a pocket,. This pulling away is called receding gums. Sensitive teeth: If a sip of a cold drink makes you wince, your teeth may be telling you something. That’s a symptom of gum disease that often goes hand in hand with shrinking gums.With receding gums, the sensitive part of the tooth is exposed -- called the dentin -- causing sensitive teeth when exposed to cold water and air. Wiggly or shifting teeth: Does your smile look a little different lately? Gum disease can attack the bones that hold your teeth in place, making them loosen or move. Periodontitis is the main cause, and it can even change the way your teeth fit together when you bite.

GUM DISEASE IS PREVENTABLE. Here are a few ways you can help keep your gums healthy 1. Dental Floss Floss at least once a day. This helps remove the plaque and food

that’s beyond your toothbrush’s reach, according to the ADA. It doesn’t matter when you floss. Do it at night, do it in the morning, or do it after lunch... just do it!

2. Get regular dental cleanings Your dentist can detect early gum disease symptoms if you see them on a regular basis. That way symptoms can be treated before they become more serious. A professional cleaning is the only way to remove tartar. It can also get rid of any plaque you missed when brushing or flossing. If you have gingivitis, brushing, flossing, and regular dental cleanings can help reverse it.

Dr. Mohammed Issa Dentist 5. Use fluoride toothpaste

3. Quit smoking Yet another reason for smokers to quit: Smoking is strongly associated with the onset of gum disease. Since smoking weakens your immune system, it also makes it harder to fight off a gum infection, say the Centers for Disease Control and Prevention (CDC). Plus, smoking makes it more difficult for your gums to heal once they’ve been damaged.

4. Brush twice a day Brush your teeth after every meal. This helps remove the food and plaque trapped between your teeth and gums. Scrub your tongue too, since it can harbor bacteria. Your toothbrush should have soft bristles and fit in your mouth comfortably. Consider a battery-powered or electric toothbrush. These can help reduce gingivitis and plaque more than manual brushing. Swap toothbrushes or toothbrush heads every three to four months, or sooner if the bristles start to fray.

As for toothpaste, store shelves are lined with brands that claim to reduce gingivitis, freshen breath, and whiten teeth. How do you know which one is best for healthy gums? Make sure to choose toothpaste that contains fluoride and has the ADA seal of acceptance. After that, the flavor and color is up to you!

6. Use a therapeutic mouthwash Usually available over the counter, therapeutic mouthwashes can help reduce plaque, prevent or reduce gingivitis, reduce the speed that tarter develops, or a combination of these benefits, according to the ADA. Plus: A rinse helps remove food particles and debris from your mouth, though it’s not a substitute for flossing or brushing. Look for the ADA seal, which means it’s been deemed effective and safe. We should always floss first, then brush and last do mouthwash or rinsing. Just do a good job and use the right products.

105

ARTICLE

Unexplained infertility

Ms. Iman Azzam Abdelhadi Senior Embryologist, Obstetrics & Gynecology Dept

he average chance of falling pregnant in any given cycle among fertile couples is 20%, reaching 60 % during the first 6 months. Studies suggest that after one year of having regular unprotected sex, around 15% of couples are still unable to conceive. When it takes longer than a year of trying with no luck, the first thing we want to know is why. After going through the full diagnostic process, from researching family medical history to physical examinations to hormonal tests, we find that in one third of the cases a male factor is involved, in another one third a female factor is involved and in 20-30 % you see a combined infertility that involves the male and the female. However, in some couples, no obvious reason for infertility is found. If it’s not her and it’s not him, then what’s keeping her from getting pregnant? This category constitutes 10-20 % of people who are facing difficulties in achieving pregnancy and they

JANUARY.FEBRUARY 2019

end up diagnosed with unexplained infertility.

food intolerance and the body’s corresponding immune reaction to it.

So what does “unexplained infertility” mean?

What are the treatment options?

It’s infertility that is idiopathic in the sense that its cause remains unknown even after an infertility workup. As a matter of fact, the diagnostic tools used to evaluate couples referring to fertility clinics will only identify the major reasons for infertility but it certainly cannot identify all the reasons. A lot of hidden factors are impossible to be tested for and those might appear later during the advanced treatment options when minimal interventions do not work. Example of which is poor egg quality that adversely affects fertilization outcome and embryo quality, as well as other issues related to implantation. Moreover, reproductive organs are not solely responsible for your infertility, other health issues can reflect on your body’s ability to carry a baby. Nearly 6% of women with unexplained infertility were found to be having Celiac disease, for example, a gut related issue that has to do with

Significant advances have occurred in the treatment of reproductive disorders over the past decade. However, the choice of the optimal treatment plan depends on individual patient characteristics such as age, response to different treatment strategies as well as cost considerations. Before jumping to invasive treatment options, sometimes minimal interventions work well. The way to figure out if it works or not is simply to try, no guarantee to succeed though. These interventions include medications like Clomiphene Citrate, controlled ovarian stimulation combine with timed intercourse or controlled ovarian stimulation combine with Intrauterine Insemination (IUI). Although it works for many, this approach is often considered frustrating for many others as it requires a lot of patience and waiting time. This leaves IVF as the optimal treatment option for those who want the fastest treatment method with a quite impressive success rate.

106

ARTICLE FEATURES . Medical Imaging Technology

JANUARY.FEBRUARY 2019

108

ARTICLE FEATURES . Medical Imaging Technology

ear after year, modern medicine and digital medical imaging technology is registering greater achievements. Every day, we hear about a new one that helps make farther developments with regard to the diagnostics that enabled access to more successful treatments. The impressive achievements of medicine are the result of combining both the digital revolution and the medical imaging equipment which resulted in a better understanding of the mechanism of the occurrence of diseases, and therefore the obtainment of a more accurate diagnosis that contributed in the development of treatments and in the reduction of surgical interventions. Medical imaging reached a stage further than seeing the body from inside. Today, it is possible to see the mechanism of the functioning of the systems of the body and its organs without interference. Perhaps the most important thing about it is that the achievements will not stop. We expect to hear about more and more every year.

Medical Imaging and Artificial Intelligence Medical imaging and radiology techniques were among the most medical fields that benefited from the introduction of the concept of artificial intelligence into the world of medicine. Researchers intended to develop neurological mechanisms and connectomes that can identify the signs of illness that appear in the radiographs such as certain cancers or fractures. Some medical companies active in the field of health technology aim to produce, through artificial intelligence, solutions and diagnostics that help to detect early symptoms of certain diseases. It is also possible to benefit from the artificial intelligence in medical imaging in terms of

reducing the necessary time to read the handwritten medical records and the diagnostic schemes. Today, the developed artificial intelligence techniques can provide a new vision regarding the diseases through using the large amounts of patientsâ€™ data from the radiation devices. This rapid development bodes well for a better future where the artificial intelligence plays an important role in radiology and in medical images analysis, so that this field benefits from reading the images and explaining them quickly but accurately amid the rapid acceleration in preparing the radiographs.

4D Medical Imaging The digital revolution culminated with the introduction of 3D and 4D medical imaging techniques until they became crucial in radiology because of their diagnostic features, their high-quality images, the resolution and all of this in no time. Therefore, 3D imaging helps produce clear-diagnostic images that contribute in reaching a high-quality treatment efficiency after taking accurate anatomical images. In a relatively short time, 3D and 4D ultrasound devices provide simplified images in all three dimensions with the possibility of having a thorough examination by getting enough data and information. It is possible to reuse in hypothetical ways all of the clips obtained to help in the diagnosis. As for the anatomical images obtained, they cannot be obtained by the 2D device, where the directions are simplified and determined to the physician who requested the procedure. The 3D imaging devices determine the required dose of radiation to achieve a successful treatment plan for the patient. Therefore, the 3D radial imaging and the CBCT (Cone

109

ARTICLE FEATURES . Medical Imaging Technology

Beam Computerized Tomography) started interfering in various medical specialties. The 3D mammography radically changed the diagnosis of breast tumors. Today, the radiologist can read the image as if he is reading a book page by page. This has led to the accuracy in diagnosis, the early detection of breast cancer, and consequently the reduced suffering of the patient. This technique relies on taking a regular mammography, and then, directly and without removing the compressor, scanning the breast for 4 seconds, and obtaining later on a 3D image. This image will let the treating physician know the critical situation of the mass or the scourge of disease in the breast, and easily get a sample of it. Dentistry also uses 3D imaging, radiography and photography, through taking 3D digital prints of the teeth with a high-quality camera. Because of this technique, traditional methods will be phased out. Three measures are being captured by the 3D technique: width, length, and depth.

Nuclear Medicine Nuclear medicine constituted a major achievement in radiology. It allowed the physicians to see more than the body’s organs. It gave them the opportunity to see how these organs work and how they perform their vital functions inside the body without hindering any of these functions. This field contributed in the fast diagnosis of diseases and maybe diagnosing them in advance sometimes, that is, once some pathological changes are noticed on a cellular level before the organ is affected by the disease as in the case of cancer cells. Nuclear medicine is most used to examine the bones, the kidneys, the thyroid, the heart, the lungs, the brain, the lymphatic system, etc. Cardiac nuclear medicine imaging contributed in estimating the amount of irrigation

JANUARY.FEBRUARY 2019

of the myocardium during effort and rest, and calculating the amount of the shortfall in irrigation in case of tight or blocked cardiac arteries. Nuclear treatment can also be used to reduce bone pain and to treat the diseases of the thyroid, its activity, its malignant tumors, liver tumors, blood diseases such as lymphoma, and benign infections in the joints. During the examination, some radioactive substances are used to diagnose several diseases and treat them. It is a painless and very safe examination for the patient, carried out with a small amount of radiation. The patient is given a radioactive substance that is concentrated in one of the body’s organs, and then a special camera detects the radiation emerging from the organ. That’s how it is possible to know what is going on inside the patient’s body. The dose of the radioactive substance depends on the type of the examination and the age of the patient.

Magnetic Resonance Imaging (MRI) Today, the MRI constitutes an irreplaceable diagnostic tool for a variety of cases, and it is particularly useful for a brain scan. Through this developed technique, the treating physician sees clearly the diseased and strange cells

110

inside the body, and it is possible to identify most of the disorders that can affect the body. This technique uses magnetic fields and radio waves in the detailed internal tissue imaging. It is used to diagnose several diseases that affect the body’s internal organs such as tumors and injuries in the liver, the kidneys, the spleen, the pancreas, the uterus, the ovaries, the prostate, and the testicles. Physicians have recourse to it to diagnose joint diseases such as all kinds of arthritis, injuries, accidents, spinal column problems, and tumors of bones and surrounding tissues. The MRI is considered one of the most important medical imaging techniques to which physicians have recourse to diagnose diseases of the nervous system such as spinal cord injuries, aneurysm, multiple sclerosis, clots, and tumors, as well as to define the functions of certain areas in the brain. This technique is also useful in cases of cardiovascular diseases in terms of assessing the size of the heart’s 4 chambers and their function, as well as identifying the thickness of the heart’s walls, the effect of a heart attack, and the fat deposition on the wall of the blood vessels that leads to their obstruction. In case the breast tissues are thick, it is possible to consider this technique as an additional diagnostic tool of the mammography.

ARTICLE FEATURES . Medical Imaging Technology

CT Scan

X-Ray

The CT scan, or the CAT scan, is a developed type of radiography that produces 3D tomograms by combining several images taken from different angles. The physician examines every one separately and might request imaging a certain part from different angles or transforming the image to a 3D one by combining several images in one image with certain angles to get more accurate information. This technique is used to diagnose bone diseases, fractures, and tumors, to scan the brain, to locate clots, tumors, and others, or to detect a cancer and lung and liver tumors. In some cases, this technique can be used for biopsy or radiotherapy.

This technique aims to image internal parts fast and without pain or surgical intervention. During the examination, an electromagnetic radiation, emitted by a special radiation device, passes through the bodyâ€™s tissues to hit a plate, placed behind the body, on which is formed an image of the organs that the radiation has passed through. This technique helps to diagnose the incidence of certain diseases in a painless way in order to evaluate the available treatment options. Also, it reinforces the surgical and treatment plans and helps the medical team during the catheterization or the insertion of any medical device in the body, the treatment and the removal

of tumors, as well as getting rid of any blood clot or obstruction in the body. There are many diagnostic uses of the X-Ray technique such as fractures, bone infections, tooth infections, decay, arthritis, osteoporosis, or bone cancer. Physicians have recourse to it to diagnose chest diseases such as pneumonia or lung cancer. Mammography is a special kind of X-Ray tests to examine the breast tissue. The sign of a congestive heart failure, as well as the obstructed blood vessels, appear clearly in this image. The liquid that the patient drinks to get ready to the imaging is the contrast mean that makes the results clear on the image and shows the problems of the digestive system.

111

MEDICAL FAIRS

U.S. HEALTH AND MEDICAL SUPPLIERS BRING SPIRIT OF PARTNERSHIP TO ARAB HEALTH 2019

merican technology and innovation, deeply valued by patients and medical professionals in the Middle East and North Africa (MENA) for improving healthcare and quality of life, will be prominently on display during the Arab Health Exhibition and Congress 2019, January 28 through 31 at the Dubai International Convention and Exhibition Centre. More than 350 U.S. manufacturers, suppliers, service providers, hospitals, clinics and practitioners are

JANUARY.FEBRUARY 2019

participating in this year’s show, a majority in the USA Partnership Pavilion in Halls 1, 2, 5, 6, Za’abeel 3 and the Hall 1 Concourse. From personal care and safety products to over-the-counter remedies, specialized medical devices, equipment, treatments, training and hospitals, U.S. exhibitors in Dubai represent a wide scope of America’s smartest health and medical solutions. The U.S. showing at Arab Health 2019 is a strong indication of how important the MENA region is to the

112

American health and medical industry, and that countries across the region are looking for innovative U.S. partners to further their progress and ambitions, such as the UAE’s Vision 2021 goal “to achieve a world-class healthcare system.” Review the Pavilion highlights below, and visit the USA Information Center on-site in the Main Concourse to find American solutions faster. You can also find more details online at www.kallman.com/arab-health-2019

MEDICAL FAIRS

ACell Inc. Booth H2.A34 CONTACT:

Nino Pionati, VP International & Business Development ninopionati@acell.com Columbia, Maryland +1-908-265-3081 www.acell.com

Airon Corporation H1.F30 CONTACT:

Eric Gjerde, President info@aironusa.com Melbourne, Florida +1 (321) 821-9433 www.AironUSA.com

Arnet Pharmaceutical Corp H1.B31 CONTACT:

Olga Das Neves, Marketing Specialist olga@arnetusa.com Davie, Florida (35) 968 629 003 www.arnetusa.com

Brigham Health/Brigham Women’s Hospital H5.A25 CONTACT:

Johanna Younghans, Media Relations & Social Media Associate jyounghans@bwh.harvard.edu Boston, Massachusetts +1-617-525-6373 www.brighamandwomens.org

ACell Increases Global Reach for Platform Technology in Wound Management and Hernia Repair. ACell has launched Cytal® Wound Matrix and MicroMatrix® in Canada, with future global expansion planned for wound management devices in 2019. Recently published data for ventral hernia repair showed promising long-term results using Gentrix® Surgical Matrix devices.

Cytal Wound Matrix 1-Layer

Finally it is Safe to Take Critical Neonates to the MRI. The new pNeuton Mini transport ventilator provides complete, safe respiratory support with remote alarms in case of disconnection or high pressure. The ventilator can be placed right next to the MRI and will not create image distortion.

pNeuton Mini transport ventilator

Arnet Pharmaceutical Launches “Dr. Max, Cognitive Line” Focus on Boosting Energy and Relaxation. The portfolio includes ten products designed to cover the different needs people can have during daily life due to excess work, stress, or activities.

Dr. Max Cognitive Line

‘Surgery in a Pill’ a Potential Treatment for Diabetes. Bariatric surgery reverses obesity and type 2 diabetes in patients with both conditions. Researchers at Brigham and Women’s Hospital have found a less invasive, potentially equally effective treatment for reversing type 2 diabetes. Results from a preclinical study were reported in Nature Materials. A substance that temporarily coats the intestine to prevent nutrient absorption was delivered via pill,

helping to avoid spikes in blood sugar. ‘Surgery in a Pill’ holds promise for millions of people.

Researchers at Brigham and Women’s Hospital have found a less invasive, potentially equally effective treatment for reversing type 2 diabetes

113

MEDICAL FAIRS

Community Medical Centers - Central California USA Information Center Main Concourse Hall 2 CONTACT:

Berj Apkarian, Vice President International Health berjapkarian@communitymedical.org Fresno, CA +1-559-696 0190 www.communitymedical.org

Corvus Health H1.F03 CONTACT:

Kate Tulenko, CEO ktulenko@corvushealth.com Alexandria, Virginia +1-202-460-9919 www.corvushealth.com

Dana-Farber Cancer Institute H5.A25 CONTACT:

Justin Solle, Program Manager justin_solle@dfci.harvard.edu Boston, Massachusetts +1-617-6323069 www.dana-farber.or

JANUARY.FEBRUARY 2019

Community Medical Centers Specialize in Advanced Technologies and a Patient-Focused Approach for the Treatment of Cancer and Obesity. Fresno Heart and Surgical Hospital’s Center of Excellence in Bariatric & Metabolic Surgery is continually recognized in the top 10% in the United States for clinical outcomes while the Community Cancer Institute offers the most innovative technologies & approaches for comprehensive cancer care.

Creation of Global Job Markets for North African Nurses. Many highly qualified nurses from Northern Africa would like to work in the U.S. or Europe, but lack the language skills or experience in U.S. and European hospital settings. Corvus Health is breaking down this barrier by connecting North African nursing schools such as Universite Centrale in Tunisia with schools and employers in the U.S. and Europe to form programs that give North African health workers the skills they need to work in advanced hospitals.

Building a Better Cancer Fighter. The excitement around CAR T-cell therapies for cancer has been growing for quite some time now. After numerous studies and clinical trials, these therapies, made from genetically modified immune cells, have been generating promising results. Specifically, more than 80 percent of patients with acute lymphoblastic leukemia (ALL) and nearly half of patients with B-cell non-Hodgkin lymphoma (NHL) have achieved remission thanks to CAR T-cell therapy.

114

Community Cancer Institute in Clovis rivals centers in Los Angeles and the Bay Area

Corvus Health offers a variety of health workforce and human resource management services

Turning Immune Cells into CAR T-Cells

MEDICAL FAIRS

Del Medical Inc. H1.D10 CONTACT:

Tony Galles, Vice President TGalles@delmedical.com Bloomingdale, Illinois +1 (914) 2822678 www.delmedical.com

Fabrication Enterprises Inc H1.C18 CONTACT:

Alexander Miller, Marketing Coordinator alex@fab-ent.com Elmsford, New York +1 (914) 345-9300 www.FabEnt.com

Firefly Global H1.B11 CONTACT:

Daniel Lucey, Director of Business Development ArabHealth2019@fireflyglobal.com Belmont, Massachusetts +1-617-8556007 www.fireflyglobal.com

Global Medical Services CONTACT:

Amy Gaston, Global Relationship Strategist agaston@globalmed.org Minneapolis, Minnesota +1-612-3252117 www.globalmed.org

Del Medical Introduces New OTC18 and FMT18 Series of Radiographic Imaging Solutions. The OTC System is precisely designed to withstand high volume throughput in hospital radiology departments, medical imaging centers and large orthopedic facilities. The FMT System offers an economical, compact design ideal for hospital radiology departments, medical imaging centers and orthopedic facil-

Fabrication Enterprises Inc Introduces the CanDo® Multi-Grip™ Exerciser. CanDo® Multi-Grip™ Exercisers have large and small loops built right into the exerciser. Loop around hands and feet to perform high impact upper and lower body exercises.

Firefly Now Offers iOS Compatible Wireless Devices. Firefly Global now offers iOS compatible wireless versions of their award-winning otoscopes and dermatoscopes. Arab Health 2019 will be the first international show where these devices will be widely available demonstrated live.

Official Launch of Global Medical Services. Global Medical Services (GMS) will debut at Arab Health! GMS, located in Minnesota, leads in providing accessible healthcare worldwide, approaching it in a way no one else is; the patient, provider, government regulations, systems. For patients seeking

ities looking to maximize space and avoid costly room modifications.

OTC and FMT Radiology Systems

Easy grip loops allow for unlimited exercise options

iOS compatible wireless scopes

concierge-style healthcare in the US, GMS provides destination health services. For governments/businesses seeking a hospital build/management strategy, GMS builds hospitals and manages operations worldwide. For providers serving patients without access to nearby physicians, GMS brings treatment through telemedicine.

115

MEDICAL FAIRS

UE LifeSciences H1.C31 CONTACT:

Akshat Shah, Strategic Partnerships Info@uelifesciences.com Philadelphia, Pennsylvania +1 (631) 980-8340 www.iBreastExam.com

International Biomedical Inc. H1.C79 CONTACT:

Caroline Strand, Marketing Communications Specialist cstrand@int-bio.com Austin, Texas +1-512-873-0033 www.int-bio.com

Koven Technology, Inc. H1.B18 CONTACT:

Kari Lowth, Marketing & Creative Director klowth@koven.com St. Louis, Missouri +1-314-542-2101 www.koven.com

iBreastExam – A new way to detect breast cancer, arrives in the Middle East. iBreastExam (iBE) is an innovative, handheld medical device designed to provide a quick, painless and radiation-free breast exam at the point-of-care, with instant results. iBreastExam recently launched commercially in Oman with the support of Oman Health Ministry and Oman Cancer Society, and the next stop is the UAE. Reducing the number of

WARMOLOGY® – The Science of Warm. The NuBorne 500 Infant Warmer is an affordable, feature rich microenvironment that provides dependable thermoregulation for the infant and allows a high level of care with a low cost of ownership. This USA manufactured product for use in the NICU, L&D and birthing centers facilitates the proven clinical practice of kangaroo care.

iBreast Exam handheld medical device deaths due to cancer is one of the key performance indicators of the pillar of world-class healthcare of the UAE National Agenda.

NuBorne 500 Infant Warmer

Introducing the FAST Sphyg by Koven Technology. Like a traditional sphyg, the FAST Sphyg is used with a Doppler or stethoscope to obtain systolic blood pressures. Unlike traditional sphygs which require pumping a bulb to increase cuff pressure, FAST reduces hand and wrist strain by inflating the cuff using Koven’s exclusive push button inflation mechanism, which increases cuff pressure with a built-in battery-operated pump. FAST’s trigger deflation method is easier to control than knobs, which need to be turned. FAST reduces hand and wrist strain

JANUARY.FEBRUARY 2019

116

MEDICAL FAIRS

LIGHTMED Corporation H1.B71 CONTACT:

Ann Land, Marketing Manager ann.land@lightmedusa.com San Clemente, California +1-949-2189555 www.lightmed.com

MagicEar, LLC H1.C16-B CONTACT:

Matt Henderson, Vice President matt@magicear.com Clearwater, Florida +1 (415) 640-1005 www.magicear.com

Mayo Clinic H5.A20 CONTACT:

Sharon Theimer, Communications Manager, International Media Relations, Public Affairs newsbureau@mayo.edu Rochester, Minnesota +1-507-284 5005 www.mayoclinic.org www.mayoclinic.org/arabic

LIGHTMED Introduces Sapphire & DermaLight 532 Lasers for Dental and Dermatology Markets. LIGHTMED has been in the medical laser business for 20+ years, focused primarily on the ophthalmology field. In recent years, LIGHTMED has taken its core laser technology and adapted it for a wide range of dental and dermatology applications. Sapphire and DermaLight 532 have been selling in Asia and the USA. Now, LIGHTMED is proud to announce these lasers are available globally.

LIGHTMED lasers adapt to a wide range of dental and dermatology applications

MagicEar is releasing a new series of next generation hearing devices! MagicEar provides the ultimate in advanced hearing aids and hearing protection devices using state-of-theart technology, in-house expertise and superior manufacturing practices to design and develop products for the benefit of consumers and partners. MagicEar has developed a series of new hearing aids that will be sold on the global market starting in Q1, 2019. These sleek and discreet hearing devices can also be connected via Bluetooth to an individual’s mobile phone.

Magic Ear devices are available direct to consumer, private label or sold in kits to manufacturers internationally

Mayo Clinic Ranked #1 Hospital in the U.S. Mayo Clinic is ranked the best hospital in the United States in U.S. News & World Report’s 2018-19 “Best Hospitals Honor Roll.” Mayo Clinic ranked No. 1 in six specialties: diabetes and endocrinology, gastroenterology and GI surgery, geriatrics, gynecology, nephrology, and neurology and neurosurgery.

More than 1.3 million people from about 140 countries turn to Mayo Clinic for diagnosis and treatment each year.

117

MEDICAL FAIRS

Medical Predictive Science Corp. H1.H50 CONTACT:

Geoffrey Alms, Executive VP galms@heroscore.com Charlottesville, Virginia +1-434-220-0715 www.heroscore.com

NOVAPROBE INC. H2.A10 CONTACT:

Manish Ingle, CEO ingle@novaprobe.com North Wales, Pennsylvania +1-215353-3141 www.novaprobe.com

NuStep, LLC/Manufacturing H2.A30 CONTACT:

Andrea Brown, Marketing Director abrown@nustep.com Ann Arbor, Michigan +1-734-418-1875 www.nustep.com/international

Sidra Medicine in Qatar Enhances Neonatology Unit with HeRO Monitoring. Medical Predictive Science Corporation (MPSC) is proud to announce that Sidra Hospital in Qatar has recently purchased HeRO Solo Systems to help better equip their hospital staff in identifying risks to neonatal infants. MPSC is a leading predictive analytics company turning data into better healthcare. The HeRO System aids the clinician to earlier identify neonatal conditions such as infection and sepsis.

NOVAPROBE launches the World’s 1st Fully Embedded 4k Camera system for Endoscopic Surgery NOVAPROBE UHDCAM4k camera system has the smallest footprint in 4K surgery eliminating the multiple equipment that are being currently used to perform endoscopic surgery. NOVAPROBE UHDCAM4k has the ability to record patient information with capture images and record videos at 4K resolutions. UHDCAM4K provides

HeRO System helps identify neonatal conditions such as infection and sepsis

a pre-programmable camera that uses the touch interface for adjusting camera parameters.

Maker of the Recumbent Cross Trainer Hire Physio Therapists to Support New Product Development Physio therapists are among NuStep’s most enthusiastic “advisors,” and through the years, their feedback has had a direct influence on how they refine existing products and develop new products. Physio Therapists are NuStep’s market Intelligence Strategist

JANUARY.FEBRUARY 2019

118

MEDICAL FAIRS

119

ARTICLE FEATURES . Immunotherapy

IMMUNOTHERAPY Boosts the immune system to fight cancer cells

mmunotherapy is a revolution in modern treatments against cancer. Scientific research and studies continue to focus on immune cells not just cancerous cells. Immunotherapy is a type of cancer treatment that boosts the bodyâ€™s natural defenses to fight cancer. It uses substances made by the body or in a laboratory to improve or restore immune system function. Immunotherapy may work by stopping or slowing the growth of cancer cells, stopping cancer from spreading to other parts of the body and helping the immune system work better at destroying cancer cells.

JANUARY.FEBRUARY 2019

120

ARTICLE FEATURES . Immunotherapy

Scientific progress has shown that the immune system in the human body has a key role in controlling tumor after scientists have linked the complex interaction between cancerous and non-cancerous cells such as immune cells. Under normal circumstances, the immune system recognizes and successfully fights cancer cells, eliminating them as they develop. However, sometimes the process breaks down and tumors form. Researchers found that when cancer cells are able to block the function of a certain gene, they are able to evade the immune system and proliferate. Today, immunotherapy is one of the most promising ways of treating cancer, but at the same time this treatment method must be compatible with the condition of every patient. Immunotherapy uses your body’s immune system to fight cancer. Hence, doctors can use the patient’s immune system to produce vaccines for specific tumors, or they can remove immune cells, stimulating the immune system to attach the tumor. Today, immunotherapy has succeeded in fighting some types of cancer such as breast, skin, lung, kidney, brain and neck cancers and some lymphomas as studies have yielded encouraging results. Since cancer cells have multiple mechanisms that allow them to evade the immune system, several types and patterns of immunotherapy have been developed to help the body cope with these protective mechanisms and boost the immune system’s ability to recognize the tumor.Immunotherapy has witnessed further developments

in light of the growing demand for international medical research and studies that seek to activate this type of treatments given its importance and usefulness in the treatment of cancer, which heralds a promising future in the fight against cancer as well as reducing its spread, based on the fact that the immune system is the first line of defense against cancer cells. Thus, research on this type of treatment has begun, which refers to a variety of therapeutic strategies designed to stimulate the patient’s immune system to fight the tumor. The immune system defends and protects our bodies from infection and disease. It is made up of organs, special cells and substances that work together to find and fight germs such as viruses or bacteria or abnormal or unhealthy cells that cause disease such as cancer. Germs and cancer cells have molecules on their surface that trigger the immune system to find and destroy them. But some cancer cells can hide from the immune system because they look a lot like normal cells. In some cases, the immune system may find cancer cells, but it isn’t strong enough to destroy all of them. And some cancer cells can even change how the immune system responds so it doesn’t work properly. Immunotherapy boosts the immune system to find cancer and attack it. Immunotherapy is used to stop or slow the growth of cancer, stop cancer from spreading to other parts of the body, help the immune system work better to destroy cancer cells and deliver toxins, such as radiation or chemotherapy, directly to cancer cells. The stages of development of scientific and medical studies that

confirm the success of immunotherapy have reached their peak in 2015. Medical conferences in Germany, Europe and USA have recently provided further scientific studies on the success of immunotherapy, which has begun to develop into several forms. In this type of treatment, the entire immune system or its components are used to deal with diseases, primarily cancer. At the forefront of the immune system’s fight against cancer cells are T lymphocytes, also known as T-cells. Immunotherapy has achieved major success in recent years, and today dozens of drugs rely on antibodies against cancer cell proteins and boosting the immune system’s ability to fight cancer cells. This treatment method depends on how the human immune system protects the body against germs, microbes, parasites and worms. If any of these organisms attempt to invade the body, the immune system cells become aware of it, rushing to attack it using several chemical or cellular weapons, such as white blood cells. This relies on a fundamental fact, the ability of the immune system to distinguish between the cells and components of a person’s body, and between microbes and bacteria that must be attacked and destroyed. Immunotherapy is a treatment for some types of cancer, for example melanoma that has spread. It uses natural body substances, or drugs made from natural body substances, to treat cancer. Three types of immunotherapy are used to treat cancer including non-specific immunotherapies, monoclonal antibodies and vaccines.

121

ARTICLE FEATURES . Wearable Technology

WEARABLE TECHNOLOGY A new era in the world of medicine

earable devices have revolutionized the health sector and have recently become a permanent companion to humans, enabling them to use many health-related technologies as well as the strength of biometric sensors capable of controlling movement, light, pressure, temperature and humidity. These devices can be also used for other purposes such as clinical, diagnostic or therapeutic procedures. Today, the healthcare market is the most important for many brands, after Apple came in the second place thanks to the smart watch that was approved for medical use by the US Food and Drug Administration. This wearable technology has changed many health sectorâ€™s trends.

JANUARY.FEBRUARY 2019

Through small devices that can be worn at anytime and anywhere, it has become possible to monitor the patientâ€™s vital functions from his home and there is no need to be present permanently in the hospital. Thus, the medical staff can monitor the patientâ€™s health condition and get detailed and timely information about his blood pressure, or heart rate for example. Wearable health devices are rapidly evolving technologically. They can range from clothing or accessories such as watches, glasses and clothes. They can provide instantaneous information tailored to specific contexts through data recording, analysis and delivery. These devices monitor and analyse the health of individuals according to several indicators such as heart rate, blood pressure and others.

122

Today, these devices enable doctors and patients alike to follow up on their weight, stress level, hours of sleep, fitness level and others. These devices include headsets that are vital for monitoring heart rate and fitness, smart contact lenses to monitor blood sugar levels and smart stickers that could be used by health professionals as implantable sensors to monitor the sleep of patients because they conform to internal organs without causing any adverse reactions. The wearable device market looks set to grow almost 26 percent next year compared to 2018, with worldwide shipment of wearable devices reaching 225 million, according to data from the International Data Corporation (IDC). Global shipments of wearable

ARTICLE FEATURES . Wearable Technology

devices reached 32 million units in the third quarter of 2018 - up 21.7% from the previous year, according to IDC’s “Worldwide Quarterly Wearable Device Tracker.” This new era of wearable devices is characterized by intelligent sensors with Internet connectivity, and Bluetooth for wireless connectivity to the smartphone. Sensors are used to stay in contact with individuals; most wearable devices are worn around the wrist, but an increasing number of those devices can be hung in the neck or implanted in the body.

Wearable devices include: •

•

Smart watches connected to the smartphone provide calls, emails and social media notifications. Fitness tracking devices come in all shapes and sizes, can be worn around the wrist or as a belt, and can calculate the number of steps daily, with continuous monitoring of the heart rate, while also providing high-accuracy data on calorie burning and exercise. Sports watches for sports lovers such as jogging, swimming and cycling. Devices implanted in the body under the skin through surgery for medical purposes such as supplying the body with insulin, or as a means of contraception.

Expectations in this regard indicate a tendency to focus more on the market of wearable devices used for healthcare and to maintain fitness in order to motivate people to follow a healthy lifestyle. With the increasing number of women resorting to such modern technologies and increasing awareness among many of them about the healthy lifestyle, some companies today are meeting these requirements

to provide the practical and aesthetic needs of women who are keen on health and fashion together, especially that today’s fashion requirements require attention to health.

Numerous Benefits The benefits of wearable devices are the ability to stimulate healthy behaviour and thus reduce the risk of diseases, especially heart disease, in addition to improving the management of chronic diseases such as control of blood sugar levels or blood pressure, heart rate or heart problems and others. The health benefit of wearable devices and the collection of patient information on an ongoing and regular basis lies in the possibility that the patient can receive better care at any time and place as it is not restricted to visiting a doctor or health institution. It also increases the chances of communication between the patient and his doctor at any time by sending the patient’s data directly to the doctor’s smartphone so he can quickly read them and get informed about his health. Heart patients can use the smart watch to measure their heart rate at all times. Diabetics can learn to read blood glucose levels through the use of a smartphone and send that data to their doctors immediately. Telemedicine is also widely used in monitoring high blood pressure, obesity, blood sugar and asthma. The benefits of these devices also include reminding patients to take their medication and record specific data as requested by the doctor. Today, through these advanced devices, the patient can save his blood pressure on the smartphone or smart watch at all times, with a reminder of the time to take the medicine, so when he sees the doctor, he has all the accurate data needed.

Smartphones and health applications The smartphone is not something we wear but something we carry at all times. Hence, many companies have deployed health applications that anyone can use on their smartphone to give them information about vital indicators, fitness rate, calorie calculation and heart rate. Smartphone applications have facilitated large-scale studies that collect data accurately and in a timely manner about people’s places by collecting information about the patients’ health status using the latest technological devices, to be sent later to a doctor for review. In addition to the information and monitoring of vital indicators in the body, there are some medical applications that rely on the microphone and smartphone camera in the process of diagnosing diseases. In other applications, small sensors and accessories can be integrated in smartphones to carry out basic tests and diagnosis of health problems. The patient can receive data on his mobile phone every five minutes, giving him an additional vision for managing diabetes, for example. ECG monitors also allow the doctor to monitor the patient’s health remotely via his or her smartphone. Modern technology devices and specialized health applications on smartphones can collect information about the patient’s health status at all times, to be sent later to a doctor for review. Prominent and promising digital healthcare applications will change the medical trends in the coming years. We are expected to see further achievements in this regard as technology and the Internet are evolving. The medical sector has been the biggest beneficiary of technology development, and the same will apply to wearable devices in the coming years.

123

MEDICAL EQUIPMENTS

Latest PAXMAN Scalp Cooling System to be showcased at Arab Heath 2019

ritish scalp cooling expert, PAXMAN is showcasing the latest model of the PAXMAN Scalp Cooling System (PSCS) at Arab Health 2019. The British-developed pioneering treatment prevents Middle Eastern cancer patients from losing their hair and retain a feeling of normality during chemotherapy.

The improved simplicity of the new generation of PAXMAN Scalp Cooling employs an interactive user interface and touchscreen ensuring ease of use for clinical staff. Maintaining coolant levels is also simplified by a visual warning system and an easy-touse self-drain coolant refill bag. The new control pump manages the speed and coolant flow, improving the consistency of treatment. Manufacturing technique changes have also been introduced – the front cover of the scalp cooling machine is now injection moulded rather than RIM moulded - to improve the overall aesthetics of the system. Following the successful launch in the US, this updated model is being rolled out across the Middle East, UK and rest of world markets. This is the first time it will be showcased at Arab Health and the company is keen to find new partners from across the Middle

JANUARY.FEBRUARY 2019

East and North Africa (MENA) region. The PAXMAN Cooling System (also known as the ‘cold cap’) alleviates the damage caused to the hair follicle by chemotherapy. It works by reducing the temperature of the scalp by a few degrees immediately before, during and after the administration of chemotherapy. Made from lightweight silicone, the scalp cooling cap is soft and flexible - providing a snug, yet comfortable fit during treatment, moulding to all head shapes and sizes. Liquid coolant passes through the cap, extracting heat from the young person’s scalp, ensuring it remains at an even, constant temperature to minimise hair loss. Chemotherapy works by targeting all rapidly dividing cells in the body. Hair is the second fastest dividing cell, and this is the reason why many chemotherapy drugs cause alopecia. The hair follicles in the growth phase

124

are attacked, resulting in hair loss approximately two weeks after the commencement of chemotherapy treatment. Richard Paxman, CEO at PAXMAN said: “Chemotherapy-induced hair loss is consistently ranked in the top five most distressing cancer chemotherapy side effects and we are working hard to ensure that cancer patients have a choice against hair loss. We are delighted to be able to offer scalp cooling to Middle Eastern patients and are keen to find new partners from across the region.” The Arab Health Exhibition & Congress is taking place from 28th – 31st January 2019 at the Dubai Convention and Exhibition Centre. Throughout the exhibition the Paxman Scalp Cooler will be located on the Leeds City Region stand (H7.H51) in the UK Pavilion.

REASONS TO ADVERTISE

OUR SOURCE OR

HEA TH ARE NE S IN THE

IDDLE EAST

CIRCULATION A carefully studied database of healthcare professionals, doctors & caregivers, that matters to your company.

READERSHIP Top decisionmakers and professionals in the healthcare sector are your main readers.

ONLINE Optimizing your exposure through our online media: website, application and all social media vehicles.

CONTENT

OUR HARD COP O THE

ARA HEA TH &

HOW TO ADVERTISE

A A INE

online www.thearabhospitalmagazine.com

The Arab Hospital Magazine

HospitalsMag

HILE ISITIN

ED A

The Arab Hospital

email advertising@thearabhospital.com

The Arab Hospital Magazine

A rich source of news on the Health Care sector presented in a fresh and modern format.

call +961 4 534058

NEWS

Abu Dhabi Launches the Emirate’s Medical Tourism e-Portal

epartment of Health - Abu Dhabi (DOH) and Department of Culture and Tourism – Abu Dhabi (DCT Abu Dhabi), have launched the Abu Dhabi Medical Tourism e-portal, a digital platform that provides visitors to Abu Dhabi with all medical offerings and healthcare facilities available throughout the duration of their visit. The launch event was attended by H.E Sheikh Abdulla Bin Mohamed Al Hamed, Chairman of Department of Health, H.E Mohamed Khalifa Al Mubarak, Chairman of the Department of Culture and Tourism – Abu Dhabi and H.E Engineer Awaidha Mur-

JANUARY.FEBRUARY 2019

shed Al Marar, H.E Mohamed Al Hameli, Undersecretary of Department of Health and H.E Saif Saeed Ghobash, Undersecretary of Department of Culture and Tourism- Abu Dhabi. The e-portal provides a list of 40 healthcare facilities included in the medical tourism network, all of which adhere to the requirements of DOH’s quality framework (JAWDA) program, as well as more than 287 medical treatment packages from over 173 doctors across the Emirate. Through the e-portal, users can also access medical tourism insurance packages, the first of its kind in the region, along with a wide range of touristic

126

services such direct contact with healthcare providers, visa issuance, as well as booking appointments, hotels, transportation and other recreational activities. In his speech, HE Sheikh Abdullah bin Mohammed Al Hamed, Chairman of DOH, stated that the development of the Medical Tourism E-Portal goes in line with the Department of Health’s ongoing commitment to promoting Abu Dhabi as a destination for medical tourism on a global scale. HE Al Hamed said: “The Department of Health is utilizing the quality indicators of the JAWDA program to

NEWS

determine the eligibility of healthcare facilities in joining the medical tourism network. By doing so, we can ensure that our healthcare network is capable of providing high-quality services and unique medical offerings that distinguish it from other healthcare systems. These medical offerings would include advanced heart surgeries, organ transplants, infertility treatments, joint surgeries, medical check-ups and cosmetic surgeries.” HE Mohamed Khalifa Al Mubarak, Chairman of the Department of Culture and Tourism – Abu Dhabi, said: “The launch of the Medical Tourism portal is a testament to our efforts to position and promote Abu Dhabi to the global medical tourist. This launch will lay out our plans to identify medical tourism initiatives to benefit from the growth of the sector in the UAE capital. We offer not only state-of-the-art medical infrastructure, facilities and treatments and world-renowned doctors, but we also have the capability to offer a complete holistic environment to foster faster rejuvenation and recovery”. “Medical tourism is one of the fastest growing sectors of global tourism. Our key strategy, at the Department of Culture and Tourism – Abu Dhabi, is to attract more visitors, to stay longer and experience more across the Emirate of Abu Dhabi, and become a leader in the global medical

tourism sector, and regional pioneer for this market”. Al Mubarak added. Brigadier Saeed Rakan Al Rashidi, Director-General of the Foreigners Affairs and Ports Department of the ICA, said: “Today, we celebrate the collective efforts in placing Abu Dhabi on the global map of medical tourism. It gives us great pride to have developed the medical tourism visa system according to a dedicated framework developed in collaboration with DoH. These standards have been developed in accordance with the JAWDA framework, which guarantees international patients access to the best-in-class health facilities in Abu Dhabi. These health facilities are members of the medical tourism network, and as per the new framework, are the best equipped to obtain medical tourism visas on behalf of their patients.” Commenting on the launch of the e-Portal and its medical tourism plans, National Health Insurance Company – Daman CEO Dr Michael Bitzer, said: “The introduction of Abu Dhabi Medical Tourism e-Portal is set to cement Abu Dhabi as a key medical tourism destination around the world. We are proud to be part of this initiative with innovative medical tourism insurance plans, and remain committed to playing a key role supporting the sustainable development and growth of the Emirate’s healthcare system.”

Tony Douglas, Group Chief Executive Officer said to commitment on Etihad’s role at the Medical Tourism e-Portal: “As the national airline of the UAE, Etihad is proud to partner with the Department of Health and Department of Culture and Tourism in supporting the development of medical tourism in Abu Dhabi. Our specialized services, including our in-flight nurses, ensure that guests with pre-existing medical conditions receive a high standard of care during their journey to the capital.” Abu Dhabi is growing its reputation as a premier destination for medical tourism through its advanced infrastructure, high quality of healthcare, and extensive tourism portfolio that enables the Emirate to deliver complete tourism experiences for its visitors. The Department of Tourism and Culture has signed a memorandum of understanding with the Medical Tourism Association to host the World Medical Tourism & Global Healthcare Congress in Abu Dhabi, which brings together experts and organisations from more than 100 countries. The MoU includes the opening of a regional office in Abu Dhabi to promote medical tourism in the Emirate on a regional and global level, and to support in organizing the World Medical Tourism & Global Healthcare Congress in Abu Dhabi.

127

ARTICLE

y name is Randa Meouchy, a 47 years old Lebanese woman, mother of three, wife of a successful husband…an ordinary woman, but with an unordinary sensitivity to the suffering and pain of human beings. My thirst to heal wounds causing these suffering and pain has always guided my life. It made me so eager to search for a healing process that I started reading psychology and psychiatry books at the age of eleven. Very good at school, I chose the Faculty of Medicine at Saint Joseph University in Beirut to start my university studies aiming to join Doctors Without Borders and help ease the suffering of people all over the world, in particular their physical ones. Unfortunately, I had to interrupt these studies for personal reasons. But nothing could stop me, so I turned towards another way of fulfilling my humanitarian goals: social work. I thought it would help heal wounds on a larger scale. Indeed, I obtained my B.A. in Social Work from the same university. During this curriculum, my psychology professor was a famous psychotherapist who awakened in me a deep well-buried desire of following the same path, but I just gave myself a pair of a “stop-it-girl” slaps and moved on with my life. Reality caught me well when I realized very soon the limits of the social work interventions that are very often confronted and failing for legal and political reasons. Such enlightenment made me fight for entering the Faculty of Law and Political Sciences at Saint Joseph University, and always with the same aim to “save” the humanity but at a higher scale now, where I thought things should start…at the macro level. My LL.B. in hand, I was heading to a Ph.D. in Public and Humanitarian Law when again I ran into another wall that stopped me from achieving further in this path, my sense of life (thinking about it, which wound a Ph.D. would have helped healing?) Life has odd ways of teaching and sculpting a human life. As at some point (years later), I realized that to go macro, we must start with… micro, that healing societies starts with healing the people composing them, that the wounds of the world, of the entire humanity, lay within the wounds

JANUARY.FEBRUARY 2019

128

of each human being in this world. Each human being has his own wounds, his own many wounds, wounds of all sources and of so many kinds. So here I am, struggling again to get a certificate in Co-Active Life Coaching from the CTI, the Coaches Training Institute, in Dubai and I got it. But it is still not enough for me... Coaching does not heal deep wounds, it helps improving the well-being. Deep wounds need deep healing, and no healing is possible if the first healer is not the wounded person him/ herself. A wound echo is pain, the wound and its echo could be found in the body, the mind, the soul…in the family, the society, the universe… in such a mix-and-match game that makes the healing process more complicated but yet simpler. A deep healing means transforming a deep wound into a whisper… For that I engaged into another battle at the age of 46, the battle of transforming my deep wounds into whispers and of helping others to do the same with their own… How and why? See you in the next article.

For our kids and their moms to feel better in hospital The complete LINET product line is designed for professional care of women and children in a beautiful and very demanding period of childbirth, puerperium and early childhood.

Birthing bed AVE 2

Baby cot MiMi

Join us at booth #S1.G30

✓ Maximum comfort an quality ✓ Design and europe essional care ✓ Safe and smart prof

Pediatric bed TOM 2