Issuu

Issue 35 / 130 July / August 2017 www.tahmag.com

Colleges of Medicine

Skin Cancer

Stroke

RAISING THE LEVEL OF MEDICAL EDUCATION IN THE ARAB WORLD

PREVENTION SHOULD START IN EARLY CHILDHOOD

THE SOONER THE MEDICAL INTERVENTION, THE LESS DAMAGE TO THE BRAIN

NEWS

JULY.AUGUST 2017

Publisher Arab Health Media Communication

A New Era for Global Health On 1 July 2017, Dr. Tedros Adhanom Ghebreyesus took office as Director-General of the World Health Organization, succeeding Dr. Margaret Chan, who has held office since 1 January 2007. Ethiopian Minister of Foreign Affairs Ghebreyesus, who was elected last May, is the first African to head the Organization. This event is more than just an election process; its importance comes from the major responsibilities and challenges facing the organization in the next phase, especially that the leadership skills of Dr Margaret Chan came under renewed criticism after a report found she lacked the “independent and courageous decision-making” that was needed during the crucial early days of the deadly Ebola outbreak. In the Arab region in particular and neighboring regions, there are many urgent cases that must be on the list of priorities in the next phase, including the rapidly spreading cholera outbreak in Yemen, which has exceeded 200,000 suspected cases in two months only. Already more than 1,300 people have died – one quarter of them children – and the death toll is expected to rise. In addition to the epidemics and injuries resulting from the war in Syria as many children suffocated due to the use of chemical weapons globally as well as the lack of supplies of medicines and necessary treatments and following up on the control of the coronavirus causing the Middle East Respiratory Syndrome (MERS). Dr Tedros, who served as Minister of Health in Ethiopia from 2005–2012, plans to focus on five main areas of work during his tenure. They are: achieving universal health coverage; strengthening the capacity of national authorities and local communities to detect, prevent and manage health emergencies; improving the health and well-being of women, children and adolescents; addressing the health impacts of climate and environmental change; and building a transformed, transparent and accountable WHO.

General Manager Simon Chammas E: schammas@tahmag.com Creative Department Roula Haddad - Georges Habka Creative Director: Jessy Chlela Photographer Hanna Nehme Copy EDITOR Jessica Achkar EDITORS Aline Debes, Mark Steven, Don Karn, Andrew Weichert, Colette Semaan, Abbas Moussa Advertising & Marketing advertising@tahmag.com Mirna Khayrallah mirna@tahmag.com Dayane Al Dib dayane@thearabhospital.com Jessie El Hajj jessie@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 E: tahmag@tahmag.com Simon Chammas E: schammas@tahmag.com Dubai Schammas@tahmag.com +967 50 2971007 KSA Moussa ALHAKIM - KSA Market Manager POBox 116197, Fahd Bin Zaghir Road Al Zahraa - Jeddah 21391 – Saudi Arabia T +966 55 600 88 60 France “Media & PR” 9 rue Victor Hugo 92400 Courbevoie, France T: + 33 1 43 34 24 90 M: + 33 6 19 03 31 86 E: jpcressot@wanadoo.fr

Kuwait Trivisions - Global Int'l Rony Kikano (Managing Director) P.O.Box 36578 Ras Salmiyah Media@trivisions.net +965 99133911 China China International Health & Medical Tourism Association (CIHMTA) 中华医疗健康旅游协会 Dr. JIA XIAO FANG T: +86-010-82825920 Whats app +86-18675588998 M: +86-18675588998 E: CIHMTA@hotmail.com Printing Offset Printing Press S.A.L. Distribution: KSA - UAE - OMAN LEBANON - JORDAN SYRIA - KUWAIT - BAHRAIN - QATAR - EGYPT

JULY - AUGUST 2017

52 56

36 60

46 68

NEWS 8

Completes Successful Kidney

HMC’s Year 1 Pharmacy

Residency Program

12 Dubai Health Authority 14 Al Jalila Children’s Specialty Hospital partners with Alder Hey Children’s

16 Riester launches new shockresistant sphygmomanometer

18 Beirut’s Clemenceau Medical Center wins major international award

20 The University of Manchester launches new specialist Masters degree

22 Igenomix Dubai Wins 2017 Frost

Transplant

32 Boehringer Ingelheim’s EMPAREG OUTCOME

38 How does a woman’s life go during and following breast cancer treatment?

36 Expert in lung transplantation

56 Medical Universities in the

joins Baylor St. Luke’s Medical Center

Arab world

50 Aster DM Healthcare Unveils Global Volunteers Program to mark its 30th Year Anniversary

54 Qatar University 90 Moorfields CEO appointed chairman of World Association of Eye Hospitals

91 Cerner Middle East & Africa

& Sullivan’s Specialized Genetic

strengthens client alignment with the

Diagnostic Services Technology

appointment of new leadership roles

Leadership Award

95 Birth defect detected at age 58

24 Ministry of Health & Prevention 28 Cleveland Clinic Abu Dhabi

FEATURES

British woman undergoes surgery in Dubai and walks within 24 hours

60 Stroke 68 Skin Cancer 72 Ovarian Cancer

INTERVIEWS

44 Konstantin Lyadov 48 Perrine Malaud Wakim

ARTICLES

64 Understanding Atrial Fibrillation 66 Cardiac care critical 76 The growing need in Healthcare 78 Can Jordan retrieve its position in the Global Healthcare Travel Industry?

80 Travel Medicine 86 Osteoporosis 88 Depression and its treatments 98 Inflammation & Chronic Pain JULY.AUGUST 2017

AMERICAN HOSPITAL DUBAI PLASTIC, RECONSTRUCTIVE AND COSMETIC SURGERY

LOOK BETTER, FEEL BETTER, BE BETTER.

American Hospital Dubai’s new Plastic Surgery Department thrives on the same high standards as the hospital and prides itself on integrity, quality and safety. We offer a comprehensive plastic, reconstructive, and cosmetic surgery services: •

Hand Surgery (Trauma & Elective)

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Burn Repair Surgery

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Breast Reconstruction (following mastectomy)

•

Skin Cancer Management

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Cosmetic Surgery (Body, Breast, & Face)

To book an appointment, please call +971 4 377 5500 or visit www.ahdubai.com

American Hospital Dubai accepts most major health insurance plans, please call (+971) 800 - 5500

MOHAP – AT35647 – 28/10/2017

Please visit our website for the complete list of procedures

NEWS

HMC’s Year 1 Pharmacy Residency Program Attains Prestigious International Accreditation

patient care in a variety of environments, apply skill in medication-related education, serve as leaders within the pharmacy profession, and excel during further post-graduate training.” “Achieving this accreditation was a challenging process but it adds another feather to the cap of HMC’s Corporate Pharmacy Department. We are sure that this specialized clinical training will provide our pharmacists with the experience they need to excel in their careers, which will further enhance the patient safety culture at HMC.

ication safety practices and enhance patient safety.

HMC is the second healthcare system in the region to achieve the prestigious ASHP accreditation - a significant achievement for the organization’s Pharmacy Department. Her Excellency Dr. Hanan Mohamed Al Kuwari, Minister of Public Health, inaugurated the accreditation ceremony and awarded graduation certificates to the first batch of residents. ASHP is an internationally recognized non-governmental, non-profit pharmacy association that has been accrediting pharmacy residency and training programs since 1962. It has been a driver for excellence, bridging education, research, and practice.

ASHP accreditation establishes and evaluates a set of entrenched standards for the methodical training of pharmacists to attain professional competence whilst delivering patient-centered care and medication safety in pharmacy operational services. Furthermore, ASHP accreditation assures residency applicants that the program meets the requirements for post-graduate training in pharmacy practice.

amad Medical Corporation’s (HMC) Post-graduate Year One Pharmacy Residency program (PGY1) has been accredited by the American Society of Health System Pharmacists (ASHP).

Today the ASHP has more than 43,000 members including pharmacists, students, and pharmacy technicians. For 75 years, ASHP has been at the forefront of efforts to improve med-

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Pharmacists are recognized as an integral part of the multidisciplinary healthcare team. The inclusion of this ASHP-accredited pharmacy residency program will further enhance the services offered to HMC patients.

“This accreditation attests to the quality of our graduates and the service we provide to our patients,” said Dr. Moza Al Hail, Executive Director of Pharmacy ay HMC. “The PGY1 is a one-year program that prepares pharmacists to practice as highly qualified independent practitioners able to provide

“After this successful accreditation, we are planning to work on starting our Post-graduate Year 2 residency; this program will help develop pharmacy specialists capable of practicing in a variety of patient care settings such asoncology, infectious diseases, and emergency medicine,” Dr. Al Hail added. Dr. Rasha Al Anany, Director of Pharmacy at Al Wakra Hospital and Residency Program Director said achieving ASHP accreditation required the program to apply a rigorous process to ensure compliance with advanced and well-established pharmacy practice standards. “The capacity for the program is two residents each year with plans to expand the number of residents, preceptors and rotation sites,” she said. “Today, the pharmacy profession has expanded beyond the traditional role of simply dispensing medication to become more patient-oriented. It’s therefore important to equip our residents with the skills and experience they need for this.”

NEWS

Dubai Health Authority adopts

smart system that will guarantee the safety and effectiveness of medication which will maintain the quality and safety of pharmaceutical medication. We have adopted the system with the support and guidance of H.E Humaid Al Qatami Chairman of the Board and Director General of DHA” said Dr Sayed.

he Dubai Health Authority’s (DHA) Pharmaceutical Services Department has announced the adoption of a smart system that monitors the cold chain of pharmaceuticals to preserve the quality and safety of medication. Cold chain is a temperature controlled supply chain, which provides an uninterrupted series of refrigerated production, storage and distribution activities to maintain the desired low temperature of consumable goods such as pharmaceuticals. Dr Ali Al Sayed, the Director of the Pharmaceutical Services Department at the DHA explained that the monitoring of cold chain especially when it comes to medication is considered one of the most important global issues and one of the biggest challenges that international health organizations face as it directly affects the quality, safety and the effectiveness of the medication. “After conducting a series of studies on international practices in the field of smart medication management systems, the pharmaceutical services department adopted an international-standard smart system that monitors and tracks the temperatures of medication through the installation of smart devices and tablets that can be controlled and tracked electronically. These systems aim to guarantee a continuous cold chain,

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Dr Sayed revealed that the smart system adopted by the DHA includes computer tablets incorporated with the medical refrigerators and refrigerator rooms. These tablets will register and document the temperature automatically and they will display the data in a graph format that shows the correct temperature limits and documents them. “The tablets will also send alerts through text messages and emails in the case that the temperature exceeded the required limit. It will provide electronic reports regarding the medical storage and safety of the medication. These systems can also be controlled electronically through their own website,” he said. Dr Sayed Added that small smart technology will document the temperature while transporting the medication from the storage to the pharmacies. These small smart devices are connected to the computer and display in graph form the temperatures the medication was subjected to through the transportation process. “The system was implemented by the authority to maintain patient’s safety and achieve customer satisfaction as these systems preserve the safety of the medication by tracking and controlling the temperature the medication is subjected to throughout the transportation process until the medication reaches the patient.”

... And Take vaccinations 2 weeks before the trip

he Dubai Health Authority (DHA) is encouraging families who are making travel plans during summer to ensure they take necessary pre-travel vaccinations, at least two weeks prior to their journey, to ensure the effectiveness of the vaccines. The pre-travel advice takes into account the destination, length of stay, medical and vaccine history, current medical state, and mandatory and recommended vaccines for the destination. The DHA has two fullfledged traveler’s clinics inside the Nad Al Hammar and Al Barsha primary health care centres, which are a hub for pre-travel medical services such as vaccinations, risk assessment and travel advice. “While there has been an increase in awareness about pre-travel vaccines, we still see families who come to us a week or a few days prior to travel. We inform them that we cannot be sure of the effectiveness of the vaccine unless it is administered a month to minimum two weeks prior to the date of travel and we recommend that they postpone their travel dates. Therefore, to avoid all such hassles our advice to travelers is to understand the importance of pre-travel vaccines and medical advice and incorporate this when they plan to travel,” said Dr Fathiya Sarkal, deputy director of DHA traveler’s clinics. Dr Sarkal said that year-on-year there has been an increase in the number of travelers for both business and leisure and that the clinics provide vaccines to residents and visitors. “We provide a full range of services for travelers and are constantly up-to-date with the latest in terms of country specific disease prevalence and outbreaks.

NEWS

Al Jalila Children’s Specialty Hospital partners with Alder Hey Children’s

with multiple specialist services, will be able to assist us through sharing of knowledge, specialist best practice and initiatives.” Having recently opened a brand new world-class hospital facility of comparable size to Al Jalila Children’s, Alder Hey will also be able to provide guidance on how best to deal with teething problems often encountered when opening any new facility. Children requiring very specialised treatments not currently available in the UAE, such as complex neurosurgery and neuro-oncology, will now benefit from being able to access those treatments at Alder Hey Children’s in a seamless manner.

l Jalila Children’s Speciality Hospital has partnered with the Alder Hey Children’s NHS Foundation Trust in Liverpool to create a healthier future for children and young people worldwide. Officials from both institutions signed an agreement witnessed by the Camilla, the Duchess of Cornwall, wife of the Prince of Wales, during an official visit to the UAE. The Duchess of Cornwall also met children currently being cared for at the hospital in Al Jalila. Al Jalila Children’s Hospital, the brainchild of His Highness Sheikh Mohammed Bin Rashid Al Maktoum, Vice-President and Prime Minister of the UAE and Ruler of Dubai, aims to deliver care to children at the highest level and on a par with international standards by establishing an official international affiliation agreement with an established world-class institution. Alder Hey Children’s NHS Foundation

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Trust in Liverpool, UK, runs one of Europe’s largest and most established paediatric institutions. The partnership will deliver the highest quality care in outstanding facilities, with continuous improvements made through medical education, innovation, and clinical research is prominent in both institutions.“We are delighted to have teamed up with Alder Hey Children’s, a world-class hospital with a long history of providing excellent care for children,” said Her Highness Princess Haya Bint Al Hussain, wife of His Highness Sheikh Mohammed and chairperson of Dubai Healthcare City Authority. “This partnership allows us to establish a wide range of collaborations which will improve the care of children in the UAE. Our immediate priority to accelerate the establishment of Al Jalila Children’s is enhanced by this collaboration, as Alder Hey, with its extensive knowledge and expertise in running a long established hospital

Training programmes will be established between the two hospitals and Alder Hey will have access to patients with rare diseases which will support their research programmes. Sir David Henshaw, chair of Alder Hey Children’s NHS Foundation Trust, said: “Increasingly, medicine is global and we wish to be an active participant in the global paediatric community by co-creating new programmes of research, training and education that will benefit our NHS teams in the UK. We highly value the collaboration between our teams.”

NEWS

OGT to be acquired by Sysmex Corporation

a leading provider of haematology and in vitro diagnostics products

xford Gene Technology (OGT), The Molecular Genetics Company, announced that it has signed an agreement to be acquired by Sysmex Corporation (Sysmex), a Japanese in vitro diagnostic company. Sysmex will acquire all of OGT’s shares, gaining access to OGT’s genetic analysis technologies and expertise in the cytogenetics domain. OGT will become a wholly owned subsidiary of Sysmex. Further terms of the agreement are not being disclosed. Sysmex develops, produces and sells integrated instruments, reagents and software used in in vitro diagnostics and is the leading supplier globally in haematology, haemostasis and urinanalysis. The acquisition of OGT will allow Sysmex to enter the cytogenetics market with FISH (fluorescence in situ hybridisation) and aCGH (array comparative genomic hybridisation) products. It will also strengthen its technology base in molecular genetics through OGT’s NGS (next generation sequencing) reagent development capabilities. The acquisition of OGT expands Sysmex’s life science business and reinforces its initiatives towards personalised medicine. For the year ended 30 September 2016 OGT recorded sales of £19.7m primarily from its fully integrated molecular genetics product portfolio of Cytocell® FISH probes, SureSeq™ NGS products and CytoSure™ microarray products that together grew by 30% in FY16. The sustained profitable growth in rapidly expanding markets along with

JULY.AUGUST 2017

Riester launches new

shock-resistant sphygmomanometer

OGT’s strong heritage in hybridisation-based technologies positions it well for the future in the field of molecular medicine and the acquisition by Sysmex serves to further strengthen this position.

iagnostic device manufacturer Riester has launched the ‘precisa® N shock-proof’, a new aneroid sphygmomanometer that is shock-resistant if dropped from up to a height of one metre.

Professor Sir Edwin Southern, founder of OGT comments “We are delighted to become part of such a well-regarded organisation and truly believe that the opportunities arising from joining a large global corporation like Sysmex will be transformational for OGT, its employees and customers”.

The precisa® N shock-proof is compliant with DIN EN 81060-1:2012-08, the German standard for non-invasive sphygmomanometers, and has also recently been validated by the British Hypertension Society for clinical use. It features a metal tube connector to help users quickly change from one cuff size to another and has a specially tempered, virtually non-aging copper-beryllium diaphragm with precision movement. It has a diaphragm pressure-loading capacity of up to 600 mmHg and a precision air-release valve and measuring system protected by a microfilter.

Several product development synergies have been identified that combine OGT’s innovation and expertise in genetic assays for haematology, solid cancer and rare disease with Sysmex’s expertise in instrument development and in vitro diagnostics to expand offerings in genomic medicine. For example, R&D teams from OGT and Sysmex will collaborate to develop an automated system for FISH testing by combining Sysmex’s automation technology with the high-quality FISH reagent development expertise OGT possesses. In addition, adding OGT’s array CGH and NGS capabilities will expand opportunities further in genetic testing in the field of rare diseases and liquid biopsies. OGT’s CEO Dr Mike Evans adds, “Alongside the exciting product development opportunities already identified, there are a number of beneficial commercial synergies that will expand market access for OGT’s products putting us at the forefront of molecular genetics. We are looking forward to the next chapter in our development as part of Sysmex”.

The precisa® N shock-proof has a three-year warranty from the date of calibration and offers a lifetime of accurate measurement.

NEWS

Beirut’s Clemenceau Medical Center wins major international award

on the Medical Travel map and today is evidence of our success,” said Dr. Mounes Kalaawi, CEO of CMC. Chairman of the judging panel and Managing Editor of IMTJ Keith Pollard says the awards celebrate the best providers in the industry and aim to encourage others to strive to match them:

lemenceau Medical Center named Best Quality Initiative, Excellence in Customer Service, and International Cancer Centre of the Year by the IMTJ Medical Travel Awards 2017. Clemenceau Medical Center has won three major international medical tourism award for their efforts in attracting international patients to Beirut, Lebanon. Clemenceau Medical Center were named Best Quality Initiative, Excellence in Customer Service, and International Cancer Centre of the Year by medical travel publication the International Medical Travel Journal Medical Travel Awards 2017 (http:// awards.imtj.com) at their annual awards ceremony, the IMTJ Medical Travel Awards 2017.

The awards were presented on 26th April at a high profile reception in Opatija, Croatia during the IMTJ Medical Travel Summit, which brought together all the pre-eminent providers and experts in medical travel and

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medical tourism sectors. The Awards were generously supported by Primorje-Gorski Kotar County. The award was given to Clemenceau Medical Center that beat similar businesses/ clinics from around the world to clinch the awards. “We are very proud of this achievement and triple win. This international acknowledgment of CMC’s efforts and relentless commitment for high quality patient care is close to heart. Medical travel is a vital and important sector and we work hard to ensure that all medical travellers get the best possible treatment, to heal well, and to be able to return safely to their homes. We want to put Beirut back

“Medical travel is an exciting and growing global industry, with many providers delivering excellence in both medical care and customer service. The IMTJ Medical Travel Awards are the only independent awards to recognise those who are the best of the best - and hopefully will encourage others to emulate their success. The judges wanted to reward innovation and excellence, highlight best practice and celebrate those who are leading the way in the industry and delivering successful outcomes for patients. “All our winners exemplify the way the medical tourism industry should be run – professional, offering exceptional patient care and providing the best possible medical outcomes. I’m already looking forward to next year’s awards in the hope that other clinics and companies will have raised their game to match or even better this year’s winners.”

NEWS

The University of Manchester launches new specialist Masters degree for healthcare professionals in the Middle East at Saudi Healthcare Exhibition 2017

he University of Manchester Middle East Centre is launching a new part-time specialist Masters degree program at the Saudi Healthcare Exhibition 2017, where the University is exhibiting for the first time. The new program is the MSc International Healthcare Leadership, delivered in a part-time blended learning format and designed for experienced and qualified medical and management professionals in Saudi Arabia and the Middle East. The program can be completed in two years, starting in September 2017; enrollment is now open until 30th July 2017 for the Middle East. The healthcare sector is one of the most dynamic industries in the region with

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continuing investment in infrastructure and facilities by the public and private sectors, and a growing need for talent to optimize this investment. The MSc International Healthcare Leadership program is designed for experienced clinicians and managers already in general management or leaders in healthcare who need to enhance their leadership skills, and those managers who need practical preparation before moving into clinical, project, specialist or business leadership positions.

Manchester Middle East Centre, comments: “The Saudi healthcare sector is the largest in the GCC accounting for more than 50% of the regional market and continued investment in capacity needs to be matched with the skills and talent to ensure this investment ultimately benefits patients.

It is designed to equip leaders and managers with the latest knowledge and global healthcare best practice, and to help facilitate experienced managers transfer their skills into the healthcare economy. Randa Bessiso, Director of The University of

The University is building on the foundation of the very successful Manchester Global Part-time MBA program and our experience of supporting working professionals across the region, many from Saudi Arabia, developed over the last 10 years.”

The University’s new healthcare MSc program for the Middle East provides close personal support and interaction for delegates and will help meet the talent gap in the sector.

NEWS

Igenomix Dubai Wins 2017 Frost & Sullivan’s

Specialized Genetic Diagnostic Services Technology Leadership Award

Dubai to have 12

new private hospitals by 2020

total of 12 new private hospitals with 875 beds will open in Dubai by 2020, totalling the number of private hospitals in Dubai to 38, the Dubai Health Authority (DHA) revealed.

genomix has achieved yet another milestone in the field of advanced reproductive genetics in the Middle East after being honored with Frost & Sullivan Best Practices Awards. This Global program recognizes outstanding industry achievements by companies worldwide. The methodology for determining Award recipients is unique – a deep dive research and analysis is conducted by Frost & Sullivan industry experts, which is presented to an esteemed and independent panel of Judges, comprising senior executives representing the top companies in the Middle East. The evening was gleaming with best of the people in business and technology from around the Arab region at Atlantis The Palm, Dubai on 24th May, 2017 where leaders became part of the proud moment shared by the team of ‘Frost and Sullivan’. The success story of Igenomix Dubai Laboratory was sanctioned and sealed by the industry experts and our promise will continue to increase the quality of life by improving fertility rate among Middle Eastern population. Mr. Francisco Rodríguez, General Manager at Igenomix Middle East & India, after receiving the Frost &

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Sullivan Award, quoted: “We are humbled by this honour. Igenomix has dedicated years in research and development to attain the best genetic techniques that helps IVF specialists achieve higher pregnancy success rates globally, besides also preventing genetic disorders through our comprehensive state-of-the-art screenings and diagnosis. This award recognises the technology and quality standards Igenomix commits to across the globe.” “We were the first private genetic lab in 2016 to be accredited by CAP. Frost and Sullivan’s award is yet another landmark for Igenomix. We have been able to successfully bring in the best genetic practices available globally to Middle East. Our customer support and quality reporting makes us unique and the most preferred genetics partner for many private and government medical bodies. We continuously keep upgrading our technologies to strive for accuracy and more comprehensive reporting,” said Dr. Rupali Chopra, Lab Director, Igenomix Dubai.

The DHA’s Health Regulation Department revealed that the private medical field in Dubai is going to witness a growth in the next few years leading to 2020. Earlier this week, the authority said that the number of private medical health facilities in Dubai have witnessed a four per cent increase in the second quarter of this year compared to the first quarter, totalling the number of private health facilities to 3,018. They include 26 hospitals, four fertility centres, 34 one-day-surgery centres, 1,624 specialised and general medical complexes, 82 dental treatment centres and laboratories, 868 pharmacies and 38 health examination and house nursing facilities. In addition to the 26 hospitals opening this year, the authority’s Health Regulation Department announced that there would be 12 new private hospitals in the next three years that will provide patients with 875 beds. This will total the number of hospitals to 38 hospitals- in addition to seven other hospitals that are undergoing expansions to include 750 beds. Meanwhile, the Health Regulation Department revealed that there are more than 36,055 licensed physicians in the medical private sector of Dubai, out of which 13,594 are new licenses.

NEWS

Ministry of Health & Prevention

hosts meeting of Supreme National Committee for Control of Non-communicable Disease

he Ministry of Health and Prevention recently hosted the meeting of the Supreme National Committee for the Control of Non-communicable Diseases in Dubai. Chaired by H.E. Dr. Hussein Abdel-Rahman Al Rand, the Ministry’s Assistant Undersecretary for Health Centers and Clinics Sector, and Dr. Buthaina Abdullah bin Belaila, head of the Supreme National Committee for the Control of Non-communicable

Diseases, the meeting was attended by representatives from Dubai Health Authority (DHA), the Abu Dhabi Health Authority, the Ministry of Education, academic institutions, the National Information Council, Friends of Cancer Patients, General Authority of Islamic Affairs And Endowments, Roads and Transport Authority and Municipalities, Emirates Authority for Standardization and Metrology and the World Health Organization (WHO).

a world-class health system in the country, and provide universal health coverage to protect the UAE society from non-communicable diseases.

H.E. Dr. Al Rand said that the National Plan for Non-communicable Diseases is designed according to the National Strategy to Combat Non-communicable Diseases for 2017-2021. The strategy seeks to reduce local cases of cardiovascular diseases, diabetes, cancer, and respiratory illnesses in line with the UAE Vision 2021 National Agenda, which aims to build

Dr. Ebtehal Fadel, the public health expert, also presented the role and functions of the members of the Higher Committee and the organized seminars to discuss achievements, challenges and follow-up guidelines and standards—serving as a follow-up to WHO’s goal of achieving a 25 per cent reduction in non-communicable disease mortality by 2025.

Dr. Buthaina Abdullah bin Belaila pointed out that the meeting also saw the review of the national plan for non-communicable diseases and the activities and measures that were agreed upon and later to be enforced by all the participating parties.

... and successfully screens 453 women as part of its free breast cancer screening campaign Dr. Ayesha Abdullah, head of the Early Breast Cancer Screening Campaign Team, noted that the campaign successfully oversaw the screening of 241 women in Dubai at Festival City, and the Mall of the Emirates. 156 women were successfully screened in Sharjah at Sahara Mall and Mega mall, and 55 women were screened at Ajman’s City Health Centre. The campaign continued to Umm Al Quwain the 7th to the 8th of June at Al Khazan Health Centre, and moved to Ras Al Khamiah Mall for the 11th and 12th of June. The campaign concluded at Fujairah City Centre from the 14th to the 15th of June.

017 as the Year of Giving The Ministry of Health & Prevention (MOHAP) announced that it has successfully examined 453 women of all nationalities, since the launch of its free breast cancer screening campaign. The campaign was launched to raise awareness about the importance of detecting cancer in its early stages. It was scheduled to continue until 15 June, and supports the wise leadership’s declaration of 2017 as the Year of Giving.

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As part of the campaign, the Ministry has also set up a mobile clinic to facilitate mammograms. The clinics were equipped with specialized medical and technical staff, and will be operational from June 21. Participating women were able to receive their results once the mammogram is complete. Educational pamphlets and newsletters were distributed among the participating women. They were also be provided therapeutic counseling, according to the highest international standards.

NEWS

Ministry of Health and Prevention unveils counterfeit drug detector

relevant policies also aim to empower domestic drug inspectors and authorities responsible for the release of medicines in ports and airports and post offices at the country level and border crossings.

Rollout of counterfeit drug detector in all ports and 4 devices are currently in use

he Ministry of Health and Prevention has unveiled the state-of-the-art TruScan RM Analyzer, a modern technology used to detect counterfeit or low-quality drugs posing great health threats to the community. The high-tech device is especially helpful to patients suffering from chronic diseases, ED, heart ailment, and cancer, as part of its ongoing commitment to providing universal health coverage and social protection for all individuals. TheTruScan RM analyzer also enables drug inspection teams in the country to make informed and timely decisions concerning the release of all drug shipments entering the UAE.

UAE’s proactive and precautionary measures H.E. Dr. Amin Hussein Al Amiri, the Ministry’s Assistant Undersecretary for Public Policy and Licensing, said the country has been fighting the spread of counterfeit medicines in the local market by implementing preventive measures, building a quality control laboratory, and conducting research on medical and other health products. The country’s

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Ministry-employed pharmacists stationed in land, air, and seaports are presently using the TruScan RM Analyzer. The Ministry is planning to roll out the device in all local ports as it moves to employ more drug inspectors to prevent counterfeit and low-quality medicines from being distributed across the UAE. He also pointed out that the devices were distributed between Abu Dhabi Airport and Abu Dhabi Post and the border ports in Al Ain and Dubai International Airport.

Reduction in chemical exposure and lesser laboratory costs According to H.E. Dr. Al Amiri, the device performs accurate, reliable, and rapid verification of a broad range of chemical compounds. Significant information is stored in the device’s database to be used to identify and verify samples. Weighing less than 900 grams, TruScan is easy to carry and use and it gives clear results in seconds depending on Raman radiation. Further, through the device, inspectors can examine the chemicals without the risk of contamination and exposure, while minimizing costly laboratory sampling tests. H.E. Dr. Al Amiri disclosed that the Ministry will organize workshops and training programs for drug inspectors, as well as build an up-to-date

medicine database – from locally registered veterinary to human drugs – to guarantee proper device usage.

Accreditation of international bodies and pharmaceutical firms Many international organizations are currently using TruScan RM Analyzer. These include the US Food and Drug Administration (FDA), the Saudi Food and Drug Administration (SFDA), the UK Medicines and Health Care Products Agency (MHRA), in addition to pharmaceutical companies Sanofi, Novartis, Merck, and Pfizer, among others. The distribution of counterfeit drugs may greatly impact the world’s medicine system and may lead to loss of public confidence in the international healthcare sector. The World Customs Organization (WCO) has placed the value of counterfeit medicines at USD 200 billion a year globally. Intensive campaign vs fake drugs The Ministry of Health and Prevention has been issuing weekly and monthly circulars to warn people against counterfeit medicines. It assured that a robust system is in place to closely monitor all pharmaceutical products entering the country. Additionally, the Ministry said it keeps abreast of the latest warnings being issued by concerned international bodies. The UAE has become one of the world’s leading countries that are fighting the distribution of fake medicines, according to the reports of international organizations, including the Uppsala Medical Monitoring Center of the World Health Organization.

NEWS

Cleveland Clinic Abu Dhabi Completes Successful Kidney Transplant UAE National Son Donates a Kidney for his Mother during “Year of Giving”

hysicians at Cleveland Clinic Abu Dhabi successfully completed a kidney transplant operation in May, taking the hospital another step towards providing full transplant facilities in line with the recent changes in UAE legislation.

than 25 years, Dr. Sankari has performed more than 1,000 kidney transplants during his career. The patient was offered the opportunity to travel abroad for the transplant but opted to remain in the UAE, citing the family’s preference to be treated closer to home.

The surgery was the first kidney transplant conducted at Cleveland Clinic Abu Dhabi. The patient, Moza Salem Almansouri, a 73-year-old UAE national who suffers from both diabetes and hypertension, received a new kidney that was donated by her son, Sultan Saeed Altamimi. Following the successful operation, she will not have to undergo dialysis treatment and will enjoy a significantly improved quality of life.

“We decided to stay in the country and do the surgery at Cleveland Clinic Abu Dhabi because I trust that our medical staff and our services are among the best in the world. Our leadership is working relentlessly to elevate our healthcare services and infrastructure to world-class standards,” explained Sultan Al Tamimi, the patient’s son and kidney donor. “My mother’s condition continues to improve. She visits the clinic regularly for medical check-ups and the results are so far so good. Our entire family is very happy to see her improvement.”

Dr. Bashir Sankari, Chief of the Surgical Subspecialties Institute at Cleveland Clinic Abu Dhabi, who was lead surgeon for the operation, explains: “By coming to the hospital for a pre-emptive transplant before needing to commence dialysis treatment, the patient has been able to add both quality and quantity of life. Cleveland Clinic Abu Dhabi aims to bring multidisciplinary expertise in a range of fields to the UAE, and this first successful transplant operation demonstrates the huge positive impact that these operations can offer.” A veteran of Cleveland Clinic for more

Sultan agreed to donate his kidney to his mother without any hesitation. He said: “This is also the Year of Giving in the UAE, which corresponds to our true nature as a nation. Donating a kidney is something small, compared to all she has given to our family throughout her life.” After being discharged from the hospital, the patient now receives regular follow-up from a broad care team of physicians, social workers, dietitians and transplant coordinators at Cleveland Clinic Abu Dhabi to help her continue her journey to better health. More than 2,000 patients in the UAE currently undergo regular dialysis treatment for kidney diseases. Patients who choose to have transplant surgery before reaching the dialysis stage typically enjoy better outcomes and better survival rates, so the expansion of transplant facilities is another positive development in the nation’s healthcare sector. The UAE has made significant progress in the legal framework surrounding organ transplants in recent years. The National Organ Transplant Committee is also developing a system to allow residents to register as possible donors via their Emirates ID Card. Cleveland Clinic Abu Dhabi has been developing extensive transplant facilities to support a full range of transplant operations. Transplant patients benefit from Cleveland Clinic Abu Dhabi’s unique group practice model, which brings together a broad spectrum of specialists from a variety of disciplines to deliver the best possible patient outcomes.

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NEWS

American Hospital Dubai

offers breakthrough cancer radiotherapy treatment

merican Hospital Dubai announced that it has successfully treated more than 10 cancer patients with the leading-edge CIVICO trUpoint ARCH SRS / SRT and Body Pro-Lok ONE SBRT Immobilization Systems, which are designed to deliver radiation therapy to cancer patients. With the arrival of these new systems, American Hospital Dubai is able to offer cancer patients in the UAE and the region, regionally unprecedented radiation oncology procedures that spare them the need for conventional surgery and a lengthy recovery. This type of Radiotherapy treatment is a noninvasive (no surgery involved) treatment process that administers very high beams of various intensities aimed at different angles to precisely target the tumor, while completely immobilizing the patient. With this breakthrough treatment, American Hospital Dubai has made the radiation treatment of cancer cases much shorter than conventional radiation, as a few sessions are able to destroy tumors, and offer new hope for patients including those suffering from brain, breast and prostate cancer. Commenting on this, Dr. Tarek Dufan, Director of the Radiation Oncology Department, American Hospital Dubai said: “This patient milestone we have taken at American Hospital Dubai demonstrates the team’s hard

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work and effort to give our patients new hope and offer them the most advanced technologies available. The leading-edge CIVICO trUpoint ARCH SRS / SRT provides superior immobilization for a variety of brain, head and neck radiotherapy treatments, while the Body Pro-Lok ONE SBRT Immobilization System, helps keep the patient in a completely still state, allowing for accurate position of the target.” “We have already seen great improvements and success from treating our patients with these systems.” He added, “I have no doubt that they will prove to be a choice of many more patients, given their ability to effectively target and treat cancer cells in few treatment sessions only, and with sub-millimeter precision, while keeping the disruption to patients’ daily lives minimal.”

Moulds and masks (immobilization)

When patients receive radiation therapy, it is imperative that they are completely immobilized throughout the treatment. Hence if the cells are in a body part, patients are requested to lie on the special radiotherapy bed, which molds into the exact shape of

the patient’s body. However, if the radiology treatment is on the head area, the patient is required to wear a unique head mask specially designed to meet the unique requirements of patient immobilization for radio therapy. The CIVICO trUpoint ARCH SRS / SRT head frame is engineered to work with the unique physics of proton beam transmission. It is designed to improve the penumbra for most treatment beam angles. The CIVICO’s Body Pro-Lok ONE SBRT Immobilization System™ provides an easy-to-use modular system for complex SBRT setups. The system features the only bridge worldwide that allows variable height adjustment, and lateral and tilting offset capabilities, enabling the bridge and respiratory plate to adapt to the patient’s natural posture and body type. American Hospital Dubai is the first medical institute in the region to offer this type of accurate cancer treatment, and hence opening up a whole new chapter for cancer patients in the region.

Side Effects

Moreover, it is important to note that SBRT targets the tumor very precisely and the risk of damage to normal surrounding tissues is low. Therefore, the side effects may be less than with other types of radiotherapy.

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Boehringer Ingelheim’s EMPA-REG OUTCOME®

long-term trial improves understanding of type 2 diabetes and cardiovascular diseases

oehringer Ingelheim, one of the world’s leading pharmaceutical companies, held an event to launch their latest innovative type 2 diabetes treatment in Lebanon. The event brought together leading experts in internal medicine and primary care physicians to highlight the latest innovative, convenient medical solutions and findings in cardiovascular implications related to type 2 diabetes.

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The leading experts also presented the latest findings of the EMPA-REG OUTCOME® Trial, a dedicated cardiovascular outcomes trial in people with type-2 diabetes and established cardiovascular disease. The trial took place in 590 clinical sites in 42 countries with 7,020 participants and was observed for a median duration of 3.1 years. EMPA-REG OUTCOME® Trial5 impressive results lead the major health authorities of the world, of which EMA AND

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FDA, to grant for the first time additional indication for the reduction of the risk of Cardiovascular death in T2D patients and established CVS diseases.

Dr. Antoine Sarkis – M.D. FESC Professor of Cardiology Hotel dieu de France Hospital – Beirut, Lebanon

The combination pill of Empagliflozin and Metformin hydrochloride – Synjardy is now available in Lebanon, to improve patient compliance and adherence to type 2 diabetes treatments and address the management of cardiovascular implications related to type 2 diabetes, reducing the relative risk of cardiovascular death, and offering more protection for patients, whilst reducing blood glucose, body weight and blood pressure in patients.

Dr. Antoine Sarkis is a Professor of Cardiology at the Hotel Dieu De France Hospital in Lebanon. He is also a Professor of Cardiology at the St Joseph University, and a member of the Lebanese Society of Cardiology. Dr. Sarkis is a Fellow of the European Society of Cardiology and the President of the Association Franco-Libano-Belge de Cardiologie.

Today, healthcare professionals treating patients with type 2 diabetes in Lebanon can now prescribe this medication used to manage type 2 diabetes for those who are diabetic and have established cardiovascular disease. Despite advances in care, cardiovascular disease is still the number one cause of death among people with type 2 diabetes. In Lebanon, 47% of deaths are due to cardiovascular disease and is the primary reason for hospital admission due to a variety of social, economic and political factors. The risk of dying from cardiovascular disease is up to four times higher in people with diabetes. Further, approximately one in two people with diabetes worldwide die due to cardiovascular disease. Dr. Mounzer Saleh, Former President of the Lebanese Society of Endocrinology Diabetes and Lipids said, “The continuous change of lifestyle in Lebanon has led to striking increase in rates of type 2 diabetes. Lifestyle interventions and adherence to medications are central to disease prevention and management. Cardiovascular disease is the number one cause of death in people with type 2 diabetes worldwide and reducing cardiovascular risk, including death, is an essential component of diabetes care that was missing in older treatment interventions.’’ “The relationship between diabetes and CVD is complex; diabetes is a risk factor for CVD and conditions such as high blood pressure and obesity, that are more common in people with diabetes, are also risk factors for CV disease. Reducing cardiovascular risk is an essential component of diabetes management and so patients need to be better educated on how to modify cardiovascular risk factors in order to offer the best chance of improving CVD out-

An international speaker, Dr. Sarkis has over 20 publications in peer-reviewed journals as well as more than 20 abstracts and posters. Moreover, Dr. Sarkis has also been featured as an investigator in internationally published studies, and advised on topics that include proactive multiple cardiovascular risk factor management, and management of acute coronary syndromes in developing countries. He received his CES in Cardiology from Pierre et Marie Curie University in France in 1986 along with a diploma in Echocardiography from the same university. comes.’’ said Dr. Antoine Sarkis, Professor in Cardiology at the Hotel dieu de France Hospital, Beirut, Lebanon. Dr. Mounzer Saleh, also noted, “The complex interaction of risk factors for type 2 diabetes, makes it necessary to apply a holistic approach to the management of this chronic disorder. The latest treatments offered, JARDIANCE® & SYNJARDY®, are shifting the mind set by not only focusing on lowering blood glucose levels in patients but also offering cardio-protection by reducing the relative risk of cardiovascular death by 38% on top of standard of care in adults with type 2 diabetes and established cardiovascular disease. Patient Knowledge of cardiovascular disease in Lebanon is scarce and so there is the need to work closely with the primary care service and government bodies, to obtain and align better outcomes for the population which has a high profile of cardiovascular risk factors.” Moreover, Fouad Jeweidi, Country Head Levant, Boehringer Ingelheim said, “Robust research & development (R&D) has always been the guiding principle that has enabled us to discover and develop innovative methods to help support patients manage type 2 diabetes more effectively. We continue to invest in R&D excellence through research and collaboration, a broad and growing product portfolio and

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Dr. Mounzer Saleh Former President of the Society of Endocrinology, Diabetes and Lipids Dr. Mounzer Saleh graduated from the American University of Beirut Medical Center in 1988 and since that time he is a staff member at the Division of Endocrinology and Metabolism American University of Beirut Medical Center, teaching medical students, interns, residents and fellows in addition to his clinical activities, which include a busy private clinic, and hospital admissions. He is also a member of many local and international societies (American endocrine society, American association of clinical endocrinologists and many others). Dr. Saleh’s activities include lectures to physicians in Lebanon and abroad, he also contributed in the preparation for many local and regional conferences. At the level of research he contributed in several local and international studies. He is the former president of the Lebanese Society of Endocrinology Diabetes and Lipids.

a continued determination to provide real solutions, to ultimately make life better for all those affected by diabetes.” Those who have type 2 diabetes have a higher risk of heart disease and stroke. Studies have shown that optimal blood glucose levels, along with the control of hypertension, weight loss and quitting smoking, are all necessary to reduce cardiovascular risks in type 2 diabetes patients. In particular, those who have diabetes and hypertension, the risk of cardiovascular disease doubles. Regular checkups can help patients living with type 2 diabetes and help to reduce adverse outcomes such as cardiovascular diseases associated with diabetes. Although the EMPA-REG OUTCOME® trial was not designed to assess the potential mechanisms behind the effect of empagliflozin on kidney outcomes, the kidney assessment was part of a pre-specified exploratory analysis plan of additional endpoints. The overall safety profile of empagliflozin was consistent with that of previous trials.

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•

Boehringer Ingelheim’s EMPA-REG OUTCOME® Trial is a dedicated cardiovascular outcomes trial in people with type 2 diabetes and established cardiovascular disease.

•

The combination of Empagliflozin and Metformin Hydrochloride (Synjardy) offers new convenient medical solutions to Boehringer Ingelheim’s type 2 diabetes portfolio.

•

Cardiovascular disease is the number one cause of death among people with type 2 diabetes, accounting for 52% of deaths in type 2 diabetes worldwide.

•

There were 464,200 cases of diabetes in Lebanon in 2015, and 47% of deaths in Lebanon are due to cardiovascular disease.

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Type 2 Diabetes has a major public health impact through high disease prevalence in Lebanon, significant downstream pathophysiologic effects, and enormous financial liabilities.

H.O: Sami el Solh Av. - Ghorayeb Bldg l T: +961 1 389067 l F: + 961 1 389379 P.O.Box: 166 - 116 AshraďŹ eh, Beirut 1100 - 2100 Lebanon l marketing@victoire.com.lb

NEWS

Expert in lung transplantation joins

Baylor St. Luke’s Medical Center

r. Gabriel Loor, a cardiac surgeon whose research focuses on maximizing donor organs for lung transplant recipients, has joined Baylor College of Medicine as director of lung transplantation in the division of cardiothoracic transplantation and circulatory support in the Michael E. DeBakey Department of Surgery. He will conduct surgeries at Baylor St. Luke’s Medical Center. “I am extremely excited to join the heart and lung transplantation team at Baylor College of Medicine and Baylor St. Luke’s Medical Center,” Loor

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said. “I’ve been very attracted to the developments in Houston, and I’ve been impressed by the way everybody approaches patient care, research and

everyday life. There is a high level of excellence, and the incredible collaboration between Baylor, Catholic Health Initiatives and Texas Heart Institute is

NEWS

plantation in the Midwest in 2014. The portable device, the TransMedics Organ Care System, which houses the lungs, originally was developed in Boston. It has a miniaturized ventilator system and pulsatile pump that delivers blood flow through the organ. A Bluetooth monitor allows for regular readouts of how the organ is performing. The System is in the final stages of the FDA review process following the completion of two international clinical trials. “In the past, all we’ve been able to do is cool the lungs down, put them on ice and transport them, and we have a certain amount of time to do that. But with this device, we’ve been able to have them outside the body for up to 12 hours or longer. That amount of time lets us understand how good the quality of the lung is, deal with logistics and ensure we can get the transplant in and allows the team to operate when they are well rested,” Loor said. “It also gives us time to consider other types of treatment we can use to improve the quality of the organ.”

sure to enhance advanced heart and lung care in the region and the world.” Loor is the national principal investigator on several trials using ex vivo lung perfusion, or the process of preparing donor lungs outside of the body for transplantation. Because of a renewed interest in understanding ways to optimize donor organs, including the heart, lungs, liver and kidneys, technological innovations have enabled physicians to house donor lungs in a sterile chamber outside of the body for 12 to 24 hours. Loor is credited with the first of this type of “breathing lung” trans-

The landmark international trial of this device, the INSPIRE trial, found that in those lungs where this device was used, there was a 50 percent reduction in graft dysfunction, a lung injury that is common after lung transplantation. Patients who received these transplants also were off the ventilator and out of the hospital sooner. The next phase in this research, the EXPAND trial, currently is looking at why surgeons are only able to use 20 percent of the lungs that are offered for transplantation and exploring use of this technology to utilize more donor lungs. Loor serves as the international principal investigator for this study and is credited with the first EXPAND lung transplant in the

world. This work allows surgeons to offer high quality transplantation to patients suffering from diseases such as pulmonary hypertension, idiopathic pulmonary fibrosis, chronic obstructive pulmonary disease, cystic fibrosis or any end stage lung disease before they become too sick for transplant. As co-chief of adult cardiac surgery at Baylor St. Luke’s Medical Center, Loor will work closely with Drs. Joseph Coselli, Joseph Lamelas and Todd Rosengart to expand surgical quality initiatives. Loor’s expertise in adult cardiac surgery includes coronary revascularization, complex re-operative surgery, valvular repair and replacement and endovascular surgery. Loor also has done work to address the issues of blood conservation and bloodless surgery and has published numerous articles on this topic. “Dr. Loor represents the first-class, cutting edge academic surgeon that we are so thrilled to have been able to recruit to the Michael E. DeBakey Department of Surgery. I have no doubt that he will make highly impactful contributions clinically and by innovation,” said Dr. Todd Rosengart, chair and professor of surgery at Baylor who also holds the DeBakey-Bard Chair in Surgery. Loor is a Fellow of the American College of Cardiology and member of the Society of Thoracic Surgeons and the International Society for Heart and Lung Transplantation. Loor is fluent in Spanish. He will see patients at Baylor St. Luke’s Medical Center Heart and Lung Clinic in Houston, Texas. For more information contact International Services at Baylor St Luke’s Medical Center Via email at international@stlukeshealth.org or call +1 832 355 3350 or visit StLukesInternational.org Texas Medical Center, Houston, Texas - USA

ARTICLE FEATURES . HER life after cancer treatment

How does a womanâ€™s life go

during and following breast cancer treatment?

any women with breast cancer pose this question, since once the doctor confronts her with the reality of her illness, her psychological suffering starts even before her physical one. Subsequently, she is overwhelmed by a flood of melancholic thoughts, especially that she is vulnerable to the loss of her female parts, namely her breasts first, and then her hair, which will fall during chemotherapy. However, there is no need to worry anymore. Medical and scientific research in recent years has been focusing on improving the quality of life for cancer patients during the treatment phase.

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Breast cancer patients have the largest share in this area of research, as new mechanisms and ways are being discovered to limit womenâ€™s loss of the most important elements of femininity. Therefore, their psychological status improves with the improved chances of recovery and escape from the claws of this horrid disease via guided, immunological, and other modern treatments. Itâ€™s most certain today that a strong relation exist between the psychological side of a cancer patient and his/ her response to treatment. And more particularly, the psychological condition of a breast cancer patient is one

of the most important ingredients for the success of treatment and healing of the patient. The strong will of the patient contributes to stimulating the immune system and supporting the treatment with the feeling that she is capable of defeating the illness. On the other hand, despair and living in a state of depression (feeling that the diseases will overcome the patient) will reflected negatively on the nervous system of the patient, causing it to secrete stress hormones, which affect the immunity system that resists cancer and cooperate with the treatment. Breast reconstruction and scalp cooling to prevent hair loss during chemotherapy are the most import-

ARTICLE FEATURES . HER life after cancer treatment

ant steps towards successful treatment and full recovery of breast cancer. These treatments are combined with the latest medical findings, e.g. guided treatment and other immunotherapy associated with chemical and radiation treatments according to treatment protocols used globally. The most important step remains the early detection and periodic follow-up with a doctor to conduct radiographic and mammography annually. Also, breast self-examination every month at the end of the menstrual cycle is important to observe any change that may affect the breast.

Today, every woman with cancer who had to undergo mastectomy is able to reconstruct her breasts immediately after mastectomy without any significant effect on the treatments she will undergo later on. In one operation, the surgeon will remove the cancer, and then the plastic surgeon, accompanied by the specialist doctor, will perform the reconstruction directly, which means that the patient will not lose any element of femininity. This step that is very important, as it boosts the psychological condition of the patient and helps her throughout the treatment.

Breast Reconstruction

Recent studies in this field emphasize the importance of cooperation between the oncologist and the plastic surgeon who should operate together during to reach satisfactory results. However, the patient has two options in this regard: either reconstruction is performed immediately after mastectomy, or the patient can wait until after the end of the radiation therapy after mastectomy. This great progress in other medical fields has contributed to the transformation of this surgery to cosmetic - reconstruction surgery, in which the surgeon seeks to remove the tumor with cosmetic breast reconstitution. This operation is more superior and more positive than it was before the operation.

Itâ€™s part of cancer treatment, and not just cosmetic surgery. Recent studies have shown that breast reconstruction contributes to the increased healing of breast cancer patients and reduces the recurrence of the disease. It is best to perform the reconstruction directly with mastectomy. This operation has proved to be the best way for womanâ€™s psychological condition compared to the option of leaving a woman without breasts following mastectomy. The first of these achievements was in the field of breast reconstruction. It is worth mentioning here that this step was first taken by the Lebanese Ministry of Health, which promised every woman who undergoes mastectomy a breast reconstruction surgery immediately after mastectomy.

But, when is the breast completely removed? The surgeon and therapist take this step when the diameter of the tumor is 3 or 4 cm. A tumor this big requires complete removal of breasts and the axillary nodes, which are the first gates for tumor transfer. In advanced cases of breast tumors, the tumor is inclusive of all breast with inflammation and ulceration on the skin, which calls for chemotherapy as well as palliative surgery to the breasts. In cases of advanced breast cancer, the patient is given about three doses of chemotherapy prior to surgery, provided that the doctor should re-establish the condition to decide the need for complete mastectomy, followed by chemotherapy. The process of breast reconstruction following mastectomy does not only mean filling the void with some filling. It is rather reconstruction the breast to what it was to restore the essential part of womenâ€™s femininity, thus providing psychological support before physical support during the treatment stage after the eradication of the tumor. Recent studies in this area have concluded that breast reconstruction contributes to the healing of breast cancer patients and decrease the chances of cancer recurrence.

Breast surgery has undergone remarkable developments over the last decade. In the beginning, this operation caused complete deformity in and around the breast region, causing psychological and social problems for patients as a result of living without her breasts and the effects of deep lingering scars.

ARTICLE FEATURES . HER life after cancer treatment

Scalp Cooling Cap

It also gives hope to women that after chemotherapy and pre-mastectomy treatment, breast reconstruction will reduces the burden of the disease. Breast reconstruction takes many forms, including the silicone breast implants instead of the excised breast, depending on how much fat is taken from any area of the body and injected into the partially-removed breast area. Artificial breast implants can be used to place natural removed breast. Today, only silicon-made breasts, whether stuffed with silicone gel or stuffed with a saline solution, are available. A silicone breast filled with a saline solution, consists of a flexible capsule with an outer shell made of silicone material and filled with a solution of sterile saline. Some of these breasts are already filled by the manufacturer, while other types come empty and then the surgeon fill them during the operation according to the size the woman chooses. Silicon-coated breasts is the other category of synthetic breasts consisting of a flexible capsule made of silicone material, filled with silicone fluid of various sizes, with either a relatively soft or hard envelop. The fillings are chosen according to several criteria. The shape of the patient’s body and her choice of breast

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size are taken into consideration. It is also important to know what fillings are used in breast implants. As for the nipple, it is reconstructed by planting dark skin, using the other nipple of the healthy breast and removing part of it to use it for the reconstruction of the second nipple or the use of a tattoo technique. On the other hand, the surgeon can take from the abdominal muscle and fat or from the back muscle to reconstruct the breast. It is best to perform the reconstruction directly with the mastectomy, which proved to be the best way to boost women’s psychological condition, compared to the option of leaving a woman without breasts following mastectomy. Many studies in this regard have praised the final form of women after the reconstruction process and its active role in helping women resume their normal life and re-engage in society. In most cases of breast tumors, tumor removal and radiotherapy is equal to complete mastectomy when it comes to the return of the disease or death caused by it. At present, there is no need for complete mastectomy except in some cases deemed unsuitable for partial mastectomy, either to detect the disease at an advanced stage or for reasons that prevent women from receiving radiation therapy.

Hair loss for women carries a lot of psychological trauma, and has a great emotional impact on her life. The cap cools the scalp by reducing blood flow to the hair follicles, and reducing the absorption of chemical toxins. The cooling cap should be placed before chemotherapy for half an hour, and during treatment and after completion. The latest achievement of modern medicine lies in cooling the scalp with a specialized cap when breast cancer, or other cancers, patients undergo chemotherapy sessions to help them avoid hair loss. In a clinical trial involving more than 200 women with breast cancer, researchers found that more than half of those who used the “cooling cap” on their scalp during their 4 sessions of chemotherapy retained their hair. It was stressed that not all patients could use the cap, depending on the condition of the disease in general. It is necessary to mention herein that hair loss for women carries a lot of psychological trauma and has a great emotional impact on her life. Therefore, it was necessary to find a way to reduce this painful negative impact. The scalp cooling cap is used either as a cool gel or a cooling pump system to lower the head’s temperature. Experts believe it can significantly reduce the risk of hair loss, and studies are considered the first to conduct randomized controlled trials to review evidence and evaluate the effect of scalp cooling on hair loss. The technology works by reducing blood flow to the hair follicles, reducing the absorption of chemotherapy toxins, provided that the cap is wore half an hour before the start of treatment, and during and after

ARTICLE FEATURES . HER life after cancer treatment

Experiments show that about 51% of patients who received scalp cooling during treatment retained at least half of their hair. The second study at the University of California, San Francisco, found that 122 patients, with two thirds of them using the scalp cooling caps, all women who did not wear the cooling cap lost all their hair.

ARTICLE FEATURES . HER life after cancer treatment

Psychological support for breast cancer patients Boosting the psychological status increases the immune resistance to diseases and contributes to the healing of the patient. Despite the amazing advances in breast cancer medicine and early detection mechanisms, it is no surprise that when a women finds out she has breast cancer, the news can be greatly shocking for her as well as for her family, friends, and others. However, it is necessary to focus on the importance of providing the necessary psychological support for the patient, because such support is very important and effective in the proportion of successful recovery. Psychological support, accompanied by the modern treatment protocols of treatments and reconstruction, and others, highly contributes in the possibility of women overcoming their disease, living healthily, and converting negative energy to positive. Studies nowadays are discussing the importance of the psychological side and its role in strengthening the immune system to fight malignant tumors. Recent studies in the last decade have focused on the link between the psychological side and its role in achieving a high rate of cancer recovery by raising patientsâ€™â€™ morale. Modern medicine has discovered that control of the disease is not limited to modern treatments, as psychological support play an important role in increasing the recovery rate. Itâ€™s been established that the psychological situation of a patient has a significant impact on their immune system. Psychological trauma and leading a dull, depressive lifestyle are a cause of tumor generation. Such conditions weaken the immune system and make it easy for the tumor to appear. Still, the result is different for each

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woman depending on the psychological support of the husband, children, family, and friends. The greater the psychological support, the greater the disease resistance, since high psychological support boost the immune system and enables it to response to the treatment protocol greater than others. The psychological aspect gets great attention at breast cancer treatment centers. Women are usually accompanied by a competent team to provide psychological support, especially as the breast cancer patient undergoes many psychological stages, starting with receiving the shocking news of cancer, and going through the stages of treatment and side effects. However, this support does not end with recovery, because the patient should keep taking medications and be periodically reviewed to ensure that the disease does not reappear at least in the first five years of recovery. Psychotherapy by competent specialists during the stages of treatment of breast cancer contributes greatly to the improvement of the patient health condition. It helps the patient to accept the disease and adapt to the accompanying physical or psychological changes in daily life. This psychological support helps the patient overcome the stress and the fear, especially since the psychological support team provides the necessary explanation for the

nature of the disease and what will go on. According to the figures, 30% to 40% of the psychological stability of tumor patients reflects positively on their health, as scientific studies have shown that the psychological state of the patient is one of the most important elements of his recovery and success of treatment. The role of family and friends is no less important than the psychological support that the patient receives in the hospital. Such support is essential, because the patient spends most of her time with her family, thus they need to know what changes the patient will undergo, and provide help and psychological support. Individuals around the patient should first be willing to accept changes that will affect the patient, whether physical or mood changes, since the treatment might make her nervous and stressful all the time. Here, they should encourage her to exercise light due to the positive impact of sport on the psychological and health status. It is also necessary to reduce the patient daily burden, as the family can participate in preparing food and taking care of young children. The patient should also be helped to relax and accept the situation. She should be reassured that her illness will not affect how everyone loves her, especially from the husband, who should seek to calm her fears, encourage her to receive treatment, and help her endure the symptoms.

INTERVIEW

The idea that patients can do rehabilitation exercises at home on their own is wrong.

Please, tell us about the organization of remote rehabilitation?

Konstantin Lyadov Member of the Russian Academy of Sciences, Director of the Medsi Group Treatment Cluster, Head of the Research Team that developed this Russian innovation The Eurasian Orthopedic Forum featured a number of workshops presenting leading edge practices in various areas of orthopedic traumatology. One of the workshops concerned remote-control rehabilitation. Prof. Konstantin Lyadov. Konstantin, why did you decide to develop this remote rehabilitation technology? The need was long overdue. Traumatologists and orthopedists have taken hold of ever increasing number of effective surgery techniques using cutting-edge technologies. However, we need to ensure that results are retained and physical/ psychological recovery is taken care of postoperatively. The issue goes full-blown when the patient gets discharged, but cannot visit rehabilitation center because of the mobility limitations. Furthermore, not every center can boast qualified professional rehabilitation staff.

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We named the technology remotecontrol rehabilitation, as it is based on continuous online control of the process by an instructor. To begin with, we use special routine to select patients. After that, a medical professional and medical technicians come to the patientâ€™s house to install special medical equipment and everything for Internet video conference calls. They instruct the patient and patientâ€™s relatives on the rehabilitation process. We design a 21-day program and schedule the time when the patient and the instructor meet online. The instructor makes the patient feel constant support, as the latter can always ask any question that is bothering him or her, and the instructor will refer the issue to the respective specialist (a clinical psychologist, speech therapist, neurologist, endocrinologist, physiotherapist, etc.) to discuss results and adjust the physical activity level. After the rehabilitation period is over, a group of medical professionals estimate the obtained results based on an international scale. In addition, they visit the patient at home on the last day of rehab to examine and estimate his/her condition, which is followed by equipment removal.

INTERVIEW

What group of patients is this method intended for? It is intended for a wide range of motor and cognitive disorders. We used it to help patients after strokes and arthroplasty, severe brain and spinal cord damage, complex hip/ upper limb/shoulder surgeries. Using this method, we cut inpatient care costs keeping the care quality unaffected and making the rehabilitation more comfortable for the patient, as it takes place at home. According to our estimates, 2-week-long rehab for the second stage in Russia requires 44 to 48 thousand rubles, while the remote rehab course takes only 22 to 24 thousand rubles. Remote control makes rehab available for many more patients, saves time, funds and other resources that can be, thus, allocated to the patients with the most severe cases needing second-stage in-patient rehabilitation. On the other hand, the technology may be used in surgical, gerontological centers, sanatoriums, nursing homes for the elderly, as well.

Are there any similar technologies? No, itâ€™s unique for Russia and has no rival in the world. We made our first international presentation of the technology two years ago, during a conference in Glasgow, and our foreign colleagues doubted its economic feasibility

suggesting remote instructorâ€™s work will be very expensive to organize. However, we proved social, clinical and financial efficiency of the technology. Development of all the methodological solutions is complete. We are sure that remote-control medical rehabilitation can successfully replace a certain part of in-patient services and are willing to share the experience. There is a number of medical areas, where Russia leads and the world follows. I hope, remote rehabilitation will become one of them. Moreover, innovative mobile equipment was designed by Russian engineers especially for this method.

What innovative features does the equipment have? Ortorent Production Company cooperating with our research group offers a complex solution for remote-control rehabilitation. It also provides technical support of the project in Russia. Currently, there is a 15-machine series for mechanic

therapy to restore motor function using special software. We plan to further expand the series. The machines are different from similar imported devices, as they are able to generate treatment regimen records giving feedback to both the patient and the doctor. It can be used for a patient of any height, even a child, and set to change physical activity level via remote control. The manufacturer is going to obtain CE certificate soon. Then, export to Europe will be allowed.

How many Russian patients have already completed the remote rehab course? According to Ortorent, about 2,500 patient have completed the rehab using their equipment during 4 years of the project development. We started using the technology in Moscow in 2013. The project was supported by the Department of Labor and Social Protection of Moscow. In November 2016, we successfully introduced the

INTERVIEW

remote rehab to the Reshma Medical Centre under the Federal Medical and Biological Agency of Russia in the Ivanovo Region. Since spring 2017, the doctors of Tatarstan have been mastering the method. Then, the doctors of the Perm Region joined them. The Tyumen Region and some other Russian entities expressed their interest, too. We are sure to see explosive development of remote rehabilitation in the next 2-3 years. Especially, since the Telemedicine Law was passed in Russia and the Russian Ministry of Health resolved to cover long-distance consultation services by compulsory medical insurance, as they saw its efficiency and now intend to provide us comprehensive support.

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Please, tell us what are the priorities of the research group in further development of the technology? Currently, we are working on maximizing its availability via use of mobile communications. Cooperating with the International Telecommunication Union, we have already designed a special solution and entered into a program testing agreement. It will allow using smartphones in addition to video conference and dedicated lines. Images from the smartphones will be transmitted to a computer screen, where the patient and the instructor will see each other. However, it requires a special QC system that would assure the process efficiency and safety.

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life sciences exhibitions

INTERVIEW

ESA Business School in Lebanon seeks to meet the needs of the society by offering educational programs and masters. About ten years ago, ESA launched Masters in Healthcare Management that aims to train experts on the evaluation of health actions. ‘Arab Hospital’ magazine conducted an exclusive interview with Mrs Perrine Malaud Wakim where she assured that the aim of ESA is not to establish a school of medicine but only creating unique programs that meet the needs of executives and managers in healthcare management. Can you tell us more about the Hospitals management program in ESA Business School? When was it launched? What is your aim? Since 2006, ESA has developed special expertise in health management that offers training programs, consulting and tailor-made seminars in order to respond effectively to the current problems of its partners in the sector. The Master in Hospital Management and Health of the ESA, which was established in 2006 and which 12th generation starts in 2017, was the first Master of this specialty in Lebanon and across the region. It has today more than 300 graduates who hold key positions in the sector. This year the Master was tailormade to fit more the needs of all professional in the sector and not only the hospital managers, that’s why we changed its name. The Executive Master in Healthcare Management aims to train experts on the evaluation of health actions and the steering of organizations and projects in the health, social and hospital sector.

What are the values that you want to achieve through this Healthcare Unit? We seek to achieve innovation in creating unique programs that meet the needs of executives and managers, and in this field we have implemented a quality initiative to support the 150 hospitals through trainings, site visits and a web portal.

Perrine Malaud Wakim Healthcare Unit Manager in ESA

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Also, we seek to make joint working groups, and one of the examples is writing the best practices of blood transfusion adapted to the specificities of the country

INTERVIEW

with representatives of major Lebanese hospitals. We seek to show social responsibility by coordinating public health projects and organizing events such as a symposium on “The coordination of criminal strategies, health and welfare in the treatment of drug addiction”.

Do you have any partners in Lebanon to enhance this program? ESA is a privileged partner of the main public and private players in the health sector in Lebanon: Ministry of Public Health, Syndicates of Private Hospitals, Biologists, Orders of physicians, nurses, ACAL, Scientific societies of oncology, endocrinology, hematology, pharmaceutical and cosmetic companies, insurers, hospitals ...

What do you offer through health management program? We offer a wide and progressive training in health management through: • Executive Master in Healthcare Management. • Ongoing trainings, provision of advice and customized trainings tailored to each company and branch of the health sector: For example: • Training program on pharmaeconomics for all stakeholders in order to write guidelines on oncology in Lebanon (with LSMO, MOPH, Army, CNSS…).

1. Health meetings for its network to tackle the issues of the sector (e.g.”The improvement of blood transfusion in Lebanon” or “Fighting against counterfeit drugs”). 2. Conferences and seminars (e.g. a conference on medical tourism). 3. A quality colloquium with the association LSQSH. 4. Congresses (quality sessions moderator). •

Coordination of major public projects of French and Lebanese partnerships for the improvement of the sector:

1. The design of national repositories of quality management of health facilities according to international standards and adapted to national conditions. 2. The improvement of the medication and medical devices by institutionalizing the procedures. 3. The reorganization of blood transfusion and the establishment of good working practices, based on international guidelines and adapted to the constraints of the country (Signature of an annual contract between ESA and the Ministry of Public Health in Lebanon, partnership agreements with ANSM, EFS and HAS and an interdepartmental agreement between France and Lebanon on cooperation projects in which ESA is partly operator).

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Training for journalists on healthcare.

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Corporate University on management and healthcare for the pharmaceutical branch of a Lebanese company.

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Training on e-health for diabetologists and nurses involved in diabetes treatment and follow-up.

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Trainings for pharmacists on finance, retailing and digital marketing.

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The High Authority of Health (HAS): for the accreditation of public and private hospitals.

Governance counselling for the new board and organization of an insurance company.

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The French Blood Establishment (EFS): for the improvement of blood transfusion circuits and the quality of labile blood products.

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The National Agency for the Safety of Medicines (ANSM): for the drug and medical devices.

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Coaching of Units Manager and GM.

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The organization and participation in health events including:

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Launching of a Healthcare Chair in Prevention for the MENA.

Since 2006, the Ministry of Public Health in Lebanon has initiated a process to improve the patient safety and the access to care. Lebanon has solicited France for these projects through ESA and three institutions:

NEWS

Aster DM Healthcare Unveils Global Volunteers Program to mark its 30th Year Anniversary

Aster Volunteers program comes in line with the UAE’s ‘Year of Giving’ initiative

positive difference in society. The launch ceremony in Dubai was flagged off by the representatives of H.E Abdul Rahman Bin Mohammed Al Owais, Cabinet Member & Minister of Health & Prevention – UAE,Dr. Amin Hussain Al Amiri, Asst Undersecretary of Public Health Policy and Licensing, Dr. Hussein Abdul Rahman Al Rand, Asst. Under Secretary for Health & Clinics, H.E. Dr. Salem Al Darmaki, Advisor to the UAE Minister of Health & Prevention, in the presence of Shri Vipul, Consul General of India, His Excellency Amb. Dr. Sa’ed Radaideh, Consul General of the Hashemite Kingdom of Jordan to the UAE, His Excellency Mr. Omar Abdilaziz Nur, Consul General of Somalia to the UAE,His Excellency Tayeb AlRais, Secretary General of Awqaf and Minors Affairs Foundation (AMAF) and Mr. Abdelouahab Soufane, Director of Salma Initiative. The event was also attended by key delegates from government authorities, NGOs officials and the Aster leadership, business associates and employees lead by Dr. Azad Moopen, Founder Chairman & Managing Director of Aster DM Healthcare.

ster DM Healthcare announced the launch of the ‘Aster Volunteers’ program as part of the milestone‘Aster @30’ campaign marking their 30th anniversary. In line with the declaration of 2017 as the Year of Giving by UAE President His Highness Sheikh Khalifa bin Zayed Al Nahyan, the ‘Aster Volunteers’ program reinforces the company’s commitment to supporting the communities it serves and recognizes volunteerism as a key pillar of giving.

The program seeks to bridge the gap between people who would like to help with those in need, across the nine markets that the company operates in through a web portal plat-

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form www.astervolunteers.com. The multi-layered initiative targets communities in the Middle East,Africa, India and Philippines, and aims to address key challenges that will help make a

“At Aster DM Healthcare, we want to renew our commitment of giving back to society and support the growth of communities.The Aster@30 initiative and the‘Aster Volunteer’ program are testimony to our effort to empower individuals who want to make a positive difference in the society and extend a helping hand to the less fortunate. During the Holy month of Ramadan, we call upon everyone to join us on this global journey of providing a healing touch to those in need by enrolling onwww.astervolunteers.com,” said Dr. Azad Moopen, Founder Chairman and Managing Director of Aster DM Healthcare. Aster DM Healthcare also announced signing an agreement with

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the Government of Dubai’s Awqaf and Minors Affairs Foundation (AMAF) to offer humanitarian aid to those affected by drought and famine in Somalia. As per the agreement, Aster DM Healthcare, donated156,217 packets of halal meals valued at AED1.5 Million, raised through the contribution of Aster employees across the network. The Salma Humanitarian Relief Program, an initiative pioneered by the Dubai Islamic Economy Development Centre and managed by AMAF, will ensure the distribution of meals to drought-stricken Somalians in June and July 2017. Speaking on the agreement, His Excellency Tayeb Al-Rais said: “Drought, hunger and famine threaten the life of one out of every three people in Somalia due to the acute lack of water and food. The crisis has already caused the death of 250,000 people in the past six years. Providing food plays an important role in reducing the number of deaths and achieving food security to ensure the sustained health of these victims of natural disasters and strife. I thank Aster DM Healthcare for its valuable generosity and efforts to support humanitarian aid and help people overcome extreme natural disasters. This public-private sector partnership reflects a shared commitment to giving for the benefit of humanity.” Aster DM Healthcare also announced providing ongoing medical support to the Syrian refugees settled in Al Zaatari, Al Azraq and Erbid refugee camps in Jordan through the deployment of its volunteers as per the guidelines of United Nations High Commissioner for Refugees (UNHCR).Already supporting the refugees with basic healthcare over the last two months, Aster DM Healthcare plans to expand its effort there soon. Through a dedicated medical

team and with the support of telemedicine facilities, Aster DM Healthcare is addressing the medical needs of hundreds of patients requiring medical aid. All Aster@30 activities will run simultaneously throughout the year across the Middle East, Africa and India, driving participation from local volunteers in each market where Aster has a presence- UAE, Oman, Kuwait, Bahrain, Saudi Arabia, Qatar, Jordan, India and Philippines. The company plans to take the initiative forward beyond its 30th year celebration through a dedicated vision focused on ‘giving back’ to the communities it serves on every day.

Overview on Aster Volunteers 1. Volunteer to help the community: An individual, wishing to volunteer his time to help people in need can register on www.astervolunteers.com, irrespective of medical or non-medical expertise. For example, a person can donate their time to help a patient reach their doctor’s appointment on time. 2. Free Surgeries and Investigations: A number of free treatments to be provided in the Middle East, India and Africa, including 5000 surgeries and MRI scans through a widespread network under Aster, Medcare and Access brands. External medical experts can also volunteer their services.

3. Recruiting people of determination: Around 100 differently-abled people to be recruited by Aster across geographies 4. Humanitarian Aid in SomaliaNorth Africa, in partnership with UAE’s Salma Initiative: Essentials like food, nutrition supplements, medicines and clothes will be delivered by Aster’s Disaster and Refugee management team through Salma Humanitarian Relief Program. 5. Permanent medical camp being set-up in the Al Zaatari, Al Azraq and Erbid Syrian refugee camps in Jordan. 6. Aster emergency mobile app to aid people in medical emergencies: Provides direct access to emergency numbers, first aid tips and access to volunteers who can come to help. The app was launched in India in May and received the appreciation and blessings of the Honorable President of India, Shri Pranab Mukherjee. 7. Basic Life Support (BLS) Training program: Up to 300,000 people would be provided with free training this year, targeting 200,000 individuals in India and 100,000 people across the GCC including school and college students.

NEWS

HMC’s Ambulatory Care Center and Women’s Wellness and Research Center Welcome First Patients to Outpatient Clinics

head of the official opening of three new hospitals within Hamad bin Khalifa Medical City later this year, Hamad Medical Corporation’s (HMC) Ambulatory Care Center (ACC) and Women’s Wellness and Research Center (WWRC) welcomed the first patients to their outpatient clinics - a uro-gynecology clinic at WWRC and a podiatry clinic at ACC . Additional clinics as well as surgical services will commence later this year at both facilities and will be

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gradually phased in ahead of the official opening of the new hospitals. These new facilities join the Qatar Rehabilitation Institute (QRI) which welcomed its first patients last year. The uro-gynecology clinic is the first Women’s Hospital clinic to re-locate to the WWRC and will be followed by its oncology and colposcopy clinics. These together with additional clinical and surgical services will also be gradually phased in throughout the course of the year. The WWRC is designed to provide women in Qatar with specialized

care through all stages of their lives. Once fully operational, it will offer a range of surgical and clinical services from preconception to childbirth, post-natal care and beyond. The 72,000 square meter facility which will replace Women’s Hospital as the largest tertiary hospital in the region will be staffed by over 2,000 highly trained clinicians specializing in gynecology, obstetrics, and newborn care. It will offer 240 private inpatient rooms, a significantly larger emergency room, 7 operating theaters, 26

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the same at both the Ambulatory Care Center and the Women’s Wellness and Research Center. This is a significant step forward towards the full opening of our new hospitals, delivering both expanded capacity and some of the most advanced healthcare facilities in the region.”

delivery rooms and 112 cots in the neonatal intensive care unit for the care of critically ill newborns. The ACC, the other new Medical City hospital to welcome its first outpatients, will also gradually phase in clinical and surgical services throughout the course of the year. Podiatry services will be followed by audiology, ENT and gastroenterology outpatient clinics and a pre-admission anesthesia clinic and surgical services will also follow.

surgery and laparoscopic equipment to ensure a faster healing time and less stress. Patients will also be supported on their journey to recovery by the ACC’s outpatient clinics, located in the same building. Clinical imaging, laboratory and pharmacy services will also be available. Mr. Hamad Al Khalifa, HMC’s Chief of Healthcare Facilities said: “Last year HMC welcomed the first outpatients to the QRI and we are proud to do

Prof. Adam Cairns, CEO of Hamad Bin Khalifa Medical City and Al Wakra Hospital reinforced this sentiment, adding: “The start of outpatient services at both the ACC and WWRC highlights Hamad’s ongoing commitment to delivering the highest quality healthcare through world class facilities and clinicians. It represents an important milestone on our journey towards the opening of the new Hamad Bin Khalifa Medical City facilities later this year. We are setting the bar even higher in terms of what our patients can expect from us as these facilities are established both within Qatar and the region as state-of-the-art centers of excellence for women’s health, outpatient care, minimally invasive surgeries and medical rehabilitation services.”

When fully operational, the ACC will offer patients an exciting new approach to surgical and clinical care in Qatar, providing day care surgery, some inpatient surgical care and clinical care in a single dedicated location. This means that within 23 hours of receiving surgery or a medical procedure, patients will be able to leave hospital and recover in the comfort of their own home, without the need for an overnight hospital stay. The new facility will offer advanced clinical and surgical practices in the most technologically advanced operating theaters and treatment rooms. Where possible, this will include non-invasive techniques, robotic

NEWS

Qatar University Health 2nd Annual Research Symposium engages more than 100 participants

atar University (QU) Health recently held its 2nd Annual Research Symposium aimed to bring together students, researchers and faculty in the field of health. The event engaged more than 100 participants from QU, the Ministry of Public Health, Hamad Medical Corporation (HMC), and Weill Cornell Medicine – Qatar (WCMQ). The program agenda included oral presentations under four themes: “Public Health”, “Communicable Diseases”, “Cancer and Diabetes” and “Cardiovascular Diseases”, and presentation of around 80 research posters by faculty, graduate and undergraduate students from QU Health colleges -- Health Sciences (CHS), Medicine (CMED), and Pharmacy (CPH). It also included a roundtable discussion led by QU Vice President for Medical and Health Sciences and CMED Dean Dr Egon Toft, CPH

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Dean Dr Mohammad Diab, CHS Dean and QU Biomedical Research Center (BRC) Director Dr Asma AlThani, and WCMQ Associate Dean for Research Prof Khaled Machaca, and moderated by CHS Professor of Human Nutrition Prof Mohamed Ahmedna. Discussions focused on the role of QU Health Cluster and its relation with other heath institutions in Qatar, and the new ways to fund research especially medical research in Qatar. Also on the event’s program were an award distribution to the three best oral presentations and three best poster presentations for faculty and undergraduate and graduate students from CHS (five awards), CMED (two awards), and CPH (eight awards). Commenting on the event, Dr Egon Toft said: “Uniting research across the three health colleges at QU and with the stakeholders is very crucial. Advancing medical knowledge and improving population’s health through

addressing the national needs lie at the top of our priorities. This symposium is definitely a great networking-channel opener and by joining efforts, focused collaboration and leveraging of resources, we will sure make greater impact on the health of the nation.” Dr Mohammad Diab said: “QU Health’s 2nd Annual Research Symposium has been an excellent platform to bring together faculty, graduate and undergraduate students from the colleges of Pharmacy, Medicine and Health Sciences to showcase extraordinary research on a variety of health related topics, in line with Qatar National Research Strategy and Qatar National Vision 2030. We are so proud of the high-quality research that our students and faculty are conducting, and the awards won during this forum highlight these efforts.” Dr Asma Al-Thani said: “It is indeed very rewarding to see such research accomplishments here at QU, that do not only involve faculty, but also students as well. This is definitely a sign of progress towards an integrated Health Cluster research and education where we soon hope to start the common first year and introduce new interdisciplinary programs in key national health priorities.” Prof Khaled Machaca said: “The Health Cluster initiative is a positive development for Qatar University and the nation. It supports our continuous efforts to align our biomedical research activities with Qatar University especially in the difficult current fiscal environment.”

NEWS

Qatar University Health Cluster

recognized as an Accredited Continuing Professional Development Provider

atar University (QU) Health Cluster celebrated its accreditation award as Continuing Professional Development (CPD) provider by the Qatar Council for Healthcare Practitioners (QCHP) of the Ministry of Public Health. The certificate was presented to QU Vice President of Medical and Health Sciences and CMED Dean Dr Egon Toft by Acting & Chief Executive Officer at QCHP Dr Samar Aboulsoud in the presence of QU President Dr Hassan Al Derham, CPH Dean Dr Mohammad Diab, CHS Dean Dr Asma Al-Thani, and practitioners from the health sector in Qatar, as well as QU officials, faculty, and staff. This is the first accreditation to be awarded to QU Health Cluster that comprises the College of Health Sciences (CHS), the College of Medicine (CMED), the College of Pharmacy (CPH), and the Health Clinic. The ceremony also included the acknowledgement of CPH Associate Professor of Pharmacy and QU Health CPD Committee Chair Dr Ahmed Nadir Kheir in recognition of his great contributions at QU as Coordinator of the Continuing Professional Development for Healthcare Practitioners

from 2010 to 2017. Commenting on this achievement, Dr Egon Toft said: “QCHP’s CPD program has national and international recognition. We are definitely proud to have QU Health acknowledged by this important accreditation provider. This accreditation comes as a testament for the quality and standards of health education at Qatar University that benefits health care professionals, and ultimately patient care in Qatar.” Dr Mohammad Diab said: “The College of Pharmacy was the first accredited CPD program in Qatar in 2011, delivering training to all healthcare providers. With the creation of the newly formed “QU Health” and well established track record throughout the health care community, this program remains committed to providing high quality continuing education to all health practitioners in Qatar and is an essential part of QU’s commitment to providing community services.” Dr Asma Al-Thani said: “I strongly believe in the importance of this accreditation as all licensed health care professionals need to participate in the CPD program. The College of Health Sciences graduates lab scientists, clinical dietitians, health educa-

tors and (recently approved) physical therapists. It definitely means a lot to be part of the QU health cluster.” Dr Samar Aboulsoud said: “Qatar University is the first academic institution in Qatar to vividly translate the concept of inter-professional education, that is embraced in our national CPD accreditation system, into real action for the benefit of health care practitioners and with the ultimate objective of improving patient outcomes.” QCHP regulates and accredits activities of Continuing Professional Development (CPD) / Continuing Medical Education (CME) (considered as a component of CPD) in the State of Qatar. It monitors such activities to ensure their adequacy, quality and compliance with national and international accreditation standards. The accreditation system for Continuing Professional Development plays an integral part in the license renewal process of health care practitioners in the State of Qatar, hence ensuring competency and quality in health care services, while regulating the health care practice based on evidence and assessment of needs of the Qatari healthcare system.

ARTICLE FEATURES . Medical Universities in the Arab World

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ARTICLE FEATURES . Medical Universities in the Arab World

he Arab world is full of universities and medical colleges that have managed to graduate the finest doctors who have honored their countries with great achievements. The Gulf countries and the Middle East have been able to establish a distinguished reputation by adopting curricula and teaching programs that contribute to the graduation of generations capable of meeting the requirements of the medical profession when it comes to diseases diagnosis or medical research and development. Medical faculties in the Arab world are striving to develop the communication and scientific research skills of their students, in addition to enhancing the scientific research capabilities of faculty members, providing the appropriate learning environment, and integrating students into scientific research. They also continuously raise the level of medical education and healthcare locally and regionally, and distribute the concepts of quality assurance to their employees and students.

Developing Studentsâ€™ Skills The medical universities in the Arab world have set a clear goal. They aspire to provide student with the necessary skills and medical ability necessary to practice the profession according to the highest standards of quality, and based on clear educational and vocational training principles in line with international standards. Now, they have been able to provide an educational environment to ensure that graduates can practice their specialties efficiently and honestly. They did not disregard scientific research and its role in developing the studentsâ€™ abilities in their professional future on the basis of continuous development, while keeping pace with the most important international achievements and being in parallel with the development of educational and training skills. It can be easily noted that Medical Faculties in the region are exerting exceptional efforts to enhance the voluntary training opportunities for students through bilateral agreements with hospitals and training centers, both inside and outside the country, as well as activating the academic guidance program for students. Such program helps develop mechanisms to encourage students to carry out scientific research. These entire endeavors stem from a deep awareness of the importance of creating a correct learning environment, in which the student finds everything needed to enhance his studies. Medical Faculties have succeeded in creating a healthy learning environment that develops creative abilities and mental skills by adopting advanced educational curricula aimed at developing thought, promoting a culture of scientific research, incorporating scientific research skills into the curriculum, and enhancing studentsâ€™ extracurricular abilities. There are huge budgets allocated by governments, as well as by medical schools, to demonstrate their strong presence in academia. Today, they are exerting extraordinary efforts to bring out distinguished doctors equipped with the ability to meet the needs of any society in which they are located, whether locally or globally.

Perhaps one of the factors that advanced the study of medicine in the Gulf countries and the Middle East region was the attraction of international universities to the region. These educational institutions established branches in the region to save travel and abroad specialization expenses, and to allow medical students in these countries to obtain a prestigious medical degree from a worldclass university without the trouble and expenses of travel.

ARTICLE FEATURES . Medical Universities in the Arab World

Finest Teaching Methods Medical Faculties in the Arab world realized since the very beginning that graduates will eventually inherit the duty of caring for the health of citizens and society. Therefore, the best educational curricula must be developed for the health professions in order to graduate competent doctors capable of carrying out the tasks assigned to them. However, the faculties did not stop there it is not enough. They realized that medical education must be continuous in terms of teaching, curriculum development, and developments follow-up. They have introduced everything that is new and developed into their teaching curricu-

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lum and still constantly seek to maintain their levels among the highest in the world by following up governmental spending, especially that the Gulf Cooperation Council countries allocate large budgets to health and public safety, placing the health of citizens at the top of their priorities.

• Change in health care methods. • Environmental changes, as well as

Therefore, Arab universities have adopted the recommendations and decisions that have been made to change the curricula and teaching methods on a global scale and based on the following: • The rapid growth of medical information. • Development in medical techniques. • Variation in the nature of diseases.

States and governments have also helped some Medical Faculties in big cities to develop special programs to educate doctors for rural areas.

psychological and social problems resulting from disasters, conflicts, and wars. • The need to improve the way professors treat students and the way doctors treat patients.

ARTICLE FEATURES . Medical Universities in the Arab World

Medical faculties have to operate within a social responsibility framework that includes responsibility for their regions. That said, there are four fundamental questions that focus on how medical faculties can contribute to education, employment, and retention of physicians in their areas. Such contribution is based on the fact that governments and medical faculties need to implement coherent strategies that include pre-school preparatory courses and admission policies that take into account the diversity of geographical backgrounds and experiences, and support tuition fees and scholarships to make medical schools accessible.

Continuous Medical Education Continuous Medical Education (CME) is now the gold standard for the success of doctors in their work and for the need for professional development. A doctor should practice medicine throughout his life, since this field witnessed successive â€‹â€‹ developments that require continued learning and acquisition of new skills, especially in light of what we are witnessing today and the emergence of sub-specialties within one jurisdiction. The Gulf States and the Middle East have recognized the importance of Continuous Medical Education for students, professionals, and medical staff. They realize that it constitutes an urgent necessity and a significant element of sustainable development, which urged governments and ministries of health to enact laws in this regard. The new laws determine the system of credit hours adopted to renew any medical license medical staff or medical students require to practice the profession. These endeavors aim to improve the medical knowledge and skills of these professional and help them keep up with the latest developments in their field of work, which is considered by the health sector to be an urgent concern for all health care organizations and actors around the world. Medical students are also required to participate in educational activities and conferences, since these events contribute to the development of the knowledge and skills medical students receive during the school years. Such events can increase experience during the professional performance phase and can provide physicians with the opportunity to continuously acquire knowledge and learn skills that qualify them to deliver services with competitive quality. Continuous Medical Education (CME) is an educational activity designed to bring modern medical information to healthcare professionals, be them doctors, pharmacists, nurses or technicians. It helps them develop their skills and experience to increase the efficiency and quality of the performance of doctors and health care providers, maintain the medical and scientific knowledge of professionals and students, and help them stay updated with the newest knowledge that enable them develop their skills and experience.

ARTICLE FEATURES . Stroke

The sooner the medical intervention, the less damage to the brain

JULY.AUGUST 2017

ARTICLE FEATURES . Stroke

very second that passes on a stroke patient has an impact on his/her life. Delay in response can lead to the death of more brain cells and hence increase the damage caused by the stroke. The cause of this incident is attributed to a sudden blockage of blood vessels in the brain that helps reduce the amount of oxygen nourishing it, thus causing cell death in the brain. The majority of those who survive this health crisis are in constant need of health care, treatment, and other means of assistance. About 85 percent of strokes occur due to blocked blood vessels in the brain, and the most common cause of this blockage is atherosclerosis. The other cause is the formation of a thrombus, which is separated from its location on the walls of the artery from outside the brain or from the heart, and then carried by the blood circulation to the brain, causing blockage in a vital blood vessel. The signs of a stroke, which are often more serious, include vision disorders, paralysis, and disorders affecting the face, arms, and legs. The problem here is that the majority of people are unaware that these symptoms may pave the way for a stroke, so they do not take it seriously, making it worse. Stroke symptoms include sudden paralysis, half-sided paralysis of the face or arm from one side, mouth dropping, motor disabilities, dizziness as if one is in a spiral, and speech disorder.

Risk factors Although older people are the most vulnerable to stroke, recent medical research has begun to warn young people of the risk of stroke due to unhealthy lifestyle, smoking, and lack of exercise, and unhealthy food.

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High blood pressure is responsible for about 70 percent of stroke cases; the higher the blood pressure, the higher the risk of stroke. Type I and II diabetes: a diabetes patient is four times more likely to suffer from a stroke than healthy people. Unbalanced levels of blood sugar can lead to a blockage of small blood vessels in the body’s organs, such as the intestines and kidneys. The clogging of the blood vessels in the brain can lead to a stroke. High blood lipids, although it is necessary to maintain good rates of both harmful cholesterol and triglycerides in the blood. The recommended maximum level (LDL) is 100 mg / dl for healthy patients, less than 100 mg / dl for those with risk and less than 70 mg / dl for those who underwent

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therapeutic catheterization, or had a heart attack or stroke. Atrial fibrillation or irregular heartbeat is a condition that can develop with age. This condition causes a slow supply of blood between the atria and the ventricle, so the blood does not functioning properly and tends to clot and form a thrombus that may drift with the flow of blood stream to reach the brain, thus leading to a stroke.

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Smoking is one of the most catalysts for the development of atherosclerosis in the arteries and increased levels of coagulation factors in the blood. It also damages the lining of blood vessels in the brain.

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Excess obesity leads to many health problems, such as high fat, blood pressure, diabetes, and heart disease.

ARTICLE FEATURES . Stroke

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one side of the body. Speech difficulty. Swallowing Disorders. Decline in sensation in different parts of the body. Dropping of some parts of the body. Difficulties in perception of time and place. The patient may find it difficult to focus, understand, think, and remember. Certain difficulties in controlling emotions. Depression and anxiety in response to post-stroke changes as a result of the nature of the part that has been damaged within the brain.

FAST Test FAST is a shortcut to Face, Arm, Speech, and Time. Friends and family of the patient should check the four signs to determine the severity of a stroke. F (Face): The movement of the facial muscles should be monitored. If the patient can only move half the muscles of his face, that indicates that he/she is paralyzed in the other half as a result of the stroke. A (Arm): The patient should extend his/her forward with the palm of its hand up. If he cannot do so, it indicates that he is crippled by stroke.

Post-stroke The treatment of stroke does not end after the early stage treatment, but it continues due to the occurrence of functional changes affecting the patient according to the affected area of the brain. The patient loses independence in his movement and has to endure changes in his lifestyle. Moreover, the patient needs rehabilitation and physical therapy sessions in order to increase the chances of recovery from the effects of stroke.

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The patient is also taught how to live naturally and independently in a manner closer to normal. His condition is improved by competent therapists to restore the function of the injured organ(s), reduce the losses, or recover some of them.

S (Speech): If the patient cannot repeat a sentence said to him/her or his/her voice is not clear and intelligible, this indicates he/she suffered a language disorder also falls within the indicators of a stroke.

This is done in specialized centers or through a physical therapist visiting the patient at home. The functional changes that the patient endures after the stroke include: • Muscle weakness or paralysis in

T (Time): It refers to the suspicion of a stroke through the emergence of one or all of the previous symptoms of the patient. If such symptoms are noticed on any patient, an ambulance must be called immediately.

ARTICLE

Why is it so important for AF patients to understand their condition and its link to stroke?

Atrial Fibrillation (AF) is the most common heart rhythm disorder and a leading cause of stroke. AF is estimated to affect over 33 million people worldwide, yet few people have heard of the condition or know what it is. AF is a type of arrhythmia (irregular heart rhythm The four chambers of the heart which normally beat in rhythm,lose the ability to do so.The heart rhythm becomes erratic – sometimes fast, sometimes slow. When this happens, the blood does not ow smoothly through the heart. A clot may form and break away, travelling to the brain to cause an AF-related stroke. “AF-related strokes are often more disabling and debilitating than most other types of stroke; yet with modern therapy, the risk of an AF-related stroke can be greatly reduced”. How does anticoagulation therapy help to protect against AF-related stroke?

Once AF is diagnosed, anticoagulation therapy may be recommended.Anticoagulation therapy is not a treatment for

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AF, it does however greatly reduce the risk of an AF-related stroke.You should discuss treatment options to manage AF with your healthcare professional. Are there any specific tools available to help patients learn more and manage their condition?

It is important to understand and therefore better manage AF with information, support and education. Although there are many resources available on the internet, it is important to ensure the information is provided by a reliable accredited source such as the AF Association, which has healthcare professionals overseeing all materials produced to ensure their accuracy. A new website – ‘Living With AF... finding my way’ – takes the viewer through interviews and resources with AF patients sharing their own experiences. It offers advice on how best to manage AF whilst still living a full life despite of AF.

The Future of AF Management

What do the recent advances in anticoagulation care mean to AF patients?

For almost 60 years the only anticoagulant available was warfarin and for many patients this has proved to be life-saving by reducing the risk of AF-related stroke. However, for some it may not be suitable. Fortunately, in the last few years, more anticoagulant medicines have become available and so the AF patient has greater choice to nd the one that best suits them and their lifestyle. The more recent anticoagulants do not require regular blood tests and are not associated with many food or drug interactions. In discussion with their doctor, patients can now nd the best

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anticoagulant to suit their needs to reduce the risk of an AF-related stroke. “More recently, there is now an option with one of the anticoagulants to use a ‘reversal agent’ if emergency surgery or urgent anticoagulant reversal is needed. Although these occasions are rare, the ‘reversal agent’ would reduce the risk of a bleed during the operation, allaying fears and concerns”. Do you think patients are aware of what options are available to physicians if they were to require unexpected emergency surgery or urgent anticoagulant reversal?

We all hope we will never require surgery of any description and certainly not emergency surgery. Few of us consider the consequences of what medication we may be taking and what might happen if emergency surgery was required. It is important to discuss with your doctor all therapeutic options to reduce your risk of an AF-related stroke as well as treatment options and how these might affect your care in the unlikely event that emergency reversal is needed. Being informed and educated on the available options ensures that both you and your doctor are making informed decisions on what is best for you, your condition and your lifestyle. With greater awareness comes greater choice and better outcomes. What advice (if any) do you give patients who want to take more of an active role in discussing and choosing anticoagulation therapy with their physician? Could this lead to better therapy adherence?

I always advise patients to download and complete our AF checklist prior to a visit to their doctor. This prepares the patient and also helps the doctor. Ideally a caregiver should accompany the patient to the appointment so they too have a greater understanding and can encourage and support the patient with their medication and living with AF. I also encourage them to ask the following questions: 1. What is anticoagulation therapy? 2. What will it do? 3. How important is it that I take it every day as

prescribed? 4. What is an AF-related stroke? 5. Will I feel better? 6. What treatment options are there for AF?

An educated and informed patient is more likely to adhere

to their medication as they understand the reason for taking it as prescribed to reduce their risk of AF-related stroke and the consequences if they do not. How can patients feel more in control of their condition?

Once a patient understands the condition they have been diagnosed with and has the information to learn more about how best to live with and manage it, they are better placed to feel in control of their condition. Patient information should be provided at doctor’s appointment and recommendations given to valuable web sites. The AF Association also hosts Patient Days where both healthcare professionals and patients attend – these have proven invaluable to so many. Meeting someone with the same condition as yourself immediately provides reassurance to the patient and their loved ones. We also host an online forum with thousands of AF patients and caregivers sharing experiences, offering advice and reassurance. The AF Association dedicated Helpline also makes it possible for patients to call at any time to seek advice and understanding, often when they do not want to worry their loved ones or if living alone. Do you think in the next 5 years, there will be an increase in AF patients wanting to take more of an active role in discussing anticoagulant options for AF-related stroke prevention?

As greater awareness of AF is achieved, so will the demands by patients and their loved ones for more knowledge, greater choice and better outcomes. What advice would you give to patients recently diagnosed with AF?

Just diagnosed with Atrial Fibrillation? Or should that be Alone and Frustrated? Millions of people worldwide are living with AF and with the right information and an informed discussion with your healthcare professional, you too can learn to live with AF and reduce the risk of AF-related stroke with appropriate anticoagulation therapy and manage the symptoms of AF with access to available treatments. Make contact with organisations such as AF Association (www.heartrhythmalliance.org) who will have a wealth of information for you, your loved ones and your healthcare professional. Make sure you discuss all available options and choose, together with your doctor, what is best for YOU. Remember, no one chooses to be a patient – we all want to be restored to a person.

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Diabetes management is not only about reducing blood sugar

by Dr. Abdulrazzak Al Madani, Consultant Internal Medicine Endocrinology, Diabetes And Metabolism at Al Burj medical center - Sheikh Zayed Road

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ype 2 diabetes may double the risk of death1. In diabetic patients over the age of 65 years, 68% of deaths are from coronary heart disease and 16% are from stroke2.

It’s often said that diabetes is a silent killer. Even seemingly healthy individuals are susceptible. But diabetes doesn’t have to be a death sentence. The thin line between life and death is often the lack of awareness. Despite the fact that lifestyle interventions and adherence to medications are central to disease prevention and management, it is often said, the biggest issue is that most people don’t understand the many combinations of complications associated with diabetes and their lasting effects on a person’s health and psyche. Around the world, about 415 million adult people in the world are living with diabetes, with Type 2 diabetes accounting for 90 – 95 percent of all cases3. In the MENA, around 35.4 million people live with diabetes since 2015 and the number is expected to rise to 72.1 million by the year 20404. People with type 2 diabetes are at increased risk of heart disease and stroke. When patients have both hypertension and diabetes, which is a common combination, the risk for cardiovascular disease doubles5. Awareness campaigns, specialized clinics and financial investments are some of the actions implemented to address not only the increase in the number of diagnosed patients, but to raise awareness and prevent diabetes complications within the diabetic population.

damages not only blood vessels but also one’s nervous system. Studies also indicate a positive association between hypertension and insulin resistance. Reducing one’s weight especially through a balanced diet and exercise can decrease insulin concentration and increase insulin sensitivity. Exercise is of course the most achievable medium of reducing these risk factors. A healthy lifestyle can not only keep type 2 diabetes at bay but also reduce blood pressure and risk of heart attack and stroke. According to the World Health Organization Multinational Study of Vascular Disease in Diabetes, cardiovascular disease was the most common underlying cause of death, accounting for 52% of deaths in type 2 diabetes. It’s wrong to stigmatize diabetes as purely a lifestyle-based outcome. Of course there is a strong link between diabetes and obesity. But people often think in stereotypes, quick to conclude that if just someone lost weight or exercised, then diabetes can be mitigated. Sometimes genetic predisposition overrules all. Completing the annual cycle of care can help achieve better outcomes for people with diabetes. Regular assessments can prevent complications and other adverse outcomes associated with the disease.

REFERENCES 1. Nwaneri et al. Br J Diabetes Vasc Dis 2013;13:192– 207. 2. Morrish et al. Diabetologia 2001;44(suppl 2):S14–21. 3. IDF Diabetes Atlas, 2014. 6th Edition. http://www.idf.org/diabetesatlas. 2 Aspirin for Primary Prevention of Cardiovascular Events in People with Diabetes https://www.ncbi.nlm.nih.gov/pmc/

The likelihood of heart disease and subsequently heart attack or stroke rises correspondingly with diabetes. Risk factors are aggravated due to high blood pressure or high cholesterol. To prevent adverse effects on one’s health, it is of course most advisable to manage glucose, also called blood sugar, and to restrict harmful lifestyle habits like smoking. The high blood glucose especially from diabetes

articles/PMC2875463/ 3 Diabetes Atlas 7th edition 2015, International Diabetes Federation. http://www.diabetesatlas.org/ 4 http://www.diabetesatlas.org/resources/2015-atlas.html 5 http://www.heart.org/HEARTORG/Conditions/Diabetes/WhyDiabetesMatters/Cardiovascular-Disease-Diabetes_UCM_313865_Article. jsp/#.VwEOm_l96XI

ARTICLE FEATURES . Skin Cancer

Skin Cancer

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ARTICLE FEATURES . Skin Cancer

kin cancer is the most common form of cancer that can be prevented; however, it can be cured if it is diagnosed early, yet, it can affect the whole body and become fatal if it was not diagnosed in the right time. Melanin is the only natural substance that helps protect the deeper layers of the skin from the harmful effects of the sun. Melanin in the skin varies from one person to another but no matter the skin color, a person always needs to use sunscreen for additional protection. Too much exposure to UV radiation is thought to be the biggest risk factor for most melanomas. The main source of UV light is the sun. Tanning lamps and booths are also sources of UV light. People with high levels of exposure to UV light are at greater risk for all types of skin cancer. The amount of UV exposure depends on the strength of the light, how long the skin was exposed, and whether the skin was covered with clothing and sunscreen. Many studies have linked melanoma in the trunk, legs, and arms to frequent sunburns (especially in childhood).

Symptoms Simple signs to detect skin cancer include a mole of no more than 1/4 inch in diameter (6mm) which can appear on the skin. It is most common on the face among older adults, chest or back in men and legs in women. The color of a mole may range from light pink to very dark brown. Dermatologists call the freckles, age spots and normal moles “colored spots”. Cancerous spots have different colors and shapes than the normal ones found on the body. The size of a mole can indicate the presence of skin cancer. A mole that is larger than 1/4 inch in diameter (6mm), or larger than the size of a pencil eraser, could be cancerous. Melanoma signs also include a large brownish spot with darker speckles, a mole that changes in color, size or feel or that bleeds, a small lesion with an irregular border and portions that appear red, white, blue or blue-black and dark lesions on your palms, soles, fingertips or toes, or on mucous

membranes lining your mouth, nose, vagina or anus. Everyone needs a regular skin check-up; non-melanoma skin cancer is due to the intermittent sun exposure while excessive tanning can enhance the growth of a malignant cancerous skin tumor. Melanoma diagnosis involves careful skin inspection and biopsy of a suspicious skin lesion. A local procedure is performed to remove as much of the suspicious mole or lesion as possible. A pathologist then looks at the tissue under a microscope to check for cancer cells.

Risk Factors Risk factors for skin cancer include: • UV light and excessive sun exposure • Fair skin • Older age • Sunny or high-altitude climates • Moles • Precancerous skin lesions • A family history of skin cancer • A weakened immune system • Exposure to radiation and certain substances • Sensitive skin

Skin cancer occurs when errors (mutations) occur in the DNA of skin cells. The mutations cause the cells to grow out of control and form a mass of cancer cells. Much of the damage to DNA in skin cells results from ultraviolet (UV) radiation found in sunlight and in the lights used in tanning beds. But sun exposure doesn’t explain skin cancers that develop on skin not ordinarily exposed to sunlight. This indicates that other factors may contribute to your risk of skin cancer, such as being exposed to toxic substances or having a condition that weakens your immune system.

ARTICLE FEATURES . Skin Cancer

Modern treatment methods Method for early diagnostics of skin cancer has developed with the help of the original complex consisting of three new devices, the press service of the Samara University in the name of the Queen. It has been stated that a team of scientists of the Samara University in the name of the Queen and the Samara medical University and clinical specialists of the Samara regional Oncology dispensary (CITY) have tested a new method for early diagnostics of skin cancer with the help of the original complex of three new instruments. As noted in the message, created by a team of scientists Samara methods have improved the efficiency of the active early diagnosis of skin tumors by up to 97%, while the accuracy of conventional, standard clinical studies do not exceed 50-60%. According to the Professor of the Samara University named for Queen Valery Zakharov, developed a system of spectral analysis enables to simultaneously record the parameters of the skin of the patient in many spectral ranges, which gives the opportunity to observe the pathological changes at the cellular level, because cancer cells of their spectrum differ from healthy. According to the developers, this method is suitable for mass surveys. It not only allows you to accurately and quickly diagnose pathology, but requires no additional consumables and reagents. Scientists discovered a new drug that could slow the spread of skin cancer but still give people the tan they desire. The new cream that mimics sunlight could give skin a golden tan without exposure to harmful UV rays, experts have discovered. Scientists have developed a drug that tricks the skin into releasing the pigment

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melanin, which causes the skin to darken. Tests on skin samples and mice showed the drug could see the end of fake tan and it even worked on gingers who typically just burn in the sun. The team from Massachusetts General Hospital hopes their discovery could prevent skin cancer and even slow the signs of ageing. The drug is rubbed into the skin and starts a chain of chemical reactions that causes the body to produce melanin and, therefore, creating a tan. While a tan is often associated with beauty, the sad truth is that a tan is a sign of damage that has been inflicted on the delicate skin cells covering your body. Treatment for skin cancer and the precancerous skin lesions varies depending on the size, type, depth and location of the lesions. Small skin cancers limited to the surface of the skin may not require treatment beyond

an initial skin biopsy that removes the entire growth. If additional treatment is needed, options may include: • Freezing • Excisional surgery • Laser therapy • Mohs Micrographic Surgery • Radiation therapy and chemotherapy

Prevention Most skin cancers are preventable. To protect yourself, follow these skin cancer prevention tips: • Avoid the sun between 10 am4pm • Wear sunscreen year-round • Wear protective clothing • Avoid tanning beds • Be aware of sun-sensitizing medications • Check your skin regularly and report changes to your doctor

ARTICLE FEATURES . Ovarian Cancer

One of the most common cancers in women

varian cancer ranks fifth in cancer deaths among women, accounting for more deaths than any other cancer of the female reproductive system. Ovarian cancer is often called the â€œsilentâ€? killer because many times there are no symptoms until the disease has progressed to an advanced stage. It often goes undetected until it has spread within the pelvis and abdomen. At this late stage, ovarian cancer is more difficult to treat and is

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frequently fatal. Early-stage ovarian cancer, in which the disease is confined to the ovary, is more likely to be treated successfully. Each woman has two ovaries that lie on either side of the womb (uterus) against the wall of the pelvis. The ovaries produce and release eggs (oocytes) into the female reproductive tract at the mid-point of each menstrual cycle. They also produce the female hormones estrogen and progesterone.

Ovarian cancer is a malignancy that occurs in one or both ovaries. Early symptoms may be subtle and presentation is often late. Onset of symptoms is insidious. Early symptoms are often vague, such as abdominal discomfort, abdominal dissension or bloating, urinary frequency or dyspepsia. Constitutional symptoms include fatigue, weight loss, anorexia and depression. It most commonly presents with a pelvic or abdominal mass that may be associated with pain.

ARTICLE FEATURES . Ovarian Cancer

ONX-0801 is the first in a new class of drugs discovered at the ICR. It attacks ovarian cancer by mimicking folic acid to enter the cancer cells. The drug then kills these cells by blocking a molecule called thymidylate synthase, thereby causing irreparable DNA damage. Ovarian cancer cells have an abnormally large number of receptors for folic acid, called alpha folate receptors. This means these cancer cells respond particularly well to the treatment. Overall, only about half of all women diagnosed with ovarian cancer live for five years or more. The results of the new trial were presented at the American Society of Clinical Oncology (Asco) meeting in Chicago. If clinical trials proved the drug’s effectiveness, it could potentially be used in early-stage disease where the impact on survival may be better. Because the new therapy is so specifically targeted at cancer cells, it leaves healthy cells alone. This means it does not have the side-effects, such as in-

fections, diarrhea, nerve damage and hair loss, often seen with chemotherapy. Experts have also created tests to detect the cells that will respond particularly well to the treatment, meaning doctors can identify those women who will benefit the most. Women who have never been pregnant have an increased risk of ovarian cancer. Overall, it seems that obese women have a higher risk of developing ovarian cancer. Having children, breastfeeding and taking birth control pills reduce the risk of having ovarian cancer.

Types Your ovaries have three main types of cells, and a tumor can develop in any of them. The three types are: • Epithelial cells, which cover the surface of your ovary • Germ cells, which make your eggs (ova) • Stromal cells, which hold the structure of your ovary together and make the hormones estrogen and progesterone.

Latest Studies Researchers have hailed the biggest breakthrough in advanced ovarian cancer for a decade after a new treatment was found to dramatically shrink tumors. Experts called results of the early-phase study “exciting” and “promising” after patients who had exhausted all other treatment options showed an impressive response. The drug, known as ONX-0801, was tested in 15 women with advanced ovarian cancer as part of a wider trial run by the Institute of Cancer Research (ICR) and the Royal Marsden NHS Foundation Trust in London.

ARTICLE FEATURES . Ovarian Cancer

Risk factors A small percentage of ovarian cancers are caused by an inherited gene mutation. The genes known to increase the risk of ovarian cancer are called breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2). These genes were originally identified in families with multiple cases of breast cancer, which is how they got their names, but women with these mutations also have a significantly increased risk of ovarian cancer. Family history, estrogen hormone replacement therapy, age when menstruation started and ended, fertility treatment, smoking, use of an intrauterine device and polycystic ovary syndrome all contribute to increasing the risk. If you have a genetic predisposition to ovarian cancer, your doctor may recommend regular pelvic imaging and blood tests to screen for the disease.

Diagnosis Tests and procedures used to diagnose ovarian cancer include pelvic examination. During a pelvic exam, the healthcare professional feels the ovaries and uterus for size, shape, and consistency. Ultrasound uses high-frequency sound waves to produce images of the inside of the body. An ultrasound helps your doctor investigate the size, shape and configuration of your ovaries. The surgeon may collect samples of abdominal fluid and remove an ovary or other tissue for examination by a pathologist. If cancer is discovered, the surgeon may immediately begin surgery to remove as much of the cancer as possible. CA 125 blood test is another test that helps diagnose ovarian cancer. CA 125 is a protein found on the surface of ovarian cancer cells and some healthy tissue. Many women with ovarian cancer have abnormally high levels of CA 125 in their blood. However, a

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number of noncancerous conditions also cause elevated CA 125 levels, and many women with early-stage ovarian cancer have normal CA 125 levels. For this reason, a CA 125 test isnâ€™t usually used to diagnose or to screen for ovarian cancer, but it may be used after diagnosis to monitor how your treatment is progressing. Doctors use many tests to find, or diagnose, cancer. They do tests to learn if cancer has spread to another part of the body from where it started. If this happens, it is called metastasis. For example, imaging tests can show if the cancer has spread. Imaging tests show pictures of the inside of the body. Doctors may do tests to learn which treatments could work best. For most types of cancer, a biopsy is the only sure way for the doctor to know whether an area of the body has cancer. In a biopsy, the doctor takes a small sample of tissue for testing in a laboratory. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis. An ultrasound wand is inserted in the vagina and aimed at the ovaries and uterus. An ultrasound uses sound waves to create a picture of the ovaries, including healthy tissues, cysts, and tumors. Researchers are studying whether this test can help with early detection of ovarian cancer.

Treatments Treatment of ovarian cancer usually involves a combination of surgery

and chemotherapy. It generally involves removing ovaries, the fallopian tubes, the uterus as well as nearby lymph nodes and a fold of fatty abdominal tissue where ovarian cancer often spreads. Your surgeon also will remove as much cancer as possible from your abdomen. Less extensive surgery may be possible if your ovarian cancer was diagnosed at a very early stage. For women with stage I ovarian cancer, surgery may involve removing one ovary and its fallopian tube. This procedure may preserve the ability to have children. After surgery, youâ€™ll likely be treated with chemotherapy to kill any remaining cancer cells. Chemotherapy drugs can be injected into a vein or directly into the abdominal cavity or both. Chemotherapy may be used as the initial treatment in some women with advanced ovarian cancer. Cancer treatments often damage the bodyâ€™s healthy cells and tissues, so their side effects are common but differ from a person to another. Not all women will suffer from these same side effects; however, the team of physicians will explain everything to the patient and help her cope with her situation. After treatment, the patient must have regular check-ups once every three months in the first two years then once every six months in the next three years then once a year. The results of these tests can show if your condition has changed or if the disease has recurred.

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by Dr. Prem Jagyasi

o other sector other than the healthcare has so much societal obligation. While the sector is undergoing rapid makeovers with state-of-the-art technological innovations, introducing lean leadership holds paramount importance to improve public service. The healthcare sector is facing new challenges everyday owing to the rising societal expectations. Lean leadership helps in establishing a value based system creating more value added services benefitting the customers (or patients) and the organization itself. This needs to be developed as a culture and not as a mere tool. Implementation of lean culture is based on 3 core principles: • Elimination of waste • Create flow • Have respect towards people who are the agents of change. [http://ac.els-cdn.com] Lean culture in short, implies - Use less. Do more.

Waste accumulation increases cost and decreases service quality: Whether it is through redundant activities or piling up of inventories, waste accumulation is possible from every operational angle which has a serious bearing on the expenditure and the quality of service. For example, a purchase manager may be inclined to procure a huge volume of any medical equipment to avail an attractive discount but the continuously changing façade of healthcare sector may render

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it obsolete in a year or two transforming this into a “costly waste”. Therefore, applying Just-in-time principle in this case would be the right application of lean principle. Identifying the “waste” factor is the biggest challenge in implementing lean leadership: Every worker feels his/her contribution in providing healthcare assistance is valuable. A healthcare attendant running here and there hunting supplies may feel that he/she is adding much value to the service but will not consider the huge time wastage which would have been devoted to skill development had the supplies been handy. Even if the wastes are identifiable, eliminating them is an uphill task as the work culture is used to such waste generation since quite long. Unwillingness to accept changes in the new work culture poses another big challenge in implementing lean culture.

Common identifiable wastes in healthcare: •

•

Time: Unnecessary long queues and waiting time for resources instead of just in time supply. Movement: Time wastage for patient and staff movement. Inventory: High inventory accumulation which could include medical equipments or even patients.

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Processing: Repetition of processes either due to errors or negligence

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Generating defective products or services: Below standard assistance to the patients or products that do not satisfy the patients.

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Transportation: Unnecessary transportation of material and staff

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Overproduction: Unnecessary tests, hospitalization, referrals and excess acquisition of materials.

Lean thinking precedes Lean Leadership: Lean Leadership having its roots in Toyota Production System (TPS) aims in devising well-knit strategies to eliminate waste from the daily operations and support system and finally form a lean culture enhancing the productivity by adding more value towards time and money. Lean Thinking in working culture is a continuous learning process where each and every person should be made aware of or trained adequately that would help in waste elimination from the products and services from the entire value generating streams. This would demand less human efforts, less capital, less cost, less space, less defects

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and would lead to faster generation of high quality service and products.

could be done much quickly. The group reaped $10 million benefit and was featured in the Fortune 100 list of employers.

Health Organizations mastering Lean leadership: •

•

Virginia Mason Medical Center in Seattle has been practicing lean management since 2002. They saved huge capital expenses to the tune of millions of dollars scrapping expansion plans with outdated medical installations. Applying lean principles on staff, providers and patients, they have showed marked improvement in waste elimination. The entire staff of 5000 had to take up a course on Introduction to Lean and many participated in intensive Rapid Process Improvement Weeks (RPIW). By 2004, the team was able to achieve striking results by eliminating waste in all key areas. The 433 bed public hospital Consorci Santiari del Garraf located on the outskirts of Barcelona, Spain presents another brilliant example of lean leadership where the CEO and the senior nurse leading the lean management have been able to enthuse the team of doctors and nurses towards lean culture. The hospital not only made up the 20% shortfall in their budget but has also bagged the prize as the best managed hospital in Spain.

•

So what should be the attributes of the lean leader? Considering the myriad complexities involved in the healthcare industry, implementing lean culture is easier said than done unless it is headed by the right person. Leaders with a vision to transform the organization culture cannot do it through mere authoritative declarations unless they intervene and involve whole heartedly demonstrating the positive outcome. This is a continuous process that creates a new culture and a new value system in the organization’s operation. •

• •

Thedacare Inc. the notable healthcare delivery system in Wisconsin running 3 hospitals, 27 physician clinics housing 5000 employees widely recognized for its performance quality almost followed a similar lean culture of Virginia Mason’s. Thedacare focused more in eliminating time waste that most of the employees do dragging a work which

Dan Florizone, the President and CEO of Saskatoon Health region is an embodiment of lean leadership. A formal hospital CEO and a regular visitor in Virginia Mason, he was instrumental in establishing province wide lean healthcare system.

•

Experience matters a lot. A person experienced in the nitty gritties of the operation of a healthcare organization can easily detect the pitfalls and can steer the organization by adopting timely proactive waste elimination. Keen observant in processes. The leader should be obsessed with the operational processes and have the grit to recreate new ones to maximize waste elimination ultimately delivering the best value to the customers. Not hurrying for overnight transformations. Healthcare organizations are bound by red tapes where lack of transparency

is inevitable. The leader should exhibit keenness in listening and understanding the complexity of the industry instead of expecting things to change overnight. •

Eagerness in maintaining transparency. An effective lean leader should be aimed in leading the organization towards more transparency. Transparency makes the problems visible which can be then dealt with properly.

•

Extraordinary communication, relationship and trust building skills. The leader should communicate the purpose and not the task. It is essential to develop an excellent rapport system with top line physicians, nurses and other professionals who will have the confidence to share their apprehensions and expectations leading towards enhanced productivity.

•

Motivating others. Transforming towards the lean culture pushes the employees out of the comfort zone. It is the duty of the lean leaders to instill the hope of optimism in their minds so they can work confidently and deliver beyond their comfort zone.

Thus, lean leadership is all about the proper utilization of lean culture maximizing the productivity and service quality with an undivided attention on the customer value.

Dr Prem Jagyasi A globally acclaimed, award-winning strategic leader and speaker, Dr Prem Jagyasi is world renowned medical tourism consultant. He has authored Medical Tourism Guidebook and Wellness Tourism Guidebook. He has also delivered numerous keynote speeches and focused corporate workshops in 45+ countries. More than 150 international organizations have benefited from his expertise through conferences, expert training, consultancy and brand management services. http://drprem.com

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By Abdallah A. Al Hindawi / Global Healthcare Travel Consultant

n the past fifteen years, Jordan has consistently developed its regional and international appeal as a foremost destination for healthcare travel standing to the leverage of the excellent medical reputation of Jordanian hospitals, internationally world-class board certified multilingual physicians, competitive cost structure supported by the magnificent natural spas, state-of-the-art resorts, accessibility, safety and clean environment that have positioned Jordan among top destinations in the global healthcare travel industry regionally and internationally. During the past two years Jordan global healthcare travel figures showed dramatic drop in numbers of patients traveling to Jordan for medical care and treatment and Jordan started losing its competitive edge very fast for other regional and international destinations such as Lebanon, Egypt, Tunisia, Turkey, Iran, India and Malaysia, despite the extensive and massive branding initiatives and efforts Jor-

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dan did for its medical services since 2009. Experts justify that mainly to certain political and regulatory issues such as visa restrictions, rising medical and non medical operational expenses and medical liability legislations. This can be part of the truth but not the whole truth as all healthcare service providers in competing countries are facing almost the same challenges Jordan are facing recently, but still they are achieving growing and positive trends in their healthcare travel statistics. The question that brings to this situation, is that why patients from traditional markets recently redirected the campus towards other destinations and patients from nontraditional markets are not even considering Jordan for their treatment Journey? From mid 1990s till early of 2000s, regional patients considered Jordan as a preferred outbound destination for medical care and treatment, and the perception of international medical travelers that era was focused on several incentives including cost,

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availability of specialty procedures, access time to care, accredited and high quality medical care, being part of insurance provider network, traveling for cultural competence and for anonymity. More recently and especially in the past five years the medical, hospitality, digitized communication, financing and insurance sectors have been witnessing tremendous development that changed the market demand driven and influenced the behavioral patterns and perceptions of medical travelers continuously. These all take place along with an increasing international demand on global healthcare services resulted due to the growth of middle class, the global healthcare shortage, the changing international health regulations, the medical travel programs for mid-size and smaller employers and the new insurer networks of institutes of quality and centers of excellence. Countries that have developed reviewed and updated strategies of their own, strategies that were communicated, implemented and monitored based on the expectations of the changing external environment and internal national performance were able compete and to become a preferred destinations for global healthcare travel, nevertheless to grow and to achieve steady and growing global healthcare travel results. As for Jordan, the global healthcare travel sector is still strong and is able to survive for longer years even within increasing global competition due to its excellent quality of medical care, its renowned global reputation, its niche medical specialties and private sector medical infrastructure. But still a lot more can be done in order to retrieve its remarkable past position in the global healthcare travel sector, create sustainable growth and development and increase its contribution to the GDP if new strategies on the national level are being formulated and communicated so as to get the sector back on the track again. These strategies should be integrating clinical, hospitality and patients experience taking into consideration adding value for patients, harnessing creativity and innovation,

leading with vision, inspiration and integrity, managing with agility, succeeding through the talent of people if wants to succeed and sustain. While formulating strategies is just the start, these strategies should be rational taking into consideration both internal and external environment and most importantly being supported by creative approaches that are unique for Jordan and obviously can create a change. These approaches could include; • Innovation and Technology including medical travel portals and social media. • Unique Value Proposition enriching patient experience and engagement. • Medical vs. Wellness & Tourism integrating treatment with wellness and tourism sectors Jordan’s unique characteristics. • Existing and New Niche Specialties & Treatments like less invasive medical procedures, dental, ophthalmology, plastic surgeries and sports medicine. These approaches relies on the fact that the global healthcare travel competition becomes a niche under developed markets that require offering unique integrated services and addressing selected target segments to attract them into Jordan. On the private sector side and most importantly that the sector should excel in parallel if wants to develop, grow, compete and sustain outstanding results. The private medical sector in Jordan shoulders the biggest responsibility and should continuously plays a creative role in excelling with their services, monitoring and improving their performance through continuous measurement and benchmarking, encouraging accountability and transparency, incorporating business solutions and sharing their best practices through standardization and developing niche integrated services powered by technology and high tech IT marketing tools, serviced by renowned hospitality and ease access to financial credits and insurance options. Abdallah.hindawi1@gmail.com

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ravel medicine is the field of medicine concerned with the promotion of health and respect for the peoples, cultures and environment of regions being visited in addition to the prevention of disease or other adverse health outcomes in the international traveler as well as any impact on the health of the local population

Dr.Ahmad Al-Ajaj Internal Medicine / Al-Ahli Hospital The Pre-Travel Consultation Pretravel consultation is very important for all travelers, in the travel clinic the doctor will take a detailed past medical history ( age, sex chronic diseases, medications… ) - Special conditions (Pregnancy, Breastfeeding, Disability or handicap, Immunocompromising conditions or medications, Older age, Seizure disorder, Recent surgery…), immunization history (Routine vaccines, Travel vaccines), Prior travel experience (Experience with malaria chemoprophylaxis, Experience with

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In 2015, 1,2 billion travelers worldwide crossed international boundaries. However, studies suggest only a small number of travelers seek pre-travel health advice. With the decreasing global boundaries and increasing activities, travel medicine has become a rapidly evolving field of medicine and has subsequently become a dynamic multidisciplinary specialty that encompasses aspects of Internal Medicine, Infectious Diseases, Public Health, Tropical Medicine, Wilderness Medicine, Psychiatry, Gynecology and appropriate immunization.

altitude, Illnesses related to prior travel), Trip Details (Itinerary, Timing, Reason for travel, Travel style, Special activities. immunization (Review routine immunizations and those travel immunizations indicated for the specific itinerary - Discuss utility of titers when records are unavailable or unreliable , Discuss indications for, effectiveness of, and adverse reactions to immunizations. ) , Malaria chemoprophylaxis. Discus other problems: Other vector borne diseases, Respi-

ratory illnesses, Travelers’ diarrhea Altitude illness, Other environmental hazards, Personal safety Sexual health and bloodborne pathogens.

Self-Treatable Conditions Prescribing certain medications in advance can empower the traveler to self-diagnose and treat common health problems. Travel health providers need to recognize the conditions for which the traveler may be at risk and educate the traveler about the diagnosis and treatment of those particular conditions, examples: Travelers’ diarrhea, Altitude illness,

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Jet lag, Motion sickness, Respiratory infections, Skin conditions, Urinary tract infections, Malaria self-treatment.

routinely provided as a part of one’s normal health maintenance (eg, tetanus immunization). These vaccines need to be updated before travel.

Basic health travel kit is recommended

Recommended vaccinations: These

Consider having a list of medications along with a medical attestation signed by a physician authenticating the need of those medications for personal use. The kit should include: •

Antiseptic wound cleanser, Antihistamines, Wound coverings, Adhesive bandages, medical tape, sterile gauze, Eye drops, Nasal decongestant, Hand antiseptic, Insect repellent / insect bite treatment ,Oral rehydration powder, Scissors, safety pins/ closure devices, Simple analgesics (eg, ibuprofen, acetaminophen), Thermometer (oral/rectal).

Additional considerations include the following •

Antidiarrheal medication, Anti Nausea medication (if any water travel or winding roads anticipated), Antifungal medication, Malaria prophylaxis (based on travel-clinic and/or CDC recommendations depending on destination), Personal medications (current medical conditions), Sleeping medications/sedatives, Water purifier/disinfectant.

Vaccination and Immunization Scheduling a visit to one’s doctor or a travel medicine provider is essential, ideally 4-6 weeks before the trip because most vaccinations require a period of days or weeks to become effective... We have 3 vaccines categories:

Routine vaccinations: Routine vaccinations are the immunizations that are

for advice.

How flying affects your health and what you can do to combat it? Airsickness: Is a sensation which is

vaccinations are recommended to protect travelers from illnesses present in other parts of the world and to prevent the importation of infectious diseases across international borders. Special considerations for aging, immunocompromised, pregnant, chronically ill, students, and disabled travelers are essential.

Required vaccinations: Like yellow fever vaccination for travel to certain countries in sub-Saharan Africa and tropical South America. In addition, those traveling during the Hajj are also required by the government of Saudi Arabia to obtain the meningococcal vaccination.

induced by air travel, It is a specific form of motion sickness, nausea and vomiting, the travelers advised not to eat before the travel if they have this condition and it can be treated with some medicines.

Sickness: The increased risk of catching a cold is more than 100 times higher on a plane. the travelers advised to use alcohol based gel to clean their hand and the chair arms. Deep Vein Thrombosis: •

•

Cruise Ship Medicine Today, most cruise ships require a ship physician to have some emergency medicine experience. Common medical conditions in cruise ships include the following: •

Sunburn, Alcohol intoxication , Seasickness, Upper and lower respiratory infections, Diarrhea and subsequent dehydration, Minor orthopedic injuries, Geographic specific illnesses, Exacerbation of common medical illnesses, Major orthopedic injuries, cardiac, diabetic crisis, and cerebrovascular accident (CVA) are not uncommon.

People planning cruise ship travel, especially those older than 65 years, those with acute or chronic illnesses, or those who are pregnant or breastfeeding should consult with a healthcare provider prior to travel

• •

•

A very well-known risk during air travel is developing leg clots or DVT, which kills thousands of people every year. Regular stretching and mobility exercises and if possible walking around the cabin during the flight. Drinking sufficient fluids to keep the urine pale. Taking a low dose aspirin tablet (75mg) for its anti-adhesive effects on blood platelets. The use of graded compression stockings. These are available at most pharmacies and are marketed specifically for use during long haul flights. Loose-fitting clothing may be beneficial in avoiding constriction of veins. Some recommend taking short naps, instead of long ones, to avoid prolonged inactivity.

Breathing difficulties The pressure in an airplane cabin at cruising altitude may make you feel like you are high in the mountains. There’s less oxygen available which puts an added load on a system trying

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to get the required amount of oxygen into the bloodstream.

Hearing problems: The human ear can tolerate 88 decibels for four hours and 85 decibels for eight hours, the noise on the plane usually 95-105 decibels (115 during take-off), the noisier part is the back, so you are at risk of hearing damage or hearing loss, and the more you fly, the greater the risk, Avoid the noisy places, move around and use the noise-reducing headphones (can cut noise by up to 40 decibels).

Reduction in taste: To taste salty and sweet can drop by as much as 30 percent in-flight. This is because plane air dries out the mucous membranes in your mouth. The solution? Stay hydrated, and stick to sour, bitter, and spicy foods, tastes that are much less affected. Jet lag: jet lag is part of long flights. Short-term problems from jet lag include fatigue, loss of concentration, irritability and loss of appetite. Consistent disruption of body rhythms could lead to cognitive decline, psychotic and mood disorders and possibly heart disease and cancer. What can we do? - A relaxed flight is important. - Avoid travelling when you are already tired and take rest before departure. - Remember the actual travelling time will usually be at least twice the actual time spent in the air since it will include travelling to and from and hanging around in airports. - Avoid heavy commitments on the first day. Be prepared for tiredness in the evenings and early waking which can last up to 5 or more days. - Sleeping tablets will help you sleep and be correspondingly alert during the next day but they do not speed up adjustment to the new time zone.

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Radiation: On most international flights, you are exposed to a not entirely insignificant dose of radiation from cosmic rays, which are energetic particles from space. The longer the flight and the higher and closer you fly to the North Pole, the greater the dose, Scientists say for the average tourist the levels are too low to worry about.

Constipation: All that sitting causes your metabolic rate and digestion to slow, and causes gas, bloating, and constipation. Suggestions to avoid it include cutting down on your calorie intake and twist from side to side in your seat to help everything keep moving, Drink a lot of water, and avoid alcohol and caffeine.But don’t even think of drinking water unless it’s bottled.

Bad Breath: Due to reduction in saliva production, which allows bacteria to flourish.Food particles left in the mouth produce a sulphur compound and cause bad breath, and overdoing it with sugary drinks, fast food, and sweets also encourages halitosis. Just as you would at home, eat healthily, drink water and brush your teeth.

Conditions that might cause problems during air travel include: • • • • • • •

Pregnancy beyond 36 weeks. New born babies during the first few days after birth. Recent or current middle ear infections or sinusitis. Unstable psychiatric illness or epilepsy. Recent myocardial infarction or moderate/severe heart failure. Recent chest, intra-cranial or abdominal surgery. Recent pneumothorax or moderate to severe hypoxic pulmonary disease.

• •

The presence of a communicable disease. Previous record of causing disruption during flights.

General advice for travelers 1. Prepare a plan for your travel. 2. Visit your doctor (travel medicine travel), preferably 3-4 weeks (minimally 10 days) before travel. 3. Use antiseptic (alcohol based gel) in the airport and the airplane. 4. Avoid the raw food (like salads, mixed fruits) and eat only the well cooked food, avoid sea food if possible. 5. Drink only the bottled water and make sure the bottle is sealed. Avoid the use of local ice cubes. 6. Don’t swim in the lakes or the rivers. 7. When you swim in the sea use the sunscreen and above it apply the mosquito repellent if indicated. 8. Don’t walk outdoor without shoes. 9. Take all the precautions against the mosquitoes (mosquito repellent, mosquito net, keep the doors and windows closed, search the room carefully for mosquitoes and kill them before you sleep, wear long sleeve and light-colored cloths). 10. Avoid the crowds and the risky places. 11. Respect the traditions and the culture of the people in the country you are visiting. 12. Keep a safety distance from animals. 13. If you are going safari or adventures in the jungle or the mountains wear a long stockings or long boot to avoid ticks bite. 14. If you have a wound or animal bite, wash it thoroughly with water and soap for 5 minutes and seek medical advice.

A4 Flyer.qxp_Layout 1 2017/06/15 7:21 PM Page 1

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EXHIBITION

Eurasian Orthopedic Forum in Moscow

brought together 3750 participants from a variety of countries panied by an adequate increase in professional and technical training. Therefore, global conferences are extremely necessary to improve the skills of orthopedic traumatologists. The Forum allowed discussing together the existing difficulties in various areas of traumatology and orthopedics and the possibility to improve the quality of diagnosis and treatment, ensuring accessibility and validity of providing high-tech orthopedic and trauma care.

he Eurasian Orthopedic Forum held on 29-30 June 2017 in Moscow brought together 3750 participants. Delegations from over 70 foreign countries, including the CIS, the countries of the Asia-Pacific region, the Middle East and the European Union registered to participate in the Forum. The largest groups of specialists were sent by: China (63), Bangladesh (46), Belarus and Thailand (25), Germany and India (13), Singapore (12), Armenia, Uzbekistan, Ukraine, France (8), Kazakhstan (6), Jordan (5). In the course of the Forum, the Association of Traumatologists and Orthopedists of Russia signed 13 memorandums of cooperation with medical institutions and professional associations of Azerbaijan, Bangladesh, Jordan, Iran, Kazakhstan, China, Moldova, Poland, Tajikistan, Uzbekistan, Japan. The increased interest in the program of the Forum is due to the significant role of traumatology and orthopedics

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in modern medicine and its high social relevance. “The number of surgeries for the implantation of various types of medical products attributed to orthopedic traumatologists outruns all clinical specialties put together, and this indicator is growing. For example, 5 years ago there were 8 to 10 thousand surgeries performed in Russia with regard to large joints arthroplasty, and more than 110 thousand in 2016” comments Sergey Mironov, Director of the Federal State Budgetary Institution Priorov Central Scientific Research Institute of Traumatology and Orthopedics, Head supernumerary specialist of traumatology and orthopedics of the Ministry of Health of Russia, President of the Association of Traumatologists and Orthopedists of Russia, Member of the Russian Academy of Sciences, Co-Chairman of the Scientific Committee of the EOF. Alongside, Chairman of the Forum’s organizing committee Sergey Mironov noted that the explosion of surgical activity is not always accom-

The high activity of developers and manufacturers of medical products at the EOF was explained by Deputy Minister of Industry and Trade of the Russian Federation Sergey Tsyb:”Support of the enterprises manufacturing medical products is one of the priority areas for the development of industrial policy in the Russian Federation, therefore the market is attractive to manufacturers, and they seek to interact with the medical community, representatives of the healthcare system and federal executive authorities. The Ministry of Industry and Trade of Russia actively promotes this integration, including at medical forums, such as the EOF. This leads to an increase in the development dynamics of manufacturing high-tech export-oriented Russian products for traumatology and orthopedics.” Another important feature of the Eurasian Orthopedic Forum was the active participation of professional associations, such as the Association of Traumatologists and Orthopedists of Russia, the Association of Traumatologists and Orthopedists of Moscow, as well as partner associations from 25 Eurasian countries, which provided

EXHIBITION

support to the Forum. Today active work is carried out on professional standards, the accreditation of specialists, clinical recommendations and protocols, as well as on the admission to the profession and particular place of work, causing the sharp growth of importance of professional medical organizations and their responsibility for the level of expert review related to documents issued by the Ministry of Health and the quality of medical care. To effectively solve all these tasks, medical specialists must act together. It is also impossible to overestimate the importance of the Euro-Asian partnership, which has strengthened during the Forum, and will now develop - this is important for both civilian healthcare and the military medical service. â€œMilitary healthcare in Russia is extremely interested in this partnership, in the development of new technologies, receiving new materials for traumatology and orthopedics, and the introduction of modern digital technologies. In addition, the development of any specialty is especially efficient within the multidisciplinary approach that was used at the Forum. It is beneficial that orthopedic traumatologists have had the opportunity to visit the adjacent sections on anesthesiology, radiology, oncology, neurosurgery and military field surgery,â€? said EvgeniyKryukov, Head of the Burdenko Main Military Clinical Hospital of the Ministry of Defense of the Russian Federation. The first Eurasian Orthopedic Forum won active acceptance of the industry community, and its organizers received numerous requests to hold the event on a regular basis.

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Osteoporosis

efining osteoporosis is commonly understood as related to bone structure itself rather than the calcium related to the structure. More the structure is lost, less the calcium supports this structure. Basically we prevent the loss of this structure and treat it when the osteoporosis develops.

Dr Majid Abi Saab Consultant Rheumatologist How we build our bone structure through life. The child start to grow and this needs certain amount of calcium daily during structure formation to keep a strength to this structure. When we measure the structure we do the bone mineral density called BMD that reflects the calcium deposit in the structure.

deviation of this peak value. If the T-score is less than -2.5 then we define it osteoporotic as per the WHO definition. (Table 1 and Diagram 1).

Factor implicated in Osteoporosis Many factors play major role in the decline mentioned above.

We then can draw a curve where an ideal peak bone mass is reached normally around the 30th. So the bone strength keep on growing until reaching this peak. Afterword it starts to decline with age. On menopausal age in women the decline is very rapid up to 2 % per year. Some people have high peak and therefore the decline never reach the osteoporosis range. If the peak is basically low, then the decline reach it earlier in life and risk to induce osteoporotic fractures. We generalize this method using a population curve and using a mean value according to which we calculate the T-score reflecting the standard

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of osteoporosis, other factors are the personal history and known diseases that affect the bone structure, some medications that induce more loss of this structure and the hormonal status of the affected person. Then come some personal habits including alcohol abuse, smoke, sedentary life style and thin persons are subject to develop earlier osteoporosis in life.

Why awareness in important in osteoporosis Osteoporosis can induce recurrent fractures mainly the vertebral bodies and hip fractures. When fracture occur in the spine it can make spinal deformities with kyphosis, reduced respiration, loss of abdominal musculature and unstable gait.

Some people are called â€œhigh losersâ€? (of bone) where the decline in BMD reaches above 2% per year. Factors are well known now-a-days that can affect this loss. First of all the genetic factors in case of strong family history

A mild fall can induce hip fracture and sometime the fracture is spontaneous during standing. Osteoporosis affects 30% of women in life and this is a very high rate that can be programmed earlier through prevention measures during growth, activity, control all the factors that can induce it and treat early.

NEWS

Article

Causes can also vary a great deal and can often be hard to identify. Sometimes depression appears to be caused by stress at home or at work, physical illness, loss, social isolation, relationship problems, bereavement, or hormonal changes caused by a recent pregnancy, and other factors.

Dr. Aicha Hind Rifai WCM-Q’s Assistant Professor of Clinical Psychiatry

epression and ways to treat it were discussed by a leading psychiatrist as members of the public were invited to Weill Cornell Medicine-Qatar (WCM-Q) for the latest installment of the Ask the Expert series. Dr. Aicha Hind Rifai, WCM-Q’s Assistant Professor of Clinical Psychiatry, gave an interactive presentation which explained the symptoms of depression, and ways that it can be effectively treated or managed with medications, therapy and lifestyle changes. Dr. Rifai also said that people suffering with depression or any form of mental illness should not be put off from seeking help by stigma. Dr. Rifai said: “Depression is an illness that we can treat, often very successfully. It is not something to be ashamed of. If you are worried that you may be depressed you should see your doctor, just as you would with any other health concern. We are here to offer help and support without judgment and in total confidence.” Dr. Rifai explained that depression is a complex condition that can be caused by many different factors or a combination of factors and which has many different symptoms. The condition is generally characterized by one or more of the following: persistent sadness, feelings of hopelessness, lethargy or anxiety, disturbed sleeping patterns, crying spells, appetite changes, irritability and social withdrawal, among others. Some people with depression may also have recurrent thoughts of death or suicide.

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In some cases, depression or depressive episodes may be triggered by a stressful or saddening life event, but in other cases people may feel depressed for no apparent reason. Whatever might be the cause, seeking help from professionals is recommended. In cases of post-partum depression where young children are involved, or when thoughts of suicide are frequent, professional care should be sought without delay. Dr. Rifai said: “Depression often appears to be caused by a complex interaction of many factors, which can be emotional, physical or cognitive. In general, if a person’s emotional state has a persistent negative effect on their daily lives and their enjoyment of life, we will be more likely to evaluate them as being depressed. The quicker depression is addressed the easier it is to treat. Early treatment also helps to prevent negative impact on the person’s health and that of their family“. Depression is often characterized by feelings of hopelessness and that things simply will never get better. I want to tell you that I personally have seen many patients who felt this way who we were able to treat successfully and who have gone on to regain happiness and fulfillment from their lives.” If depression is diagnosed, treatment can include antidepressant medication, cognitive therapy, counseling, lifestyle changes such as altering one’s work-life balance, or a combination of several approaches. Dr. Rifai added: “Our goal is to help people regain enjoyment of their lives and to help them return to their normal level of function.”

NEWS

Moorfields CEO

appointed chairman of World Association of Eye Hospitals

avid Probert, chief executive at Moorfields Eye Hospital NHS Foundation Trust, has been appointed chairman of the World Association of Eye Hospitals (WAEH). David will lead the association for the next two years, taking over from Charity Wai, chief operating officer at the Singapore National Eye Centre. The announcement was made at the WAEH 11th annual meeting, which was held at the Tianjin Medical Uni-

versity Eye Hospital - the first time the meeting has been held in China. Moorfields Eye Hospital Dubai, the first overseas branch of the world-renowned Moorfields Eye Hospital in London, hosted the 2014 board meeting of the World Association of Eye Hospitals, followed by a special conference on the future of eye care. The event, which coincided with World Sight Day 2014, was hosted by the Mohammed bin Rashid Academic Medical Center (MBR-AMC) at Dubai Healthcare City.

London Hospitals NHS Foundation Trust (UCLH) and has 18 years experience in healthcare management.

Since joining Moorfields in April 2016, David successfully led the trust to gain a rating of ‘Good’ from the Care Quality Commission, the independent regulator of all health and social care services in England, and accreditation for five further years as a National Institute for Health Research (NIHR) Biomedical Research Centre and Clinical Research Facility. He is the former director of strategic development at University College

Over the last three years as chairman, Charity Wai has been instrumental in growing the WAEH membership from its eight founding member hospitals. She helped connect the association to eye hospitals in the United States, Central America and Asia. There are now 40 eye hospitals that participate in the annual meetings, connecting members across five continents to discuss the future of eye care.

Commenting on his appointment, David Probert said, “The World Association of Eye Hospitals is an invaluable forum to work together and share knowledge. I am looking forward to leading the association to ensure that it continues to promote collaboration in ophthalmology to improve care and outcomes for people with sight loss around the world.”

Dubai will have clinics for your headaches

wo clinics to treat headaches will soon be launched by the Dubai Health Authority (DHA). The multidisciplinary headache clinics that will include treating headaches through the use of botox will be opened in Nad Al Hamar Health Centre and Al Barsha Health Centre this month.

The launch of these headache clinics came after a notable demand from patients as the neurology department at the Rashid Hospital receives around 5,000 patients annually complaining from headaches. Dr Manal Taryam, the CEO of primary health care (PHC) sector said the launch of the Headache Clinic is in line with the PHC’s initiative to launch specialised clinics within health centres in Dubai to make sought-after specialisation more accessible and time efficient. In order to launch these specialised centres the PHC has collaborated with doctors from the DHA hospitals to provide their services to customers at these specialised centres. “We have decided to first launch a headache clinic after we conducted a study and found that there is a high demand from patients. We are first going to launch a headache clinic in Nad Al Hamar Health Centre on July 17 and after that in two weeks, we will be launching a second headache centre in Al Barsha Health Centre,” she said. Dr Taryam said the centre will offer a one-stop-clinic for patients where they will be examined by a neurology consultant, a psychologist, physiotherapist and a family physician who is especially trained in neurology as studies have found that getting examined across these four specialities is the most effective way to treat headaches and migraines.

JULY.AUGUST 2017

NEWS

Cerner Middle East & Africa

strengthens client alignment with the appointment of new leadership roles Dey’s new appointment is in support of the plans of Qatar’s Ministry of Public Health and other leaders in the country. Dey will be responsible for advancing Cerner’s government-level relationships with providers and suppliers to help facilitate improved health outcomes.

erner Middle East and Africa announced the appointment of two additional general managers to strengthen its client engagement model in the Middle East. Adrian Dey has been appointed as the new general manager for Qatar, and Michael Schelper, chief operating officer in the Middle East & Africa, will take on the additional role of general manager for the United Arab Emirates (UAE) and Kuwait. The move comes at a time when Cerner Middle East & Africa has established a strong presence in the region and is working with client organizations to support a focus on population health management.

Dey has more than 18 years of experience in IT managed services, with a primary focus on client relationships, transition, transformation, and service delivery. Before joining Cerner Middle East & Africa, Dey had leadership positions with Electronic Data Systems, Hewlett Packard and Injazat Data Systems (a Mubadala company).

“Adrian will be a key member of our management team, identifying opportunities to collaborate more closely with the ministry and our existing client organizations to fulfill their strategic vision,” said Mike Pomerance, vice president and managing director, Cerner Middle East & Africa. “I am confident that Adrian will lead Cerner on the next phase of our journey in Qatar.” Schelper joined Cerner in 2009 and has had various regional leadership roles, including in business development, sales, consulting, mergers and acquisitions and operations. As the chief operating officer for Cerner Middle East & Africa the past two years, Schelper has led Cerner’s core business operations including quality, performance management and new market entries. In his new role, Michael will oversee strategic client alignment and development with clients to shape the future of healthcare. Schelper’s focus will be to support the UAE and Kuwait governments to achieve a world-class, seamlessly integrated healthcare system that manages the population, one person at a time. “Michael has proven to be both a dynamic leader and accomplished

at strategy execution. Under his leadership, we’ll continue working with Cerner’s client organizations to enhance the healthcare experience for patients and caregivers,” said Pomerance. Over the past 26 years, Cerner has collaborated with leading healthcare organizations in the Middle East to create integrated healthcare systems designed to help improve the patient’s experience with the person at the center of care. This highlights the region’s vision to create a healthy population by having a healthcare system whose services are accessible to the entire community. Dey and Schelper join Ali Slimani and Bachir Awad as Cerner Middle East & Africa general managers. Slimani joined Cerner in 2005 and has had client-facing and implementation roles. As a general manager, Slimani manages all facets of the Cerner business development relationship with healthcare organizations to facilitate making the vision of these prospective clients a reality. Awad joined Cerner in 2006 and has worked in different leadership capacities around the globe. In his current role, Awad oversees strategic collaborations with the United Arab Emirates’ Ministry of Health and Prevention, Al Jalila Children’s Specialty Hospital and the Abu Dhabi Health Services Company. The alignment between Cerner and its clients helps accelerate the use and adoption of health IT with the goal to improve the health and well-being of the UAE population.

NEWS

PENTAX Medical Europe

launches PROfILE single-use cleaning brushes for endoscope reprocessing deliver reliable reprocessing results and enhance the performance of PENTAX Medical endoscopes.

esigned specifically for use with PENTAX Medical endoscopes, together providing a verified and validated tool to facilitate manual cleaning. Hamburg, 21 June 2017 – PENTAX Medical Europe announces the launch of PROfILE single-use cleaning brushes for endoscope reprocessing to the EMEA market. This range of disposable brushes has been designed to meet the high standards expected of PENTAX Medical, with a focus on patient safety and hygiene. In addition to its high quality endoscope offerings, PENTAX Medical is committed to providing a complete and hygienic solution for endoscopy that also includes hygiene consumables, accessories, and tools for advanced therapy. The new PROfILE single-use brushes have been extensively tested in combination with PENTAX Medical endoscopes to meet the strict standards of the Association for the Advancement of Medical Instrumentation (AAMI) and FDA’s 2015 Final Guidance on Reprocessing Reusable Medical Devices. When used according to the Instructions for Use for the brush and the scope reprocessing, we are confident that the new single-use brushes help

JULY.AUGUST 2017

Designed exclusively for PENTAX Medical endoscopes, the use of these dedicated brushes supports compliance with PENTAX Medical Instructions for Use and recommended reprocessing practices, according to guidelines issued by gastroenterology associations around the globe. ESGE and ESGENA guidelines recommend a switch from reusable to disposable brushes to allow for maximum effectiveness of cleaning and to avoid tissue carryover. The full portfolio of PROfILE single-use cleaning brushes from PENTAX Medical includes nine different competitively priced models, exclusively designed to cover most of PENTAX Medical’s endoscopes. The range includes six long channel brushes and three short channel brushes. A pull-through technique takes advantage of the bristles located at one end of the brushes to facilitate proper and complete cleaning. In addition to the support it offers throughout the complete clinical pathway, PENTAX Medical has a strong focus on patient safety and hygiene, which is positioned at the forefront of its product design and development programs. Demonstrating this ongoing commitment to patient safety, the PROfILE single-use cleaning brushes have been designed to address reprocessing needs. These cleaning brushes are the first accessories in a line of hygiene-related products that will be released by the company over the next months.

This new range of accessories is designed specifically for PENTAX Medical’s endoscopes, to support you in fulfilling the needs of hygiene departments, reducing the risk of infection and cross contamination, and increasing confidence in safety of the reprocessing outcome. Rainer Burkard, President EMEA, PENTAX Medical commented, “Proper manual cleaning of flexible endoscopes is key to reliable high-level disinfection and infection prevention. At PENTAX Medical, we take patient safety and hygiene incredibly seriously. As the majority of the cleaning procedures are carried out by a combination of manual pre-cleaning and automated reprocessing we have focused on providing enhanced manual cleaning accessories. With our new range of PROfILE single-use cleaning brushes, we provide a tool that has been validated and verified for use with PENTAX Medical endoscopes to improve confidence in manual cleaning and support compliance with our instructions for use.” PENTAX Medical is a division of HOYA Group. Its mission is to improve the standard of patient care and quality of healthcare delivery by providing the best endoscopic products and services with a focus on QUALITY, CLINICALLY RELEVANT INNOVATION, and SIMPLICITY. Through leading edge R&D and manufacturing, PENTAX Medical provides endoscopic imaging devices and solutions to the global medical community. Headquartered in Japan, PENTAX Medical has a worldwide focus and presence with R&D, regional sales, service, and in-country facilities around the globe.

NEWS

Sultan Al Qasimi witnesses the signing of a memorandum

of understanding between The American University of Sharjah Enterprises and Oxford Sciences Innovation the city of Oxford. The agreement was signed during the recent meeting of the Board of Trustees of the American University of Sharjah. Dr. Schauer’s visit started on May 6, 2017; his schedule included bariatric surgeries like Sleeve Gastrectomy, Gastric bypass, Redo Bariatric surgeries and consultations, in addition to lecture on the 8th of May 2017 under the supervision of General Surgery and Obesity Surgery Department at Royale Hayat. Dr. Philip Schauer, is the Chief of Minimally Invasive General Surgery and Director of the Cleveland Clinic Bariatric and Metabolic Institute (BMI), Director of endoscopic surgery, Director of bariatric surgery and Director of the Mark Ravitch/Leon Hirsch Center for Minimally Invasive Surgery at the University of Pittsburgh Medical Center.

is Highness Sheikh Dr. Sultan bin Muhammad Al Qasimi, Supreme Council Member and Ruler of Sharjah, President of the American University of Sharjah (AUS) witnessed in London, the signing of a strategic Memorandum of Understanding (MoU) between AUS Enterprises and Oxford Sciences Innovation (OSI), a company that commercializes science and technology from the UK’s University of Oxford, to mutually enhance the innovation ecosystems of the Emirate of Sharjah and

He is an expert in treating severe obesity, minimally invasive surgery (laparoscopic), gastrointestinal surgery, and has performed more than 5000 operations for severe obesity. Royale Hayat Hospital offers the services and expertise of a highly qualified medical team and visiting doctors program along with advanced technology and caring atmosphere to ensure safety and comfort to patients and their families.

Royale Hayat Hospital

Announces the Visit of Dr. Philip Schauer tric bypass, Redo Bariatric surgeries and consultations, in addition to lecture on the 8th of May 2017 under the supervision of General Surgery and Obesity Surgery Department at Royale Hayat.

eneral Surgery and Obesity Surgery Department at Royale Hayat Hospital is pleased to announce the successful visit of Dr. Philip Schauer, Head of Bariatric and Metabolic Surgery of Cleveland Clinic, USA. Dr. Schauer’s visit started on May 6, 2017; his schedule included bariatric surgeries like Sleeve Gastrectomy, Gas-

Dr. Philip Schauer, is the Chief of Minimally Invasive General Surgery and Director of the Cleveland Clinic Bariatric and Metabolic Institute (BMI), Director of endoscopic surgery, Director of bariatric surgery and Director of the Mark Ravitch/Leon Hirsch Center for Minimally Invasive Surgery at the University of Pittsburgh Medical Center. He is an expert in treating severe obesity, minimally invasive surgery (laparoscopic), gastrointestinal surgery, and has performed more than 5000 operations for severe obesity. Royale Hayat Hospital offers the services and expertise of a highly qualified medical team and visiting doctors program along with advanced technology and caring atmosphere to ensure safety and comfort to patients and their families.

NEWS

Cochlear applauds WHO hearing health action plan for prevention of deafness and hearing loss globally

ochlear Limited (ASX: COH), the global leader in implantable hearing solutions, welcomed the news that the World Health Assembly (WHA) has today supported a resolution that provides a hearing health policy action plan and recognizes the benefits of prevention, intervention and treatment of hearing loss globally. The WHA, the governing body of the World Health Organization (WHO), which includes senior health leaders from 192 member nations, has reaffirmed that concrete steps must be taken in order to make progress in dealing with the rising prevalence of hearing loss. The resolution reinforces that hearing loss is a significant public health issue, requiring every government to make it a higher priority and develop a national action plan to address it. The WHO estimates that over 360 million people — over 5 per cent of the world’s population — live with disabling hearing loss, 32 million of whom are children. With prevalence rates rising, the global cost of unaddressed hearing loss has recently been estimated at $750 billion per year. The WHA resolution

outlines practical, cost effective steps, starting with awareness, hearing screening programs at key stages of life, and making assistive hearing technologies, such cochlear implants, more accessible to those who need them. Chris Smith, Cochlear CEO & President, welcomed the leadership of government health policy leaders worldwide. “This resolution gives hope to people with disabling hearing loss, no matter their age, or where they’re from,” said Smith. “In some countries, children with hearing loss are excluded from schooling. Adults with hearing loss are unable to find work or fulfil their potential, and older adults face costly health problems when hearing loss is unaddressed.” “The jury is no longer out — deafness and hearing loss have been found to be a significant global public health issue and the world’s leading health policy-setting body has said it’s time to act. At Cochlear, we are driven by our mission to improve the lives of people with hearing loss, and as a hearing health expert, we join with other stakeholders to play our part in tackling this global health issue.” “This resolution is a major milestone and if implemented, has the potential

to alleviate the enormous burden experienced by millions of people and many societies.” The resolution sets out a number of critical steps for addressing the impact of deafness and hearing loss, including: •

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Raised awareness among decision-makers and the general public about the high prevalence of hearing loss and its social and economic impact. Improved access to affordable, high-quality assistive hearing technologies and products, including hearing aids and cochlear implants, as part of universal health coverage. Enhanced screening programs to identify and diagnose ear disease and hearing loss early, with attention placed on infants, young children and older adults. Raised awareness of noise-induced hearing loss and implementation of measures that address occupational, environmental and recreational exposure to noise. Better data collection on ear disease and hearing loss to educate and inform policy decision-makers to develop evidence-based strategies.

GV Health transforming Safety and Hygiene

nd-to-end environmental hygiene and safety solutions deliver improved standards to public health and social care providers. GV Health announced a new end-toend approach for public health and social care designed to transform safety and hygiene at the Health+ Care event, that took place in London from 28-29 June 2017. With

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the increasingly complex range of environmental hygiene and safety requirements and the huge variations in settings where care is delivered it is now more than ever vital that public health and social care providers partner with an organization with the appropriate levels of expertise, skill and experience. By taking a new integrated, end-to-end approach to

hygiene and safety GV Health will empower health and care providers to successfully deliver best practice across all areas of their activities. GV Health is uniquely placed as a solution provider. With over 25 years experience working with the NHS acute sector and with health authorities in Europe, the Middle East, Africa and Asia, the company has pioneered

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developments in a number of areas, providing some of the most widely used and respected waste management, environmental hygiene and safety solutions in the world. SoChlor, GV Health’s market leading environmental disinfectant played a huge part in halting the West Africa Ebola outbreak. Used by the major aid agencies and by government health authorities in every coun-

try affected by the outbreak, the company won a prestigious Africa Healthcare award for its work in this area. The end-to-end hygiene and safety approach addresses four key areas where leading public health and social care providers are seeking transformation. These are the management of waste, in particular infectious waste, to reduce environmental impact and increase safety; environmental hygiene, decontamination

and equipment sterilization, to create cleaner, safer service delivery environments; effective and timely response to emergency spillages of infectious biohazards and other substances including cytotoxins and chemicals to provide higher levels of protection for patients, staff and the public; and the need to provide better personal protective equipment and tools for care givers to reduce risk and improve patient safety.

Birth defect detected at age 58

British woman undergoes surgery in Dubai and walks within 24 hours

58-year-old British woman successfully underwent surgery at Aster Hospital Mankhool to correct a birth defect and regained her ability to perform normal daily activities. Throughout her life, the patient struggled with mobility and found it difficult to execute certain movements such as going up the stairs, sitting cross legged or even stretching her legs. Dr. Manjunatha G.S., Specialist Orthopedic Surgeon at Aster Hospital, diagnosed the patient with Developmental Dysplasia (dislocation) of the Hip, or dysplastic hip, on the right side. Further complicating her case, the friction caused by the abnormal and continuous gritting of the joint, caused the patient’s right hip center to be 1.6 cms above her left hip and also lead to

the development of severe secondary osteoarthritis. The congenital condition, which is usually diagnosed at birth and early stages in life, had gone undetected throughout the patient’s life, until the team at Aster discovered the cause of the patient’s discomfort. Commenting on the case, Dr. Manjunatha said: “Dysplastic hip is the most common congenital hip disorder in children and generally leads to secondary osteoarthritis of the hip joint at a very young age. However, it is uncommon for the condition to go undetected for so many years. At age 58, we diagnosed the patient with dysplastic hip after her condition had drastically deteriorated and hindered her daily life activities. By performing the total hip replacement surgery and limb correction we successfully managed to alleviate the patient’s pain and enabled her to regain the ability to perform daily tasks and functions.” The surgery involved minimally invasive incisions and the patient was able to walk in less than 24 hours without experiencing any pain. As part of Aster Hospital’s post-op protocols, the patient also underwent mild sessions of physiotherapy and was able to walk without any support or walking aids by the third week post-surgery.

Commenting on her recovery the patient said: “Throughout my life, I experienced discomfort while performing simple activities like going up the stairs where I would always lean on one side to climb up. At the time, I used to think that this was completely normal, but I was very lucky to find Dr Manjunatha and his team at Aster Hospital, who made an effort to detect the root cause of the problem and diagnosed the real reason behind the discomfort that I was facing. Thanks to the team at Aster, I am now able to perform daily tasks with ease and pain-free.” Dysplastic hip occurs in two forms, namely partial subluxation and complete dislocation. It is more likely for the condition to be diagnosed when it occurs in a single joint, however in the patient’s case; it remained undiagnosed until the age of 58. Dysplastic hip condition is generally recognized and corrected at one of the following stages: • at the time of birth • when a child starts walking at age 1 or 1.5 years, he/she may face a delay • during teenage years • during pregnancy • in the late 30’s • at the end of osteoarthritis

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Ministry of Health & Prevention

partners with Jafza to develop pharmaceutical sector try. It is one of the key sectors of the Dubai Industrial Strategy launched by His Highness Sheikh Mohammed bin Rashid Al Maktoum, Vice President and Prime Minister of the UAE and Ruler of Dubai. It is also a key part of the Dubai 2021 Plan, aimed at transforming Dubai into a regional hub for medical tourism as the country prepares for the post-oil era. The ultimate aim is to manufacture high quality medicines and healthcare products in Dubai comparable to those around the world with our focus on boosting investment in research and development, and attracting qualified professionals.”

he UAE Ministry of Health and Prevention and Jafza, a DP World company, have signed a Memorandum of Understanding (MoU) for the development of the healthcare and pharmaceutical sector in the country. The Memorandum was signed at Jafza head office by Dr. Amin Hussein Al Amiri, Assistant Under Secretary of Public Health and Licensing Policy at the Ministry of Health and Protection and Mohammed Al Muallem, CEO Jafza and Senior Vice President and General Manager of DP World, UAE Region. Senior Ministry and Jafza officials were also present. Under the agreement, Jafza will develop details for the licensing of pharmaceutical factories within the Free Zone and help them promote public health. The Ministry will approve licenses for existing factories based on the industrial license issued by Jafza, regardless of the nationality of their owners. Factories need to register

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their products and declare whether they are for export or distribution. For use in the UAE companies need to obtain a medical warehouse license. Both organizations will exchange knowledge and remove any barriers to the development of the pharmaceutical sector in the Free Zone. They will also review the process of obtaining approvals and permits from the Ministry, enabling Jafza to attract more foreign investment in the sector. The agreement is part of Jafza’s efforts to enhance the healthcare sector by providing the environment for companies to grow and establish ‘Made in Dubai’ pharmaceutical products, using Jebel Ali’s infrastructure to access regional and international markets. DP World Group Chairman and CEO, Sultan Ahmed bin Sulayem, said: “This is a major step forward in efforts to raise the competitiveness of the pharmaceutical industry in the coun-

Dr. Amin Al Amiri said the agreement builds on cooperation between federal and local government institutions to promote a legislative and investment environment in keeping with international best practice. The UAE aims to become a global hub for international pharmaceutical companies and to encourage them to set up factories here. There are 54 international pharmaceutical companies already present in the free zone which is expected to rise to over 75 by 2021, with investments of up to AED 2 billion annually. He added that the Ministry is keen to partner with international companies to establish research centers for the production of innovative and generic drugs in cooperation with local factories. The plan is to secure medical supplies and provide medicines for patients, especially those suffering from chronic diseases as well as to ensure the sustainability of the pharmaceutical supply chain and capacity of the medical sector.

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In 2016, the market value of drugs in the UAE amounted to AED 9.61 billion. By 2020, spending on medicine is expected to reach AED 13.13 billion and by 2025 AED 21.74 billion, driven by population growth, changing morbidity and the use of modern medicines such as biotechnology drugs. The UAE currently has 17 pharmaceutical factories with 34

expected by 2021. The Ministry supports them in establishing strategic partnerships with international manufacturers to produce innovative medicines and has five such agreements in place. The total medicine market in UAE reached AED 9.61 Billion in 2016, according to a recent report by Business Monitor International. It predicts

that the medical equipment market in the Middle East and North Africa will grow 8.8% year-on-year from 2015-2020, opening up opportunities for health care and pharmaceutical companies. Multinational companies in the healthcare and pharmaceutical sector are currently based in Jafza, such as Johnson & Johnson, Colgate, Roche, Sanofi, GlaxoSmithKline and Quest Vitamins.

... And partners with Jafza to develop pharmaceutical sector za head office by Dr. Amin Hussein Al Amiri, Assistant Under Secretary of Public Health and Licensing Policy at the Ministry of Health and Protection and Mohammed Al Muallem, CEO Jafza and Senior Vice President and General Manager of DP World, UAE Region. Senior Ministry and Jafza officials were also present.

he Ministry of Health and Prevention recently hosted the second meeting of the GCC Health Councilâ€™s Central Registration Committee for Medical Devices and their Manufacturers in Dubai under the chairmanship of H.E. Dr. Amin Hussein Al Amiri, the Ministryâ€™s

Assistant Undersecretary for Public Health Policy and Licensing. Also present during the meeting were Dr. Hajed bin Mohammed, Deputy Director General of the GCC Health Council, and other high-level representatives from the member countries. The Memorandum was signed at Jaf-

Under the agreement, Jafza will develop details for the licensing of pharmaceutical factories within the Free Zone and help them promote public health. The Ministry will approve licenses for existing factories based on the industrial license issued by Jafza, regardless of the nationality of their owners. Factories need to register their products and declare whether they are for export or distribution.

ARTICLE

Inflammation & Chronic Pain By QU-CMED Professor of Biochemistry Prof Bared Safieh-Garabedian

atar University College of Medicine (QU-CMED) Professor of Biochemistry Prof Bared Safieh-Garabedian was recently invited as Visiting Distinguished Faculty to give a lecture at the Neuroscience School of Advanced Studies, Certosa di Pontignano, Italy, among an exciting array of international speakers from France, Germany, Sweden, UK, and the USA.

Around 40 postdoctoral scientists and clinicians from around the world attended the stimulating course entitled “Chronic Pain: Plasticity and Therapeutic Perspectives” that ran presentations over a period of seven days where Prof Bared presented his lecture on “Inflammation and Chronic Pain”, and in which he discussed the different components of inflammation and how targeting inflammatory mediators might result in novel therapeutic approaches in neuropathic pain. Prof Bared noted that unresolved inflammatory reactions can contribute to several pathological states. He said: “A common underlying mechanism of neuropathic pain is the presence of inflammation at the site of the damaged or affected nerve(s). This inflammatory response, especially when unresolved, initiates and maintains a cascade of events resulting in the activation of innate immune

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cells at the site of tissue injury.” He highlighted that the release of inflammatory mediators such as cytokines, neurotrophic factors, and chemokines initiate local actions and can result in a more generalized immune response. “The resultant neuroinflammatory environment can cause activation of glial cells which can release in an uncontrolled manner, more of these mediators exasperate the situation, thus having a prominent role in nociception”, he said, adding, “The neuropathic pain pathophysiology is complex and includes peripheral and central neuronal alterations as well as neuro-immune interactions, which become more prominent during inflammatory reactions.” Prof Bared noted that neuropathic pain, often referred to as chronic pain, unlike acute pain, is considered to be pathological in nature. He said: “neuropathic pain is a severe

chronic disease that can develop following lesions to the central nervous system (CNS) (spinal cord injury, stroke, and multiple sclerosis) or to peripheral nerves.” He observed that the peripheral nerve damage can be caused by diseases -- diabetes and herpes zoster -- or trauma -compression, stretch, and amputation. He said: “Given that current therapies are unsatisfactory, neurogenic pains are often characterized by their resistance to traditional treatments with analgesics including opiates.” In closing, Prof Bared said: “Symptomatic treatments with various strategies have been used, including sympatholytics, antidepressants, anti epileptics and various anti-inflammatory drugs or their various combinations. Investigations of mechanisms by which nerve damage triggers pain are ongoing, the goal of which is to find new targets for better treatment.”

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