The UAE Ministry of Health and Prevention (MOHAP) has launched a ‘virtual doctor’ to assess potential cases of coronavirus, as part of the efforts to curb the spread of the pandemic.

According to recent reports, the UAE has carried out more than 125,000 tests for coronavirus. MOHAP has highlighted that almost 13,000 people per million had been assessed as part of efforts to combat the spread of the pandemic. The authority also said its testing coverage was "the highest in the world".

Coronavirus queries answered

The virtual doctor aims to ease the burden on the health services across the country. It asks users five multiple-choice questions, including a person’s travel history, symptoms and if they’ve been in contact with someone who has been infected with the coronavirus.

The tool tells users, “Salam Alaikum, I’m here to guide you through the Coronavirus Assessment Tool. If you’re experiencing a life- or limb-threatening emergency, call (998). I’m not a substitute for professional medical advice, diagnosis, or treatment. Always consult a medical professional for serious symptoms or emergencies.”

The first question asked is if the person has travelled to China Including Hong Kong, Italy, Iran, Republic of Korea, Spain, France, Germany, United States of America, Switzerland, Netherlands, Denmark, Sweden, Norway, Japan, Belgium, Austria, Kuwait, Bahrain.

It then asks if the person has been in contact with someone who has travelled or transited through these countries and is now sick. This is followed by a question on if they’ve been in contact with anyone who is infected and if they are experiencing any symptoms such as a fever, cough, runny nose, sore throat or shortness of breath.

Depending on the answers, the tool gives two different responses. It could be ‘we would like to talk with you as soon as possible. Please call 998’ or ‘dear patient, you have a low risk for Covid-19. If you need further information please call the following number: 800-FLU(358)’.

Help is at hand

There are also online tools in the UAE that are available to residents. This includes the ‘Doctor for Every Citizen’ initiative, launched by the Dubai Health Authority (DHA), which offers 24/7 consultations with doctors regarding Covid-19 concerns via video and voice calls. Appointments can be made on DHA’s hotline, 800 324.

Moreover, the Abu Dhabi Department of Health has launched a website, www.doh.saal.ai, to keep residents informed about the coronavirus.

According to reports, the Dubai Health Authority (DHA) has instructed all hospitals in Dubai to postpone all elective and non-urgent surgeries from March 18 until the end of March. This move has reportedly been made to prepare the country's healthcare system to fight the new coronavirus. The extension will be subject to review after March 31.

Safeguarding public health

A DHA circular said: "The purpose of this action is to protect the citizens and residents of the emirate of Dubai by ensuring adequate resources such as the availability of the hospital beds and qualified healthcare professionals to provide adequate care."

Health insurance for the procedures will also be suspended by the Dubai Health Insurance Corporation, the DHA circular added.

"The decision is in line with the ongoing efforts to safeguard public health and manage the cases of Covid-19 virus, and based on the current need of ensuring the preparedness of health facilities to provide the required healthcare," a statement from the authority said.

According to the 5th annual Philip sleep survey titled “Wake Up Call: Global Sleep Satisfaction Trends”, which surveyed more than 13,000 adults in 13 countries to capture attitudes, sleep apnoea and the importance of Continuous positive airway pressure (CPAP) therapy is not well understood – even among those who have the condition.

Risk factors for sleep apnoea

Even when aided, people are not able to consistently identify risk factors for obstructive sleep apnoea. The risk factor most often identified is being overweight/obese, but still only about half select it (including 51 per cent of those who have sleep apnoea, 47 per cent of those who do not have sleep apnoea).

The survey identified that a substantial portion of people with sleep apnoea (30 per cent) somewhat or completely agree that they do not think it is necessary to be treated for sleep apnoea. Meanwhile, 39 per cent of those with sleep apnoea somewhat or completely agree treatment for sleep apnoea is worse than the disease itself and nearly half of the people who have sleep apnoea have never been prescribed CPAP therapy (48 per cent).

Sleep trends

Overall, the survey highlighted that in 2020, people are significantly less likely to be actively doing something to improve their sleep compared to results from the Philips’ 2019 World Sleep Day Report.

While watching TV (2019: 37 per cent vs. 2020: 33 per cent – the most common strategy people currently use to improve their sleep) is used by fewer people now compared to 2019, the decline in use is most notable for reading, listening to soothing music, using sunrise alarm clock and meditation.

“The decrease in people taking action to improve sleep is alarming, especially when it is clear people around the world deeply value sleep. Sleep deficit impacts people both mentally and physically, so we need to educate people on available sleep resources and empower them with the confidence that their efforts will pay off,” said Mark Aloia, PhD, Global Lead for Behavior Change, Sleep & Respiratory Care at Philips.

Side effects

According to the National Sleep Foundation, obstructive sleep apnoea can occur when the upper airway becomes blocked repeatedly during sleep, reducing or completely stopping airflow.

There have been a number of studies highlighting that there is growing evidence that the condition affects glucose metabolism and promotes insulin resistance, leading to type 2 diabetes, and weight gain. However, studies also found that treating sleep apnoea might actually improve glycaemic control and long-term complications from diabetes.

Moreover, the connection between sleep apnoea and heart disease has also been evolving rapidly. Sleep apnoea has been linked with heart arrhythmias, atrial fibrillation, heart failure, heart attacks, and strokes, most likely because it is associated with high blood pressure. Whether sleep apnoea actually causes heart disease is still unclear, however, it does increase the chance of developing hypertension in the future significantly.

A study in the journal of the American Heart Association discovered that moderate to severe obstructive sleep apnoea (OSA) can cause changes in the heart’s shape and function, similar to the effects of hypertension. But six months after CPAP treatment, the abnormalities returned to near-normal measurements in patients.

The winner of the Heinz Stammberger award for excellence in teaching at this year’s ME OTO, which is taking place between June 18 to 20, is Professor Narayanan Janakiram, an ENT & Skull Base surgeon from India. The professor is renowned world over in the Endoscopic management of Juvenile Nasopharyngeal Angiofibroma (JNA) and for his work in Skull Base surgery. He is currently the Managing Director of Royal Pearl Hospital, Tiruchirapally, India.

The Heinz Stammberger award for excellence honours the legacy of the late Professor Heinz Stammberger and his commitment to teaching surgeons in the far corners of the world. The prize honours Otorhinolaryngologists who have significantly contributed to ENT education. For Professor Janakiram, this award holds an even more special place in his heart as Professor Stammberger was one of his teachers.

He shares: “Inspired by pioneers like Professor Stammberger, I am committed to providing creditworthy education in sinus and skull base surgeries in over 40 countries with the integration of advanced multimedia technology live procedures, orations, lectures and web telecasts. As a training chief of Neuroendoscopy, Asia Pacific, my objective is to improve patient care globally.” Excerpts from the interview:

Tell us about yourself, how did you get into the profession and what inspired you?

I completed my graduation and post-graduation from India’s Madras Medical College. India is a country with enormous diversity with 80 per cent of its population living in villages. Coming from a village in India with an enormous number of underprivileged people, I wanted to serve my community and, hence, my dream was to become a doctor since childhood. Moreover, during my college years, my mother developed oral malignancy, and this was a powerful motive for me to become an ENT surgeon.

Any anecdotes about what your early years at medical school were like?

I did my ENT during an era in which there were no endoscopes or high-end camera systems nor where there high-end surgeries like implants or advanced endoscopic skull base procedures, which are being done now. People from other faculties used to call us "Tonsil Surgeons". I used to feel depressed about it.

When I was doing my Masters in ENT in 1995, that was the first time I had a look into the nasal cavity and Nasopharynx with a cystoscope, which my professor brought from the Urology department. It was the greatest day of my life, which I can never forget. That day I decided I will be a Rhinologist.

Furthermore, my father and grandfather were great teachers and I grew up listening to their classes as a child. So, teaching was in my blood and once I joined ENT, I made up my mind to teach whatever I could to the best of my abilities.

I started teaching at a very early age at Trichy Medical College. I joined the institution as an Assistant Professor in the Department of Anatomy. I then got trained by leaders in the field of Rhinology such as Professor DS Sethi, Professor Heinz Stammberger at the University of Graz in Austria, and Professor David Kennedy. My life took a new turn when I met Professor Riccardo Carrau and Professor Amin Kassam. This was the time I decided that I wanted to become a skull base surgeon.

Professor Narayanan Janakiram with the late Professor Heinz Stammberger

 

Would you like to talk about the students you have trained and about your work with the community?

My students are numerous and are famous all over the world. Some of them include Dr. Shilpee Bhatia Sharma (India), Professor Ksenia Klimenko (Russia), Dr. Mitya Pylpyk (Ukraine) and the list goes on.

As part of the Royal Pearl Hospital, we have written five textbooks with Thieme Publications in the field of Rhinology. These are read by doctors all over the world. We have also been doing a lot of service to humanity by conducting free camps all over our country. The hospital carries out more than 1,000 surgeries free of cost every year. We also do free surgeries regularly in various parts of Africa, Vietnam, Indonesia, Philippines just to name a few.

Are there any aspects of otolaryngology that you are researching currently that you are very excited about?

My contribution is pioneering research on new concepts, classification and improved techniques in the management of Juvenile Nasopharyngeal Angiofibroma (JNA). My academic work is published in an exclusive JNA book that has chapters in neurosurgery from eminent authors.

My other field of interest is Surgery on tumours of the Sellar, Supra Sellar and Parasellar (Cavernous Sinus) lesions. We have a huge series of Pituitary tumours, Craniopharyngiomas, Meningiomas and Cavernous Sinus tumours. We have published a book titled Atlas of Sellar, Suprasellar and Parasellar Lesions with Thieme Publications, which was one of the bestselling books of 2019.

With a background of acting in Tamil films, would you like to share any lessons you learnt from your experiences in the world of film?

My acting stint was almost 20 years ago when I was selected as a model for a multinational company. I did professional modelling for a few years and then had offers to act in Tamil, Malayalam and Telugu movies. I acted as a Hero in four Tamil movies and also produced a movie in Tamil. I was a music composer and playback singer in three movies. A surgeon is basically an artist who sculptures a surgery! These are all manifestations of left-brain activity.

For more information visit www.me-oto.com

Recent advances in maternal and Foetal medicine have taken many pregnancies to term and improved the well-being of preterm babies as well as twin/triplet pregnancies. In the wake of the same, IVI Middle East Abu Dhabi started its IVI Fetal Medical Centre to enhance foetal care in the UAE and the region. IVI Fetal emphasises that foetal medicine is different from the typical gynaecological care during pregnancy.

According to Dr. Desislava, Lead, Fetal Medicine, IVI Fetal Clinic, which is a part of the IVI Fertility clinics, it is imperative to educate couples about the vital role of maternal foetal medicine (MFM) specialist in achieving a healthy pregnancy. This is especially true for women who are categorised as high pregnancies because of their health condition, multiple pregnancies or advanced age, among others. Couples who have an increased risk of chromosomal and genetic anomalies are also considered high risk.

“Patients often need clarity on Foetal Medicine. It is an advanced area of medicine that addresses the specific and unique health concerns of expectant mothers who have health issues, including high blood pressure, bleeding, and multiple miscarriages, and their unborn babies. Pregnant women with high-risk pregnancies are going to immensely benefit if they also seek the counsel and services of Foetal specialists. Timely and accurate foetal screening and diagnosis allow doctors to meet the specific and unique needs of the babies while they are still in the womb,” Dr. Desislava said.

Risk management options

Babies who were younger than 24 weeks’ gestation (or under 500g) had low survival rates. However, the longer the babies stay in the womb, the better the chance of survival they have. This is where the foetal medicine centre comes in, offering specialised, individualised care for the mother and the baby.

At the IVI Fetal Medical Centre, Abu Dhabi the team of doctors use modern technologies to perform in-depth screening and diagnosis in order to prevent complications and other medical concerns with the fetus that may arise in high/low-risk pregnancies. After the risk assessment and analysis, appropriate risk management options and the right treatment path are suggested to patients.

“Foetal specialists prioritise the health and safety of mothers carrying a foetus with a congenital anomaly, among other concerns, by providing specialised management plan,” added Dr Desislava.

With advances in pregnancy and childbearing growing sharply, Foetal medicine is a solution that focuses on managing the health concerns of the mother and foetus prior to, during, and shortly after pregnancy, especially those undergoing high-risk or problematic pregnancies.

Today on International Women’s Day 2020, we reveal seven exceptional female professionals achieving great things in healthcare around the world:

Reenita Das

Reenita Das, Partner and SVP, Transformational Health, Frost & Sullivan, was recently named in the Top 100 Women in Wearable and Consumer Tech by Women of Wearables. She founded GLOW (Growth, Innovation and Leadership of Women) at Frost & Sullivan after becoming the first woman partner in the company. She explained: “Gender diversity is a big issue today. I realised that I had to do something for the billions of women who have not been heard yet."

Dr Sana Farid

Dr Sana Farid is the co-founder of Munfarid, an enterprise that strives to uplift society through VR. She has amassed valuable experience working with VR and immersive technology. She is also co-President of the MENA chapter of the VR/AR Association, which brings together innovators from around the world to collaborate on the development of immersive technology.

Dr Maliha Hashmi

Where to begin? Dr Hashmi (image, right) is a NEOM executive, a recent speaker at Medlab Middle East 2020, and one of five global experts selected by the WEF to share their vision of life in 2030. She also received her Doctor of Law & Jurisprudence Degree from Harvard Law School, her Master’s degree in History of Medicine & Ethics from Harvard Graduate School of Arts & Sciences, and concentration in Healthcare System Design Management from MIT Sloan. She was named one of the Top 20 College Women in the US, making it into the Who's Who ln America list. A notable female leader in Saudi Arabia, Dr Hashmi advocates women empowerment in the GCC region.

Dr Maryam Matar

Dr Maryam Matar is a genetic scientist, which is impressive enough, but she is also Founder and Chairperson of the UAEGDA, established with the aim of increasing awareness programmes in order to prevent the occurrence of common genetic disorders in the UAE and throughout the region. In 2014 she was selected among the Twenty Most Influential Women in Science in the Islamic World.

Dana Al Mazrouei

Emirati artist Dana Al Mazrouei was recently commissioned by the Great Ormond Street Hospital for Children (GOSH) in London to create a unique art installation for The Zayed Centre for Research into Rare Disease in Children. The centre promises to bring together pioneering research and world-leading clinical care to drive new tests, treatments and cures for children with rare and complex diseases.

Nancy Steenbakkers

Nancy Steenbakkers, founder and CEO of UltraZonic in Belgium, was a nurse for 20 years and used to assist in the operating theatre. Responsible for the cleaning of surgical instruments, she spotted an opportunity, explaining "It is very hard to clean these instruments. I was observing a lot of hospitals and noticed the same issues and problems across the world, when it comes to patient safety and ensuring the medical instruments are cleaned properly." UltraZonic is now a three-year-old business and their main focus is precleaning. That's what we call a problem solver!

Dr Emily Stein

After her grandmother suffered a stroke due to poor oral hygiene, Dr. Emily Stein, CEO of Primal Health, decided to take the matter into her own hands. Armed with her microbiology and rheumatology knowledge, she started the company to make people healthier by focusing on promoting oral hygiene. Dr Stein completed her Post-Doctoral Fellowship in the Department of Immunology & Rheumatology at Stanford University, and she also holds a PhD in Microbiology from the University of California at Berkeley.

Is there a female healthcare professional who you find inspirational? Let us know by commenting after the article.

Innovation is a hot topic in healthcare and a major theme at Arab Health 2020 held in January 2020. We sat down with Dr Nizar Zein, Chairman of Global Patient Service for Cleveland Clinic and attending as part of an international contingent, to hear his perspective on how the event facilitated innovation and what he saw as the biggest technological change this year.

From his perspective, change is the new normal, with innovation now occurring on a daily basis, driven primarily by need. Innovation encompasses a broad spectrum, from therapeutics and vaccination to improving surgical outcomes and access to healthcare.

Artificial Intelligence is the most important technology in healthcare today

Related: Home is where the heart is: Dr. Curtis Rimmerman reveals today’s trends in cardiology

There is one innovation in particular, however, that Dr Zein believes is the most important technological change applied today in healthcare: Artificial Intelligence (AI).

He cited AI’s unparalleled ability to process and interpret large amounts of data to drive an outcome, offering two examples of its current application in healthcare.

Related: Ascom unlocks the power of data to heal

First, AI’s voice and image recognition capabilities are far more accurate than anything a human can do. In the space of three to four years, image recognition went from being worse than humans to being far more accurate. Through its ability to screen large sets of data more efficiently, AI technology is now used for screen mammographies across the world. Voice technology in healthcare has also come a long way, being able to type three times faster than any human and with an error rate of just five percent.

Second, AI can solve problems through, for example, processing medical literature amounting to thousands of scientific papers and making recommendations.

These same machines can famously defeat humans at chess and poker, and therefore they are able to forecast possible movements. In time, an AI will be able to prescribe and dispense medications.

Despite the threat that all of this suggests to human workers, Dr Zein remained optimistic.  

AI is evolutionary, not revolutionary

He reminded that while everyone thought automation in manufacturing would put people out of work, the opposite is true, allowing humans to focus on innovation.

In a similar vein, AI will enhance or complement work carried out by healthcare professionals conducting day-to-day operations or highly focused tasks, arguing that pathologists won’t be put out of business simply because AI can interpret technology well: there will always be a need for human verification.

Similarly, voice recognition will help physicians take care of the patient rather than spend time behind the computer. And while an AI can very capably screen mammographies, it’s human workers (radiologists) who look for abnormalities - humans possess a broad intelligence across multiple fields at once.

Furthermore, Dr Zein was keen to point out that AI was an evolutionary development as opposed to an overnight phenomenon, not unlike 3D printing or indeed any other technology. This will help address present concerns – including those relating to ethics.

He acknowledged that privacy was a sensitive issue globally, and that bias remained a problem (processing large amounts of data makes it difficult to identify where the bias is). However, any ethical concerns will be worked out “in time”.

Arab Health: a platform for bringing minds together

Perhaps the ideal forum for discussing these challenges is Arab Health, an opportunity for professionals from different healthcare sectors to interact, which will make a return in 2021.

A participant for 10 years, Dr Zein sees the event as an “incredible” platform for innovation simply through bringing together professionals holding different points of view, from physicians to manufacturers and entrepreneurs. He pledged to be back next year, where he hopes to see stakeholders interact further in roundtable discussions.