Zayed Military Hospital

Abu Dhabi, United Arab Emirates

Zayed Military Hospital

Abu Dhabi, United Arab Emirates
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Raheem M.S.,Asyut University Hospital | Raheem M.S.,Zayed Military Hospital | Wahba O.M.,Asyut University Hospital
Anesthesia and Analgesia | Year: 2010

Background: Several devices have been proposed to monitor end-tidal carbon dioxide tension (PETCO2) in spontaneously breathing patients; however, many have been reported to be inaccurate. We designed this study to investigate the accuracy of a balloon-tipped nasal catheter in measuring PETCO2 in nontracheally intubated, spontaneously breathing patients. Methods: The catheter was assembled using a 14-F rubber Foley catheter, a tracheal tube pilot balloon, and the plastic sheath from an 18-gauge needle. The catheter was connected to the sampling tube of a gas analyzer. PETCO2 and PaCO2 were determined simultaneously in 20 otherwise healthy postsurgical patients while receiving oxygen. Results: The mean PETCO2 - PaCO2 difference was -4.4 ± 1.6 (SD) mm Hg with a correlation coefficient r = +0.87 (P < 0.001). Conclusion: Our results suggest that a balloon-tipped nasal catheter can provide a simple, easy, and reliable method for PETCO2 measurement in nontracheally intubated, spontaneously breathing patients. Copyright © 2010 International Anesthesia Research Society.

Bonser R.S.,University of Birmingham | Ranasinghe A.M.,University of Birmingham | Loubani M.,Vascular Domain Committee of the European Association of Cardiothoracic Surgery | Loubani M.,Castle Hill Hospital | And 13 more authors.
Journal of the American College of Cardiology | Year: 2011

Acute type A aortic dissection is a lethal condition requiring emergency surgery. It has diverse presentations, and the diagnosis can be missed or delayed. Once diagnosed, decisions with regard to initial management, transfer, appropriateness of surgery, timing of operation, and intervention for malperfusion complications are necessary. The goals of surgery are to save life by prevention of pericardial tamponade or intra-pericardial aortic rupture, to resect the primary entry tear, to correct or prevent any malperfusion and aortic valve regurgitation, and if possible to prevent late dissection-related complications in the proximal and downstream aorta. No randomized trials of treatment or techniques have ever been performed, and novel therapies - particularly with regard to extent of surgery - are being devised and implemented, but their role needs to be defined. Overall, except in highly specialized centers, surgical outcomes might be static, and there is abundant room for improvement. By highlighting difficulties and controversies in diagnosis, patient selection, and surgical therapy, our over-arching goal should be to enfranchise more patients for treatment and improve surgical outcomes. © 2011 American College of Cardiology Foundation.

Alzaabi A.,Zayed Military Hospital | Alseiari M.,General Secretariat of Executive Council | Mahboub B.,University of Sharjah
ClinicoEconomics and Outcomes Research | Year: 2014

This study evaluates the direct costs of treating asthma in Abu Dhabi in the United Arab Emirates. Data was compiled for 2011 from health insurance claims covering all medical interventions or treatments coded as asthma. Costs were calculated from a health care perspective. The total direct cost of treating 139,092 asthma patients was estimated to be United Arab Emirates Dirhams (AED) 105 million (US$29 million), corresponding to around AED 750 per patient per annum. The total cost is principally generated by outpatient visits (>AED 85 million; 81% of the total cost). Ten point four percent of patients had made an emergency room visit. The cost per visit seems to be higher during hospital admissions (AED 7,123) compared to outpatient visits and emergency room visits. The direct cost of asthma medications was around AED 33 million (31% of the total cost). The economic burden of asthma in Abu Dhabi is high and the number of emergency visits suggests that the disease is not optimally controlled. © 2014 Alzaabi et al.

Aljunaibi A.,Zayed Military Hospital | Abdulle A.,United Arab Emirates University | Nagelkerke N.,United Arab Emirates University
PLoS ONE | Year: 2013

Parental participation is a key factor in the prevention and management of childhood obesity, thus parental recognition of weight problems is essential. We estimated parental perceptions and their determinants in the Emirati population. We invited 1541 students (grade 1-12; 50% boys) and their parents, but only 1440 (6-19 years) and their parents consented. Of these, 945 Emirati nationals provided data for analysis. Anthropometric and demographic variables were measured by standard methods. CDC BMI percentile charts for age and sex were used to classify children's weight. Parental perception of their children's weight status (underweight, normal, and overweight/obese) was recorded. Logistic regression analyses were used to identify independent predictors of parental perceptions of children's weight status. Of all parents, 33.8% misclassified their children's' weight status; underestimating (27.4%) or overestimating (6.3%). Misclassification was highest among parents of overweight/obese children (63.5%) and underweight (55.1%) children. More importantly, parental perceptions of their children being overweight or obese, among truly overweight/obese children, i.e. correct identification of an overweight/obese child as such, were associated with the true child's BMI percentile (CDC) with an OR of 1.313 (95% CI: 1.209-1.425; p<0.001) per percentile point, but not age, parental education, household income, and child's sex. We conclude that the majority of parents of overweight/obese children either overestimated or, more commonly, underestimated children's weight status. Predictors of accurate parental perception, in this population, include the true children's BMI, but not age, household income, and sex. Thus, parents having an incorrect perception of their child's weight status may ignore otherwise appropriate health messages. © 2013 Aljunaibi et al.

Al Junaibi A.,Zayed Military Hospital | Abdulle A.,United Arab Emirates University | Sabri S.,United Arab Emirates University | Hag-Ali M.,Zayed Military Hospital | Nagelkerke N.,United Arab Emirates University
International Journal of Obesity | Year: 2013

Objectives:To estimate the prevalence and determinants of obesity in childhood and adolescence and their association with blood pressure (BP) in Abu Dhabi, United Arab Emirates (UAE).Design:A cross-sectional population- representative study.Subjects:A total of 1541 students (grades 1-12; aged 6-19 years) were randomly selected from 246 schools (50% male). Anthropometric and demographic variables were measured, and CDC criteria were used to classify children's weights.Results:A total of 1440 (93%) students provided complete results. Crude prevalences were: 7.6% underweight, 14.7% overweight and 18.9% obesity. Further analyses were restricted to UAE nationals (n=1035), of whom these figures were: 8.3% underweight (females 6.5%, males 10.1%; P=0.06), 14.2% overweight (females 16.7%, males 11.6%; P<0.01), 19.8% obesity (females 18.1%, males 21.4%; P=0.09). Obesity significantly (P<0.001) increased with age. The majority (61.3%) of students had body mass index (BMI) percentiles above the 50th CDC percentile. Stepwise linear regression of BMI percentile on age, sex, dairy consumption, exercise and family income showed a significant (P<0.01) positive association with age and lack of dairy consumption, but not exercise and income. BP significantly (P<0.01) increased with BMI percentile.Conclusions:The prevalence of childhood obesity is high across the age spectrum in the UAE. Older age, male sex, lack of dairy intake and higher parental BMI, are independent determinants of childhood obesity in this population. Higher BMI percentile is associated with a higher BP. Prevention strategies should focus on younger children, particularly children of obese parents. Longitudinal studies are needed to investigate trends and the impact of childhood obesity on the risk of non-communicable diseases. © 2013 Macmillan Publishers Limited. All rights reserved.

Luehr M.,University of Leipzig | Bachet J.,Zayed Military Hospital | Mohra F.-W.,University of Leipzig | Etza C.D.,University of Leipzig
European Journal of Cardio-thoracic Surgery | Year: 2014

Arch surgery is undoubtedly among the most technically and strategically challenging endeavours in aortic surgery, requiring thorough understanding not only of cardiovascular physiology, but also in particular, of neurophysiology (cerebral and spinal cord), and is still associated with significant mortality and morbidity. In the late 1980s, when deep hypothermic circulatory arrest (HCA) had gained widespread acceptance as the standard approach for arch surgery, antegrade selective cerebral perfusion (SCP), as an adjunct to deep HCA, began its triumphal march, offering excellent neuroprotection and improved overall outcome. This encouraged the use of antegrade SCP in combination with steadily increasing body core temperatures-a trend culminating in the progressive advocation of moderate-to-mild temperatures up to 35oC, and even normothermia. The impetus for progressive temperature elevation was the limitation of adverse effects of profound hypothermia and the most welcome side effect of significantly shorter cooling and rewarming periods on cardiopulmonary bypass (CPB), and thereby, potentially, the alleviation of the systemic inflammatory response and, in particular, the risk of severe postoperative bleeding (and other organ dysfunctions). The safe limits of prolonged distal circulatory arrest, particularly with regard to the ischaemic tolerance of the viscera and the spinal cord, have not yet been clearly defined. Adverse outcomes due to inappropriate temperature management (core temperatures too high for the required duration of distal arrest) are probably highly underreported. Complications historically associated with hypothermia, namely excessive bleeding, are possibly overestimated. Trading effective neuroprotection and excellent outcomes for the risk of prolonged 'warm' distal ischaemia might constitute a significant step back, jeopardizing visceral and, in particular, spinal cord integrity, with unpredictable consequences for long-term outcome and quality of life, particularly affecting those in need of more complex surgery or with previous neurological deficits. © The Author 2013. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Alfaresi M.S.,Zayed Military Hospital | Elkoush A.A.,Zayed Military Hospital
Indian Journal of Gastroenterology | Year: 2010

Background Clarithromycin therapy is effective in eradicating Helicobacter pylori. However, the resistance of H. pylori to clarithromycin is increasingly reported. The present study aimed to characterize the types of mutations present in the 23S rRNA genes of isolates of clarithromycin-resistant H. pylori from the UAE. Methods Clarithromycin susceptibility of H. pylori isolates (n=26) was determined by E tests. Analyses for point mutations in domain V of the 23S rRNA genes in clarithromycin-resistant and-sensitive strains were performed by sequence analysis of amplified PCR products. Results Out of 100 gastric antral biopsy samples, 26 were positive for H. pylori by culture, and 29 were positive by PCR. Of the 26 culture isolates, five (19.2%) were resistant to clarithromycin and 24 were sensitive. The MIC of the resistant strains ranged from 3 to 24 μg/mL (median 24). All of the clarithromycin-resistant isolates had point mutations in the 23S rRNA gene. Two isolates had an A2142G 23S rRNA mutation, and three had A2143G mutations. Conclusion Clarithromycin resistance was common in this small collection of H. pylori isolates from the UAE. The A2142G and A2143G mutations were associated with clarithromycin resistance. © Indian Society of Gastroenterology 2010.

Alfaresi M.S.,Zayed Military Hospital | Elkoush A.A.,Zayed Military Hospital
Indian Journal of Medical Microbiology | Year: 2010

Purpose: This study aimed to develop an improved method for the detection of bacterial SHV-type extended-spectrum β-lactamases (ESBLs). Materials and Methods: Our method was based on real-time polymerase chain reaction (PCR) in which the amplification of the product was monitored with a uorescent probe. This method enabled the detection of bla SHV genes with high degrees of sensitivity and specicity. Results: Based on ESBL phenotyping methods and bla gene DNA sequencing, we identified 240 bla genes from 662 Enterobacteriaceae isolated from clinical culture specimens. Of these 240 isolates, 26 had the bla SHV-28 genotype and three had the bla SHV-1 genotype. With our new real-time PCR assay, we detected 29 out of 29 bla SHV genes in ESBL-producing isolates. Conclusion: This method represents a powerful tool for epidemiological studies of SHV ESBLs. Furthermore, it has potential for use in diagnostic microbiology.

Despite considerable progress in the operative management of lesions involving the transverse aortic arch, replacement of this portion of the vessel remains a surgical challenge and is still associated with mortality and morbidity. This situation is due not only to the technical difficulties of the procedure but, often, to the unsatisfactory preservation of the integrity of the central nervous system during the period of arch exclusion. The techniques of cerebral protection during surgery of the aortic arch can be divided into those aimed at suppressing the metabolic demand of the central nervous system and those aimed at maintaining the metabolic supply during the time of exclusion of the cerebral vessels. Whichever technique is used, it must maintain the normal metabolism of the central nervous system or, at least, allow restoration of the physiologic conditions of its function. In this regard, selective antegrade cerebral perfusion has demonstrated experimentally and clinically its superiority over the other proposed protective techniques. © 2010 Elsevier Inc.

Alfaresi M.S.,Zayed Military Hospital
BMC Research Notes | Year: 2010

Background. The bacterium Streptococcus pyogenes causes a variety of human diseases that range from relatively mild skin infections to severe invasive diseases, such as acute rheumatic fever, glomerulonephritis, puerperal sepsis, necrotizing fasciitis, meningitis, and streptococcal toxic shock syndrome. Accurate identification and typing of group A hemolytic streptococci (GAS) is essential for epidemiological and pathogenetic studies of streptococcal diseases. For this reason, The genetic diversity of group A streptococcal (GAS) isolates from subjects in the United Arab Emirates with streptococcal disease was studied using emm gene sequence analysis. The emm typing system which is based on sequence analysis of PCR products of the N-terminal hypervariable region of the M protein gene, concurs with M serotyping almost 1:1. Findings. A total of 38 GAS isolates were analyzed, including 35 isolates from throat and 3 from skin. Among the 38 isolates, a total of 25 different emm/st types were detected: 20 isolates (53%) belonged to 16 validated standard reference emm types and 18 isolates (47%) belonged to 9 recognized sequence types. Conclusions. This is the first emm typing study in the United Arab Emirates to demonstrate the heterogeneity of the GAS population. © 2010 Alfaresi et al; licensee BioMed Central Ltd.

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