New Emirates Medical Journal - Volume 5, Issue 1, 2024

Integration of research into medical education is crucial for cultivating physician-scientists capable of advancing medical breakthroughs. It is imperative to take these measures for early medical students to establish a strong research foundation for future healthcare professionals.

This study investigated the impact of early research exposure on pre-clinical medical students at Gulf Medical University (GMU). A sample size of 85 MD students participated in the study, which spanned six months. In GMU, early exposure to research begins with sessions integrated into the Medical Education and Lifelong Learning (MEL) course during the first year, covering the structure and function of different sections of a research paper and practical application through Journal Article Discussions (JADs) in journal clubs in the 2nd year.

The intervention involved the evaluation of these measures through pre-validated MCQs and a self-administered questionnaire. MCQ results revealed that over 70% of students scored above 40% on research knowledge assessments. Additionally, a questionnaire comprising open and close-ended questions revealed that most of the students reported a positive agreement in understanding research structures.

The findings underscored the necessity of incorporating research into medical curricula to enhance students' research competencies and foster a positive attitude toward research. This study highlighted the importance of early research exposure in developing future physician-scientists.

Crush syndrome is the second most common cause of death in earthquakes, following direct trauma. Crush syndrome develops when toxic substances released after tissue injury or crushing reach the bloodstream. The aim of this study was to investigate factors associated with morbidity and mortality in patients rescued from the rubble after the February 6 earthquake and admitted to our hospital who had crush syndrome by retrospectively analyzing their data.

Hemodialysis, fasciotomy, and other parameters during hospitalization and time to transfer to a ward or death of 36 adult patients with crush syndrome who were rescued from the rubble and hospitalized after the February 6 earthquake were retrospectively analyzed.

Thirty-six patients were included in the study. There was no significant correlation between the mortality of patients according to their time of rescue or need for fasciotomy, dialysis, or inotropes (p=0.767, p=0.294, p=0.625, p=0.865, respectively). There was a high inverse correlation between the time of rescue and time to death. There was a weak inverse correlation between the time of rescue and hospitalization duration (r=-0.767 and r=-0.341, respectively). There was a significant correlation between the need for inotropes and mortality (p<0.001). No one who didn't need dialysis passed away. Dialysis was necessary for all six of the deceased individuals. We can conclude that one significant factor in predicting death in CS patients is the requirement for dialysis.

Crush syndrome, which develops in patients rescued from the rubble alive, is a life-threatening condition. It is an important syndrome and an important cause of mortality for earthquake victims. Further large-scale studies are needed to elucidate the association of time of rescue, the need for fasciotomy and hemodialysis, and other factors with mortality.

Despite significant advancements in COVID-19 treatment and prevention, immunocompromised individuals, particularly those with hematological malignancies, remain at high risk for severe infection and suboptimal vaccine response. Pre-exposure prophylaxis strategies for these vulnerable populations have been limited. Monoclonal antibodies, proteins designed to target specific antigens, offer a promising preventive solution for individuals unable to mount a sufficient immune response to vaccination. However, there is a critical unmet need to establish clear patient selection criteria for pre-exposure prophylaxis with monoclonal antibodies in these groups. This consensus statement explores recent research to address this gap, outlining profiles of patients most likely to benefit from monoclonal antibody-based prophylaxis.

The consensus statement was developed through a rigorous process, utilizing a pre-Delphi search method and a modified Delphi technique to gather expert opinions. This approach ensured a comprehensive and informed consensus among experts in the field. Initially, nine distinct patient categories requiring pre-exposure prophylaxis with monoclonal antibodies were identified. Through iterative rounds of expert feedback, discussion, and refinement, these nine categories were expanded and subdivided into twelve more specific groups of hematological malignancies and immunocompromised disorders. This refinement aimed to better capture the diverse patient profiles requiring prophylaxis, providing a more detailed framework for the targeted administration of monoclonal antibodies.

The study resulted in the panel members agreeing on nine categories for the use of monoclonal antibodies in COVID-19 prevention for high-risk patients. Achieving consensus among experts is crucial as it reflects the collective validation of evidence-based recommendations that can be reliably applied in clinical practice. A 100% agreement was reached for HIV and AIDS, underscoring the unanimous recognition of the vulnerability of this group to severe COVID-19 outcomes. Similarly, 96% agreement was reached for patients on immunomodulatory drugs (IMiDs), and 90.5% for those with hematological diseases, highlighting strong expert support for prophylaxis in these categories. Immunodeficiencies and renal conditions garnered 86% agreement, indicating broad, although slightly more varied, expert consensus on these groups. Lastly, 80% of the panel supported patients with solid organ cancer, liver conditions, rare neurological disorders, and severe life-limiting neuro-disabilities, reflecting recognition of their elevated risk despite more diverse opinions for these categories.

This consensus statement offers healthcare professionals in the UAE a clear, evidence-based framework for the use of monoclonal antibodies in preventing COVID-19 among patients with hematological malignancies and immunocompromised conditions. By outlining specific patient categories, the statement provides a practical guide that enables clinicians to make informed decisions about pre-exposure prophylaxis, ensuring that high-risk individuals receive timely and appropriate protection. The consensus not only enhances the ability of healthcare providers to identify and prioritize at-risk populations, but also optimizes patient outcomes by streamlining preventive measures in clinical practice. In addition, these findings lay the groundwork for future research and the development of standardized protocols, ultimately improving the management of vulnerable populations in the ongoing fight against COVID-19.

Among women of reproductive age, Polycystic Ovarian Syndrome (PCOS) is a common endocrine condition marked by insulin resistance, metabolic abnormalities, and hormonal imbalances. Infertility, irregular menstrual periods, acne, hirsutism, and obesity are among the symptoms that this illness frequently causes. Traditional PCOS therapies usually include drugs like insulin sensitizers and oral contraceptives, which can have negative side effects and might not deal with the underlying causes of the condition. This study aims to examine the etiology of PCOS and the effectiveness of natural management techniques in reducing symptoms and enhancing general health outcomes.

The objective of this study is to comprehend the pathophysiology and underlying mechanisms of PCOS, including hormonal and metabolic factors, assess the effectiveness of natural management strategies, such as dietary changes, herbal supplements, physical activity, and lifestyle interventions, in managing symptoms, investigate the effects of particular diets and lifestyle changes on insulin sensitivity, inflammation, and hormonal balance in PCOS patients, compare natural strategies with conventional treatments to determine the advantages and disadvantages of each treatment, identify research gaps, and suggest areas for future study.

A thorough examination of pertinent literature, including clinical studies, randomized controlled trials, and meta-analyses published in peer-reviewed journals, was a part of the search approach. Studies on the pathophysiology of PCOS, traditional therapies, and natural management strategies were found using databases like PubMed, Scopus, and Web of Science.

The review concentrated on studies conducted within the last 15 years to guarantee that the most recent findings were included. This study intends to shed light on the possible advantages of incorporating natural methods into PCOS care by combining the available data and comprehensive treatment choices.

In summary, PCOS is a common and complex disorder that affects women's health worldwide. Effective management requires knowledge of its symptoms, risk factors, and underlying mechanisms. Women can be empowered to manage PCOS better and enhance their general well-being by emphasizing a holistic approach that incorporates lifestyle changes and natural therapies.

The study investigated the impact of incorporating fruits or fruit juices into the diets of prediabetic individuals to mitigate oxidative stress. Previous research presented divergent approaches, making replication of findings challenging. This study aimed to evaluate whether advising the consumption of two low-calorie fruits daily could improve oxidative stress, glycemic control, and anthropometric measurements in prediabetic individuals.

An open-label, parallel, randomized controlled trial was conducted at a medical college hospital in Mangalore, Karnataka, India. Thirty participants, aged 40-70 years, with impaired fasting glucose or impaired glucose tolerance, were recruited through screening of first-degree relatives of patients with type 2 diabetes. Participants were randomly allocated in a 1:1 ratio to either the intervention group, which consumed two low-calorie fruits daily or a wait-list control group. The inclusion criteria were adults aged 40-70 years with prediabetes. Exclusion criteria included a history of diabetes, chronic diseases, normal glucose tolerance, smoking, alcohol use, recent antioxidant/vitamin use, and participation in dietary trials within the past year. Outcomes included plasma vitamin C levels and blood pressure, oxidative stress markers, glycemic parameters, and anthropometric measures. Over three months, measurements were taken at the beginning and end of the study. Statistical analysis was performed using the Wilcoxon signed-rank test and Mann-Whitney U test, with a significance level set at p < 0.05.

The mean age of participants was 43.1 ± 10.1 years in the intervention group and 44.7 ± 9.6 years in the control group. The intervention group demonstrated a significant 15% increase in plasma vitamin C levels (mean change: 4.0 µmol/L; p = 0.021; 95% CI: 1.2–6.8), whereas the control group experienced a 9% decrease. Systolic blood pressure decreased significantly in the intervention group (mean change: -3.0 mmHg; p = 0.04; 95% CI: -4.5 to -1.5), while the control group showed an increase. No significant differences were observed between groups in terms of oxidative stress markers, glycemic parameters, or anthropometric measures.

Overall, our study provided insights into the effects of incorporating low-calorie fruits into the diet of individuals with prediabetes. While improvements in vitamin C levels and systolic blood pressure were observed, there were no significant changes in oxidative stress, glycemic status, anthropometry, and other antioxidant measures. These findings contribute to the existing literature on the potential benefits of fruit consumption in individuals with prediabetes, highlighting the importance of vitamin C as a biomarker and its potential role in blood pressure regulation and cardiovascular benefits. This study also highlights plasma vitamin C as a promising biomarker for assessing the effects of fruit supplementation. Additionally, this study suggests that broader dietary and lifestyle modifications may be necessary to achieve comprehensive metabolic improvements, particularly in prediabetic individuals.

(CTRI/2011/05/001739).

The global impact of COVID-19 resulted in widespread illness and death. The rapid evolution of SARS-CoV-2, accompanied by increased transmission caused by Variants of Concern (VOC), became a significant concern in the post-pandemic.

This study has been conducted to evaluate the performance of multiplexed real-time reverse transcription-PCR (RT-PCR) assays for COVID-19 detection and the use of specific mutation RT-PCR-based approach to identify VOC in SARS-CoV-2 positive samples in the northern part of the UAE.

We selected 200 respiratory specimens tested between October 2022 to January 2023, at the Pure Lab, COVID Screening Lab, Al Qassimi Women's and Children's Hospital, Sharjah, UAE. We evaluated the performance of four commercially available RT-PCR kits for COVID-19 detection. Further, the positive samples were used to identify variants by variant detection kit as required for mutations in Spike protein (HV 69-70 DEL, N501Y, E484K, K417N) to identify Omicron, British and SARS-CoV-2 wild type (WT) E Gene variants, respectively.

In the post-pandemic period, 153/200 (76.5%) positivity was observed. There was a higher prevalence of COVID-19 among males, accounting for 52% of the cases, in comparison to females 48% aged between 20-40 years. Variant analysis showed that 50 samples were detected for the SARS-CoV-2 OMICRON variant (B.1.1.529), 4 samples were detected for the SARS-CoV-2 British variant (B.1.1.7), however, 99 samples were detected for SARS-CoV-2 wild type (WT) E gene with no mutation.

This study demonstrates the efficacy of a rapid and cost-effective RT-PCR assay designed to detect spike mutations to effectively contribute to public health response efforts. Additionally, by performance evaluation of PCR kits for COVID-19 detection with the Cycle Threshold (CT) values obtained from diagnostic PCR, we can gather valuable insights into the viral load of samples. This information helps us gauge the extent of transmission and assess the severity of the disease within the population.

This study examines the factors contributing to the shortage of medical doctors teaching medical students despite their crucial role in training the future medical workforce.

To analyze the factors behind the lack of medical doctors in the training of medical students, we used ‘phenomenology’ to understand clinical educators' lived experiences and their constructed meanings. Within the domain of phenomenology, we applied hermeneutic (interpretive) phenomenology. The experiences of eight clinical educators at the Gulf Medical University were explored through interviews and analyzed using Interpretative Phenomenological Analysis (IPA) and Socio-Cognitive Career Theory (SCCT).

The findings revealed that entry into medical education often occurred serendipitously due to inadequate career counseling and the undervaluation of the field. Acquiring a postgraduate qualification in medical education contributed to professional growth of the participants by enhancing expertise and fostering a stronger professional identity. Key motivators included a passion for the field, student interaction, support from colleagues, and an encouraging working environment. Clinical educators faced challenges, particularly when they compared their careers to those of practicing clinicians. These challenges included perceived undervaluing of their field, an unclear professional identity, slower career progression (notably in the UAE) and low income. Furthermore, clinicians who serve as educators as well, often struggle with insufficient time dedicated to teaching responsibilities. Coping strategies involved cultivating a positive work environment and maintaining optimism. Growing awareness and a positive outlook for medical education were noted.

This study uncovered the underlying issues faced by clinical educators through their lived experiences. To change the status quo, we propose facilitating medical students and young doctors in joining the field of Medical Education early in their careers. This can be achieved by providing strong career counseling and establishing clear entry and progression pathways in the field of Medical Education, through medical universities and health centers. Medical educators should be facilitated by providing an encouraging environment, acknowledging their medical education-related qualifications, and improving remuneration.

Olanzapine is an atypical antipsychotic drug for treating bipolar disorders and Schizophrenia. Regardless of being used as a common antipsychotic drug, there are reports of hepatic abnormalities caused by using Olanzapine. Silymarin and Vitamin C have been shown to have hepatoprotective effects.

The purpose of the present study was to study the hepatotoxic effects of Olanzapine and the hepatoprotective role of Silymarin and Vitamin C on the Liver of Albino rats.

The study was conducted on 24 albino rats. The animals were randomly divided into four groups of six rats each: Group A consisted of six rats and served as the control group; Group B consisted of six rats who received orally 4mg/kg of Olanzapine daily; Group C consisted of six rats who received 4mg/kg of Olanzapine plus 200mg/kg of Silymarin daily and Group D consisted of six rats which received orally 4mg/kg of Olanzapine plus 15mg/kg of Vitamin C daily. The animals were sacrificed in two sittings at four and eight weeks, and tissues were processed by routine histopathological technique. The liver enzymes (AST, ALP, ALT) were calculated and analyzed statistically using one-way ANOVA.

It was found that the liver of rats treated with Olanzapine showed sinusoidal dilatation, sinusoidal congestion, central venous congestion, central venous dilatation, cellular infiltration, and portal triaditis. The liver enzymes (AST, ALP, ALT) were markedly raised in the drug-treated rats, showing Olanzapine as a hepatotoxic agent. On the other hand, Silymarin and Vitamin C) both proved to show an excellent hepatoprotective effect.

Olanzapine administration causes histopathological and biochemical abnormalities in the liver. Vitamin C and Silymarin are both potent hepatoprotective agents against Olanzapine-induced hepatic toxicity.

Cardiomyopathies are a broad range of cardiac illnesses defined by mechanical and/or electrical dysfunction and abnormal ventricular hypertrophy or dilatation. Cardiomyopathies are classified into two categories: either primarily related to myocardial disease or secondary to other systemic or organ disorders, including the thyroid gland. Thyroid hormones have been linked to a wide range of significant effects on the cardiovascular system.

We experienced a case of a 37-year-old male who presented with symptoms of heart failure and was discovered to have dilated cardiomyopathy. The echocardiography study revealed significant left ventricular global hypokinesia and severely depressed left ventricular systolic function. The laboratory testing confirms the presence of severe normocytic, normochromic anemia with severe hypothyroidism.

The present case illustrates that hypothyroidism should be addressed systematically by healthcare providers when dilated cardiomyopathy is identified, and thyroid function testing should be regularly performed.

The Enhanced Recovery After Surgery (ERAS) program is a multidisciplinary approach aimed at minimizing postoperative complications, shortening hospital stays, and improving clinical outcomes. The current study assesses the knowledge, attitudes, and practices (KAP) of nurses and anesthesia technicians regarding the ERAS program, which is essential for evaluating their understanding and readiness to implement the program, as well as identifying factors influencing the successful adoption of ERAS in clinical practice.

The cross-sectional study involved nurses and anesthesia technicians with at least two months of experience at the University Medical Center in Ho Chi Minh City, Vietnam. A validated questionnaire assessed their KAP regarding the ERAS program. Data were collected via electronic surveys during ERAS group meetings and analyzed with Stata 16.0. The Wilcoxon and Kruskal-Wallis tests compared qualitative variables, while Spearman regression identified relationships between quantitative variables.

Among the 193 nurses and anesthesia technicians, knowledge and attitude scores towards the ERAS program were highly rated, with mean scores of 7.66 ± 1.46 and 40.10 ± 5.24, respectively. Their mean practice score was 6.51 ± 1.26. Age, work experience, and educational level significantly influenced the participant's knowledge, attitudes, and practices. Additionally, there was a positive correlation between attitude and practice (p < 0.001).

This study shows that nurses and anesthesia technicians possess the knowledge and a positive attitude toward the ERAS program; however, their practices remain limited. These results highlight the importance of continuous training and professional development to enhance the effectiveness of ERAS implementation in clinical practice.

Helicobacter pylori (H. pylori) is the most prevalent chronic bacterial infection in humans. Limited research has been conducted both internationally and locally to evaluate the general community’s collective understanding of H. pylori infection, its diagnosis, and its management.

This study aims to evaluate the level of understanding of H. pylori infection, its diagnosis, and management among the general population residing in the western region of Saudi Arabia.

The study employed a cross-sectional online survey method to gather data from a sample of 1,025 of the general population. Four major cities were selected for this study: Makkah, Madinah, Jeddah, and Taif. The knowledge scores were classified into three categories: low, fair, and good.

63.5% of participants had a fair knowledge of H. pylori infection. A statistically significant difference was observed between regions, with a P value of 0.022. Furthermore, there was a strong correlation between the respondents' degree of knowledge and age (p < 0.001), education level (p < 0.001), number of family members at home (p < 000.1), monthly income (p < 0.001), and previous exposure to H. pylori infection (p < 000.1).

Most participants know about H. pylori However, its transmission, link with stomach cancer, diagnosis, and treatment are had low level of knowledge. Several additional educational and policy interventions are recommended to enhance public knowledge of H. pylori To address the identified gaps in understanding, targeted educational campaigns should be developed.

Intestinal malrotation in adults is more common in chronic, insidious patterns, reported to be around 88% in the literature, with features ranging from intermittent abdominal pain and vomiting to food intolerance, malabsorption, and motility disorders. This clinical spectrum can be debilitating for the patient in terms of morbidity and mortality, especially in the context of acute presentation in the background of chronic features.

We present a 26-year-old male with a history of over 10 hospital admissions since childhood with intermittent abdominal pain and vomiting labeled as cyclic vomiting syndrome. He was in distress regarding the chronicity of his symptoms and presented with an acute abdomen due to acute small bowel intestinal obstruction. He underwent diagnostic laparoscopy and reduction of internal hernia followed by exploratory laparotomy and division of Ladd’s band and realignment of bowel. Postoperatively, he recovered and recuperated well.

Intestinal malrotation should be in the routine differential diagnosis of acute abdomen, especially with the history of nonspecific abdominal symptomatology, so that diagnosis can be made early to prevent morbidity and mortality in this age group.

This study focuses on the mental health and resilience of migrant students at RAK Medical and Health Sciences University (RAKMHSU) in the UAE, who often face unique challenges such as cultural adjustment, language barriers, and separation from family and friends.

This study aimed to evaluate the resilience levels of RAKMHSU's migrant students, identify their challenges, and provide evidence-based recommendations to enhance their mental health and resilience.

A total of 206 university students who migrated participated in the study. The study analyzed the resilience-mental health relationship using the Positive Mental Health Scale and the Brief Resilience Scale.

The study found that most students, 92.23%, had normal levels of resilience. A smaller proportion, 1.46%, exhibited high resilience. The mental health assessment revealed that 84.95% of students had high positive mental health scores. Furthermore, the study found a significant positive correlation (r = 0.188, p = 0.007) between mental health and resilience scores.

Migrant students face academic and migratory challenges. However, the student body at RAKMHSU exhibits high levels of mental health resilience. Tailored support programs can strengthen this resilience for better mental health and academic outcomes in the multicultural educational setting.

To evaluate the suitability of commercially available glucometers in the UAE in terms of accurate and reliable blood glucose measurements.

Portable glucometers are employed for measuring blood glucose levels, offering distinct advantages such as providing instant results and being user-friendly when compared to laboratory reference analyzers. However, certain molecules, such as those found in medications, can interfere with the accuracy of glucometer readings.

To evaluate the precision and interference in the presence of maltose and vitamin C of three glucometers commercially available in the UAE.

We utilized plasma samples to conduct two types of experiments: a precision experiment and an interference experiment. We compared the precision of three glucometer brands available in the United Arab Emirates [Accu-Chek Instant^TM, One Touch Select Plus Flex^TM, and Trister GlucoScan^TM] in the presence or not of various interfering molecules, such as Maltose and Ascorbic Acid (Vitamin C).

Accu-Chek Instant^TM demonstrated the highest precision among the glucometers tested, with a coefficient of variation of less than 5% for all measured glucose values. In contrast, OneTouch Select Plus Flex^TM and Trister Glucoscan^TM exhibited higher variability in precision, with coefficients of variation of 11.4% and 11%, respectively. Accu-Chek Instant^TM consistently performed well in terms of bias and precision in the presence of interferences, and does not display glucose readings above 50mg/dL of Vitamin C. Notably, Ascorbic acid induced a greater bias compared to Maltose for all three glucometers.

The performance of the glucometer is affected by its testing methodology. Accu-Chek Instant^TM shows improved precision and is able to detect the presence of Vitamin C. When it comes to Maltose interference, it results in a higher bias change but lower variability, which can be addressed by applying a correction factor.