ISSUE TWO JULY 2012

Caring for you and your family

STATESunshine

Cool in a CRISISEMERGENCY DEPARTMENT EXPANDS

RAMADAN MUBARAK!HEALTHY FASTING FOR INDIVIDUALS WITH DIABETES

BEAT THE HEAT THIS SUMMER

PedFACTSHELPING YOU ENSURE YOUR CHILD’S SAFETY

THE LATEST MAFRAQ HOSPITAL NEWS & ACHIEVEMENTS

PLUSHOLIDAY THE RIGHT WAY

VACATION

CENTRAL

BabyonBoard

The first issue of Tabibi, Mafraq Hospital’s health and lifestyle magazine, has been an incredible success, and it gives us great pleasure to bring you the much-anticipated second issue. We are well into the UAE summer and many of us have begun fasting for the

Holy Month of Ramadan. The intense heat during these months, the likelihood of many vacationing away from home and the celebratory atmosphere during Eid, means that we need to be extra careful with maintaining our well-being this season. Individuals with chronic conditions, such as diabetes, may encounter their own challenges during the fasting period, and specific precautions should be taken for these individuals to be able to make the most of the Holy Month.In this issue of Tabibi, we aim to address some of these concerns and challenges through information and advice from our esteemed expert physicians. People with diabetes that are fasting this Ramadan are given basic guidelines on how to maintain blood glucose control and avoid hyper- or hypoglycaemia. Parents with children suffering from diabetes are also offered advice on protocols that would allow for their children to remain healthy while fasting. For people who are travelling during the summer vacation, our experts make sure that you are well-prepared; a range of physicians also offer their tips on surviving the summer heat, from burns to eye protection – Mafraq Hospital has you covered. You can also find out more about the expansion of the Mafraq Hospital emergency department and the child safety training program for caregivers that is on offer.As always, you can get the latest news on your ‘Carer of Choice’ and send us your health related questions.

Wishing you good health.

Marketing & CommunicationsMafraq Hospital

Tabibi

ISSUE TWO JULY 2012

Caring for you and your family

STATESunshine

Cool in a CRISISEMERGENCY DEPARTMENT EXPANDS

RAMADAN MUBARAK!HEALTHY FASTING FOR INDIVIDUALS WITH DIABETES

BEAT THE HEAT THIS SUMMER

PedFACTSHELPING YOU ENSURE YOUR CHILD’S SAFETY

THE LATEST MAFRAQ HOSPITAL

NEWS & ACHIEVEMENTS

PLUSHOLIDAY THE RIGHT WAYVACATION

CENTRAL

BabyonBoard

WelcomeInside

T +971 4 427 0120 F +971 4 427 0121info@leadingbrandspublishing.comwww.leadingbrandspublishing.comThe Custom Publishing Specialists

Mafraq Hospital was established in 1983 and is one of the largest tertiary hospitals in the UAE. Mafraq Hospital is part of the SEHA HealthSystem and is owned and operated by Abu Dhabi Health Services Company PJSC (SEHA) which is responsible for the curative activities of the public hospitals and clinics of the Emirate of Abu Dhabi. Visit www.mafraqhospital.ae for details of our services, specialties and clinics. © Copyright 2012. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means without permission in writing from Leading Brands Publishing.

Please RecycleTHIS PUBLICATION

Updates from your healthcare provider of choice

Ramadan Fasting and Diabetes Dr. Asma Deeb

Holiday Health HintsDr. Mohammed Abu Mahfouz and Dr. Ibrahim Salah Moumne

Summertime StrainsDr. Khaled Ebrahim Abu Haleeqa, Dr. Hatem Mohy Eldin and Dr. Mariam Al Hashemi

Child Safety Initiative Dr. Taisser Atrak

Emergency Care EnhancementHigh quality treatment and efficient patient flow

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08

10

13

14

Dear Readers

Become a fanwww.facebook.com/pages/Mafraq- Hospital/280861541965251

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eem

Ram

adan

A Mafraq Hospital surgical team performed a complex reconstructive surgical procedure on a patient’s hip that involved implanting veins and other soft tissue to restore mobility to the patient and close an infected wound. The patient had an old, deep wound in the hip area, which caused serious complications and resulted in an inability to walk, and the wound had been left open for an extended period, which caused blood clotting and severe infection. “This type of surgery is considered a rarity in the UAE given the lack of experienced surgeons doing soft tissue and vein implant work,” explains Dr. Muqdad al-Hammadi, a German Board of Plastic Surgery-accredited professional at Mafraq Hospital. The Mafraq Hospital medical team, including the plastic surgery and anaesthesia departments, successfully conducted the complex surgery within four hours.The patient remained in hospital for 10 days to reach full recovery and is now mobile.

ADVANCED SURGERY

Abu Dhabi Health Services Company (SEHA), the owner and operator of the public healthcare system of the Emirate of Abu Dhabi, has introduced a new management team at Mafraq Hospital.

Moving from its previous position as operator and owner of the facility, SEHA now assumes full managerial responsibilities for the tertiary care facility. A new team, with international expertise, and led by Mr. Lee Huntley, Chief Executive Officer of Mafraq Hospital, has been appointed to guide Mafraq Hospital into the future while upholding the facility’s existing success in delivering the highest standards of care.

EXPERT NEW MANAGEMENT

Mafraq Hospital recently welcomed theworld’s only Emirati Ocular Oncologist,Dr. Khaled Abu Haleeqa, as its residentConsultant Ophthalmologist, Oculoplastic Surgeon, Neuro-Ophthalmologist and Ocular Oncologist. Dr. Abu Haleeqa is among an estimated 150 specialists worldwide who hold the necessary training to treat rare cancers. He recently moved back to the UAE from Canada where he earned his doctorate and subspecialist qualifications in ocular oncology at McMaster University. Dr. Abu Haleeqa explains that ocular cancer is relatively unknown in the UAE, and that patients may defer treatment due to fear and uncertainty. He adds that the larger problem is that many doctors are not trained to diagnose such a rare form of cancer and that patients have had to travel for treatment.

“As the only Emirati doctor to specialise in ocular oncology, and, the only specialist currently practicing in the UAE, I take my responsibility very seriously,” says Dr. Abu Haleeqa.

PRACTICING PIONEERS

The Latest Developments at Mafraq Hospital

CARER OFCH ICE

The UAE’s first and only dedicated Allergy, Immunology and Rheumatology Clinic was opened at Mafraq Hospital; it treats a weekly average of 15

complicated cases and is equipped to conduct skin prick tests for up to 200 unique substances. Dr. Mustafa Al Maini, Deputy Medical Director, Chief of Rheumatology, Allergy and Clinical Immunology Division, Consultant Rheumatologist, Allergist, and Clinical Immunologist, is the only Emirati healthcare professional certified in each of the three areas of specialisation. Dr. Al Maini runs the clinic with the help of other allergists, immunologists, rheumatologists and nurses.

SPECIALISED HEALTHCARE

THE CHALLENGE FOR CHILDREN DURING RAMADAN

Tabibi

Mafraq Hospital is very proud of its nurses, and we are very proud that we have pioneering Emirati nurses. Nursing as a career offers personal satisfaction and growth. As a nurse, you’re making a real difference in people’s lives every day and as an Emirati nurse, you are contributing to the development of your country and providing much needed care to people in your community.

No two days are the same, and nursing provides you with knowledge and experience you can use for yourself, your family, your country, and your patients. Nursing also offers the best of both worlds – a profession with collaboration and independence. Yes, nurses often work in teams, but they also have a great deal of autonomy. With advanced education, many nurses enjoy a great deal of independence as managers, educators, researchers, nurse practitioners, clinical nurse specialists and more.

NURSES MAKE A DIFFERENCEBY ZULAIKHA AL HOSANI, ACTING DIRECTOR OF NURSING, MAFRAQ HOSPITAL DO YOU

HAVE A

MEDICAL

QUESTION?Got a health related question? Write to

Tabibi and we will get one of Mafraq

Hospital’s highly experienced and qualified

doctors to respond to your question; your

questions may even be published.

Send your queries, at any time, to:

tabibi@mafraqhospital.ae

Ramadan Mubarak! During the Holy Month, we mothers are usually busy planning meals for Iftar (evening meal). The afternoons are often spent preparing delicious feasts for adults, and we can sometimes forget to cook healthy meals for our children who are not fasting. Because adults fast during the day, the most important daytime meals for children are ignored, and they suffer as a result. During Ramadan, breakfast and lunch are overlooked, forcing children into an unhealthy diet. There is usually nothing for breakfast, because adults are tired after staying up all night and find it difficult to wake up before noon; for lunch, children are so often simply given a bowl of noodles, and as a result, the child gradually loses weight, while his/her parents gain more.

The situation is no different for those who have a maid at home responsible for preparing the food; the maid, also exhausted from the marathon of breakfast and the pre-dawn meal (Suhoor), will be in a deep sleep in the morning during breakfast time, and the child will consequently help him/herself to a breakfast that includes potato chips and a bar of chocolate, starting the day with loads of energy but no useful nutrition. It is a sad but funny recurrent scene during Ramadan, before breakfast, when a hungry child is enticed by the smell of Sambusa, and he/she sneaks into the kitchen to snatch a piece, running to quickly devour it, the poor child is then reprimanded for eating food that has been carefully prepared for fasting adults.

There are clear solutions which are not difficult to apply: children should not undergo a diet free of nutrients which are vital for their mental and physical growth even if it is for one month. Because children grow more every day, are permanently active, and are learning continuously, they need proper daily nutrition. Let us therefore try to make breakfast and lunch time during Ramadan as regular as every other day for them.

Fadya Al KatheeriMarketing, PR and Events OfficerMafraq Hospital

05

Tabibi

04

ISSUE TWO JULY 2012

www.mafraqhospital.ae

Patients and their family members should be mindful of the risks associated with fasting when a person has diabetes. The body

constantly works to regulate blood sugar levels; hyperglycaemia, or high blood sugar (glucose) is harmful, as is hypoglycaemia (low blood glucose levels). Both are equally dangerous, and both can lead to additional short- or long-term health conditions. The medication and diet that people with diabetes are prescribed by their doctors are meant to keep blood glucose within the normal range, promoting better health.

Each individual with diabetes responds differently to fasting, depending on the level of control and care taken; often the drastic changes in lifestyle associated with fasting can interfere with how the body deals with blood glucose. Another possible health problem during fasting is dehydration; this threat is exacerbated by the high temperatures during Ramadan. In addition to the interference caused to the body because of a change in routine, timing and dosage of medication that has not been adjusted for the fasting period can also have an effect on the well-being of a patient with diabetes.

“Complications might arise during fasting and that can be due to diabetes itself or related to the type of medications taken. Patients with diabetes can get dehydrated or hypoglycaemic if medications are not adjusted properly. Certain types of insulin (mixed insulin) predispose patients to hypoglycaemia, while fasting can be better tolerated on new, genetically engineered, insulin (analogs) which are fast-acting and flexible. In addition, some medications can be associated with the sudden lowering of blood glucose,” explains Dr. Deeb.

That is why people with diabetes, who decide to fast during Ramadan, should usually consult their doctors for a check-up and specific advice a few weeks before Ramadan begins.

“It is advisable that patients with diabetes visit their doctor before fasting. This is because there might be changes needed in their medications including dose adjustment or timing of medications,” elaborated Dr. Deeb.

Dr. Deeb describes a number of basic guidelines that should apply to people with diabetes planning to fast during Ramadan:• Frequentlymonitorbloodglucoseathome• KeepascheduledhospitalvisitduringRamadan• Avoidexcessivephysicalactivitybutdonot

avoid regular physical activity altogether• Maintainahealthyandbalancedlow-calorie

diet during non-fasting hours• Eatfoodwithlotsoffibre,suchascereals,

brown rice or whole-grain bread to sustain your appetite

• Avoideatingtoomanysweets,fattyorfried food during non-fasting hours

• Breakfastwithlightfoodsuchassaladorsoup• Drinkplentyofnon-caffeinatedfluidsduring

non-fasting hours to avoid dehydration• Breakthefastimmediatelywiththeonsetof

symptoms of hypoglycaemia or dehydration• Don’tfastwhenfeelingunwell–consultadoctor

“Measures to control blood glucose are no different from those on non-fasting days. However, two major rules should be adhered to during fasting; more frequent self-monitoring of blood glucose and breaking fast in case of a drop or a major rise in blood glucose levels,” Dr. Deeb re-iterates.

As long as the diabetes is controlled and careful attention is paid to diet and medication during non-fasting hours, individuals who have diabetes can fast during Ramadan without problems. Each person is different, however, so it is very important to touch base with a healthcare professional before, during and after fasting.

During the Holy Month of Ramadan, many Muslims with diabetes will decide to fast, despite being exempt due to this serious illness. Dr. Asma Deeb, Consultant and Chief of Paediatric Endocrinology, offers up her advice on how people with diabetes can fast safely and healthily during Ramadan.

Calculated CONTROL

Ramadan fasting for diabetics

Dates have immense nutritional value through the variety of essential vitamins and minerals the fruit contains. According to Dr. Deeb, it can offer a number of health benefits for people with and without diabetes, such as:

• Preventstheabsorptionofbad(LDL)cholesterol in the gut as it is rich in dietary fibre

• Promotesmacular(eye)healththrough vitamin A

NATURALLY NUTRITIOUS

children...For the

Many children and teenagers with diabetes like to fast for Ramadan. Some insist on it because they do not want to feel any different from their siblings or peers. Children and teenagers with diabetes can fast for Ramadan provided that certain measures are taken. Dr. Asma Deeb lists some of these important protocols:

• Visitanendocrinologistpriorto the fasting month in order to put a plan together for controlling diabetes during fasting

• Discussthetypeofinsulintobeusedwith the doctor. Some insulin, e.g. the new insulin analogs, are more compatible with fasting as they can be taken in a more flexible way and they are associated with a much lower risk of hypoglycaemia. Mixed insulin and older types of insulin are difficult to adjust during fasting and can cause an unpredictable drop in blood sugar

• Itiscrucialtoperformfrequentbloodglucose monitoring. This enables the provision for treatment at the early stages of either a drop or a rise in blood glucose

• Drinkingplentyofwaterisvitalduringnon-fasting hours, as is avoidance of high sugar and high calorie food

• Energyisreplenishedinstantly,as dates contain simple, easily absorbable sugars such as fructose and dextrose – which is very useful for treating hypoglycaemia

“Eating excessive amounts of dates will result in increasing blood glucose, however,” warns Dr. Deeb.

“As a general rule, three dates equal 15 grams of carbohydrates which should be sufficient to treat hypoglycaemia.”

Dr. Asma DeebConsultant & Chief of

Paediatric Endocrinology

www.mafraqhospital.ae 0706

ISSUE TWO JULY 2012Tabibi

Drop the PressureWith the stressors of a modern-day lifestyle, the body’s stress-response system experiences long-term activation. When a person is met with a stressful situation, the hypothalamus, at the base of the brain, sets an alarm off in the body causing it to send off signals through nerves and hormones. This causes the release of a surge of hormones, including adrenaline and cortisol. Adrenaline speeds up heart rate, raises blood pressure and boosts energy. Cortisol raises sugar in the blood and hinders certain functions in the body. Too much of these hormones in the body can be harmful and can put a person at risk of a number of health problems. Stress is therefore unhealthy.

An effective way of reducing stress is through relaxation, one way of relaxing is to take a laid-back vacation. Try going to a destination that is at a distance from a city, and where your vacation activities are unlikely to be stressful. Getting some distance from the usual daily stressors can put a person at ease. Although he cites that there is limited clinical evidence to support the notion that a vacation can provide health benefits, Dr. Mohammed Abu Mahfouz, Mafraq Hospital Cardiologist, claims:

“In my personal opinion, I think that the mood before and during a vacation may have a positive effect on the heart, and on general well-being.”

THE TEMPERATURES ARE RISING, SCHOOLS ARE CLOSING FOR THE SUMMER, AND MANY OF US NEED A BREAK FROM THE TRAFFIC, COMPUTER SCREENS, HOUSEWORK AND PHONE CALLS – SOMETIMES A VACATION ISN’T JUST WANTED, IT IS NEEDED. MAFRAQ HOSPITAL’S EXPERTS ARE HERE TO HELP YOU ENJOY A HOLIDAY THE HEALTHY WAY.Summer

HOLIDAY

The experience of flying is not always pleasant, many people experience ear pain, body cramps, motion sickness, dizziness, headaches, and so on. Mafraq Hospital physicians have compiled some recommendations on how to ease in-flight discomfort:

• Forblockedears,orearpain– try swallowing or yawning, this can allow air to flow in and equalise the pressure in the ear. While flying, particularly during take-off and landing, chew gum, or suck on a sweet/ lozenge, this encourages frequent swallowing, which helps activate the muscles that open your Eustachian tube (earcanal).

• Formotionsickness–over-the-counter medication is widely available to treat individuals who suffer from motion sickness on airplanes. If you are sceptical about self-medicating, consult

Dr. Ibrahim Salah Moumne

General Medical Consultant

Dr. Mohammed Abu Mahfouz

Cardiologist

Sunny SideMany people prefer holidays with sunshine because it has a positive effect on mood, and a range of vacation activities can be enjoyed under a bright sky. It is widely known that the sun’s rays can be damaging, in that it can cause age spots, wrinkles and even skin cancer, however, modest exposure to sunshine has its advantages. Sunlight stimulates the body to produce vitamin D, which has several health benefits.

“VitaminDassistswiththeabsorptionofnutrientsthatstrengthenbones and the immune system; it prevents rickets (skeletal deformity in children), osteomalacia (weak muscles and brittle bones in adults), and provides a calcium balance in the body for osteoporosis and arthritis prevention,” says Dr. Ibrahim Salah Moumne, General Medical Consultant, Mafraq Hospital.

“VitaminDprovidesaprotectiveliningforbloodvessels,whichhelps regulate blood pressure, improves kidney function and cardiovascular strength,” he adds.

In addition, vitamin D is recommended in the treatment of various diseases, such as cancer, diabetes and others that affect the kidneys, bones and muscles.

Location, LocationStudies have suggested that high altitude destinations can have both positive and negative health implications. A study by a renowned medical journal showed that those living at altitudes above 3,000 feet in Greece had a longer life expectancy than those living closer to sea level; their heart disease rate was also almost half that of their sea level counterparts. The body gradually acclimates to the lower air pressure and decreased oxygen intake, in high altitudes, by raising heart and breathing rates and increasing the production of red blood cells to carry more oxygen to the body. The study implies that these adjustments made in the body, may be beneficial for overall health. There are, however, possible pitfalls to health at high altitudes – a condition commonly referred to as “altitude sickness” can result from the change in environment; symptoms include nausea, dizziness, headaches, swollen feet, and sleep problems. In addition, for patients who already have cardiovascular diseases, high altitudes can have a negative effect on the condition;

“There is a lot of literature about the effects of high altitude in patients with coronary artery disease and heart failure. High altitude results in increased myocardial oxygen demand which may have adverse outcomes in patients with these conditions,” explains Dr. Mahfouz.

a doctor, or try the following: eat light, low-calorie meals the day before flying, sit towards the front of the plane or in a seat above the wing, and turn the air vent towards your face.

• Toavoidachesandpainsin the body, try some of these basic exercises:

- Rotate your ankles clockwise and then counter-clockwise

- Put both feet flat on the floor; raise your heels, keeping the balls of your feet down

- Lift your leg, with the knee bent, a few times on each side

- Hunch shoulders forward and then roll them upwards, backwards and downwards gently

In addition to all of the above, drink lots of water, drink less tea and coffee, and carry a skin moisturiser, in an acceptable travel size, along for the journey.

Plane Pain

People who are travelling outside the country

may require vaccinations or immunisations

against some serious diseases that may be

prominent in other countries or continents. This

can protect you from conditions such as cholera,

hepatitis, yellow fever, meningitis and many more.

When planning your trip, ensure that you

contact your doctor and inform him/her of

where and when you will be travelling;

the doctor will then advise you as to

whether or not you would require

these immunisations.

Dr. Ibrahim Salah Moumne, General Medical Consultant, Mafraq Hospital, recommends a list of basic items to pack, from a health and medical perspective, when you travel:

Prescribed medications with the letter-headed prescription from your doctor – ensure that you will be allowed to carry the medicine in the country you are travelling to

Health insurance card Antidiarrheal medication Antihistamines(forallergies) Pain and fever medicine Antifungal and antibacterial

ointments or creams Insect repellent Sunscreen Antibacterial hand sanitizers Water purification tablets Aloe Vera gel for sunburn A first aid quick reference card

BAGS OF HEALTH

Safe Travels

www.mafraqhospital.ae

ISSUE TWO JULY 2012

0908

Tabibi

While sunshine can lift our moods and symbolise a more relaxed time of year, the sun’s rays can be very harmful. In the UAE, temperatures can soar up to 50˚C, and apart from being near unbearable, the heat can do some physical damage. The experts at Mafraq Hospital offer up their summer survival tips – from skincare and ear and eye protection to avoiding dehydration and heat stroke. Mafraq Hospital has you covered.

Sunny

Dr. Abu Haleeqa’s advice for selecting sunglasses that offer the best protection for your eyes is as follows: Do not focus on the colour or darkness the

lenses: Select sunglasses that protect against UVrays.TheabilitytoblockUVlightisnotdependent on the price tag or the darkness of the lenses.

Checkfor100%UVprotection:Makesureyoursunglassesblock100percentofUV-AraysandUV-Brays.

Choose wrap-around styles: Ideally, your sunglasses should wrap all the way around to your temples, so that the sun’s rays cannot enter from the side.

The heat can also lead to tired, puffy or red eyes. Dr. Abu Haleeqa says that a good night’s sleep should help the eyes to regain their moisture; if that does not clear the eyes, he explains that it may be an indication of other problems.

“Puffiness beneath the eyes can also be hereditary, or caused by dehydration, sinus problems, allergies, medication, or hormonal fluctuations, for example,” elaborates Dr. Abu Haleeqa.

If a lack of sleep isn’t the cause, seek medical help to find out what is, and take the necessary steps to correct the problem.

Shaded view According to several studies, exposure of the eye to bright sunlight can increase the risk of several conditions, including flash burns (painful inflammation of the front of the eye), cataracts (clouding of the lens), age-related macular degeneration (gradual loss of sight with age) and growths on the eye, including cancer.

“UVradiation,whetherfromnaturalsunlightor indoor artificial rays, can damage the eye’s surface tissues as well as the cornea and lens,” explains Dr. Khaled Ebrahim Abu Haleeqa, Ophthalmologist, Mafraq Hospital.

“This harmful radiation is present throughout the year, and especially in a country like the UAE, where people go out into the sun more during the winter months than the summer. So it is very important to wear sunglasses all year round.”

Now ear this Whether swimming in the ocean, in a lake or a pool this summer, adults and children (mostly children) can be at risk of an external ear infection, commonly known as swimmer’s ear. When water gets stuck in the ear canal, the water can irritate the skin. The irritated skin then attracts bacteria, causing an infection which will fester and cause pain – this can happen within hours or days. The symptoms of swimmer’s ear include ear pain when yawning or swallowing, pus (white liquid) oozing out of the ear, or severe pain around the ear. Seek medical help if you suspect swimmer’s ear and the doctor will prescribe antibiotics to treat the infection. To prevent the condition, swimmer’s ear drops can be purchased from a pharmacy – these are to be used as instructed and not to treat swimmer’s ear, but to prevent it.

Not so cool With summers that are intolerably hot and humid, people in the UAE naturally depend on air-conditioning (AC) when in the office, at home, in the car, or indoors in general. AC filters can keep dust and other irritants circulating through a room which can lead to leaky noses, irritable coughs, sinus and allergy attacks, or flu. In some cases, with AC filters that are not regularly cleaned, very harmful bacteria can breed and cause severe conditions, such as Legionnaire’s disease, a bad strain of pneumonia – it is therefore important to ensure that AC filters are regularly cleaned. When people spend time out in the sun and then go indoors, they immediately set the AC on high in an attempt to cool down quickly; this can also have negative health implications. Heat opens the skin’s pores for ventilation; however, it also allows the skin to absorb more bacteria and fungi in the air – as the AC keeps dust and irritants circulating, this can be bad for your skin and it can further

increase your chances of becoming ill, not to mention the common headaches

caused from the interchange between two extreme temperatures.

Dry on supply When the body loses more fluid than it takes in, and there isn’t enough water and other fluids to carry out the body’s normal functions, a person can become dehydrated. Dr. Hatem Mohy Eldin, Nephrologist, Mafraq Hospital, explains: “When we are exposed to heat, we excrete more water through the skin. If the loss of fluids is not replaced, we could become dehydrated.”

His advice, in general, to prevent dehydration, is to drink sufficient amounts of fluids and avoid exposure to the heat.

The symptoms of moderate dehydration include thirst, dry mouth, exhaustion, light-headedness, headache, dry skin, decreased urine output and constipation. Dr. Mohy Eldin says that this level of dehydration is easily treatable with oral fluids, like water and energy drinks (without caffeine). Dehydration can get severe, often in children, and the symptoms include excessive thirst, irritability in children or confusion in adults, sunken eyes, little or no urination, dry skin with little elasticity, lack of sweating, rapid heartbeat and breathing, fever and even unconsciousness. Dr. Mohy Eldin regards this form of dehydration a medical emergency, which would “necessitate intensive care management”. The severe form of dehydration can cause additional health complications which can affect the body’s vital organs.

Individuals fasting during Ramadan are also at risk of dehydration during fasting hours. Dr. Mohy Eldin’s advice is: “Avoid manual labour in the sun, drink sufficient amounts of non-caffeinated fluids at Iftar, and eat slightly salty food, which can help the body to retain water”.

Beat the heat Heat stroke is a genuine medical concern, with many local reports of child fatalities as a result of children being left by their parents in locked cars – it is something that UAE residents have to be aware of. Extended exposure to high temperatures or physical activity in hot weather can cause heatstroke. The first step is that the body overheats and starts cramping, if no attempts to cool down are made thereafter, the body will progress to experience symptoms of heat exhaustion, including nausea, light-headedness and heavy sweating. At this point, if the body’s temperature continues rising, heatstroke will occur and emergency treatment will be required.

Heatstroke, left untreated, can cause damage to the brain, kidneys, muscles and heart within a matter of hours – the longer treatment is delayed, the worse the damage and risk of complications can be; heatstroke can even lead to death.

Ways to beat the heat: Do not leave children, or anyone,

alone in a parked car Ensure you avoid extreme high temperatures Avoid strenuous activity between

10 a.m.and 4 p.m. Drink plenty of fluids

Drink Up!Dehydration can get severe,

often in children, and the

symptoms include excessive

thirst, irritability in children

or confusion in adults, sunken

eyes, little or no urination, dry

skin with little elasticity, lack

of sweating, rapid heartbeat

and breathing, fever and even

unconsciousness.

Days

Dr. Khaled Ebrahim Abu

HaleeqaOphthalmologist

Dr. Hatem Mohy EldinNephrologist

Tabibi

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ISSUE TWO JULY 2012

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The UAE Ministry of Health recently reported that 65 per cent of child deaths in the country are traffic-related, while 23 per cent are caused

by home-based accidents, including drowning, falls and fires. The Ministry further concluded that 83 per cent of these child deaths are preventable. Realising that the responsibility for the prevention of these tragedies lies with the people that spend the most time with children, Mafraq Hospital decided to launch the only child safety and emergency education and training course in Abu Dhabi for caregivers.

Starting in April 2011, Mafraq Hospital’s Paediatrics Department, Chaired by Dr. Taisser Atrak, ran the American Academy of Paediatrics First Aid training course for caregivers, called PedFACTS (Paediatric First Aid for Caregivers and Teachers). Up to 150 parents, nannies, housekeepers and teachers across the Abu Dhabi Emirate were certified in life-saving techniques including the Heimlich manoeuvre to prevent choking, cardio-pulmonary resuscitation and child car safety seat installation and use.

“Through proper education and training, we have the opportunity to prevent fatal accidents and save children’s lives. As a doctor, not only is this a priority for me, but it is also my duty and obligation,” explains Dr. Atrak.

SAVERSTroubling stories in the local news often document tragic accidents involving child fatalities. As the majority of these accidents are preventable, Mafraq Hospital has introduced a program to provide caregivers with the necessary education and training to deal with emergency situations.

The Ministry of Health further confirmed that, although nannies and housekeepers play a vital role in the upbringing of children in the UAE, the majority lack the training necessary to respond to emergency situations.

According to Dr. Mohammed Yaman, Chief Medical Officer, Mafraq Hospital, “Parents should never assume that caregivers will know what to do in an emergency situation. This is why PedFACTS training is key.”

Graduates of the pilot PedFACTS programme have already had to put their new skills to use and, thankfully, the outcomes have been very positive.

Dr. Atrak will be running the 2012 PedFACTS programme after Ramadan and the summer break, from September to December 2012; anyone wishing to register can contact Ms. Eve at 02 501 1425 for additional information. Classes are conducted at the Mafraq Hospital Campus or at private venues for larger groups.

LIFE

Without the proper training, trying to administer emergency procedures such as CPR or the Heimlich manoeuvre can do more harm than good. Here’s how to identify an emergency and then call 999:

+ When you find a child unconscious flick his/her foot, if he/she does not move, open the mouth and listen and feel for breathing for 10 seconds – gasping is not normal breathing.

+ If a child falls and you suspect the child has a bone injury, do not move the child, unless the environment is unsafe or the child’s life is in danger. Do not try to move or straighten the injured limb.

+ Do not try to stop the convulsions if a child is having a seizure – do not hold down or restrain the child. Clear away sharp or hard objects that could potentially cause injuries. Place a thin cushion or folded clothing under the child’s head.

THROUGH PROPER EDUCATION AND TRAINING, WE HAVE THE OPPORTUNITY TO PREVENT FATALACCIDENTSANDSAVECHILDREN’S LIVES

Burning Questions According to Dr. Mariam Al Hashemi, for any skin burn caused by the sun or the summer heat, there is a set procedure for home treatment that should be followed: The affected area should be held under cold

running water for 10 to 15 minutes (do not apply ice, as it is capable of damaging the skin and nerves)

Apply aloe vera gel to the affected area – aloe gel is believed to have anti-inflammatory effects and is used topically to soothe burned skin and to help heal wounds

For minor contact burns with heated surfaces, if blisters appear, do not break them; apply sterile gauze over the blister to avoid irritation. If the blister opens, clean with water and apply an antibiotic ointment and a loosely wrapped sterile gauze bandage. If necessary, a pain reliever like acetaminophen can be used until the pain becomes tolerable.

Sunburn, in general, does not require medical attention from a doctor, however, there are times when sunburns are serious and physician must be consulted, says Dr. Al Hashemi: When a small child or a baby gets sunburnt When blisters or a rash appear on sunburnt

skin and it becomes very painful (too painful to touch or move that part of the body)

When a fever accompanies the sunburn

Surface protection The sun, and heat, can certainly do a number on the skin. Apart from sunburn, which is a common risk in the summer months, melasma, rashes, dry skin, acne and even skin cancer are all potential risks. Dr. Mariam Al Hashemi, Specialist Dermatologist, Mafraq Hospital, has the following recommendations for skincare during the summer months: Try to avoid the sun between 10 a.m. and 4

p.m. when the sun’s rays are the strongest Use a broad-spectrum sunscreen with a sun

protection factor (SPF) of at least 15 Apply sunscreen every two hours

when outdoors Stay in the shade whenever possible and avoid

reflective surfaces, which can reflect up to 85 per cent of the sun’s damaging rays

Wear protective, clothing (garments made of unbleached cotton, high-lustre polyesters, and thin, satiny silk, darker materials and clothes with tight weaves or knits prevent the penetration of harmful rays)

Look for lip-care products with SPF 15 or higher, and apply the lip product every two hours or so, based on the amount of contact withtheUVrays

While in the sun, stay away from baby oil, petroleum jelly or high-shine lip gloss

Mineral cosmetics, darker foundations, powders, and eye shadows do have better sun-protective qualities than other cosmetics. Wear sunscreen first, and then apply make-up

In addition, Dr. Al Hashemi recommends taking particular care when it comes to infants and children.

“ToshieldchildrenfromUVdamage,thebasicrules of using sunscreen, wearing sun-protective clothing, lip protection, and sunglasses apply,” Dr. Al Hashemi explains. She then adds that there are some exceptions and additions to the rules, including: Babies younger than six months should be

kept out of the sun. If they are outdoors, a wide-brimmed hat and protective clothing are recommended

Children older than six months should always wear sunscreen with SPF 15 or higher

EMERGENCY

Dr. Taisser AtrakChairman of Mafraq Hospital

Paediatrics Department

Tabibi

www.mafraqhospital.ae

ISSUE TWO JULY 2012

1312

The expansion of the Mafraq Hospital Emergency Department (ED) includes an extended triage area, three additional patient registration kiosks

(bringing the total to six), separate male and female waiting areas with increased capacity, a dedicated ambulance entrance, enhanced signage, and a 230 per cent increase in patient beds.

According to Mrs. Brenda Flynn, Director of Ambulatory Care Services, “Emergency care doesn’t have to be an unpleasant experience, and we have designed our new facility with this in mind. Research shows that calm patients are more receptive to treatment, which in turn reduces wait times and results in a more efficient experience for doctors and patients alike.”

An estimated average of 300 patients a day pass through the ED, 40 per cent of which are

Critical CARE

The Mafraq Hospital Emergency Department was expanded earlier this year, almost trebling potential patient intake. Significant enhancements were included in the expansion to ensure swift and first-rate emergency treatment and reduced waiting times.

It is important to recognise medical emergencies, whether it happens to you or someone in your presence. The following information will help you to identify serious medical emergencies:

Stroke+ Unexpected numbness,

weakness or paralysis + Drooping face, arm or leg

(especially on one side of the body)+ A loss of balance or co-ordination+ Sudden blurry or decreased

vision in one or both eyes+ Slurring, difficulty speaking or

inability to understand or be understood

Heart Attack+ Discomfort, pain or pressure

in the centre of the chest+ Pain or discomfort spreading

to the shoulders, arms, back, neck, teeth or jaw

+ Shortness of breath+ Abdominal (stomach) pain+ Feelings of anxiety or panic+ Light-headedness, dizziness+ Cold sweats+ Nausea or vomiting

Asthma Attack+ Breathing difficulty+ Wheezing with high-pitched

inhalation and exhalation sounds+ Uncontrollable coughing+ Pressure or pain in the chest+ Blue or grey lips or fingernails+ Feelings of anxiety+ Pale and sweaty face

Anaphylaxis (Severe Allergic Reaction)+ Hot flushes (warmth and

redness of skin)+ Breathing difficulty+ Swollen tongue, throat

or nasal cavity+ Heavy heartbeat (palpitations)+ Rapid and weak pulse+ Slurred speech+ Anxiety+ Light-headedness

The victim will likely experience only some of the symptoms. If you do witness a medical emergency, do your best to immediately get that person to an ED at a hospital, whether you call an ambulance or drive the person there yourself – it is always advisable to call 999 first and seek their advice. If you are a victim of a medical emergency, call for help, do not try and drive yourself anywhere.

SOUND THE ALARM

الإنــذارال�ضــوتي

trauma cases; prompt, high quality treatment and efficient patient flow are therefore crucial to the department’s success.

“Mafraq Hospital employs a dedicated team of 62 nurses and 19 doctors who work around the clock to ensure our patients receive the highest quality of care, as well as a positive treatment experience,” explains Mrs. Flynn.

Further boosting efficiency, an Urgent Care Clinic was opened to manage patient overflow from the ED. Fitted with five beds, the clinic is equipped to handle urgent, but non-life threatening cases and treats an average of 70 patients a day.

The Mafraq Hospital Emergency Department operates 24 hours a day, 7 days a week.

Mafraq Hospital employs a dedicated team of 62 nurses and 19 doctors who work around the clock to

ensure our patients receive the highest quality of care

Brenda FlynnDirector of Ambulatory Care Services

www.mafraqhospital.ae

الرعــاية الحرجـة

تم تو�ضيع ق�ضم الطوارئ بم�ضت�ضفى المفرق في وقت �ضابق من هذا العام، حيث ت�ضاعفت قدرة الم�ضت�ضفى على ا�ضتقبال المر�ضى ثالث مرات تقريًبا. وقد �ضملت هذه التو�ضعة تعزيزات مهمة ل�ضمان عالج الحالت الطارئة ب�ضرعة وباأعلى م�ضتوى وتقليل

مدة النتظار.تو�سعة ق�سم الطوارئ بم�ست�سفى

المفرق منطقة فرز مو�سعة، واإن�ساء ثالثة اأك�ساك اإ�سافية

لت�سجيل المر�سى )لي�سل العدد الإجمالي بذلك اإلى �ستة(، ومناطق انتظار منف�سلة للرجال ولل�سيدات مع زيادة �سعة

كل منطقة، بالإ�سافة اإلى مدخل خا�ص ل�سيارات الإ�سعاف، وتعزيز الالفتات، وزيادة الأ�سرة

المخ�س�سة للمر�سى بن�سبة ٪230.وطبًقا لما ذكرته ال�سيدة بريندا فلين مدير خدمات رعاية الإ�سعاف

فاإن "رعاية الطوارئ ل يلزم اأن تكون تجربة غير �سارة، وقد �سممنا من�ساأتنا الجديدة وا�سعين ذلك في اعتبارنا. وتبين الدرا�سات اأن المر�سى الهادئين

اأكثر ا�ستجابة للعالج، وهو ما يوؤدي بدوره اإلى تقلي�ص مدة النتظار في تجربة اأكثر كفاءة بالن�سبة لالأطباء وللمر�سى

على حد �سواء."ويمر على ق�سم الطوارئ بالم�ست�سفى 300 مري�ص في

المتو�سط يوميًا، 40٪ منهم حوادث. لهذا فقد اأ�سبح

الهتمام بالعالج الفوري بجودة عالية من اأهم عواملنجاح الق�سم.

وت�سرح ال�سيدة فلين ذلك قائلة: "يعمل بم�ست�سفى المفرق فريق متخ�س�ص يتكون من 62 ممر�سة و19 طبيًبا يعملون

على مدار ال�ساعة ل�سمان ح�سول مر�سانا على اأعلى جودة للرعاية، وعلى تجربة عالج اإيجابية."

وفي خطوة اأخرى عززت من كفاءة الق�سم، تم افتتاح عيادة لرعاية الطوارئ ل�ستيعاب العدد الفائ�ص من

المر�سى الذين ي�ستقبلهم ق�سم الطوارئ؛ وهذه العيادة مجهزة بخم�سة اأ�سّرة كما اأنها مزودة بالأجهزة والمعدات الالزمة للتعامل مع الحالت الطارئة - التي ل تمثل خطًرا

ا في اليوم في المتو�سط. على الأرواح - وتعالج 70 مري�سًجدير بالذكر اأن ق�سم الطوارئ بم�ست�سفى المفرق يعمل

على مدار 24 �ساعة في اليوم و7 اأيام في الأ�سبوع.

ت�ضمل يعمل بم�ضت�ضفى المفرق فريق متخ�ض�س يتكون من62 ممر�ضة و19 طبيًبا يعملون على مدار ال�ضاعة ل�ضمان ح�ضـــول مر�ضــانا على اأعلـى جـــودة للرعــــاية

من المهم التعرف على الحالت الطبية الطارئة، �سواء حدثت لك اأو لأ�سخا�ص في ح�سورك.

و�سوف ت�ساعدك المعلومات التالية على التعرف على الحالت الطبية الطارئة الخطيرة:

الجلطة خدر اأو �سعف اأو �سلل غير متوقع. +

تدلي الوجه اأو الذراع اأو ال�ساق )خ�سو�سًا في +اأحد جانبي الج�سم(.

فقدان التزان. +ت�سو�ص اأو �سعف القدرة على الإب�سار ب�سكل +

مفاجئ في اإحدى العينين اأو كلتيهما.التلعثم، اأو العجز عن فهم الكالم اأو التحدث +

بطريقة غير مفهومة.

الأزمة القلبية ال�سعور بالتعب اأو الألم اأو ال�سغط في +

منت�سف ال�سدر.ال�سعور بالألم اأو التعب ينت�سر اإلى الكتفين +

اأو الذراعين اأو الظهر اأو الرقبة اأو الأ�سنان اأو الفك.

�سعوبة التنف�ص. +األم في البطن )المعدة(. +

ال�سعور بالقلق اأو النزعاج. +الدوار. +

التعرق البارد. +القيء اأو الغثيان. +

نوبة الربو �سعوبة التنف�ص. +

ال�سهيق والزفير مع �سدور �سفير مرتفع. +�سعال ل يمكن التحكم فيه. +

ال�سعور ب�سغط اأو األم في ال�سدر. +ازرقاق اأو �سحوب ال�سفتين اأو الأظافر. +

�سحوب الوجه وكثرة اإفرازه للعرق. +

الح�ضـا�ضــية المفـرطة )رد الفعل ال�ضـديد

للح�ضـا�ضــية( احمرار الجلد و�سخونته. +

�سعوبة التنف�ص. +تورم الل�سان اأو الحلق اأو تجويف الفم. +

ت�سارع �سربات القلب )الخفقان(. +التاأتاأة في الكالم. +

القلق. +الدوار. +

من المحتمل األ يعاني المري�ص اإل من بع�ص هذه الأعرا�ص ولي�ص كلها. واإذا لحظت وجود

حالة طبية طارئة، فابذل ما في و�سعك لتو�سيل هذا ال�سخ�ص فوًرا اإلى ق�سم الطوارئ باأي

م�ست�سفى، �سواء بالت�سال بالإ�سعاف اأو بتو�سيل ال�سخ�ص بنف�ســك في �سيارتك - نن�سـح دائًما بالت�سال بالطوارئ على رقم 999 اأوًل وطلب الم�سورة منهم. واإذا وقعت اأنت �سحية لحالة

طبية طارئة، فاطلب النجدة، ول تحاول قيادة ال�سيارة بنف�سك والتوجه بها اإلى اأي مكان.

طبيبيالعدد الثاني يوليــو 2012

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