Dubai Hospital Research Articles

The Use of Bone Density Scan in Monitoring Treatment Response in Patients Diagnosed with Osteoporosis: A Retrospective Cohort Study.

Osteoporosis is characterized as a metabolic bone disease defined by low bone mineral density (BMD) and bone tissue degeneration, particularly a reduction in the number of trabeculae and a drop in cortical bone thickness, and a rise in porosity, which is mainly due to an imbalance between bone resorption and formation. As a result, it increases bone fragility, and the susceptibility to fracture increases, especially among the elderly. The objective is to assess the effectiveness of dual-energy X-ray absorptiometry (DXA) scan in monitoring the response to osteoporosis treatment and compare the scan's response to different osteoporosis treatments. This retrospective cohort study included 51 adults selected from 300 patients diagnosed with osteoporosis based on World Health Organization (WHO) diagnostic criteria of a T-score of -2.5. Data were acquired from the electronic medical records between 2016 and 2019 from a private hospital in Dubai, United Arab Emirates (UAE). The study included sociodemographic characteristics, biomedical parameters, comorbidities, history of fracture, medications, laboratory, and DXA scan results. Ninety-four percent of the patients were females; the mean (±SD) age was 58.1 ± 11.5 years. Most patients were expatriates (84.3%), of which Asian ethnicity was 66.7%. The mean (±SD) duration of osteoporosis was 2.82 ± 1.8 years. Eleven (21.6%) patients had a history of fragility fracture. Ninety-six percent of the patients had vitamin D deficiency. One-third (29.4%) of the patients had hyperparathyroidism. Alendronate/cholecalciferol, received by nine patients (17.6%), showed a significant improvement (p = 0.018) in the BMD of the femoral neck among the study group. In conclusion, the DXA scan as a monitoring tool has shown a significant improvement in the BMD of the femoral neck among patients taking alendronate/cholecalciferol treatment compared to other medications.

Early Versus Late Endotracheal Intubation in Subjects with COVID-19 Pneumonia Treated with High-Flow Oxygen: A Retrospective Observational Study.

The availability of high-flow oxygen (HFO) machines allowed patients with COVID-19 pneumonia to be comfortably treated for longer periods of time until endotracheal intubation became inevitable. Patients treated with invasive mechanical ventilation (MV) preceded by HFO treatment may continue to progress and die. Hence there is a belief in physicians that patients treated with HFO might have delayed invasive MV. The study was conducted as a retrospective review of subjects with confirmed COVID-19 admitted to the Dubai Hospital ICU. Study variables included time to intubation, duration of HFO, and cumulative duration of tachypnea and tachycardia while on HFO usage. Early intubation was defined as within 24 hours of the start of HFO, and late intubation was defined as after seven days on HFO. Groups were compared for outcome measures; mortality and length of stay (LOS) in the ICUand hospital. Clinical outcomes of mortality and LOS in ICU and hospital were not significantly different among patients intubated early versus late. Duration of tachypnea and tachycardia was also not different comparing patients intubated early versus late. There was no significant difference in clinical outcomes in patients intubated early versus late in patients treated with HFO for COVID-19 pneumonia.

Examining the Influence of Joint Commission International (JCI) Accreditation Surveys on Medication Safety Practices: A Cross-Sectional Study from Mediclinic Welcare Hospital in Dubai, UAE

Examining the Influence of Joint Commission International (JCI) Accreditation Surveys on Medication Safety Practices: A Cross-Sectional Study from Mediclinic Welcare Hospital in Dubai, UAE

Stress Level of Parents of Children Diagnosed with Attention-deficit/ Hyperactivity Disorder (ADHD) in Dubai, United Arab Emirates

Background: Attention-deficit/ hyperactivity disorder (ADHD) is a neurodevelopmental disorder that starts during childhood. It is commonly associated with elevated levels of parenting stress. This study aimed to examine parents’ stress levels, potential contributing factors, as well as changes associated with the COVID-19 pandemic. Methods: This study was based on a cross-sectional design. The target population was parents of children with ADHD aged 6-18 years who were evaluated in a tertiary care hospital in Dubai, United Arab Emirates (UAE) from January 2018 to August 2021. Participants completed a survey, which gathered information on the child’s personal characteristics and medical history as well as the parents’ and family characteristics. Additionally, the parents stress level was evaluated using the English and Arabic-translated versions of the Perceived Stress Scale (PSS). Results: Parents of 103 children diagnosed with ADHD participated in this study. Most children were males (74.8%), and their mean age was 10.0 ± 3.4 years. Most children had ADHD as a primary diagnosis (87.4%), with ADHD subtypes being mainly combined presentation (60.2%), followed by a predominately inattentive presentation (35.9%). Psychiatric morbidity was present in 87.4% of the children, mainly learning disorders (41.7%), conduct disorder (34%), or autism spectrum disorder (24.3%). On the other hand, physical disorders were present in 68.9% of the children. Parents’ perceived stress levels differed significantly according to their children’s ADHD subtypes (p=0.002), with the highest stress levels among parents of children with predominately hyperactive/impulsive ADHD. PSS scores were moderate in 62.1% of the sample and high in 32% of the sample. Significant associations with elevated PSS scores was found in the presence of comorbid tic disorders (p<0.001) as well as in comorbid autism spectrum disorder (p=0.029). The most frequently reported items on the PSS were: being upset because of something that happened unexpectedly; feeling nervous and stressed; being angered because of things that were outside of your control; feeling unable to control important things in life; and feeling that difficulties were piling up so high that could not be overcome. Various changes were reported during the COVID-19 pandemic, which included a significant decrease in social activities (31.1%), time spent with friends (26.2%), conflicts between the child and siblings (18.5%), and conflicts between parents (25.3%). Furthermore, a significant increase was reported in children’s average screen time (28.2%), the quality of the child’s relationship with parents (19.4%), and the overall stresses faced by the family (16.5%). Conclusion: ADHD is commonly associated with high levels of parental stress. Factors associated with an increased level of stress include ADHD predominantly hyperactive/ impulsive subtype as well as comorbidity with tic disorders or autism spectrum disorder. Furthermore, the COVID-19 pandemic had a marked impact on children with ADHD and their families’ social functioning.

Evaluating the Quality of Pain Management Satisfaction Among Oncology Patients in a Hospital Setting: Psychometric Properties of the Arabic Version of Pain Care Quality Survey.

The purpose of this mixed-methods psychometric study was to translate and adapt the Arabic Pain Care Quality (APainCQ) Survey to Arabic and to measure the quality of pain care provided to Arab patients. This study used an iterative, mixed-methods approach that employed cognitive interviews, expert content analysis, and factor analysis to develop the APainCQ Survey. The study was conducted at Dubai Hospital, Dubai Health Authority, United Arab Emirates. Arabic-speaking patients admitted to the oncology/hematology inpatient units with a minimum 24-hour stay were eligible for the study. The sample consisted of 155 patients. The iterative exploratory factor analysis process resulted in the sequential removal of three items. The results of the significant Bartlett test (P < .001) of sphericity and Kaiser-Meyer-Olkin test of 0.93 for both the health care team scale and the nurse scale. The total variance explained was 76.17% for the health care team scale and 60.91% for the nurse scale, which explained 56.51% for factor 1 with 14 items and 4.40% for factor 2. Regarding internal consistency reliability, Cronbach's alpha and McDonald's omega for the health care team scale and nurse scale were high; both values were .95. Internal consistency reliability of pain assessment and pain management subscales of nurse scales were also high, with values of 0.96 and 0.79, respectively. Moreover, there was a moderate correlation (r = 0.66; P < .001) between the two subscales in the nurse scale. This study provides evidence that the APainCQ is a reliable and valid measure of pain dimensions, including pain management and monitoring. This APainCQ scale can potentially expand research and clinical assessment in the Arab world.

A Live Advanced Tubal Ectopic Pregnancy-A Case Report from Dubai Hospital

A Live Advanced Tubal Ectopic Pregnancy-A Case Report from Dubai Hospital

Celiac disease in paediatric patients in the United Arab Emirates: a single-center descriptive study.

Celiac disease (CD) is an autoimmune disorder that is provoked by the consumption of gluten in genetically vulnerable individuals. CD affects individuals worldwide with an estimated prevalence of 1% and can manifest at any age. Growth retardation and anemia are common presentations in children with CD. The objective of this study is to estimate the prevalence of CD in multiple "at risk groups" and to characterize children with CD, presented to a tertiary hospital in Dubai, United Arab Emirates (UAE). The study reviewed medical charts of all patients <18 years who had received serologic testing for CD. The study was conducted at Al Jalila Children's Specialty Hospital in Dubai, UAE, from January 2018 to July 2021. Extracted information from medical records included sociodemographics, laboratory findings, clinical presentation, and any associated co-morbidities. The European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) criteria were used to identify patients with CD. During the study period, 851 paediatric patients underwent serological screening for CD, out of which, 23 (2.7%) were confirmed with CD. Of the 23 patients diagnosed with CD, 43.5% had no gastrointestinal symptoms. Diabetes type 1 (30.4%) followed by iron deficiency anaemia (30%) and Hashimoto thyroiditis (9%) were the most commonly associated comorbidities. The prevalence of CD among paediatric patients with autoimmune thyroiditis (12.5%) was 1.92-times higher than that among paediatric patients with diabetes type 1 (6.5%). The results of this study show that almost three out of every 100 paediatric patients who were screened for CD were confirmed to have the condition. These findings highlight the importance of screening children who are at risk or present symptoms suggestive of CD, to ensure early diagnosis and appropriate management.

The optimal time for endotracheal intubation in subjects with coronavirus disease 2019 pneumonia: A retrospective observational study.

The optimal timing of intubation has been debated among healthcare professionals, current studies do not show any differences between early and late intubation. most studies failed to show any significant difference in clinical outcomes between early or late intubation. The study was conducted as a retrospective review of subjects with confirmed coronavirus disease 2019 admitted to the Dubai Hospital intensive care unit (ICU). Study variables included time to intubation, duration of supplemental oxygen requirement >15 L/min, and cumulative duration of tachypnea and tachycardia while on the aforementioned oxygen requirement on this oxygen usage level. Each time duration was assessed for correlation with clinical variables including mortality and length of stay in ICU and hospital. Subjects who require endotracheal intubation within 4 h after the start of oxygen >15 L/min have lower survival (P = 0.03). Subjects who have tachypnea on the aforementioned oxygen requirement for 6-19.5 h (P = 0.01) before they require intubation have better survival. No duration of tachycardia has any significant effect on survival. Only the duration of invasive mechanical ventilation (MV) correlated with the hospital length of stay. Subjects who require endotracheal intubation within 4 h after the start of oxygen >15 L/min have lower survival. The optimal time for intubation is after tachypnea of 6 h but before 19.5 h. No duration of tachycardia has any significant effect on survival. Only the duration of invasive MV correlated with the hospital length of stay.

Perinatal Risk Factors in Children Diagnosed with Autism Spectrum Disorder in Dubai: A Case-Control Study

Introduction: Autism spectrum disorder (ASD) is a heterogeneous disorder characterized by deficits in social-emotional reciprocity and associated behavioral symptoms. The goal of this study was to examine perinatal risk factors for ASD and their correlates in a tertiary care hospital in Dubai, United Arab Emirates (UAE). Methods: We conducted a case-control study of 87 children diagnosed with ASD using the DSM-5 criteria, who were born between 1999 and 2014, and diagnosed between 2014 and 2016, and 134 age- and gender-matched control subjects. Data were collected from hospital medical records. Associations between ASD and maternal, birth, and neonatal risk factors were examined using logistic regression analysis. Results: Maternal fever was associated with ASD (p = 0.018), with 0% in the control group and 5% in the cases. Multivariate logistic regression analysis revealed a trend for an association between high birthweight (>4,000 g) and ASD (95% CI: 0.76–59.93, p = 0.086). Conclusion: The data affirmed the established gender difference of approximately four males to one female and supported previous findings associating ASD with prematurity. Larger representative studies are further required to explore risk factors for ASD in the UAE.

Clinical characteristics and outcomes in adult patients with COVID-19 infection admitted to a Tertiary Care Hospital in Dubai, United Arab Emirates

Clinical characteristics and outcomes in adult patients with COVID-19 infection admitted to a Tertiary Care Hospital in Dubai, United Arab Emirates

Prevalence of Polycystic Ovary Syndrome amongst Females Aged between 15 and 45 Years at a Major Women's Hospital in Dubai, United Arab Emirates.

Objective criteria have been scarce in published data on the occurrence of polycystic ovary syndrome (PCOS) in the United Arab Emirates (UAE). It is crucial that we enhance our comprehension of PCOS prevalence in the UAE to inform key stakeholders about the disease's burden and enable comparisons with other nations. This research aimed to examine the PCOS prevalence at a large academic tertiary centre in Dubai, UAE, called Latifa Women and Children's Hospital. We performed a cross-sectional study by reviewing the electronic medical records of patients accessing care between 2017 and 2022 (5 years). By utilizing the international classification of diseases codes (ICD-10), we discovered a period prevalence of PCOS of 1.6% among 64,722 women aged between 15 and 45 years. It is worth noting that the estimated annual point prevalence rose from 1.19% in 2020 (at the beginning of the COVID19 pandemic) to 2.72% in 2022 (after the start of the COVID-19 pandemic). Therefore, the odds ratio of the risk of a PCOS diagnosis in 2022 compared to 2020 was 2.28. The majority of the women diagnosed with PCOS in this study had an ICD-10 code of E28.2. Women with PCOS were younger than the controls, less likely to be pregnant, and had a higher body mass index and systolic and diastolic blood pressure. This is the most extensive research to date examining PCOS prevalence in the UAE, and it emphasizes the significance of this condition. It is crucial to prioritize PCOS to prevent morbidity and mortality from reproductive and long-term health consequences, including infertility, type 2 diabetes and endometrial cancer, which is presently the most frequent gynecological cancer in the UAE.

Prevalence and Predictors of Remission and Sustained Remission in Patients with Rheumatoid Arthritis from the United Arab Emirates: A Two-Year Prospective Study.

To estimate the prevalence of remission and sustained remission for more than 12 months in a cohort of patients with rheumatoid arthritis in the United Arab Emirates and explore predictors of remission and sustained remission in these patients. A two-year prospective study conducted in Dubai Hospital (January 1, 2018-December 31, 2019) included all consecutive patients with rheumatoid arthritis attending the rheumatology clinic. Patients with a Simplified Disease Activity Index ≤3.3 and/or Clinical Disease Activity Index ≤2.8 in December 2018 were considered in remission and followed until December 2019. Those who maintained remission through 2019 were considered in sustained remission. In this study, a total of 444 patients were followed for a 12-months period. The percentage of remission achieved in RA patients was 30.4% according to the Clinical Disease Activity Index, 31.1% according to Simplified Disease Activity Index, and 50.9% according to the Value of Disease Activity Score 28 (DAS28) remission criteria. The 12-months sustained remission rates ranged from 38.3% for the ACR-EULAR to 69.3% for the DAS28. Male gender, shorter disease duration, better functioning as evaluated by the Health Assessment Questionnaire Disability Index (lower HAQ scores), and higher compliance rates are among sustained remission predictors. Establishing "real-world" data and understanding local predictors to sustained remission is principal for implementing timely and appropriate patient-tailored strategies. These strategies include early detection, close monitoring, and enhancing treatment adherence among UAE patients.

Coping strategies used by healthcare professionals during COVID-19 pandemic in Dubai: A descriptive cross-sectional study

The coronavirus disease 2019 (COVID-19) pandemic has affected physical, social, and psychological well-being of all people, especially healthcare professionals (HCP), who are vulnerable to work-related stress. The aim of this study was to explore the effectiveness of coping strategies practiced by HCPs during the COVID-19 pandemic. A cross-sectional study was conducted in Mediclinic Welcare Hospital in Dubai during the pandemic between March 2020 and April 2021. The questionnaire was used to collect demographic data and validated Brief Coping Orientation to Problems Experienced (Brief-COPE) scales instrument was used to measure the coping strategies. A total 112 respondents were included in the final analysis consisting of physicians (11.6 %), nurses (60.7%), other clinical HCPs (24.1%), and non-clinical staff (7.2%). The common and effective coping strategies used by HCPs were within the problem-focused category. The female HCPs used multiple coping strategies to help them to manage their stress during COVID-19 pandemic. The nurses were more likely to report using emotional support as a coping strategy than doctors or other hospital staff members. Among 48.21% of the respondents that venting helped them release their feelings and distracted themselves through watching movies or television, reading, sleeping, or shopping. Moreover, 42.86% respondents found comfort in practicing religion and spiritual beliefs. Interestingly, the use of alcohol or other drugs was used as a coping mechanism during the pandemic, whereas emotional support and actions as well as taking other advice, were common strategies. Based on these data, healthcare institutions should consider a variety of support measures and programs for the mitigation of stress and negative emotional responses among HCPs during any future outbreaks or pandemics, such as providing access to mental health services, regular check-ins with colleagues or supervisors, peer support groups, educational resources on coping strategies, and paid time off for rest and recovery. Counseling and executive support services also could help staff to manage the mental health during future disasters.

Demographic and risk characteristics of healthcare workers infected with SARS-CoV-2 from two tertiary care hospitals in the United Arab Emirates.

Understanding the transmission dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among healthcare workers (HCWs) and their social contacts is crucial to plan appropriate risk-reduction measures. To analyze the socio-demographic risk factors and transmission of SARS-CoV-2 infection among HCWs in two tertiary care hospitals in Dubai, United Arab Emirates. The demographic and clinical characteristics were available for all HCWs in both facilities from the human resources department. A cross-sectional survey was conducted from January-April 2022 among HCWs who tested positive through Reverse Transcriptase Polymerase Chain Reaction of the nasopharyngeal swab for SARS-CoV-2 between March 2020 and August 2021 in two tertiary-level hospitals. The survey included questions on demographics, work profile, characteristics of coronavirus disease 2019 (COVID-19), and infection among their household or co-workers. The survey also checked the knowledge and perception of participants on the infection prevention measures related to SARS-CoV-2. Out of a total of 346 HCWs infected with SARS-CoV-2, 286 (82.7%) HCWs consented to participate in this study. From the sample population, 150 (52.5%) of participants were female, and a majority (230, 80.4%) were frontline HCWs, including 121 nurses (121, 42.4%). Only 48 (16.8%) participants were fully vaccinated at the time of infection. Most infected HCWs (85%) were unaware of any unprotected exposure and were symptomatic at the time of testing (225, 78.7%). Nearly half of the participants (140, 49%) had co-infection among household, and nearly one-third (29.5%) had co-infection among three or more household. Another 108 (37.8%) participants reported cross-infection among co-workers. The frontline HCWs were significantly more infected (25.1% vs 8.6%, P < 0.001) compared to non-frontline HCWs. Another significant risk factor for a high infection rate was male sex (P < 0.001). Among the infected frontline HCWs, a significantly higher proportion were male and shared accommodation with family (P < 0.001). COVID-19 vaccination significantly reduced the infection rate (83.2% vs 16.8, P < 0.001) among HCWs. Most participants (99.3%) were aware about importance of appropriate use of personal protective equipment. However, only 70% agreed with the efficacy of the COVID-19 vaccination in preventing an infection and severe disease. The risk profiling of the HCWs infected with SARS-CoV-2 found that working at frontline and being male increase the rate of infection. COVID-19 vaccination can effectively reduce the rate of transmission of SARS-CoV-2 among HCWs.

Vitamin D Status and SLE Disease Activity among Dubai Hospital Lupus Patients

Background: Vitamin D deficiency is common worldwide, but is particularly prevalent in the Middle Eastern region, where cultural and religious factors influence its incidence further. As patients with Systemic Lupus Erythematosus (SLE) avoid sun exposure and use medications that could potentially result in vitamin D deficiency, this problem becomes more apparent. Unfortunately, there are no data available on the prevalence of vitamin D deficiency among patients with SLE in our local area. Objective: To assess the prevalence of vitamin D deficiency among patients with a new onset of systemic lupus erythematosus in Dubai, and to determine whether low vitamin D levels are correlated with disease activity. Methodology and Data Collection: a retrospective cohort study of patients with new onset of Systemic Lupus Erythematosus, being diagnosed in less than 1 year and were followed up at Dubai Hospital (UAE) from January 2009 till December 2012. Demographic and clinical data were collected as well as 25(OH) D3 levels. The incidence of vitamin D insufficiency was calculated as a ratio between the numbers of patients with 25(OH) D levels below the specified cut-off values (30ng/ml and 10ng/ml, respectively). SLE was diagnosed according to the American college of rheumatology (ACR SLE) classification criteria of 1997. Patients with drug-induced SLE and vitamin D deficiency were excluded. Results: a total number of 150 patients were included. 87% (n=131) were females and 13% (n=19) were males. The mean vitamin D level at the baseline was 21.6+/- 47 (mean +/- SD), increased to 27.8+/- 16 at 1 year, while the SLEDAI has improved from 8.3+/-5 (mean +/- SD) to 2.4 +/- 2.9 at 1 year respectively. The changes in vitamin D level as well as the SLEDAI were statistically significant with a P value &lt;0.001. Spearman correlation test showed a statistically significant inverse correlation between vitamin D level versus SLEDAI % from baseline to 1-year later. Conclusion: This study showed a direct inverse relationship between lupus activity and a low level of vitamin D. Furthermore, the SLE disease activity score got better with the improvement in vitamin D level, measured at baseline, and after 12 months period.

An Exploratory Study on Adherence to Joint Commission International Standards on Facility Management and Safety at a Tertiary Care Hospital in Dubai, United Arab Emirates

Introduction: According to the International Society for Quality in Healthcare, accreditation is a process in which "trained external peer reviewers evaluate a healthcare organisation's compliance with pre-established performance standards. Unlike licensure, accreditation focuses on continuous improvement strategies and achievement of optimal quality standards, rather than adherence to minimal standards intended to assure public safety".1,2 This study aims to observe and identify gaps in adherence to Facility Management and Safety Standards as prescribed by the Joint Commission International (JCI). Methodology: A time-bound single-centre observational study was carried out using the JCI Accreditation Standards for Hospitals (Sixth Edition). Questionnaires were shared with 20 purposively and conveniently (based on consent) selected participants after obtaining signed informed consent. Following the questionnaire examination, one-on-one interviews with management were held to acquire the necessary data for the study, including the reasons for non-compliance with specific requirements. This research closely examined JCI-recommended policies (Chapter: Facility Management and Safety) and the hospital's compliance with them. Results and Conclusion: Based on the study, it can be concluded that the hospital has complied with most of the standards on Facility Management and Safety Standards of the Sixth Edition of JCI. However, the clauses FMS.2:ME.3, FMS.6:ME.4, FMS.9.2.1:ME.3, and FMS.9.2.1:ME.4 were not met.

Maternal and Fetal Outcome in Pregnant Women With Critical COVID-19 Treated With Tocilizumab in a Tertiary Care Hospital in Dubai.

Pregnancy, complicated by coronavirus disease 2019 (COVID-19), results in higher hospitalization and mortality rate. Pathogenesis of COVID-19 is similar to any other systemic inflammatory condition but results in a cytokine storm ofhigher magnitude causing severe acute respiratory distress syndrome and multiorgan failure. Tocilizumab, a humanized monoclonal antibody, targets soluble and membrane-bound IL-6 receptors and is used in the treatment ofjuvenile idiopathic arthritis, rheumatoid arthritis, and cytokine release syndrome. However, studies exploring itsrole in pregnancy are minimal. Hence, this study was done to study the effect of tocilizumab on maternal and fetal outcomes incritical COVID-19 pregnant women. A retrospective study was conducted on 28 pregnant women with critical COVID-19 who received tocilizumab. Clinical status, chest x-ray, biochemical parameters, and fetal well-being were monitored and documented. The discharged patients were followed up through telemedicine. On treatment with tocilizumab, improvement was seen in thenumber of zones and patterns of chest x-ray, along with 80% reduction in the c-reactive protein (CRP) levels. Based on the WHO clinical progression scale, 20 patients improved by theend of first week, and by the end of first month, 26 patients became asymptomatic. Two patients died during thecourse of the disease.No fetal adverse effects were noted. Based on the encouragingresponse and as tocilizumab did not impartany adverse effects on the pregnancy, tocilizumab may be administered as an adjuvant to criticalCOVID-19 pregnant women in their second and third trimesters.

Perinatal anxiety and depression amidst the COVID-19 pandemic in Dubai, United Arab Emirates

Pregnancy and COVID-19 increase the risk of mental health conditions. The stress of pregnancy, childbirth, and uncertainty about the global pandemic has negatively impacted the obstetric population. To study the effects of the COVID-19 pandemic in terms of anxiety and depression (Point Prevalence) in antenatal and postnatal mothers using the EPDS (Edinburgh Postnatal Depression scale) scale and GAD (Generalized Anxiety Disorder)-7 scale at Dubai Hospital, UAE. Cross-Sectional Observational Study. Of the 784 women approached, 438 gave consent to participate in our survey, and 43.6% of the women screened positive for depression by the EDPS scale with a cutoff of 10 or more as significant. 42% of the women had a GAD-7 score of 5 or more indicating anxiety. 32.4% of the women had both anxiety and depression. 7.5% had considered self-harm in the last 14 days. 15% had COVID-19 during this pregnancy. The 11.87% who had COVID-19, but prior to the pregnancy, had a higher mean EDPS and GAD-7 score than others. Surprisingly, the women who had COVID-19 during pregnancy had statistically significant (p < 0.05) lower EDPS and lower GAD-7 scores. University graduates had significantly (p < 0.05) higher EDPS and GAD scores. Women of middle eastern ethnicity (50% positive for depression and 48.5% positive for anxiety) were more prone to depression and anxiety compared to South Asian (29% positive for depression and 25.2% positive for anxiety) and African women (39.6% positive for depression and 43.4% positive for anxiety). There was no statistically significant difference between antenatal and postnatal patients for the prevalence of anxiety or depression. The COVID-19 pandemic is associated with an increase in depression and anxiety in pregnant and postnatal women. Women who were more concerned about the effects of the pandemic had higher mean EDPS and GAD scores. Additional psychological support for women is necessary during the pandemic for maternal perinatal well-being.

The distribution of surface contamination with SARS-COV-2 in various parts of an emergency department at a tertiary care hospital in Dubai- a prospective study

Objective: This study aimed to find if certain places are more contaminated by SARS COV-2 than the others in an Emergency Department (ED) of a tertiary care hospital. Methods: This was a prospective cross-sectional study carried out at the tertiary care hospital of Dubai. The study was carried out over a course of 4 weeks. Total 50 swab samples were taken. Twenty five were collected from the &amp;quot;dirty&amp;quot; areas and twenty five from the &amp;quot;clean&amp;quot; areas. Patients who had a positive SARS-COV-2 polymerase chain reaction (PCR) test in both areas were included in the study. Results: From a total of 50 swabs collected, large number of swabs was collected from resuscitation and major treatment area (38% and 30%, respectively). Of total, positive SARS-COV-2 PCR was detected on 38% of swabs. Of which 44% were from dirty areas and 32% were from clean areas. Considering areas of ED positive SARS COV-2 PCR, it was detected majorly from zone 4 (50%) followed by major (40%) and minor treatment areas (33.3%), respectively. Conclusion: The detection of the virus in 32% of the samples taken from clean areas emphasizes on the importance of using personal protective equipment and hand hygiene measures even when working in areas where patients have been triaged without the presence of symptoms suggestive of a COVID-19 infection.

Diabetic Ketoacidosis in COVID-19 Patients: Clinical Characteristics and Outcomes – A Retrospective Study in a Single Tertiary Care Hospital, Dubai, United Arab Emirates

Introduction: We aimed to evaluate the clinical characteristics of patients presenting with DKA and COVID-19 infection and describe the clinical outcomes compared to those without COVID-19. Methods: A retrospective study in a single tertiary care hospital in Dubai was conducted on patients admitted between 1st March 2020 and 30th July 2020 with a diagnosis of DKA with and without COVID-19 infection. Results: A total of 32 patients with DKA were identified. Eleven patients had a positive COVID-19 test and 21 patients were negative. The majority of DKA patients were males (84.4%). In the COVID-19 group, the mean age was 41.3 years old. Seven patients had preexisting diabetes (63.7%) and 4 patients (36.4%) had newly diagnosed diabetes. COVID-19 patients had a longer median length of hospital stay (7 days vs. 4 days; p = 0.278), shorter duration of DKA (16 h vs. 24 h; p = 0.043), and higher mortality (18.2% vs. 0%; p = 0.047). Conclusion: COVID-19 infection can precipitate DKA in patients with either newly diagnosed or preexisting diabetes. DKA patients with COVID-19 infection had higher mortality compared to those without COVID-19. This should urge physicians to be more vigilant in assessing the glycemic status of patients presenting with COVID-19 infection.