UAE Patients Research Articles

Hepatitis B virus genotypes and precore and core mutants in UAE patients

BackgroundKnowledge of the HBV genotype with which a patient is infected is crucial information for a physician to have when planning clinical treatment for that patient. Previous studies have suggested that there are possible differences in the pathogenicity and therapeutic response of different HBV genotypes. However, the prevalence of the various HBV genotypes and Precore and Core mutations is unknown in the UAE. Therefore, we sought to determine the prevalence of the different HBV genotypes in the UAE population.Methodology/Principal FindingsA total of 88 HBsAg-positive patients were included in the study.A method for genotyping and subtyping HBV by partial HBsAg gene sequencing using primers that are complementary to all known genotypes was used. Precore and core region of these viruses were also sequenced in 88 patients.HBV genotype D was the most prevalent (79.5%) genotype identified in our study population, followed by genotypes A (18.2%) and C (2.3%). The following subtypes were isolated: ayw2 (80.7%), adw2 (14.8%), and adw (2.3%). The HBV-DNA viral load was higher in HBeAg-positive patients than it was in patients who were HBeAg-negative. Precore mutants were found in 51 (58.0%) of 88 patients. Mutations in the basal core promotor were found in 22 (25.3%) of 88 patients.Conclusion/SignificanceHBV infection is a major health problem in the UAE, and while genotypes B and C are the most prevalent HBV genotypes in the Asian population, our study reveals that genotype D is the predominant genotype that is present in the UAE. More patients were HBeAg-negative than were HBeAg-positive in our study sample, which could be due to the duration of infection of the included patients. Additionally, the viral loads of the HBeAg-positive patients were higher those of the HBeAg-negative patients. Analysis of nucleotide 1858 showed presence of thymine in all patients with genotypes C, and D and in a few patients with genotypes A. This nucleotide was closely related to the presence of precore mutants. Mutations in the basal core promoter were found in 22 of 88 (25.3%) samples. These mutations were more frequent in patients infected with genotype A (37.5%) and not found in patients infected with genotype C.

Oral health condition and treatment needs of a group of UAE children with down syndrome

Objectives: Several studies have described the oral health condition and treatment needs of individuals with Down syndrome (DS), but there are no reports about DS patients in UAE. This study was conducted to determine the oral health condition and treatment needs in these patients.Methods: Sixty children with DS attending Sharjah School for Humanitarian Service (SSHS) were selected for the study. In the evaluation, the children were compared with a normal non-DS control group selected from children attending college of dentistry Ajman University dental clinics and matched for age and sex. Clinical assessment included extraoral and intraoral examination, measurement of decayed (D), missing (M) and filled (F) teeth (DMFT) for permanent dentition and (dmft) for primary dentition, while periodontal evaluation included recording of oral hygiene status, plaque index (P1), gingival index (GI), probing depth (PD), and clinical attachment level (CAL). Periodontal and gingival health status was recorded according to the Community Periodontal Index of Treatment Needs (CPITN). DS children were also examined for malocclusion, dental hypoplasia, crowding, and missing teeth.Results: Compared with normal controls, children with DS had mean number of DMFT almost twice as high as that in the parallel healthy controls (13.2 ± 0.84 vs. 7.4 ± 3.94). More of the DS children showed poor oral hygiene. The assessment of the periodontal treatment needs of the DS children revealed that only 10% of the children had healthy gingiva compared with 38.3% of healthy controls. Significantly high proportion of DS patients (p < 0.05) require complex periodontal treatment. DS patients have shown a significantly higher proportion of malocclusion (p < 0.01), compared with non-DS subjects.Conclusion: Individuals with DS in UAE have poor oral health and an increased occurrence of periodontal disease and dental caries compared with otherwise normal, age-matched control groups. Preventive, restorative and periodontal treatment needs are unmet in DS children. These findings reinforce the importance of promoting the integration of the dental specialists to the interdisciplinary team that provides healthcare for this group of children.

Culture-Related Service Expectations

To compare service expectations between Arab and Austrian patients. We used a Kano model-based questionnaire with 20 service attributes of relevance to the dialysis patient. We analyzed 530, 172, 60, and 68 responses from Saudi, Austrian, Syrian, and UAE patients, respectively. We compared the customer satisfaction coefficient and the frequencies of response categories ("must be," "attractive," "one-dimensional," and "indifferent") for each of the 20 service attributes and in each of the 3 national groups of patients. We also investigated whether any differences seen were related to sex, age, literacy rate, or duration on dialysis. We observed higher satisfaction coefficients and "one-directional" responses among Arab patients and higher dissatisfaction coefficients and "must be" and "attractive" responses among Austrian patients. These were not related to age or duration on dialysis but were related to literacy rate. We speculate that these discrepancies between Austrian and Arab patients might be related to underdeveloped sophistication in market competitive forces and to cultural influences.

Computed tomography angiogram for failed uterine artery embolization

It was the aim of this study to discuss the efficacy of computed tomography angiograpy after failed uterine artery embolization. We performed a review of cases where embolization of myomata failed to relieve symptoms, or shrink myomata. If MRI showed continued uptake, patients were offered CT angiograms to better direct therapy. Repeat embolization details were compared with findings on CT angiogram. During the study, 675 patients underwent uterine artery embolization. 229 patients underwent follow-up MRI with intravenous contrast, 29 of which showed persistent uptake into myomata. Twelve patients had CT angiogram of the abdomen following MRI and six elected to undergo repeat UAE after CT angiogram. There was a 75% concurrence between CT angiograms and live studies (angiogram during repeat uterine artery embolization). With CTA, five patients showed a unilateral non-uterine blood supply, one showed a bilateral non-gonadal supply to the uterus, and two showed a normal blood supply, with all but two cases confirmed on live angiogram. Based on post-repeat MRI, one of the six repeat UAE patients shows no continued uptake of intravenous contrast to myomata. Four show continued uptake, however, one patient did show decreased size of myomata. CT angiography is a valuable tool to identify collateral and persistent uterine artery supply, and offers great potential for accurate identification and evaluation of extra-gonadal supply to the uterus. It will allow for pre-operative planning, as well as discussion of risks and benefits with patients.

Transformational leadership and service quality in UAE hospitals

PurposeThis paper investigates the relationship between transformational leadership and service quality in UAE hospitals. The paper first determined the level of satisfaction of patients with the service quality they received. The paper also analyzed how hospital employees perceived the dimensions of transformational and transactional leadership of their leaders. Finally, the relationship between the dimensions of service quality and those of transformational and transactional leadership was investigatedDesign/methodology/approachTwo questionnaires were administered. The first questionnaire addressed service quality using an adapted SERVQUAL. The second one addressed transformational and transactional leadership using the multi‐level leadership questionnaire. The first questionnaire was distributed to patients of six major UAE hospitals while the second one was distributed to employees of the same hospitals. Data were collected and analyzed using SPSS.FindingsThe paper found that UAE patients were generally satisfied with the service quality rendered by their hospitals. It however found that hospital employees had a low rating of their leaders in terms of the transformational leadership and contingent reward. Finally, service quality was found to be positively related to all dimension of transformational leadership and the transactional leadership dimension of contingent reward. The two dimensions of active exception and passive avoidant leadership were negatively related to service quality.Originality/valueThis paper bridged an important gap in the literature by addressing the relationship between service quality and transformational leadership. It provided important guidelines for managers on the dimensions of leadership that needed to be enhanced in order to improve service quality.

Outcome of insulin requiring diabetic pregnancies at the Al Corniche Hospital.

The aim of this study was assess the outcome of diabetic pregnancies requiring insulin under the care of a Combined DiabeticTeam and to evaluate the necessity of pre-pregnancy counseling. This is a prospective study undertaken for a 2 year period(Jan 2001 to Dec 2002) at Al Corniche Hospital, Abu Dhabi. Three hundred and eighty six pregnant diabetic womenrequiring insulin at varying gestations were looked after by Combined Diabetic Team (Team “0”) during the pregnancy andearly postpartum period, and then re-transferred back to original teams. Audit forms with comprehensive details weremaintained and data were doubly checked with the Main Delivery Unit computer data/statistics register. Main outcomemeasures were compliance to Combined Diabetic Clinic, control of Diabetes with home monitoring. Perinatal mortality rate,congenital fetal anomalies and attitude of patient to pre and post pregnancy counseling were also assessed. Out of 386 women156 ( 40.2%) were UAE patients. Grandmultiparity was 16 (4.14%). Highest parity was 16+2. Only 47 (12%) patients startedpregnancy with normal BMI while rest were overweight to obese. 322 (83.4%) were compliant to Combined Diabetic Clinic,358 (92.7%) self-injected with insulin while 325 (84.1%) did home-monitoring. Caesarian section rate was 48.4%. Grossperinatal mortality rate was 22.8/ 1000. 16 babies had congenital anomalies. Contraception was accepted by 46%, and morethan 50% defaulted Postnatal Clinic. In conclusion, maternal and perinatal outcome was good, pre pregnancy counseling wasdifficult as most pregnancies are unplanned, postnatal counseling is more relevant in our setup of diverse ethnic andgeographical population.