Rashid Hospital

Background The Healthy Minds Study (HMS) Questionnaire is an assessment tool that examines mental health, service awareness and help-seeking behaviour (including stigma and knowledge) among university students. Aims A shortage of tools specifically designed to cater to student populations has resulted in limited data from Arabic-speaking countries on mental health in university students. Our study aimed to describe the prevalence of mental health symptoms, service awareness, stigma and help-seeking attitudes among medical students at the United Arab Emirates (UAE) University. Method We conducted a cross-sectional survey of 87 medical students at the UAE University, using the HMS Questionnaire. Results A total of 73.6% reported at least mild depressive symptoms (Patient Health Questionnaire-9 (PHQ-9) ≥ 5), 35.8% met criteria for probable major depression (PHQ-9 ≥ 10), 46% screened positive for anxiety, 11.5% reported non-suicidal self-injury, 9.2% reported seriously thinking of suicide, 13.8% reported symptoms of an eating disorder, 8.1% agreed that they would think less of a person who has received mental health treatment and 69% agreed that most people would think less of a person who has received mental health treatment. Conclusions We found a high prevalence of mental health difficulties and a reluctance to report and seek help for mental health difficulties among medical students in the UAE, which may be associated with a negative perceived public stigma.

This is a summary of the original article "Safety and effectiveness of concomitant iGlarLixi and SGLT-2i use in people with T2D during Ramadan fasting: a SoliRam study sub-analysis." iGlarLixi is a fixed-ratio combination of insulin glargine 100U/ml and glucagon like peptide1 receptor agonist (GLP-1RA) lixisenatide which has demonstrated its effectiveness of improving glycemic parameters and reducing body weight with low risk of hypoglycemia incidence in adults with type2 diabetes (T2D) who were previously sub-optimally controlled with oral antidiabetic drugs (OADs) alone or in combination with basal insulin or GLP-1RA. This sub-analysis of the SoliRam study assessed the safety and effectiveness of concomitant iGlarLixi and sodium/glucose cotransporter2 (SGLT-2i) use with or without other OADs in adults with T2D who fasted during Ramadan. Participants were divided into two groups: SGLT-2i-users and SGLT-2i-non-users. The findings showed low incidence of severe and/or symptomatic documented hypoglycemia, improved glycemic control, and body weight benefits, irrespective of SGLT-2i use. No serious adverse events were reported in either group. The sub-analysis concluded that the concomitant iGlarLixi and SGLT-2i therapy, with or without other OADs, was demonstrated to be a safe treatment for people with T2D during Ramadan fasting.

Background: Findings of in-vivo studies incorporated with study of human diseases has contributed to the theory of immunology of various diseases. Humoral and cell mediated immunity plays a crucial role in humans for protection against extracellular and intracellular pathogens. Research in this area is important considering the phytoconstituents and therapeutic effects associated with the selected plants in this research as plants are free of adverse effects unlike allopathic medications. Objective: To study cellular and humoral mediated immune response of three medicinal plants – Convolvulus pluricaulis (CP), Michelia champaca (MC) and Chromolaena odorata (CO) and to evaluate the synergistic effects by combination (CI), from the herbal combination prepared by combination of above three medicinal plant extracts. Methods: The ethanolic extracts of selected plants were subjected to in-vivo models – Delayed Type Hypersensitivity (DTH) and Haemagglutination Antibody Titre (HAT) based on acute oral toxicity results. Results: Delayed type hypersensitivity: highly significant activity was noticed after 48 hours at 100 and 200 mg/kg dose levels. Haemagglutination antibody titre: The individual plant extracts were found to be insignificant. However, the combination of three extracts (COMB) showed significant antibody levels at low dose. Combination Index: the combination index was less than 1 (CI <1) for herbal combination thus indicating synergism among the plants. Conclusion: The combination extract of CP, MC and CO proved its synergistic effects through DTH and HAT models thus promising immunomodulatory potential associated with the plants. Such combination could be explored for further research studies.

Neuromyelitis optica spectrum disorder (NMOSD) is a severe autoimmune disorder affecting the central nervous system, often misdiagnosed as multiple sclerosis. The identification of aquaporin-4-IgG (AQP4-IgG) has improved diagnostic precision and enabled targeted therapies. Given the unique regional challenges in healthcare delivery across the Middle East and North Africa (MENA) region, the Middle East and North Africa Committee for Treatment and Research in Multiple Sclerosis (MENACTRIMS) convened an expert panel to develop evidence-based, region-specific consensus recommendations for diagnosis and management. These guidelines endorse the 2015 International Panel for NMO Diagnosis (IPND) criteria, emphasizing AQP4-IgG testing via cell-based assays. Differential diagnosis should consider multiple sclerosis, myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), and acute disseminated encephalomyelitis (ADEM). For acute treatment: initiate high-dose intravenous methylprednisolone promptly and use plasma exchange early for severe or steroid-refractory attacks. For long-term immunotherapy, monoclonal antibodies (rituximab, inebilizumab, eculizumab, ravulizumab, satralizumab, or tocilizumab) are recommended according to availability and patient factors; conventional immunosuppressants remain alternatives when biologics are inaccessible. Guidance is provided for pediatric patients and for pregnancy and breastfeeding, including planning after ≥ 12 months of disease stability and early postpartum treatment resumption. These MENACTRIMS guidelines aim to improve NMOSD outcomes across the region by promoting accurate diagnosis and timely, effective therapy.

Background Electrocardiographic analysis algorithms have consistently evolved, becoming essential tools for physicians in diverse settings, particularly in assessing patients with acute chest pain. Moving forward, it is crucial to classify unstructured automated ECG reports into clinically relevant outcomes using advanced large language models. This approach holds significant potential to enhance an accelerated clinical decision pathway in clinical settings. Objective This study aims to integrate automated electrocardiogram algorithms with advanced machine learning techniques, enhancing the classification of ECG reports within emergency department settings. Specifically, it investigates how natural language processing can augment traditional methods to accelerate the electrocardiographic-directed management of acute chest pain. Methods Employing a retrospective observational dataset from Rashid Hospital, Dubai, spanning from June 2022 to August 2022, we analyzed 860 ECGs from patients presenting with acute chest pain. The ECGs were categorized into four classes, namely, STEMI, NSTEMI, normal ECG, and new arrhythmia using a hybrid model that combines the established Glasgow algorithm with a large language model,GPT-4. The Glasgow algorithm produced structured text inputs, which were then classified by GPT-4 using few-shot prompting (temperature = 0.2, top_p=1.0). Results The model demonstrates high predictive accuracy for normal ECGs, achieving an F1 score of 0.93, followed by STEMI with an F1 score of 0.80. New arrhythmias, however, present more challenges, reflected by the lowest F1 score of 0.45. Notably, the model excels in discriminating between STEMI and normal ECGs (AUC=0.92) and between STEMI and new arrhythmias (AUC=0.91). Overall accuracy was 85.9% (95% CI: 0.816-0.895) Conclusion The findings suggest that leveraging deep learning alongside traditional algorithms can significantly improve the rapid classification of ECGs, supporting accelerated decision-making pathways in clinical practice.

Background: Prolonged postoperative immobility is associated with preventable complications and delayed functional recovery, contributing to extended hospital length of stay and increased healthcare utilization. Early mobilization within 24 hours of surgery is increasingly incorporated into enhanced recovery pathways, yet its combined impact on clinical, functional, and patient-reported outcomes across elective surgical populations requires further evaluation. Objective: To assess the association between early postoperative mobilization and hospital length of stay, postoperative complications, mobility at discharge, 30-day readmission, and patient satisfaction among elective surgery patients. Methods: A cross-sectional observational comparative study was conducted among 200 adults undergoing elective surgery at a tertiary-care hospital. Patients were categorized into an early mobilization group (mobilized within 24 hours post-surgery; n = 100) and a standard care group (mobilized after 24 hours; n = 100) based on routine postoperative documentation. Outcomes included length of stay, in-hospital complications (deep vein thrombosis, pneumonia, pressure ulcers), discharge mobility score (10-point scale), 30-day readmission, and discharge satisfaction score (10-point scale). Group comparisons used t-tests and chi-square tests, with effect estimates reported as mean differences and odds ratios. Results: Early mobilization was associated with shorter length of stay (5.4 ± 1.2 vs 7.2 ± 1.5 days; mean difference −1.8 days; p = 0.02), lower complication rates (deep vein thrombosis: 2.5% vs 7.0%, OR 0.34; pneumonia: 1.0% vs 5.0%, OR 0.19; pressure ulcers: 1.5% vs 6.5%, OR 0.22; all p ≤ 0.03), higher mobility scores (8.4 ± 1.3 vs 6.2 ± 1.8; mean difference 2.2; p = 0.001), reduced 30-day readmission (3.0% vs 7.5%, OR 0.38; p = 0.04), and higher satisfaction (9.0 ± 0.9 vs 7.2 ± 1.1; mean difference 1.8; p = 0.002). Conclusion: Early mobilization within 24 hours after elective surgery was associated with improved postoperative outcomes, including shorter hospitalization, fewer complications, better functional recovery, lower readmission, and higher patient satisfaction, supporting its integration into routine postoperative care pathways.

Background: The relationship between optic nerve sheath diameter (ONSD) and mortality outcomes in critically ill intensive care unit (ICU) patients is an area of increasing interest. This study aimed to explore whether ONSD can serve as a reliable predictor of mortality in ICU patients, potentially offering a non-invasive tool to guide clinical decision-making and patient management.Materials and methods: This prospective cohort study included critically ill ICU patients aged 14 years and above, excluding those with pre-existing optic nerve disorders, traumatic brain injury (TBI), or intracerebral hemorrhage (ICH). Demographic and clinical data, including age, sex, comorbidities, injury severity score, Glasgow Coma Scale (GCS), and laboratory data, such as liver function tests (LFTs), hemoglobin (Hb) level, and procalcitonin (PCT) level, were collected. ONSD was measured on Day 1 and Day 10 using transorbital ultrasonography. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 21 (released 2012; IBM Corp., Armonk, New York, United States) to determine the association between ICU mortality and other outcomes.Results: The patients in this study had a mean age of 58.29 years, with the majority presenting with comorbidities such as diabetes mellitus (DM) and hypertension (HTN). Clinical outcomes showed significant reductions in C-reactive protein (CRP) over ten days, with a notable prevalence of sepsis (91.2%) and a survival rate of 66.2%, while the ONSD values on ICU admission day were significantly higher in non-survivors (mean right/left ONSD = 4.02/3.97 mm) versus survivors (mean right/left ONSD = 3.68/3.67 mm), with p-values of 0.001 indicating statistical significance.Conclusions: ONSD measurement is a valuable prognostic tool in ICU patients, correlating with mortality outcomes, especially in septic patients, and can help guide timely interventions for better outcomes.

Pancreatic cancer and other solid pancreatic lesions present significant diagnostic challenges owing to their deep anatomical location and nonspecific symptoms. Endoscopic ultrasound (EUS) has emerged as a critical modality for high-resolution imaging and tissue sampling of pancreatic lesions. However, comprehensive data on its utilization and findings in Gulf Cooperation Council (GCC) countries remain scarce. This study aimed to evaluate the demographic characteristics, clinical presentations, and diagnostic outcomes of solid pancreatic lesions assessed via EUS in GCC countries. A retrospective, descriptive analysis was conducted on 551 patients who underwent EUS for the evaluation of solid pancreatic lesions between 2020 and 2024 across multiple healthcare institutions in the GCC countries. Demographic data, clinical symptoms, imaging findings, and diagnostic outcomes were also collected. Statistical analyses included descriptive statistics, Chi-squared tests for categorical variables, and Mann-Whitney U tests for non-normally distributed continuous variables. A total of 551 patients (mean age 61.5±13.7 years; n=330 males, 59.9%) were included. Most were symptomatic (n=499, 90.6%), with abdominal pain (n=354, 64.2%) being the most common symptom. Computed tomography was the initial diagnostic modality in the majority (n=469, 85.1%). Lesions were most frequently located in the pancreatic head/uncinate on imaging (n=329, 59.7%) and EUS (n=361, 65.6%). Vascular involvement was observed in 260 (47.2%) radiologically and 226 (41.1%) on EUS. Lesion size was smaller on EUS (34 vs. 37 mm, P=0.008), while side branch dilation was more often detected (P<0.001). The most common diagnosis was pancreatic ductal adenocarcinoma (n=417, 80.1%), followed by neuroendocrine tumors (n=49, 9.4%). EUS plays a pivotal role in diagnosing solid pancreatic lesions in the GCC countries, offering safe and effective lesion characterization and tissue sampling. Standardized protocols and further molecular research are warranted to enhance diagnostic precision and outcomes in pancreatic adenocarcinoma.