Browsing by Author "Ho, Samuel B"

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Clinical Characteristics of Children with COVID-19 in the United Arab Emirates: Cross-sectional Multicenter Study
(2021) Ennab, Farah; ElSaban, Mariam; Khalaf, Eman; Tabatabaei, Hanieh; Hassan Khamis, Amar; Saravanan, Ketharanathan; Cremonesini, David; Popatia, Rizwana; Malik, Zainab; Ho, Samuel B; Abusamra, Rania
Background: COVID-19 has infected over 123 million people globally. The first confirmed case in the United Arab Emirates (UAE) was reported on January 29, 2020. According to studies conducted in the early epicenters of the pandemic, COVID-19 has fared mildly in the pediatric population. To date, there is a lack of published data about COVID-19 infection among children in the Arabian region. Objective: This study aims to investigate the clinical characteristics, laboratory findings, treatment, and outcomes of children with COVID-19. Methods: This cross-sectional, multicenter study included children with confirmed COVID-19 infection admitted to 3 large hospitals in Dubai, UAE, between March 1 and June 15, 2020. Serial COVID-19 polymerase chain reaction (PCR) testing data were collected, and patients’ demographics, premorbid clinical characteristics, and inpatient hospital courses were examined. Results: In all, 111 children were included in our study and represented 22 nationalities. Of these, 59 (53.2%) were boys. The mean age of the participants was 7 (SD 5.3) years. About 15.3% of children were younger than 1 year. Only 4 (3.6%) of them had pre-existing asthma, all of whom had uneventful courses. At presentation, of the 111 children, 43 (38.7%) were asymptomatic, 68 (61.2%) had mild or moderate symptoms, and none (0%) had severe illness requiring intensive care. Fever (23/111, 20.7%), cough (22/111, 19.8%), and rhinorrhea (17/111, 15.3%) were the most common presenting symptoms, and most reported symptoms resolved by day 5 of hospitalization. Most patients had no abnormality on chest x-ray. The most common laboratory abnormalities on admission included variations in neutrophil count (22/111, 24.7%), aspartate transaminase (18/111, 22.5%), alkaline phosphatase (29/111, 36.7%), and lactate dehydrogenase (31/111, 42.5%). Children were infrequently prescribed targeted medications, with only 4 (3.6%) receiving antibiotics. None of the 52 patients tested for viral coinfections were positive. COVID-19 PCR testing turned negative at a median of 10 days (IQR: 6-14) after the first positive test. Overall, there was no significant difference of time to negative PCR results between symptomatic and asymptomatic children. Conclusions: This study of COVID-19 presentations and characteristics presents a first look into the burden of COVID-19 infection in the pediatric population in the UAE. We conclude that a large percentage of children experienced no symptoms and that severe COVID-19 disease is uncommon in the UAE. Various laboratory abnormalities were observed despite clinical stability. Ongoing surveillance, contact tracing, and public health measures will be important to contain future outbreaks.
COVID-19 and healthcare workers: A systematic review and meta-analysis
(2021) Gholami, Mandana; Fawad, Iman; Shadan, Sidra; Rowaiee, Rashed; Ghanem, HedaietAllah; Hassan Khamis, Amar; Ho, Samuel B
Background: The COVID-19 pandemic has focused attention on the challenges and risks faced by frontline healthcare workers (HCW). This study aimed to describe the clinical outcomes and risk factors for SARSCoV-2 infection in HCW. Methods: Three databases were surveyed and 328 articles were identified. Of these, 225 articles did not meet inclusion criteria; therefore, 97 full-text article were reviewed. Finally, after further revision, 30 articles were included in the systematic review and 28 were used for meta-analysis. Results: Twenty-eight studies were identified involving 119,883 patients. The mean age of the patients was 38.37 years (95% CI 36.72–40.03) and males comprised 21.4% (95% CI 12.4–34.2) of the population of HCW. The percentage of HCW who tested positive for COVID-19 was 51.7% (95% CI 34.7–68.2). The total prevalence of comorbidities in seven studies was 18.4% (95% CI 15.5–21.7). The most prevalent symptoms were fever 27.5% (95% CI 17.6–40.3) and cough 26.1% (95% CI 18.1–36). The prevalence of hospitalisation was 15.1% (95% CI 5.6–35) in 13 studies and of death was 1.5% (95% CI 0.5–3.9) in 12 studies. Comparisons of HCW with and without infection showed an increased relative risk for COVID-19 related to personal protective equipment, workplace setting, profession, exposure, contacts, and testing. Conclusion: Asignificantnumber of HCWwere reported to be infected with COVID-19 during the first 6 months of the COVID-19 pandemic, with a prevalence of hospitalisation of 15.1% and mortality of 1.5%. Further data are needed to track the continued risks in HCW as the pandemic evolves and health systems adapt.
The COVID-19 Pandemic and Health and Care Workers: Findings From a Systematic Review and Meta-Analysis (2020–2021)
(2023) Gholami, Mandana; Fawad, Iman; Shadan, Sidra; Rowaiee, Rashed; Ghanem, HedaietAllah; Hassan Khamis, Amar; Ho, Samuel B
Objectives: The COVID-19 pandemic has greatly impacted health and care workers (HCW) globally, whom are considered at greater risk of infection and death. This study aims to document emerging evidence on disease prevalence, clinical outcomes, and vaccination rates of HCWs. Methods: Three databases were surveyed resulting on 108 final articles between July–December 2020 (period 1) and January–June 2021 (period 2). Results: Amongst the overall 980,000 HCWs identified, in period 1, the estimates were 6.1% (95% CI, 4.1–8.8) for the PCR positivity rate. Regarding outcomes, the hospitalization prevalence was 1.6% (95% CI, 0.7–3.9), and mortality rate of 0.3% (95% CI, 0.1–0.8). In period 2, the PCR positivity rate was 8.1% (95% CI, 4.6–13.8). Analysis of outcomes revealed a hospitalization rate of 0.7% (95% CI 0.3–1.8), and average mortality rate of 0.3% (95% CI 0.1–0.9). Our analysis indicated a HCW vaccination rate of 59.0% (95% CI, 39.4–76.1). Conclusion: Studies from the latter half of 2020 to the first half of 2021 showed a slight increasing trend in PCR positivity among HCW, along with improved clinical outcomes in the 1-year period of exposure. These results correlate well with the improving uptake of COVID-19 vaccination globally.
COVID‐19 under 19: A meta‐analysis
(2021) Toba, Nagham; Gupta, Shreya; Ali, Abdulrahman; ElSaban, Mariam; Hassan Khamis, Amar; Ho, Samuel B; Popatia, Rizwana
Background: The coronavirus disease 2019 (COVID‐19) pandemic continues to cause global havoc posing uncertainty to educational institutions worldwide. Understanding the clinical characteristics of COVID‐19 in children is important because of the potential impact on clinical management and public health decisions. Methods: A meta‐analysis was conducted for pediatric COVID‐19 studies using PubMed and Scopus. It reviewed demographics, co‐morbidities, clinical manifestations, laboratory investigations, radiological investigations, treatment, and outcomes. The 95% confidence interval (CI) was utilized. Results: Out of 3927 articles, 31 articles comprising of 1816 patients were selected from December 2019 to early October 2020 and were defined by 77 variables. Of these studies 58% originated from China and the remainder from North America, Europe and the Middle East. This meta‐analysis revealed that 19.2% (CI 13.6%–26.4%) of patients were asymptomatic. Fever (57%, CI 49.7%–64%) and cough (44.1%, CI 38.3%–50.2%) were the most common symptoms. The most frequently encountered white blood count abnormalities were lymphopenia 13.5% (CI 8.2%–21.4%) and leukopenia 12.6% (CI 8.5%–18.3%). Ground glass opacities were the most common radiological finding of children with COVID‐19 (35.5%, CI 28.9%–42.7%). Hospitalization rate was 96.3% (CI 92.4%–98.2%) of which 10.8% (CI 4.2%–25.3%) were ICU admissions, and 2.4% (CI 1.7%–3.4%) died. Conclusion: The majority of pediatric patients with COVID‐19 were asymptomatic or had mild manifestations. Among hospitalized patients there remains a significant number that require intensive care unit care. Overall across the literature, a considerable level of understanding of COVID‐19 in children was reached, yet emerging data related to multisystemic inflammatory syndrome in children should be explored.
Development of a national Department of Veterans Affairs mortality risk prediction model among patients with cirrhosis
(2019) Ho, Samuel B
Objective: Cirrhotic patients are at high hospitalization risk with subsequent high mortality. Current risk prediction models have varied performances with methodological room for improvement. We used current analytical techniques using automatically extractable variables from the electronic health record (EHR) to develop and validate a post hospitalization mortality risk score for cirrhotic patients and compared performance with the model for end-stage liver disease (MELD), model for end-stage liver disease with sodium (MELD-Na), and the CLIF Consortium Acute Decompensation (CLIF-C AD) models. Design: We analysed a retrospective cohort of 73 976 patients comprising 247 650 hospitalisations between 2006 and 2013 at any of 123 Department of Veterans Affairs hospitals. Using 45 predictor variables, we built a time dependent Cox proportional hazards model with all-cause mortality as the outcome. We compared performance to the three extant models and reported discrimination and calibration using bootstrapping. Furthermore, we analysed differential utility using the net reclassification index (NRI). Results: The C-statistic for the final model was 0.863, representing a significant improvement over the MELD, MELD-Na, and the CLIF-C AD, which had C-statistics of 0.655, 0.675, and 0.679, respectively. Multiple risk factors were significant in our model, including variables reflecting disease severity and haemodynamic compromise. The NRI showed a 24% improvement in predicting survival of low-risk patients and a 30% improvement in predicting death of high-risk patients. Conclusion We developed a more accurate mortality risk prediction score using variables automatically extractable from an EHR that may be used to risk stratify patients with cirrhosis for targeted postdischarge management.
Dietary Patterns and Associated Microbiome Changes that Promote Oncogenesis
(2021) Ibragimova, Shakhzada; Ramachandran, Revathy; Ali, Fahad R; Lipovich, Leonard; Ho, Samuel B
Abstract: The recent increases in cancer incidences have been linked to lifestyle changes that result in obesity and metabolic syndrome. It is now evident that these trends are associated with the profound changes that occur in the intestinal microbiome, producing altered microbial population signatures that interact, directly or indirectly, with potentially pro-carcinogenic molecular pathways of transcription, proliferation, and inflammation. The effects of the entire gut microbial population on overall health are complex, but individual bacteria are known to play important and definable roles. Recent detailed examinations of a large number of subjects show a tight correlation between habitual diets, fecal microbiome signatures, and markers of metabolic health. Diets that score higher in healthfulness or diversity such as plant-based diets, have altered ratios of specific bacteria, including an increase in short-chain fatty acid producers, which in turn have been linked to improved metabolic markers and lowered cancer risk. Contrarily, numerous studies have implicated less healthy, lower-scoring diets such as the Western diet with reduced intestinal epithelial defenses and promotion of specific bacteria that affect carcinogenic pathways. In this review, we will describe how different dietary patterns affect microbial populations in the gut and illustrate the subsequent impact of bacterial products and metabolites on molecular pathways of cancer development, both locally in the gut and systemically in distant organs.
Drug-induced acute pancreatitis in a bodybuilder: a case report
(2022) Shabestari, Seyed Ali Safzadeh; Ho, Samuel B; Nathwani, Rahul A
Background: Unregulated use of a variety of drugs and supplements by bodybuilders and athletes is common and can lead to severe adverse complications. Only a small proportion of acute pancreatitis cases are drug induced, and case reports are essential for identifying potential drug-related risks for pancreatitis. Here we present the first case report published of acute pancreatitis linked to recreational use of anabolic–androgenic steroids, subcutaneous growth hormone, and clenbuterol in a previously healthy male after excluding all other causes of pancreatitis. Case presentation: A 31-year-old Arab male bodybuilder presented with acute abdominal pain associated with nausea and sharp pain radiating to the back. The patient was not using tobacco or alcohol but was using multiple drugs related to bodybuilding, including anabolic–androgenic steroids, subcutaneous growth hormone, clenbuterol, and multiple vitamin supplements. Laboratory studies revealed a normal white blood cell count, elevated C-reactive protein, minimally elevated aspartate aminotransferase and total bilirubin with normal remaining liver tests, and elevated amylase and lipase. The patient had no hypertriglyceridemia or hypercalcemia, and had had no recent infections, abdominal procedures, trauma, or scorpion exposure. Imaging and laboratory investigations were negative for biliary disease and IgG4 disease. Abdominal computed tomography revealed hepatomegaly and difuse thickening and edema of the body and tail of the pancreas with peripancreatic fat stranding. An abdominal ultrasound showed slight hepatomegaly with no evidence of cholelithiasis. Genetic testing for hereditary pancreatitis-related mutations was negative. A diagnosis of drug-induced acute pancreatitis was made, and he was treated with aggressive intravenous hydration and pain management. The patient has avoided further use of these drugs and supplements and had no further episodes of pancreatitis during 1 year of follow-up. Conclusions: This case describes a patient with drug-induced acute pancreatitis after the intake of anabolic–androgenic steroids, subcutaneous growth hormone, and clenbuterol, where all other common causes of acute pancreatitis were excluded. Clinicians should be alert to the possibility of drug-induced acute pancreatitis occurring in bodybuilders and athletes using similar drug combinations.
An Inquiry-Based Distance Learning Tool for Medical Students Under Lockdown (“COVID-19 Rounds”): Cross-Sectional Study
(2023) Akhras, Aya; ElSaban, Mariam; Selvan, Varshini Tamil; Alzaabi, Shaika Zain; Senok, Abiola; Zary, Nabil; Ho, Samuel B
Background: The COVID-19 pandemic presented significant challenges to both clinical practice and the delivery of medical education. Educators and learners implemented novel techniques, including distance learning and web-based rounds, while trying to stay updated with the surge of information regarding COVID-19 epidemiology, pathogenesis, and treatment. Hence, we designed and implemented a technologically enhanced course called “COVID-19 Rounds” to educate students about the rapidly evolving pandemic. Objective: The objectives of this study are to describe a technologically enhanced course called “COVID-19 Rounds” and evaluate the following: (1) student satisfaction and program usefulness in achieving preset objectives, (2) perceived improvement in literacy regarding the pandemic, and (3) the impact of student engagement by designing infographics and initiating COVID-19–related research projects. Methods: This is a cross-sectional study measuring the impact of the implementation of the web-based “COVID-19 Rounds” course. This program included web-based clinical experiences with physicians on actual rounds in COVID-19 wards in the hospital, weekly updates on evolving data and new research, and engagement in student-led projects. The study population included 47 fourth-year medical students at the Mohamed Bin Rashid University of Medicine and Health Sciences in Dubai, the United Arab Emirates, who attended the course. We designed and administered a 47-item survey to assess student satisfaction, program usefulness, impact on knowledge, and student engagement. Data were collected at the end of program delivery via Microsoft Forms. Results: In total, 38 (81%) out of 47 fourth-year medical students participated in this study. The final course evaluation revealed an overall high satisfaction rate, with a mean rating of 3.9 (SD 0.94) on the 5-point Likert scale. Most students were satisfied with the course format (27/38, 71%), organization (31/38, 82%), and the learning experience (28/38, 74%) that the course offered. The course was particularly appreciated for offering evidence-based talks about aspects of the pandemic (34/38, 90%), providing weekly updates regarding emerging evidence (32/38, 84%), and enhancing understanding of the challenges of the pandemic (34/38, 90%). Satisfaction with distance learning was moderate (23/37, 62%), and a minority of students would have preferred an in-person version of the course (10/37, 27%). Student engagement in the course was high. All students participated in small group presentations of infographics of pandemic-related topics. Perceived advantages included conciseness and visual appeal, and disadvantages included the lack of detail and the time-consuming nature of infographic design, especially for students with no prior design experience. After the course ended, 27 (57%) students began research projects. This resulted in 6 abstracts presented at local meetings and 8 scientific papers published or submitted for publication. Conclusions: This inquiry-based adaptive approach to educating medical students about updates on COVID-19 via web-based learning was successful in achieving objectives and encouraging engagement in research. However, shortcomings of the course related to the lack of in-person teaching and clinical activities were also highlighted.
Inverted Yield Curve: The Alarming Rising Incidence of CRC in Young People
(2020) Ho, Samuel B; Zaher, Shroque
EDITORIAL
Medical students’ perception of resilience and of an innovative curriculum-based resilience skills building course: A participant-focused qualitative analysis
(2023) Nair, Bhavana; Otaki, Farah; Ho, Samuel B
Background: Medicine is one of the most demanding academic fields with an extensive curriculum that entails plenty of potential stressors. There is sufficient evidence that medical students are more prone to psychological distress when compared to their peer group of other disciplines. Despite the established need to prioritize resilience skills building within the medical curriculum, very few medical programmes in the Middle East and North Africa region (MENA) proactively empower the students to help themselves in sustaining their mental health. The purpose of the current study is to explore the perception of medical students in Dubai, United Arab Emirates (UAE) regarding their understanding of, and personal experience with building resilience, and their engagement with the content of an innovative curriculum-based resilience skills building course, designed in alignment with the constructivism theory of education. Method: The current study utilized a qualitative phenomenological research design. The curriculum based resilience skills building course, that was investigated as part of this study, is offered at a medical school in Dubai, UAE. A total of 37 students submitted reflective essays about resilience building, in general, and the respective course, in specific. The collected data was inductively analysed following a six-step framework. Findings: The qualitative analysis generated three interlinked themes, namely: Awareness, Application, and Appraisal. Conclusion: This study showed that integrating a resilience skills building course into medical curricula is likely to be positively appraised by the students, where it raises their level of awareness and likelihood of proactively applying the learned concepts in their daily lives. This is especially true when the course is anchored in constructivism experiential learning theory and designed to foster self-directed learning.
Mucin Secretion in Cystic Fibrosis: A Systematic Review
(2021) Ho, Samuel B
Background: Mucus protects the epithelium against invaders and toxic materials. Sticky and thick mucus is characteristic of CF. Objective: The aim of this systematic review is to characterize the specific mucins secreted in the lung and intestinal tract of CF patients. Methods: A systematic literature search was conducted up to December 31, 2019. The following terms were used: “cystic fibrosis” AND “mucin.” Casecontrol studies comparing mucin expression in CF patients to healthy controls were included. Results: We found 741 eligible studies, 694 studies were rejected because they were performed in animals and not in full text, and 32 studies were excluded being editorials, duplications, review articles, meta-analysis, or not in English. Fifteen studies were eligible for our study, including 150 CF patients compared to 82 healthy controls, all fulfilled the inclusion criteria. The main mucin types expressed in the sinus submucosal glands, sputum, tracheobronchial surface epithelium, and lung submucosal glands were MUC5AC and MUC5B. Increase in the number of sinusoidal submucosal glands and expression of MUC5B was found in CF patients, but no such difference from healthy controls was found for the number of goblet cells in the surface epithelium nor in the expression of MUC5AC. The opposite was found in the tracheobronchial surface epithelium and in the lungs. Conclusions: Increased expression of MUC5AC in the surface epithelium and of MUC5B in the subepithelial glands may be the result of higher secretion rate of mucin into the lumen of the respiratory tract, causing mucus plaque, infection, and inflammation.
Predicting 30‑Day Hospital Readmission Risk in a National Cohort of Patients with Cirrhosis
(2019) Ho, Samuel B
Background: Early hospital readmission for patients with cirrhosis continues to challenge the healthcare system. Risk stratification may help tailor resources, but existing models were designed using small, single-institution cohorts or had modest performance. Aims: We leveraged a large clinical database from the Department of Veterans Affairs (VA) to design a readmission risk model for patients hospitalized with cirrhosis. Additionally, we analyzed potentially modifiable or unexplored readmission risk factors. Methods: A national VA retrospective cohort of patients with a history of cirrhosis hospitalized for any reason from January 1, 2006, to November 30, 2013, was developed from 123 centers. Using 174 candidate variables within demographics, laboratory results, vital signs, medications, diagnoses and procedures, and healthcare utilization, we built a 47-variable penalized logistic regression model with the outcome of all-cause 30-day readmission. We excluded patients who left against medical advice, transferred to a non-VA facility, or if the hospital length of stay was greater than 30 days. We evaluated calibration and discrimination across variable volume and compared the performance to recalibrated preexisting risk models for readmission. Results: We analyzed 67,749 patients and 179,298 index hospitalizations. The 30-day readmission rate was 23%. Ascites was the most common cirrhosis-related cause of index hospitalization and readmission. The AUC of the model was 0.670 compared to existing models (0.649, 0.566, 0.577). The Brier score of 0.165 showed good calibration. Conclusion: Our model achieved better discrimination and calibration compared to existing models, even after local recalibration. Assessment of calibration by variable parsimony revealed performance improvements for increasing variable inclusion well beyond those detectable for discrimination.
Professionalism-training in undergraduate medical education in a multi-cultural, multi-ethnic setting in the Gulf Region: an exploration of reflective essays
(2024-02) Buhumaid, Rasha; Otaki, Farah; Stanley, Adrian; Ezimokhai, Mutairu; Jackson, Lisa; Ho, Samuel B
Abstract: Background: Despite the established need to prioritize professionalism-training in developing future physicians, very few medical programs in the Gulf Region embed in their curricula discrete contextualized courses aimed at developing the corresponding competencies, while fostering self-directed learning. This study aims at exploring the perception of undergraduate medical students in a multi-cultural, multi-ethnic setting regarding their understanding of, and personal experience with professionalism through their engagement with the content of an innovative curriculum-based professionalism course, offered at a Medical School in Dubai, United Arab Emirates. Methods: The study used a qualitative phenomenological research design. Out of 33 students, 29 students had submitted reflective essays. The content of these essays was inductively analyzed following a six-step framework for conducting thematic analysis. The framework's steps include familiarizing oneself with the data, generating initial codes, searching for themes, reviewing themes, defining and naming themes, and producing the report. Findings: The inductive qualitative analysis generated the Professionalism Learning Journey model. This conceptual model includes four interconnected themes: Awareness, Acknowledgement, Realization, and Application. The generated model depicts the trajectory that the learners appear to experience while they are engaging with the content of the course. Conclusion: Integrating a professionalism-training course into an undergraduate medical curriculum is likely to be positively appraised by the learners. It raises their awareness, enables them to value the subject matter and the sophistication of its application, and empowers them to put into practice the taught principles, on an individual basis and collectively. This is especially true when the course is entrenched in constructivism experiential learning theory and designed to foster self-directed learning. The introduced conceptual model, in conjunction with the innovative professionalism-training course curriculum, can serve as a template for other competencies and other schools.
Response to “RE: COVID-19 and healthcare workers: A systematic review and meta-analysis.”
(2021) Gholami, Mandana; Hassan Khamis, Amar; Ho, Samuel B
Letter to the Editor: The purpose of this paper was to extract data for meta-analysis from all comprehensive studies reporting characteristics and outcomes of healthcare workers (HCW) with PCR-proven Covid-19 infection. We included the N (total population) of HCW in all the tables only if actual data concerning this population was provided in the publication. Our requirement for this data was that it be collected by some form of actual survey or testing and not from secondary sources. We did not include data that merely represented an estimate, was a secondary source or had unclear methodology. We were consistent throughout the study to use these criteria. We acknowledge that a limitation of this analysis is that some of the included papers lacked accurate data related to the denominator, resulting in overestimating the result as it relates to an entire population of HCW. Furthermore, we would like to emphasize that the final estimates of percentages and confidence intervals reported in meta-analyses result from estimates of the individual weight of a given study, which is derived from the measures of study size and homogeneity and does not reflect a simple input of the total numbers from all studies into the numerator and the denominator.
Study protocol for a pilot randomized, double-blind, placebo-controlled trial to investigate the anti-inflammatory effects of Frondanol in adults with inflammatory bowel disease
(2022-12) Ghelani, Hardik; Adrian, Thomas E; Ho, Samuel B; Akhras, Jamil; Azar, Aida J; Jan, Reem Kais
Introduction: Inflammatory bowel disease (IBD), consisting of Crohn's disease and ulcerative colitis, is a debilitating condition with a rising incidence globally over recent years. Frondanol, a widely available nutraceutical extract of the edible sea cucumber Cucumaria frondosa has been reported to possess potent anti-inflammatory effects, likely mediated by the inhibition of 5-lipoxygenase and 12-lipoxygenase pathways, whilst showing no signs of toxicity. The potent anti-inflammatory effects of Frondanol in a mouse model of IBD provide encouragement for investigating its effects in human IBD patients. Here we describe the study protocol of a pilot randomized, double-blinded, placebo-controlled trial of Frondanol in patients with mild to moderate IBD who are on standard therapy. Material and methods: One hundred patients will be randomized (1:1) to receive Frondanol or placebo as an adjunct to their standard therapy for the period of six months. Blood and stool samples will be obtained during routine visits at baseline, and after three months and six months of treatment, and tissue samples from colon biopsies will be obtained during clinically indicated colonoscopies at baseline and after six months of treatment. The levels of inflammatory markers will be compared in serum and tissue samples between patients treated with Frondanol and those treated with placebo, and findings will be correlated with clinical and histological parameters. Discussion: If proven beneficial, treatment with Frondanol may increase the likelihood of patients remaining in remission and potentially provide an effective, natural and safe addition/alternative for treatment-naive patients in the future.(Clinical trial registration number: NCT05194007).
Telehealth to the Rescue During COVID-19: A Convergent Mixed Methods Study Investigating Patients' Perception.
(2021) Al-Sharif, Ghadah A; Almulla, Alia A.; AlMerashi, Eman; Alqutami, Reem; Almoosa, Mohammad; Otaki, Farah; Ho, Samuel B
Background: The onset of the pandemic necessitated abrupt transition to telehealth consultations. Although there is a few tools that gauge the patients' perception about their experiences, none of them are contextualized to an emergency in the Middle East and North Africa region. Accordingly, this study aims at developing and validating a tool to address this gap, and deploying it to assess the patients' perception of telehealth services during COVID-19 in Dubai, United Arab Emirates (UAE). Methods: A convergent mixed methods design was adapted. A random selection of 100 patients from Dubai, UAE were invited to participate. Qualitative and quantitative datasets were collected using a tailor-made survey. The qualitative data, collected through open-ended questions, was analyzed using multi-staged thematic analysis. As for the quantitative data, it captured the patients' extent of satisfaction, and was assessed using SPSS (with a series of descriptive and inferential analyses). The qualitative and quantitative findings were then merged via joint display analysis. Results: Out of the 100 patients that were randomly selected, 94 patients participated in this study. The reliability score of Cronbach's Alpha for the instrument was 98.9%. The percentage of the total average of satisfaction was 80.67%. The Principal Component Analysis showed that 88.1% of the variance can be explained by the instrument (p < 0.001). The qualitative data analysis expanded upon the quantitative findings enabling a better understanding of the patients' perception. Three themes, revolving around the quality of the patient telehealth experiences, surfaced: “Factors that worked to the benefit of the patients,” “Factors that the patients were not in favor of,” and “Opportunities for improvements as perceived by the patients.” Discussion: This study introduced a novel patient satisfaction with telehealth consultation survey contextualized to the COVID-19 times in Dubai, UAE. The participants were quite satisfied with the quality of their experience, however they suggested areas for improvement. Regional healthcare decision-makers can leverage the identified advantages and opportunities for improvement of telehealth. This will enable making informed decisions regarding the continuity of telehealth irrespective of how matters unfold in relation to the pandemic. It will also better prepare the healthcare sector for potential resurgence(s) of COVID-19 and/or the occurrence of other similar emergencies.