Sami Kenz

OBJECTIVE: Telemedicine reporting of diabetic retinopathy (DR) screening using ultra-widefield (UWF) fundus camera. MATERIALS AND METHODS: Cross-sectional study of diabetic patients who visited the endocrinology department of a private multi-specialty hospital in United Arab Emirates between April 2015 and January 2017 who underwent UWF fundus imaging. Fundus pictures are then accessed at the Retina Clinic in the Department of Ophthalmology. Primary outcome measure was incidence of any form of DR detected. The secondary outcome measure was failure to take good image and inability to grade. RESULTS: A total of 1,024 diabetic individuals were screened for DR from April 2015 to January 2017 in the department of Endocrinology. Rate of DR was 9.27%; 165 eyes of 95 individuals were diagnosed to have some form of DR. Mild non-proliferative DR (NPDR) was seen in 114 of 165 eyes (69.09%), moderate NPDR in 32 eyes (19.39%), severe NPDR in six eyes (3.64%), and proliferative DR (PDR) in 13 eyes (7.88%). The secondary outcome measure of poor image acquisition was seen in one individual who had an image acquired in one eye that could not be graded due to bad picture quality. CONCLUSIONS: The present study has shown the effectiveness of DR screening using UWF fundus camera. It has shown the effectiveness of trained nursing personnel taking fundus images. This model can be replicated in any private multi-specialty hospital and reduce the burden of DR screening in the retina clinic and enhance early detection of treatable DR.

A 82-year-old woman on warfarin for atrial-fibrillation was admitted via the acute medical take having developed a large haematoma in the right thigh (picture). She gave a history of recent acupuncture treatment for trochanteric bursitis. Acupuncture treatment had been given in the community and we do not know if the therapist was aware of the fact she was being treated with warfarin, nor do we know if enquiry was made about the state of anticoagulant control at the time of needle insertion. Retrospective examination of the anticoagulant clinic records revealed that her international normalized ration (INR) was 2.4 at the time of needle insertion.

The 8th Ramadan and Diabetes International Alliance Annual Conference was held over 2 days on January 24th and 25th in Dubai, United Arab Emirates. The program included six sessions in total. The three states of the art lectures addressed (a) an overview of the current knowledge on insulin therapy during Ramadan, (b) journey of diabetes from EPIDIAR, to CREED and ending by DAR-MENA-T2DM, and (c) feasibility and management of fasting after bariatric surgery. Sessions on the 1st day considered four themes spanning from the impact of Ramadan on physical and mental well-being, efficacy and safety of newer antidiabetic medications during Ramadan, adherence to medications for diabetes and hypothyroidism, and the safety of Ramadan fasting in high-risk groups (cardiovascular and renal). The 2nd day started with a session on bridging the gap between physicians and religious scholars, including a live question and answer session “ask the imam.” The rest of the sessions covered management of type 1 diabetes during Ramadan, patients and doctors perceptions of fasting from various regions and finally a scientific session on nutrition and weight management during Ramadan. RaD activities seem to develop progressively in variety and quality of content and also far-reaching audiences and participants.