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Search Results: 1 - 10 of 18623 matches for " Kefah Al Qawasme "
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Physicians’ Perception of Drug Information Resources in the Emirate of Abu Dhabi-UAE  [PDF]
Hadaya Gharibyar, Yasser Sharif, Kefah Al Qawasme, Sahar Fahmy
Pharmacology & Pharmacy (PP) , 2013, DOI: 10.4236/pp.2013.41007
Abstract: Objectives: To determine physicians’ preferences for different drug information resources in the United Arab Emirates. Methods: A questionnaire survey to determine preferences for different drug information resources was created and sent electronically from April 1 to May 13, 2012. A total of 3463 licensed physicians were identified from a comprehensive list of healthcare professionals provided by the Health Authority-Abu Dhabi Licensing Department. A total of 431 started the survey but only 372 physicians completed it entirely. Key Findings: Continuing medical education (46%) was ranked as the most favored source of information, followed by drug information references (28%), diagnosis/patient information (20%), and lastly peer-to-peer interactions (7%). Online sources of drug information were preferable (74%) to hardcopy (26%). A comparison of different physicians’ qualifications (consultant, specialist, and general practitioner) and number of references utilized for a particular topic (up to 3 resources versus 3 references or more) showed that their differences were statistically significant (p-value = 0.000). The most utilized sources of drug information by physicians was the British National Formulary (BNF), followed by Package Inserts, UpToDate, Drugs in Pregnancy & Lactation, Physicians’ Desk Reference, and Micromedex. When asked which drug information resource they would like to have access to, the majority of physicians choose the BNF, followed by UpToDate, MD Consult, Drugs in Pregnancy & Lactation, Micromedex, and Drugs Facts & Comparisons. Physicians from Europe/USA/Australia spent less time utilizing drug information resources (p-value of 0.013) compared to other nationalities. Conclusion: Preferences for different drug information resources did not vary significantly even amongst a diverse group of expatriate physicians licensed to practice in the United Arab Emirates.
Oculomotor neuropathy following tetanus toxoid injection
Jamous Mohammad,Al-Hayek Kefah,Hani Abdel
Neurology India , 2008,
Skin-Sparing Mastectomy: An Update for Clinical Practice  [PDF]
Kelly Lambert, Kefah Mokbel
Surgical Science (SS) , 2013, DOI: 10.4236/ss.2013.41010

Aim: To review the oncological safety and aesthetic advantage of skin-sparing mastectomy (SSM) for invasive breast cancer (IBC) and ductal carcinoma in-situ (DCIS). Controversies including the impact of radiotherapy (RT) on immediate breast reconstruction (IBR), preservation of the nipple-areola complex (NAC) and the role of endoscopic mastectomy are also considered. Methods: Literature review using Medline and PubMed. Results: SSM is safe in selected cases; including IBC < 5 cm, multi-centric tumours, DCIS and for risk-reduction surgery. Inflammatory breast cancers and tumours with extensive involvement of the skin represent contra-indications to SSM due to an unacceptable risk of local recurrence. SSM can facilitate IBR and is associated with an excellent aesthetic result. Prior breast irradiation or the need for post-mastectomy radiotherapy (PMRT) do not preclude SSM, however the cosmetic outcome may be adversely affected. Nipple/areola preservation is safe for peripherally located node negative tumours. A frozen section protocol for the retro-areolar tissue should be considered in these cases. The advent of acellular tissue matrix systems has widened the applicability of implant-based immediate reconstruction following SSM. Data on endoscopic mastectomy is limited and superiority over conventional SSM has not been demonstrated. Conclusion: SSM is safe in selected cases and is associated with advantages over simple mastectomy, including a superior aesthetic outcome and a potential reduction in the number of reconstructive procedures per patient.

Current Treatment of DCIS  [PDF]
Christina Choy, Kefah Mokbel
Journal of Cancer Therapy (JCT) , 2014, DOI: 10.4236/jct.2014.52022

Abstract: Ductal carcinoma in-situ DCIS is a heterogeneous entity in breast neoplasm with unpredictable biological behavior. This poses challenge in the management of DCIS. Various trials on DCIS have shown good outcome with integral treatment of adequate surgery, radiotherapy and hormonal therapy. Identification of subgroup of DCIS for radiotherapy and hormonal therapy could improve recurrence rate, contralateral tumours incidence and perhaps overall survival. Various risk score calculations could help to direct radiotherapy and hormonal treatment verses surgery alone and to avoid over treatment. Oncotype DX assay could be a new way of risk calculation to direct types of DCIS treatment. The recent increased use of MRI could increase the detection of DCIS and a more accurate extent of disease estimation. This article is a summary of major literatures and major trials result for DCIS.

Health Literacy, Self-Care Behavior and Quality of Life in Acute Coronary Syndrome Patients: An Integrative Review  [PDF]
Kefah Zaben, Amani Khalil
Open Journal of Nursing (OJN) , 2019, DOI: 10.4236/ojn.2019.94035
Abstract: Purpose: The review aimed to find the best evidence on the relationship between health literacy, self-care behavior and perceived quality of life (QoL) among patients with acute coronary syndrome (ACS). Methods: Searching engines included Cumulative Index to Nursing Allied Health Literature (CINAHL), Pro Quest, MEDLINE, Google Scholar, SAGE Journals, Wiley on Line Library, and Science Direct electronic databases from 2010 to 2018. Fifteen research articles assessed the main variables and their associations with demographic and clinical variables. Results: Different methodologies and samples were analyzed: analytic descriptive, systematic review, a randomized control trial, retrospective cohort, a prospective Cohort, cross-sectional, and correlational designs. The fifteen studies showed that the patients with ACS have inadequate health literacy. Patients’ ability to understand basic and complex information or to accurately assess health risks was impaired and may hinder patients’ engagement in self-care. Low HL in patients having ACS is consistently associated with poor QoL. Physical domain of QoL remained the significant outcome of both self-care behavior and health literacy after adjusting for demographics and clinical variables in patients with ACS. Conclusion: The literature pointed to the importance of considering health literacy and self-care behaviors as predictors of quality of life among patients with ACS. However, there has been no previous evidence on the best process of the association between these three variables.
The Increasing Focus on Managing Relationships and Customer Retention
Kefah Njenga
Journal of Language, Technology & Entrepreneurship in Africa , 2010,
Abstract: There has been unprecedented need for firms and organizations today to focus on customer service, retention and loyalty as a way of increasing their competitive advantage and improving their bottom line. This paper discusses the increasing focus on managing relationships and customer retention in recent years. Initially customer retention strategies are identified, followed by an analysis of the benefits of value creation for both customers and services providers, key indicators of customer relationship and managing relationship. The study identified the competitive nature of business today and hence many businesses devising strategies such as switching barriers and retaining employees to retain customers. Consumers are increasingly developing relationships with numerous services providers rather than committing to one, hence associating loyalty with repeat patronage rather than long-term commitment.
Skin-Sparing Mastectomy and Breast Reconstruction: An Update for Clinical Practice  [PDF]
Abdul Kasem, Christina Choy, Kefah Mokbel
Journal of Cancer Therapy (JCT) , 2014, DOI: 10.4236/jct.2014.53034

Aim: To provide an up-to-date review of the literature on skin-sparing mastectomy (SSM) for breast cancer (BC). The article also reviews the oncological safety, effects of radiotherapy (RT) on immediate breast reconstruction (IBR), the indications for preserving the nipple-areola complex (NAC) and the emerging role of allogenic grafts as adjuncts to implant in IBR. Methods: Review of the English literature from 1965 to 2013 was carried out using Medline and PubMed research engines. Results: SSM is oncologically safe in appropriately selected cases of invasive breast cancer (IBC) and ductal carcinoma in-situ (DCIS) including IBC < 5 cm, multi-centric tumours, DCIS and for risk-reduction surgery. Inflammatory breast cancer and tumours with extensive skin involvement represent contra-indications to SSM due to an unacceptable risk of local recurrence. Prior breast irradiation or the need for post-mastectomy radiotherapy (PMRT) do not preclude SSM with IBR, however the aesthetic outcome may be compromised by radiation. Preservation of the nipple-areola complex (NAC) has aesthetic and psychological benefits and is safe for peripherally located node negative unifocal

Comparison of intestinal parasitic infection in newly arrived and resident workers in Qatar
Marawan A Abu-Madi, Jerzy M Behnke, Ahmed Ismail, Nada Al-Olaqi, Kefah Al-Zaher, Roda El-Ibrahim
Parasites & Vectors , 2011, DOI: 10.1186/1756-3305-4-211
Abstract: We analyzed intestinal parasitic infections recorded in 2008 among immigrant and long-term resident workers in Doha city, Qatar (n = 1538). Stool examinations were carried out at the Hamad Medical Corporation and at the Medical Commission in Doha using standard procedures.Overall, 21.5% of subjects were infected with at least one of the species recorded (8 helminth and 4 protozoan species; the highest prevalence was for hookworms = 8.3%) and there were strong regional effects on prevalence of helminths, with subjects from North East Africa and Nepal showing particularly high prevalence. Most helminths declined in prevalence in subjects that acquired residency status in Qatar, especially among female subjects, but there was a marked exception among male Nepalese workers, who continued to harbour helminth infections (notably hookworms) after they became residents. Contrary to all other regional groups the prevalence of Giardia duodenalis was higher among Nepalese residents compared with new arrivals, while Blastocystis hominis infections were more common among residents of all regions, and especially among North East Africans.Our analysis has identified male Nepalese workers as a particular risk group continuing to harbour hookworm infection and G. duodenalis as residents, and subjects from North East Africa are as particularly likely to acquire B. hominis infection after settling in the country. These conclusions have important implications for the health authorities in Qatar.The rapid growth of Qatar in the last two decades has been associated with an enormous expansion of building programs in its cities, notably in Doha, and in the provision of new service industries. This in turn has attracted a large influx of immigrant workers seeking employment in jobs associated with food handling, domestic service and the building industry. Many of these immigrants come from countries in the tropics and subtropics where intestinal parasitic infections are common [1-3].Immigra
Ductal Carcinoma In Situ: Recent Advances and Future Prospects
Kelly Lambert,Neill Patani,Kefah Mokbel
International Journal of Surgical Oncology , 2012, DOI: 10.1155/2012/347385
Abstract: Introduction. This article reviews current management strategies for DCIS in the context of recent randomised trials, including the role of sentinel lymph node biopsy (SLNB), adjuvant radiotherapy (RT) and endocrine treatment. Methods. Literature review facilitated by Medline, PubMed, Embase and Cochrane databases. Results. DCIS should be managed in the context of a multidisciplinary team. Local control depends upon clear surgical margins (at least 2?mm is generally acceptable). SLNB is not routine, but can be considered in patients undergoing mastectomy (Mx) with risk factors for occult invasion. RT following BCS significantly reduces local recurrence (LR), particularly in those at high-risk. There remains a lack of level-1 evidence supporting omission of adjuvant RT in selected low-risk cases. Large, multi-centric or recurrent lesions should be treated by Mx and immediate reconstruction should be discussed. Adjuvant hormonal treatment may reduce the risk of LR in selected cases with hormone sensitive disease. Conclusion. Further research is required to determine the role of new RT regimes and endocrine therapies. Biological profiling and molecular analysis represent an opportunity to improve our understanding of tumour biology in DCIS to rationalise treatment. Reliable identification of low-risk lesions could allow treatment to be less radical. 1. Introduction 1.1. Diagnosis The introduction of national mammographic screening programmes and the increasing use of digital mammography and MRI have dramatically changed the clinical presentation of DCIS. Prior to this, DCIS made up a small proportion of all breast malignancy and was only diagnosed in patients presenting with a palpable mass, pathological nipple discharge, or occasionally found as an incidental biopsy finding [1, 2]. In contrast, it is now most frequently identified in asymptomatic women with screen-detected micro calcifications [3] and makes up a larger proportion of breast malignancy. Approximately one fifth of all screen-detected breast cancers are now DCIS [4]. Although the rates of all breast malignancy have increased with time, between 1980 and 1995, Western countries have experienced a four-fold “increase” in the incidence of DCIS specifically, particularly in women of screening age [5]. Data from a systematic review of 374 studies reported the pooled incidence of DCIS in the early 1970s as 5.8/100000 and this had risen to 32.5/100000 in 2004 [6]. A higher proportion of the cases post screening were non comedo DCIS, which is considered less aggressive. Screening and cancer registry
Risk-reducing strategies for women carrying brca1/2 mutations with a focus on prophylactic surgery
Mohamed Salhab, Selina Bismohun, Kefah Mokbel
BMC Women's Health , 2010, DOI: 10.1186/1472-6874-10-28
Abstract: The literature review is facilitated by Medline and PubMed databases. The cross-referencing of the obtained articles was used to identify other relevant studies.Prophylactic surgery (bilateral mastectomy, bilateral salpingo-oophorectomy or a combination of both procedures) has proved to be the most effective risk-reducing strategy. There are no randomised controlled trials able to demonstrate the potential benefits or harms of prophylactic surgery; therefore, the evidence has been derived from retrospective and short follow-up prospective studies, in addition to hypothetical mathematical models.Based on the current knowledge, it is reasonable to recommend prophylactic oophorectomy for BRCA1 or BRCA2 mutation carriers when childbearing is completed in order to reduce the risk of developing breast and ovarian cancer. In addition, women should be offered the options of rigorous breast surveillance, chemoprevention with anti-oestrogens--especially for carriers of BRCA2--or bilateral prophylactic mastectomy.The selection of the most appropriate risk-reducing strategy is not a straightforward task. The impact of risk-reducing strategies on cancer risk, survival, and overall quality of life are the key criteria considered for decision-making. Notably, various other factors should be taken into consideration when evaluating individual mutation carriers' individual circumstances, namely woman's age, morbidity, type of mutation, and individual preferences and expectations.Although prospective randomised controlled trials concerned with examining the various interventions in relation to the woman's age and type of mutation are needed, randomisation is extremely difficult and rather deemed unethical given the current available evidence from retrospective studies.Breast cancer remains the leading cause of death in women aged 40-55 years[1]. Sporadic breast cancer accounts for 70-80% of all cases [2]. It is estimated that 5-10% of all breast cancers and 25%-40% of breast cancers
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