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Objectives: This study aimed to assess the knowledge, attitude and practices of patients with type 2 diabetes on insulin regarding insulin therapy., Design: A cross-sectional study., Setting: This study was conducted at the Dubai Diabetes Center from 1 December 2018 to 1 March 2020., Participants: Face-to-face interviews were conducted for 350 participants with type 2 diabetes at the Dubai Diabetes Center. Interviews followed the structured format of a questionnaire designed to obtain demographic details and score participants on knowledge, attitude and practices. We included patients aged >18 years and receiving insulin therapy. Patients with type 1 diabetes, pregnant women with gestational diabetes, those aged <18 years or those with a history of dementia were excluded., Results: The median age of participants was 61 years (first quartile, 53 years; third quartile, 67 years); 35.7% were male individuals and 64.3% were female individuals. The median percentage scores for knowledge, attitude and practices were 62.5% (62.5%, 75%), 85.7% (71.4%, 100%) and 77.7% (66.6%, 88.8%), respectively. Highly educated participants had a high level of knowledge. Significant negative correlations were found between the percentage knowledge scores and participants' age and between the participants' percentage attitude scores and haemoglobin A1C levels; Spearman's correlations were -0.182 (p<0.001) and -0.14 (p=0.008), respectively. A significant positive Spearman's correlation of 0.123 (p=0.021) was found between the percentage knowledge and percentage practice scores. No correlations were found among knowledge levels, participants' haemoglobin A1c levels and duration of insulin use., Conclusion: Patients with type 2 diabetes receiving insulin therapy and attending the Dubai Diabetes Center had adequate knowledge, a positive attitude and correct practice regarding insulin therapy. However, knowledge of specific facts did not always translate into correct behaviours and practices., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Antimicrobial Resistance (AMR) presents a pressing public health challenge globally which has been compounded by the COVID-19 pandemic. Elucidation of the impact of the pandemic on AMR evolution using population-level data that integrates clinical, laboratory and prescription data remains lacking. Data was extracted from the centralized electronic platform which captures the health records of 60,551 patients with a confirmed infection across the network of public healthcare facilities in Dubai, United Arab Emirates. For all inpatients and outpatients diagnosed with bacterial infection between 01/01/2017 and 31/05/2022, structured and unstructured Electronic Health Record data, microbiological laboratory data including antibiogram, molecular typing and COVID-19 testing information as well as antibiotic prescribing data were extracted curated and linked. Various analytical methods, including time-series analysis, natural language processing (NLP) and unsupervised clustering algorithms, were employed to investigate the trends of antimicrobial usage and resistance over time, assess the impact of prescription practices on resistance rates, and explore the effects of COVID-19 on antimicrobial usage and resistance. Our findings identified a significant impact of COVID-19 on antimicrobial prescription practices, with short-term and long-lasting over-prescription of these drugs. Resistance to antimicrobials increased the odds ratio of all mortality to an average of 2.18 (95% CI: 1.87-2.49) for the most commonly prescribed antimicrobials. Moreover, the effects of antimicrobial prescription practices on resistance were observed within one week of initiation. Significant trends in antimicrobial resistance, exhibiting fluctuations for various drugs and organisms, with an overall increasing trend in resistance levels, particularly post-COVID-19 were identified. This study provides a population-level insight into the evolution of AMR in the context of COVID-19 pandemic. The findings emphasize the impact of COVID-19 on the AMR crisis, which remained evident even two years after the onset of the pandemic. This underscores the necessity for enhanced antimicrobial stewardship to address the evolution of AMR., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Moradigaravand et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

We describe the protocol for identifying COVID-19 severity specific cell types and their regulatory marker genes using single-cell transcriptomics data. We construct COVID-19 comorbid disease-associated gene list using multiple databases and literature resources. Next, we identify specific cell type where comorbid genes are upregulated. We further characterize the identified cell type using gene enrichment analysis. We detect upregulation of marker gene restricted to severe COVID-19 cell type and validate our findings using in silico , in vivo , and in vitro cellular models. For complete details on the use and execution of this protocol, please refer to Nassir et al. (2021b)., Competing Interests: The authors declare no competing interests., (© 2022 The Author(s).)

Understanding host cell heterogeneity is critical for unraveling disease mechanism. Utilizing large-scale single-cell transcriptomics, we analyzed multiple tissue specimens from patients with life-threatening COVID-19 pneumonia, compared with healthy controls. We identified a subtype of monocyte-derived alveolar macrophages (MoAMs) where genes associated with severe COVID-19 comorbidities are significantly upregulated in bronchoalveolar lavage fluid of critical cases. FCGR3B consistently demarcated MoAM subset in different samples from severe COVID-19 cohorts and in CCL3L1 -upregulated cells from nasopharyngeal swabs. In silico findings were validated by upregulation of FCGR3B in nasopharyngeal swabs of severe ICU COVID-19 cases, particularly in older patients and those with comorbidities. Additional lines of evidence from transcriptomic data and in vivo of severe COVID-19 cases suggest that FCGR3B may identify a specific subtype of MoAM in patients with severe COVID-19 that may present a novel biomarker for screening and prognosis, as well as a potential therapeutic target., Competing Interests: The authors declare no competing interests., (© 2021 The Authors.)

Introduction: It is well known that family medicine (FM) is a cornerstone for developing a community-based health-care system, and training family physicians is critical for the society. In Middle East, only 5%-10% of physicians, nurses, and health technicians are citizens. This demands more efforts toward having national FM practitioners in the country. The development of FM residency training program through the past two decades in Dubai has played a crucial rule in this aspect., Methods: The primary purpose of this study is to review the status of FM specialty training in the Emirates of Dubai throughout the past two decades., Results: The FM residency training program started since 1993 and had intake of 230 residents till 2017; out of which, 200 (87%) were female and 211 (92%) were the United Arab Emirates national. From 176 residents who are supposed to be graduated by 2017, 162 (92%) completed 4-year training, 132 (75%) has got the Arab Board certificate, and 116 (66%) qualified by the Membership of the Royal College of General Practitioners (MRCGP) international., Conclusion: The present study revealed that despite all challenges, the well-structured FM program enabled the graduates to reach high clinical, administrative, leadership, and academic positions such as consultant (40), chief executive officer (1), chief advisor for primary care (1), director (9), head of sections (9), head/deputy head of primary health center (55), head of academic affair center (1), chair of MRCGP international (1), program director of FM (4), MRCGP convener (6), MRCGP coordinator (6), and MRCGP examiner (42). However, the program is still lacking certification by an international accreditation body. This will help in reaching a better balance between education and clinical duties for all trainers and faculty; and will positively advocate support for an environment conducive to learning for residents as well as faculty members., Competing Interests: There are no conflicts of interest.

Background : Vaccination of healthcare providers (HCPs) against seasonal influenza has been consistently recommended worldwide. Despite that, healthcare providers (HCPs) globally and in other Middle Eastern countries continue to have a low rate of influenza vaccination due to various reasons. No data are available from our country, United Arab Emirates. Objectives : To identify the percentage of vaccinated HCPs, identify the most common reason for receiving the vaccine or not and to identify the level of HCPs knowledge towards the influenza vaccine itself. Methods : Using a cross-sectional study design, anonymous 18-item self-administered questionnaires were distributed among healthcare providers in the 11 primary healthcare centers of Dubai Health Authority over a period of 5 months. Results : Of the 431 participants who completed the questionnaires, 53.4% reported getting vaccinated. The difference in the vaccine uptake between the different professional categories was significant [P value < .000].The most common reason reported by HCPs for getting the vaccine was to protect themselves (94.8%). Of the 46.6% who did not accept the vaccine, the most common reason for not being vaccinated was their belief of not being at high risk to contract influenza (39.8%). Despite fairly good knowledge (63.3%), healthcare providers continue to have their reservations with regards to the yearly influenza vaccination. Conclusion : Although our HCPs attitude towards vaccine uptake, knowledge and practice were positive; the misconception about the vaccine remains the main reason for not being vaccinated as per our study findings. Overall, the study results raise hope of prospective increase in vaccination through educational and technical interventions and by increasing physician involvement. One suggested method would be to apply mandatory vaccination policies since voluntary vaccinations have shown lesser than satisfactory results and to be integrated in the online staff file system to be able to verify the uptake, in addition to provide easily accessible vaccine centers, during the season in order to facilitate tracking and verification of the vaccination status & to encourage staff compliance.