Although children in general and patients with type 1 diabetes mellitus, in particular, are exempted from fasting during Ramadan, many elect to observe the fast. There is a sizeable amount of opinion and research data that warrants revisiting. This is a narrative nonsystematic review to explore the views and supporting data on Ramadan fasting and to examine the safety of fasting and its impact on diabetes control and management in children and adolescents. The key areas covered include epidemiology, the physiology of fasting, risk stratification, counseling strategy, nutrition advice, insulin therapy adjustment with a particular focus on multiple injection regimen, and insulin pump therapy. Findings from various studies and expert opinions were appraised and presented to illustrate points of agreements and differences. This review should enhance knowledge and form the basis to clear some doubts and differences of opinions surrounding the issue of diabetes and Ramadan fasting in young people. It should also empower healthcare professionals to develop consensus based on the most up-to-date advice and the best possible support to patients and families regarding fasting during Ramadan.

Background: Vitamin D deficiency is very common worldwide but highly prevalent in the Gulf region. The clinical manifestations of Vitamin D deficiency vary depending on the severity and duration of the deficiency. Effective treatment should correct the vitamin D levels and improve other metabolic markers. Objectives: We aimed to (1) compare the efficacy of Vitamin D3 and Vitamin D2 in terms of raising serum 25(OH) total Vitamin D levels, (2) evaluate the time of its attainment, and (3) demonstrate the effect of replacement with either preparation on serum markers of bone or calcium metabolism. Patients and Methods: We conducted a randomized controlled study involving 250 adults with Vitamin D deficiency or insufficiency, assigned into 1:1 ratio to receive weekly capsules of either 50,000 IU of D2 or 50,000 IU of D3 for up to 12 weeks. Serum total Vitamin D level, calcium, phosphorus, alkaline phosphatase, and parathyroid hormone (PTH) levels were measured at 0, 8, and 12 weeks. Analysis of variance and nonparametric test Kruskal–Wallis were used for the comparison of quantitative values and the Chi-square test for comparison of categorical variables. Results: After 8 weeks of treatment, the improvement in Vitamin D level was greater for patients in the D3 group (mean = 18.74, standard error [SE] = 1.08) than that for D2 group (mean = 5.88, SE = 0.65), F (1, 240) = 113.840; P < 0.0005. Similarly after 12 weeks, the improvement in Vitamin D levels was greater for those in the D3 group (mean = 20.76, SE = 1.14) than that for the D2 group (mean = 7.93, SE = 0.79), F (1, 224) = 90.78; P < 0.0005. At 12 weeks, serum calcium, phosphorus, alkaline phosphatase, and PTH levels were not significantly different between the D3 and D2 treatment groups. Conclusions: Vitamin D3 is more efficacious and faster in increasing the level of total Vitamin D than Vitamin D2. However, no significant differences were evident on calcium, phosphorus, alkaline phosphatase, or PTH levels between groups.

Objectives: We aimed to investigate the level of family satisfaction in three intensive care units (ICUs) in a tertiary hospital in the United Arab Emirates, which is a multicultural society.Methods: This was a cross-sectional study. Family members of patients who were admitted to the ICU for more than 48 h were included in the study. Families were approached with a validated FS24-ICU Family Satisfaction Survey Questionnaire. One hundred questionnaires were collected over 3 months from January 1, 2016, to March 31, 2016, in the pediatric medical-surgical and cardiac, adult cardiac, and adult medical/surgical ICUs.Results: The overall level of satisfaction measured as total satisfaction score, medical care score, and decision-making score were 75.1 ± 14.2, 80.1 ± 18.6, and 68.1 ± 11.5, respectively. These results are comparable to other high-income and developed countries. Conclusions: This is the very first study from the UAE demonstrating a high level of patient family satisfaction in both adult and pediatric ICUs. This study also highlighted areas where further improvement needs to occur.

Background: Bronchial asthma affects 10%–15% of children worldwide. Parental attitudes constitute a major factor in helping to achieve successful asthma control in children. We aimed to assess parental knowledge, attitudes, and practices (KAPs) regarding the use of prescribed inhalers for children with asthma in Abu Dhabi, United Arab Emirates. Subjects and Methods: This was a cross-sectional survey-based study conducted at the Ambulatory Healthcare Services (AHS) clinics across Abu Dhabi. Questionnaires that assessed parental KAPs regarding inhalers used in asthma were distributed to 365 parents of children (≤10 years of age) who had a diagnosis of asthma and had been followed up at an Abu Dhabi AHS clinic in the past 12 months.Results: Only 9.3% of the participants correctly answered ≥75% of the questions assessing knowledge, whereas 49.0% gave positive responses to ≥80% of the questions related to attitudes and 56.2% correctly performed ≥53% of the practices. Higher levels of knowledge and practices were demonstrated among nonnationals and those with a higher level of education, and more positive attitudes were found among older parents. Knowledge and attitudes positively correlated with the level of practice. Conclusions: Although a minority of the participants had a good level of knowledge, they tended to demonstrate positive attitudes and good practices with regard to the use of an inhaler. Overall, a much more concerted effort is required by healthcare providers in Abu Dhabi to assess parental understanding about their child's inhaler as well as educate parents about their practical use.

Background: Residency is a stressful period in physicians' life. During this period, residents are subjected to fatigue, depression, anxiety, and burnout. In 2016, we did our first study in Abu Dhabi hospitals to investigate residents' well-being; we found that 86.4% of residents were stressed, 50.8% of them were depressed, and 65.7% of the residents felt emotionally exhausted. Following this study, we introduced interventions to improve residents' well-being in Sheikh Khalifa Medical City (SKMC) residency programs. Objectives: To assess the difference between the well-being of residents in the year 2018 compared to 2016 after the implementation of interventions to SKMC residents. Methods: Following the initial cross-sectional surveys, interventions were made to improve residents' well-being. Repeated cross-sectional surveys were done to compare between the two periods and quantify the change. Results: The percentage of nonsmokers increased in phase 2 from 90% to 94%. The percentage of residents who exercise 1–2 times a week increased from 37.6% to 40.7%. The prevalence of perceived depression was 80% in phase 1 and become 82.4% in phase 2. In phase 1, 89% felt emotionally exhausted compared to 85.5% in phase 2. 28.3% and 22.4% of the residents felt always stressed in phase 1 and 2, respectively. The percentage of residents who are satisfied with their job was 31.7% in phase 1 but improved to 55.3% in phase 2. Conclusions: Residents' well-being and satisfaction of their work improved in our research after interventions. The percentage of those who were feeling emotionally exhausted and stressed also improved in phase 2.

Objectives: The aim of the study is to measure the percentage of patients receiving health education services regarding diagnosis, treatment, prevention, health promotion, and its relation to the satisfaction level in primary healthcare (PHC) centers in Abu Dhabi, United Arab Emirates. Patients and Methods: This is a cross-sectional study using a questionnaire targeting the population aged 18 and above who attend PHC centers in Abu Dhabi Island. A total number of 333 participants were enrolled in this study. Results: About 89.6% of participants reported receiving health education regarding diagnosis, treatment, prevention, and health promotion. 81% of health education was delivered by the physician using verbal methods, 94.4% of the participants reported it to be the most preferred method. A relationship was found between health education and satisfaction level (P = 0.000). 86.4% were satisfied with the health education service they received. The main reasons of satisfaction included provider medical knowledge 43.6% and good communication skills 41.2% (P = 0.045). A correlation was found between patient satisfaction and the continuity of care of participants as 88.2% who are satisfied reported will revisit the same physician (P = 0.000). Conclusions: Majority of the patients received health education about diagnosis, treatment, prevention, and health promotion. Most of them preferred a verbal method to be delivered by a physician. Moreover, participants who received health education found to be more satisfied and complaint with their follow-up as well as recommend the physician to others. The main reason for dissatisfaction was the provider's poor medical knowledge and poor communication skills. Therefore, physicians may need training courses to achieve better communication skills and to improve medical knowledge delivered to patients.

Echocardiography is the main procedure for diagnosis in both acquired and congenital heart diseases (CHD). In pediatric cardiology, the surgeons accept more than 80% of children with CHD for surgery just based on echocardiography investigation. The role of nurses before, during, and after the procedure is well known since 1982. Their role is becoming more and more challenging with the development of technology and easier manipulation during echocardiography procedure. In this practice point, we are highlighting a new role for female cardiac nurses in the outpatient clinical setting. This new nurse's role is to handle the probe during the echocardiography procedure for the adolescent girls by a female nurse.