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Article ; Online: Score Gains on the NBME Subject Examinations in Internal Medicine Among Clerkship Students: a Two-Year Longitudinal Study from the United Arab Emirates.

Babiker, Zahir Osman Eltahir / Gariballa, Salah / Narchi, Hassib / Shaban, Sami / Alshamsi, Fayez / Bakoush, Omran

Medical science educator

2022 Volume 32, Issue 4, Page(s) 891–897

Abstract: Background: The impact of clinical proficiency on individual student scores on the National Board of Medical Examiners (NBME) Subject Examinations remains uncertain. We hypothesised that increasing the length of time spent in a clinical environment ... ...

Abstract	Background: The impact of clinical proficiency on individual student scores on the National Board of Medical Examiners (NBME) Subject Examinations remains uncertain. We hypothesised that increasing the length of time spent in a clinical environment would augment students' performance. Methods: Performance on the NBME Subject Examination in Internal Medicine (NBME-IM) of three student cohorts was observed longitudinally. Scores at the end of two unique internal medicine clerkships held at the third and fourth years were compared. The score differences between the two administrations were compared using paired Results: Of the 236 students enrolled during the third year, age, gender, CBSE, and NBME-IM scores were similar across all cohorts. The normalised score gain on the NBME-IM at the fourth year was 9.5% (range -38 to +45%) with a Cohen's Conclusions: Despite the increased length of clinical exposure, modest improvement in students' performance on repeated NBME-IM examination was observed. Medical educators need to reconsider how the NBME-IM is used in clerkship assessments.
Language	English
Publishing date	2022-06-27
Publishing country	United States
Document type	Journal Article
ISSN	2156-8650
ISSN (online)	2156-8650
DOI	10.1007/s40670-022-01582-1
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Article ; Online: Imported dengue fever in East London: a 6-year retrospective observational study.

Riddell, Anna / Babiker, Zahir Osman Eltahir

Journal of travel medicine

2017 Volume 24, Issue 3

Abstract: Background: Dengue fever (DF) is a frequently imported arthropod-borne infection in the United Kingdom but its broad range of clinical presentations makes it potentially unrecognized by clinicians.: Methods: We conducted a 6-year retrospective case ... ...

Abstract	Background: Dengue fever (DF) is a frequently imported arthropod-borne infection in the United Kingdom but its broad range of clinical presentations makes it potentially unrecognized by clinicians. Methods: We conducted a 6-year retrospective case note review of laboratory confirmed DF patients in East London in the period from 1 January 2010 through 31 December 2015. Epidemiological, clinical and laboratory features of imported DF were described. Risk factors associated with viraemic DF presentations were assessed. Results: Forty-four patients (4 from primary care clinics and 40 from three acute hospitals) were confirmed to have DF through RNA and/or IgM detection. In total, 86.4% (38/44) had primary infection compared to 13.6% (6/44) with secondary infection. Viraemic DF presentations accounted for 59.1% (26/44) of cases. The median age was 34 years (IQR 25-43). Most patients were males (68.2%, 30/44) and of non-white ethnicity (81.8%, 36/44). South Asia was the most frequent travel destination (52.3%, 23/44) followed by Southeast Asia (20.5%, 9/44). July-September was the peak season of presentation (43.2%, 19/44). The median interval between arrival in the UK and laboratory testing was 7 days (IQR 4-13). Arriving from abroad ≤ 7 days before molecular testing (age-adjusted odds ratios [OR] 16.98, 95% CI 2.43-118.75, P = 0.004) and travel to South or Southeast Asia regions (age-adjusted OR 4.41, 95% CI 1.07-18.21, P = 0.040) were associated with detectable viraemia at presentation. Only one DF patient met the WHO severity criteria. HIV serostatus was determined in 61.4% (27/44) of cases. Conclusion: Clinicians need to improve DF recognition as well as rates of HIV testing in tropical travellers. Region of travel and time since arrival from DF endemic settings may help clinicians optimize requests for molecular testing. Further research on the clinical and public health aspects of imported DF is needed.
MeSH term(s)	Adult ; Communicable Disease Control ; Dengue/blood ; Dengue/epidemiology ; Dengue/etiology ; Dengue/prevention & control ; Female ; Humans ; London/epidemiology ; Male ; Retrospective Studies ; Travel
Language	English
Publishing date	2017--01
Publishing country	England
Document type	Journal Article ; Observational Study
ZDB-ID	1212504-0
ISSN	1708-8305 ; 1195-1982
ISSN (online)	1708-8305
ISSN	1195-1982
DOI	10.1093/jtm/tax015
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Zs.A 4120: Show issues

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Article: Importation of Entamoeba histolytica and predominance of Klebsiella pneumoniae in liver abscesses: a 7-year retrospective cohort study from the United Arab Emirates.

Mousa, Hussam / Al-Bluwi, Ghada Salameh Mohammed / Al Drini, Zainab Fathi Mohammed / Gasmelseed, Huda Imam / Alkoteesh, Jamal Aldeen / Babiker, Zahir Osman Eltahir

Tropical diseases, travel medicine and vaccines

2021 Volume 7, Issue 1, Page(s) 17

Abstract: Background: There is a dearth of information on liver abscesses in the United Arab Emirates. Herein, we describe the clinical features of liver abscesses and determine their incidence rates and clinical outcomes.: Methods: We retrospectively reviewed ...

Abstract	Background: There is a dearth of information on liver abscesses in the United Arab Emirates. Herein, we describe the clinical features of liver abscesses and determine their incidence rates and clinical outcomes. Methods: We retrospectively reviewed the clinical charts of adult patients with a primary diagnosis of liver abscess at a major hospital over a 7-year period. Results: Amongst 45 patients, 82.2% (37/45) had a pyogenic liver abscess (PLA) and 17.8% (8/45) had amoebic liver abscesses (ALA). Overall, patients were young (median age 42 years, IQR 35-52), mostly males (77.8%, 35/45) from the Indian subcontinent (55.6%, 25/45), presented with fever (88.9%, 40/45) and abdominal pain (88.9%, 40/45), and had a solitary abscess on imaging (71.1% (32/45). Crude annual incidence rates were 35.9/100,000 hospital admissions (95% CI 26.2-48.0) and 5.9/100,000 inhabitants (95% CI 4.3-7.9). All ALA patients were from the Indian subcontinent (100%, 8/8). Klebsiella pneumoniae was the most frequent pathogen in PLA (43.2% [16/37], 95% CI 27.1-60.5%). The hospital stay was shorter in ALA (7.5 days, IQR 7-8.5) than in PLA (14 days, IQR 9-17). No deaths were recorded within 30 days of hospitalisation. Conclusions: ALA was exclusively seen in migrants from the Indian subcontinent, suggesting importation. Further research to characterise K. pneumoniae isolates and assess potential risk factors is needed.
Language	English
Publishing date	2021-06-12
Publishing country	England
Document type	Journal Article
ZDB-ID	2835327-4
ISSN	2055-0936
ISSN	2055-0936
DOI	10.1186/s40794-021-00140-8
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Article: Vetting requests for molecular diagnostics for CNS infections based on cerebrospinal fluid measurements undermines the quality of patient care.

Babiker, Zahir Osman Eltahir / Mutton, Kenneth

Clinical medicine (London, England)

2012 Volume 12, Issue 2, Page(s) 184; author reply 184–5

MeSH term(s)	Central Nervous System Viral Diseases/cerebrospinal fluid ; Central Nervous System Viral Diseases/diagnosis ; Female ; Humans ; Male ; Polymerase Chain Reaction
Language	English
Publishing date	2012-05-11
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	2048646-7
ISSN	1473-4893 ; 1470-2118
ISSN (online)	1473-4893
ISSN	1470-2118
DOI	10.7861/clinmedicine.12-2-184
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Article ; Online: Exploring drivers and challenges influencing antibiotic prescribing in outpatient settings and possible mitigation strategies in the United Arab Emirates: a qualitative study.

Sadeq, Ahmed A / Issa, Farah Ahmed / Bakhit, Mina / Al-Tamimi, Maitha Abdul-Aziz / Babiker, Zahir Osman Eltahir / Alshabebi, Raghad S Ismail / Abdallah, Jehad / Nsutebo, Emmanuel Fru / Moukarzel, Marleine B / Abukhater, Rawan / Conway, Barbara R / Bond, Stuart E / Khan, Sidra / Aldeyab, Mamoon A

JAC-antimicrobial resistance

2023 Volume 5, Issue 5, Page(s) dlad109

Abstract: Objectives: Healthcare institutions implement antimicrobial stewardship (AMS) programmes to optimize the use of antibiotics. The focus is often on inpatient rather than outpatient settings. We aimed to explore perceptions of AMS stakeholders on ... ...

Abstract	Objectives: Healthcare institutions implement antimicrobial stewardship (AMS) programmes to optimize the use of antibiotics. The focus is often on inpatient rather than outpatient settings. We aimed to explore perceptions of AMS stakeholders on effective interventions for appropriate antibiotic use in outpatient settings, and the role of clinical pharmacists in the AMS multidisciplinary team. Methods: A qualitative semi-structured interview study using thematic analysis by two researchers independently. Participants that practice AMS programmes were recruited from healthcare facilities in the United Arab Emirates (UAE). Interviews were conducted face to face or online and transcribed verbatim. Results: Four themes emerged: (i) Perceived factors leading to unnecessary or inappropriate antibiotic prescribing and their impact on patients and the community; (ii) current outpatient AMS activities and perceived barriers and facilitators for their sustainability; (iii) suggested outpatient AMS strategies to be implemented in outpatient settings; and (iv) perceived future AMS implementation barriers and suggested mitigation strategies. Conclusions: Several AMS interventions, together with the presence of a clinical pharmacist, may be effective in improving antibiotic use in UAE outpatient settings. Future research should investigate the most appropriate AMS strategy considering barriers and possible mitigation strategies to ensure sustainability.
Language	English
Publishing date	2023-10-09
Publishing country	England
Document type	Journal Article
ISSN	2632-1823
ISSN (online)	2632-1823
DOI	10.1093/jacamr/dlad109
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Article: Exploring Antimicrobial Stewardship Influential Interventions on Improving Antibiotic Utilization in Outpatient and Inpatient Settings: A Systematic Review and Meta-Analysis.

Sadeq, Ahmed A / Hasan, Syed Shahzad / AbouKhater, Noha / Conway, Barbara R / Abdelsalam, Abeer E / Shamseddine, Jinan M / Babiker, Zahir Osman Eltahir / Nsutebu, Emmanuel Fru / Bond, Stuart E / Aldeyab, Mamoon A

Antibiotics (Basel, Switzerland)

2022 Volume 11, Issue 10

Abstract: Antimicrobial stewardship interventions are targeted efforts by healthcare organizations to optimize antimicrobial use in clinical practice. The study aimed to explore effective interventions in improving antimicrobial use in hospitals. Literature was ... ...

Abstract	Antimicrobial stewardship interventions are targeted efforts by healthcare organizations to optimize antimicrobial use in clinical practice. The study aimed to explore effective interventions in improving antimicrobial use in hospitals. Literature was systemically searched for interventional studies through PubMed, CINAHL, and Scopus databases that were published in the period between January 2010 to April 2022. A random-effects model was used to pool and evaluate data from eligible studies that reported antimicrobial stewardship (AMS) interventions in outpatient and inpatient settings. Pooled estimates presented as proportions and standardized mean differences. Forty-eight articles were included in this review: 32 in inpatient and 16 in outpatient settings. Seventeen interventions have been identified, and eight outcomes have been targeted. AMS interventions improved clinical, microbiological, and cost outcomes in most studies. When comparing non-intervention with intervention groups using meta-analysis, there was an insignificant reduction in length of stay (MD: -0.99; 95% CI: -2.38, 0.39) and a significant reduction in antibiotics' days of therapy (MD: -2.73; 95% CI: -3.92, -1.54). There were noticeable reductions in readmissions, mortality rates, and antibiotic prescriptions post antimicrobial stewardship multi-disciplinary team (AMS-MDT) interventions. Studies that involved a pharmacist as part of the AMS-MDT showed more significant improvement in measured outcomes than the studies that did not involve a pharmacist.
Language	English
Publishing date	2022-09-26
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2681345-2
ISSN	2079-6382
ISSN	2079-6382
DOI	10.3390/antibiotics11101306
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Article: Impact of Multidisciplinary Team Escalating Approach on Antibiotic Stewardship in the United Arab Emirates.

Sadeq, Ahmed A / Shamseddine, Jinan M / Babiker, Zahir Osman Eltahir / Nsutebu, Emmanuel Fru / Moukarzel, Marleine B / Conway, Barbara R / Hasan, Syed Shahzad / Conlon-Bingham, Geraldine M / Aldeyab, Mamoon A

Antibiotics (Basel, Switzerland)

2021 Volume 10, Issue 11

Abstract: Antimicrobial stewardship programs (ASP) are an essential strategy to combat antimicrobial resistance. This study aimed to measure the impact of an ASP multidisciplinary team (MDT) escalating intervention on improvement of clinical, microbiological, and ... ...

Abstract	Antimicrobial stewardship programs (ASP) are an essential strategy to combat antimicrobial resistance. This study aimed to measure the impact of an ASP multidisciplinary team (MDT) escalating intervention on improvement of clinical, microbiological, and other measured outcomes in hospitalised adult patients from medical, intensive care, and burns units. The escalating intervention reviewed the patients' cases in the intervention group through the clinical pharmacists in the wards and escalated complex cases to ID clinical pharmacist and ID physicians when needed, while only special cases required direct infectious disease (ID) physicians review. Both non-intervention and intervention groups were each followed up for six months. The study involved a total of 3000 patients, with 1340 (45%) representing the intervention group who received a total of 5669 interventions. In the intervention group, a significant reduction in length of hospital stay (
Language	English
Publishing date	2021-10-22
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2681345-2
ISSN	2079-6382
ISSN	2079-6382
DOI	10.3390/antibiotics10111289
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Article ; Online: Admission levels of Soluble Urokinase Plasminogen Activator Receptor (suPAR) are Associated with the Development of Severe Complications in Hospitalised COVID-19 Patients: A Prospective Cohort Study.

Oulhaj, Abderrahim / Alsuwaidi, Ahmed R / Suliman, Abubaker / Gasmelseed, Huda / Khan, Shaima / Alawi, Shamma / Hukan, Yaman / George, Junu / Alshamsi, Fayez / Sheikh, Farrukh / Babiker, Zahir Osman Eltahir / Prattes, Juergen / Sourij, Harald

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases

2021 Volume 107, Page(s) 188–194

Abstract: Objective: To examine the association between plasma levels of the soluble urokinase plasminogen activator receptor (suPAR) and the incidence of severe complications of COVID-19.: Methods: 403 RT-PCR-confirmed COVID-19 patients were recruited and ... ...

Abstract	Objective: To examine the association between plasma levels of the soluble urokinase plasminogen activator receptor (suPAR) and the incidence of severe complications of COVID-19. Methods: 403 RT-PCR-confirmed COVID-19 patients were recruited and prospectively followed-up at a major hospital in the United Arab Emirates. The primary endpoint was time from admission until the development of a composite outcome, including acute respiratory distress syndrome (ARDS), intensive care unit (ICU) admission, or death from any cause. Patients discharged alive were considered as competing events to the primary outcome. Competing risk regression was used to quantify the association between suPAR and the incidence of the primary outcome. Results: 6.2% of patients experienced ARDS or ICU admission, but none died. Taking into account competing risk, the incidence of the primary outcome was 11.5% (95% confidence interval [CI], 6.7-16.3) in patients with suPAR levels >3.91 ng/mL compared to 2.9% (95% CI, 0.4-5.5) in those with suPAR ≤3.91 ng/mL. Also, an increase by 1 ng/mL in baseline suPAR resulted in a 58% rise in the hazard of developing the primary outcome (hazard ratio 1.6, 95% CI, 1.2-2.1, p = 0.003). Conclusion: suPAR has an excellent prognostic utility in predicting severe complications in hospitalised COVID-19 patients.
MeSH term(s)	Adult ; Aged ; COVID-19/blood ; COVID-19/complications ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Patient Admission ; Prospective Studies ; Receptors, Urokinase Plasminogen Activator/blood ; SARS-CoV-2
Chemical Substances	Receptors, Urokinase Plasminogen Activator
Language	English
Publishing date	2021-04-20
Publishing country	Canada
Document type	Journal Article
ZDB-ID	1331197-9
ISSN	1878-3511 ; 1201-9712
ISSN (online)	1878-3511
ISSN	1201-9712
DOI	10.1016/j.ijid.2021.04.026
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Zs.A 4516: Show issues

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Article ; Online: Extreme elevation of ferritin and creatine kinase in primary infection with HIV-1.

Babiker, Zahir Osman Eltahir / Wingfield, Tom / Galloway, James / Snowden, Neil / Ustianowski, Andrew

International journal of STD & AIDS

2015 Volume 26, Issue 1, Page(s) 68–71

Abstract: The diagnosis of primary HIV-1 infection can be challenging, especially in the absence of reported risks or when presenting features are unusual and uncommon. We report an atypical case of primary HIV-1 infection with HIV-1 subtype C in a 61-year old ... ...

Abstract	The diagnosis of primary HIV-1 infection can be challenging, especially in the absence of reported risks or when presenting features are unusual and uncommon. We report an atypical case of primary HIV-1 infection with HIV-1 subtype C in a 61-year old Caucasian man who presented with extreme hyperferritinaemia without iron overload and marked elevation of serum creatine kinase without rhabdomyolysis. In view of his symptomatic seroconversion and low baseline CD4+ T-lymphocyte count, the patient was treated promptly with combination antiretroviral therapy. Subsequently, he made good clinical improvement on treatment and no opportunistic infections were diagnosed at presentation or as part of a later immune reconstitution syndrome. This novel case highlights the importance of clinical suspicion of HIV and suggests that primary HIV-1 infection should be considered in patients presenting with severe hyperferritinaemia or markedly elevated creatine kinase levels. Further studies are required to explain the causative biological mechanisms underlying this rare presentation.
MeSH term(s)	Anti-Retroviral Agents/administration & dosage ; Blood Chemical Analysis ; CD4 Lymphocyte Count ; Creatine Kinase/blood ; Drug Therapy, Combination ; Ferritins/blood ; HIV Infections/diagnosis ; HIV Infections/drug therapy ; HIV Infections/virology ; HIV-1/isolation & purification ; Humans ; Male ; Middle Aged ; Treatment Outcome
Chemical Substances	Anti-Retroviral Agents ; Ferritins (9007-73-2) ; Creatine Kinase (EC 2.7.3.2)
Language	English
Publishing date	2015-01
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	1018089-8
ISSN	1758-1052 ; 0956-4624
ISSN (online)	1758-1052
ISSN	0956-4624
DOI	10.1177/0956462414531936
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Zs.A 2829: Show issues

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Article ; Online: Does interferon-sparing tenofovir disoproxil fumarate-based therapy have a role in the management of severe acute hepatitis delta superinfection?

Babiker, Zahir Osman Eltahir / Hogan, Celia / Ustianowski, Andrew / Wilkins, Edmund

Journal of medical microbiology

2012 Volume 61, Issue Pt 12, Page(s) 1780–1783

Abstract: Infection with hepatitis delta virus (HDV) always occurs in association with hepatitis B virus (HBV) and is a cause of significant morbidity and mortality. We present a case of severe acute HDV infection superimposed on a previously unrecognized HBV ... ...

Abstract	Infection with hepatitis delta virus (HDV) always occurs in association with hepatitis B virus (HBV) and is a cause of significant morbidity and mortality. We present a case of severe acute HDV infection superimposed on a previously unrecognized HBV infection, in which an interferon-sparing antiviral therapy consisting of tenofovir disoproxil fumarate (TDF) and lamivudine was initiated and subsequently maintained. Evidence of successful suppression of HDV ribonucleic acid (RNA) was obtained after 65 weeks of TDF-based treatment. This was mirrored by a significant reduction in the levels of HBV DNA and HBV surface antigen. HDV RNA subsequently rebounded after our patient stopped antiviral therapy of his own accord. Interferon-sparing TDF-based antiviral therapy was safe and effective in achieving HDV RNA suppression in acute HDV superinfection. Further research into the utility of interferon-sparing TDF-based regimes in the treatment of acute HDV infection is needed.
MeSH term(s)	Acute Disease ; Adenine/analogs & derivatives ; Adenine/pharmacology ; Adenine/therapeutic use ; Antiviral Agents/therapeutic use ; DNA, Viral/analysis ; Drug Therapy, Combination ; Hepatitis B/drug therapy ; Hepatitis D/drug therapy ; Hepatitis Delta Virus/drug effects ; Hepatitis Delta Virus/genetics ; Hepatitis Delta Virus/isolation & purification ; Humans ; Interferons ; Lamivudine/pharmacology ; Lamivudine/therapeutic use ; Male ; Organophosphonates/pharmacology ; Organophosphonates/therapeutic use ; RNA, Viral/analysis ; Superinfection/drug therapy ; Superinfection/virology ; Tenofovir ; Young Adult
Chemical Substances	Antiviral Agents ; DNA, Viral ; Organophosphonates ; RNA, Viral ; Lamivudine (2T8Q726O95) ; Interferons (9008-11-1) ; Tenofovir (99YXE507IL) ; Adenine (JAC85A2161)
Language	English
Publishing date	2012-09-06
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	218356-0
ISSN	1473-5644 ; 0022-2615
ISSN (online)	1473-5644
ISSN	0022-2615
DOI	10.1099/jmm.0.046649-0
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