Surgeons in Abu Dhabi perform breakthrough surgery on Colombian fetus with spina bifida

Surgeons in Abu Dhabi perform breakthrough surgery on Colombian fetus with spina bifida
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Although the procedure is not new, it was a first for the region. (Burjeel Medical City)
Surgeons in Abu Dhabi perform breakthrough surgery on Colombian fetus with spina bifida
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Team from Burjeel Medical City provide life-changing treatment free of charge. (Burjeel Medical City)
Surgeons in Abu Dhabi perform breakthrough surgery on Colombian fetus with spina bifida
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A team of 10 were involved in the procedure. (Burjeel Medical City)
Surgeons in Abu Dhabi perform breakthrough surgery on Colombian fetus with spina bifida
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If left untreated, the condition can have life-altering effects on the child. (Burjeel Medical City)
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Updated 16 June 2023
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Surgeons in Abu Dhabi perform breakthrough surgery on Colombian fetus with spina bifida

Surgeons in Abu Dhabi perform breakthrough surgery on Colombian fetus with spina bifida
  • Team from Burjeel Medical City provide life-changing treatment free of charge
  • Hospital gave ‘a ray of hope for our baby,’ mother Valentina Rodriguez says

DUBAI: The number of reported cases of spina bifida in the Gulf region and around the world is on the increase, but many doctors believe this is due to increased awareness and better diagnostic methods, rather than a spike in the condition.

Spina bifida is a birth defect that occurs when bones forming the spine do not develop properly, leading to the spinal cord being left exposed to the amniotic fluid — the liquid that surrounds the unborn child in the womb — and resulting in a permanent disability.

No one wants to be told their baby is going to have anything other than a perfect life, but as with all things in the medical world, knowledge is power.

The increase in early diagnosis means there is a greater chance to improve the child’s life through prenatal surgery, and that is precisely what happened in Abu Dhabi this month.

Although the procedure is not new, it was a first for the region.

The operation was led by Dr. Mandeep Singh, a consultant in maternal and fetal medicine at Burjeel Medical City hospital.

He explained that before the breakthrough in prenatal surgery there were other procedures to treat the condition but they were more risky.

“We had to wait for the babies to be born. And then once the babies are born, the spinal cord needs to be closed within the first 24 hours, otherwise, there is the risk of infection, and that infection could go to the brain and cause meningitis, which is a very serious condition,” he said.

An initial study to see if an in utero procedure was possible was conducted in 2003.

“After 12 years of research, results showed that if you repair the defect in the womb, there is two times more power in the lower limbs and 1.5 times more likely to have reduced need for a shunt,” Singh said.

Spina bifida can be caused by many things. Although rare, it can be genetic but most of the time there are multiple factors preventing the spinal cord from closing, including a deficiency of folic acid (vitamin B), which is important for a healthy pregnancy.

If left untreated, the condition can have life-altering effects on the child.

“When the spinal cord is left exposed to the amniotic fluid, it causes damage. Most of the time, the centers that are controlled by the lower part of the spinal cord, or bowel and bladder, are severely damaged.

“That means these babies may not be able to walk or run. They may in the initial part of their life, but as the upper part of the body gets heavier, they are unable to walk.

“And most of them are wheelchair-bound. Or if they can walk, it is only with support. So it’s a pretty debilitating disorder if not treated,” Singh said.

He and his team successfully performed spinal correction surgery on the unborn child of a Colombian couple.

For Jason Gutierrez and Valentina Rodriguez being told their baby had spina bifida was life-changing, not least because it meant they had to fly half way round the world, leaving everything they knew behind so she could undergo the surgery.

“When I found out my baby had spina bifida, I felt really sad,” Rodriguez said. “I am a nurse and I’ve seen moms with babies with disabilities and never thought this could be a possibility for me.”

In Colombia, couples expecting babies with spina bifida have only two options: wait for the child to be born and then operate, or terminate the pregnancy.

“As time went by and no real solution came about, by miracle we heard about a center in Abu Dhabi which was able to perform the surgery immediately and at no cost to us,” Rodriguez said.

“We decided to resign from our jobs, leave our families and home and travel all the way here for our baby.”

It was not an easy decision to make, but Rodriguez said her family gave her their full support.

“My family was really sad, but on the other hand they were really happy that we were given this opportunity and a ray of hope for our baby. In Colombia, there was no solution.

“I was diagnosed during the 20th week and it could have been spotted since the 11th week, so I suspect if I stayed in Colombia, no action would have been taken and the baby would have disabilities and complications,” she said.

According to Singh, between two and four babies per 10,000 are diagnosed with the condition and the numbers are rising. While there is no clear reason for the increase, the doctor thinks it is down to more diagnoses, especially in the GCC region.

“Medical facilities are increasing so the statistics are increasing, because more people are being aware of the condition and getting the diagnosis they need,” he said.

Prenatal surgery was not without risk, however, to the baby and the mother, Singh said.

“Since this operation requires a cut to be taken from the womb, the biggest risk is scar rupture. Because this is a scar on the upper part of the womb, if she were to go into labor, there is a higher chance that the scar will give way. If the scar gives way in the pregnancy, it’s not only dangerous for the mother, but the baby will die or will be born with severe brain damage,” he said.

But Rodriguez was not thinking about the risk to herself before undergoing the surgery, which took place just two days after she arrived in Abu Dhabi.

“I wanted everything to go okay for the baby,” she said. “My preparation was more mental and spiritual. The center helped with visa arrangements, the flight tickets and the cost of the surgery was covered as well. Everything from food to accommodation has been provided. Otherwise there was no way we could afford it.”

A team of 10 people, including four surgeons, were involved in the procedure. While Singh is an expert in maternal–fetal medicine, the repair to the baby’s spine was carried out by a neurosurgeon.

Singh said there were many hospitals in East Asia, Africa, North America and Europe that could perform the procedure but Burjeel Medical City was a center for the Gulf region.

“There is a vast geographical area where this procedure is not done. Our center now provides solutions for parents who are seeking help in the region,” he said.

“We promise to make our results available to every prospective parent who comes here, because that’s the best way of giving confidence to prospective parents. And in medicine, there is nothing to hide. The outcomes have to be open and transparent for people to trust you.”

Rodriguez is expected to have her baby in Abu Dhabi in August. She does not know how long she and her husband will stay in the country but said they would remain as long as it took to ensure her baby was healthy and safe.


Iran says it gave warning before attacking Israel. US says that’s not true

Iran's Foreign Minister Hossein Amir-Abdollahian (L) and US President Joe Biden. (Agencies)
Iran's Foreign Minister Hossein Amir-Abdollahian (L) and US President Joe Biden. (Agencies)
Updated 6 sec ago
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Iran says it gave warning before attacking Israel. US says that’s not true

Iran's Foreign Minister Hossein Amir-Abdollahian (L) and US President Joe Biden. (Agencies)
  • An Iranian source briefed on the matter said Iran had informed the US through diplomatic channels that included Qatar, Turkiye and Switzerland about the scheduled day of the attack, saying it would be conducted in a manner to avoid provoking a response
  • Israel has killed more than 33,700 Palestinians in Gaza, mostly women and children, according to the health ministry in the Hamas-run territory

WASHINGTON/BAGHDAD/DUBAI: Turkish, Jordanian and Iraqi officials said on Sunday that Iran gave wide notice days before its drone and missile attack on Israel, but US officials said Tehran did not warn Washington and that it was aiming to cause significant damage.
Iran launched hundreds of drones and missiles on Saturday in a retaliatory strike after a suspected Israeli strike on its embassy compound in Syria.
Most of the drones and missiles were downed before reaching Israeli territory, though a young girl was critically injured and there were widespread concerns of further escalation.
Iranian Foreign Minister Hossein Amirabdollahian said on Sunday that Iran gave neighboring countries and Israel’s ally the United States 72 hours’ notice it would launch the strikes.
Turkiye’s Foreign Ministry said it had spoken to both Washington and Tehran before the attack, adding it had conveyed messages as an intermediary to be sure reactions were proportionate.
“Iran said the reaction would be a response to Israel’s attack on its embassy in Damascus and that it would not go beyond this. We were aware of the possibilities. The developments were not a surprise,” said a Turkish diplomatic source.
One senior official in US President Joe Biden’s administration denied Amirabdollahian’s statement, saying Washington did have contact with Iran through Swiss intermediaries but did not get notice 72 hours in advance.
“That is absolutely not true,” the official said. “They did not give a notification, nor did they give any sense of ... ‘these will be the targets, so evacuate them.’“
Tehran sent the United States a message only after the strikes began and the intent was to be “highly destructive” said the official, adding that Iran’s claim of a widespread warning may be an attempt to compensate for the lack of any major damage from the attack.
“We received a message from the Iranians as this was ongoing, through the Swiss. This was basically suggesting that they were finished after this, but it was still an ongoing attack. So that was (their) message to us,” the US official said.
Iraqi, Turkish and Jordanian officials each said Iran had provided early warning of the attack last week, including some details.
The attack with drones, cruise missiles and ballistic missiles risked causing major casualties and escalating the conflict.
US officials said on Friday and Saturday they expected an imminent attack and urged Iran against one, with Biden tersely saying his only message to Tehran was: “Don’t.”

ESCALATION
Two Iraqi sources, including a government security adviser and a security official, said Iran had used diplomatic channels to inform Baghdad about the attack at least three days before it happened.
The exact timing of the attack was not disclosed at that point, but was passed to Iraqi security and military authorities hours before the strikes, allowing Baghdad to close its airspace and avoid fatal accidents.
“The government clearly understood from the Iranian officials that the US military in Iraq was also aware of the attack in advance,” said the Iraqi security official.
A senior Jordanian official said Iran had summoned Arab envoys in Tehran on Wednesday to inform them of their intention to carry out an attack, though it did not specify the timing.
Asked if Iran had also given details about the targets and kind of weapons to be used, the Jordanian source did not respond directly but indicated that that was the case.
An Iranian source briefed on the matter said Iran had informed the US through diplomatic channels that included Qatar, Turkiye and Switzerland about the scheduled day of the attack, saying it would be conducted in a manner to avoid provoking a response.
How far escalation can be avoided remains in question. Biden has told Israel the United States will not join any Israeli retaliation, the US official said.
However, Israel is still weighing its response and will “exact the price from Iran in the fashion and timing that is right for us,” Israeli minister Benny Gantz said on Sunday.

 


Israelis rattled by Iranian attack, fear escalation

A man crosses an empty street in Jerusalem on April 14, 2024. (AFP)
A man crosses an empty street in Jerusalem on April 14, 2024. (AFP)
Updated 15 April 2024
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Israelis rattled by Iranian attack, fear escalation

A man crosses an empty street in Jerusalem on April 14, 2024. (AFP)
  • Israel has killed more than 33,686 Palestinians, according to Gaza’s Health Ministry

JERUSALEM: The first direct attack on Israel by Iran has shaken Israelis and left them fearful that a bigger war is looming.
While the population has long been used to sirens warning of attacks from Hamas, the hundreds of drones and missiles sent from Iran over Saturday night marked a new element in the over-lapping Middle East conflicts.
Israel reported modest damage on Sunday after the military said it shot down almost all of the more than 300 drones and missiles launched by Iran.
But the attack still rattled Israelis, whose army has fought Hamas for years in Gaza but never engaged in direct warfare with regional superpower Iran. Iranian weapons and interceptors could be seen flashing over the sky at night.

I hope there won’t be a big war; none of us in Israel wants a big war, so I hope that’s it, and I hope Iran would stop no.

Jeremy Smith, Resident of Tzur Hadassah

“I think it was quite scary when we started hearing booming in the middle of the night, and we did not know what it was. I mean, we knew what it was, but we didn’t know to what extent it would be,” said Jerusalem resident Cecile Smulowitz.
“But thank God the Israeli army came through, and so far it’s quiet, and we hope it will continue that way.”
Iran mounted its attack in retaliation for a suspected Israeli air strike on Tehran’s embassy compound in Damascus on April 1, which killed 13 people. Israel has neither confirmed nor denied carrying out the attack but is widely believed to have done so.
Following Iranian senior leader Ali Khamenei’s promise to hit back, Israelis were put on high alert.
Iran warned Israel and the US on Sunday of a “much larger response” if there was any retaliation for its mass drone and missile attack.
Israeli Prime Minister Benjamin Netanyahu, who has repeatedly told the world that Iran is an existential threat to the Jewish state, vowed Israel would achieve victory.
The threat of open warfare erupting between Iran and Israel and dragging the US into the conflict has put the region on edge.
Some Israelis said they did not want an escalation, but with the stakes so high, they are nervous despite having the most powerful and technologically advanced military in the region.
“I hope there won’t be a big war; none of us in Israel wants a big war, so I hope that’s it, and I hope Iran would stop now,” said Jeremy Smith, 60, a resident of Tzur Hadassah.
“I imagine Israel will respond because, I mean, our whole country was covered in missiles and drones. So what can you do? But we have to stop it somehow.”
Before the Iranian attack, Israeli authorities had instructed the public not to hold large gatherings, to close all schools and venues for children’s camps during the Jewish holiday of Passover, and to close some beaches and travel sites.
“We didn’t want the war with Hamas. They attacked us. We don’t want a war with Iran, they attack us,” said Jerusalem resident Amy Friedlang Morgans, 71.
“We don’t want a war with Iran. They, somehow, cannot accept Jewish people living here. This is our homeland. It’s written in the Bible.”
The Iranian attack took place against the background of the Israel-Hamas war in Gaza, in which Israeli forces have killed more than 33,000 Palestinians, according to the Gaza health ministry figures.

 


Ambrey says Israel intercepted UAV ‘launched from Yemen’

Ambrey says Israel intercepted UAV ‘launched from Yemen’
Updated 15 April 2024
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Ambrey says Israel intercepted UAV ‘launched from Yemen’

Ambrey says Israel intercepted UAV ‘launched from Yemen’
  • Israel used its seaborne missile defense system for the first time on Tuesday to shoot down a drone approaching from the Red Sea that had set off sirens in the port city of Eilat, the military said

CAIRO: British security firm Ambrey said on Sunday that Israel Defense Forces (IDF) intercepted an Unmanned Aerial Vehicle (UAV) near Eilat, stating that it assessed the UAV was launched from Yemen.
Ambrey said it also observed unprecedented levels of Automatic Identification Systems (AIS)interference off Eilat and neighboring Aqaba, Jordan, on Sunday.
“These were due to electronic warfare counter-measures,” the statement said.
“A Sa’ar 6-class corvette successfully intercepted a UAV that approached Israeli territory from the southeast using the ‘C-Dome’ Defense System earlier this evening,” the IDF posted on X.
Israel used its seaborne missile defense system for the first time on Tuesday to shoot down a drone approaching from the Red Sea that had set off sirens in the port city of Eilat, the military said.
Eilat has been a frequent target for launches by Iran-backed Houthis in Yemen as a show of support for Hamas, the Palestinian group that rules Gaza and is also backed by Iran.

 


US judge tosses out lawsuits against Libyan commander accused of war crimes

US judge tosses out lawsuits against Libyan commander accused of war crimes
Updated 15 April 2024
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US judge tosses out lawsuits against Libyan commander accused of war crimes

US judge tosses out lawsuits against Libyan commander accused of war crimes
  • The ruling was a significant reversal of fortune for Haftar

ALEXANDRIA, Virginia: A US judge has tossed out a series of civil lawsuits against a Libyan military commander who used to live in Virginia and was accused of killing innocent civilians in that country’s civil war.
At a court hearing Friday, US District Judge Leonie Brinkema said she had no jurisdiction to preside over a case alleging war crimes committed in Libya, even though the defendant, Khalifa Haftar, has US citizenship and lived for more than 20 years in the northern Virginia suburbs of the nation’s capital as an exile from the regime of Muammar Qaddafi.
The ruling was a significant reversal of fortune for Haftar. In 2022, Brinkema entered a default judgment against Haftar after he refused to sit for scheduled depositions about his role in the fighting that has plagued the country over the last decade.
But Haftar retained new lawyers who persuaded the judge to reopen the case and made Haftar available to be deposed. He sat for two separate depositions in 2022 and 2023 and denied orchestrating attacks against civilians.
Once a lieutenant to Qaddafi, Haftar defected to the US during the 1980s. He is widely believed to have worked with the CIA during his time in exile.
He returned to Libya in 2011 to support anti-Qaddafi forces that revolted against the dictator and killed him. During the country’s civil war, he led the self-styled Libyan National Army, which controlled much of the eastern half of Libya, with support from countries including Russia, Egypt and the United Arab Emirates. He continues to hold sway in the eastern half of the country.
In the lawsuits, first filed in 2019, the plaintiffs say family members were killed by military bombardments conducted by Haftar’s army in civilian areas.
The lawsuits also alleged that Haftar and his family owned a significant amount of property in Virginia, which could have been used to pay off any judgment that would have been entered against him.
While the lawsuits were tossed out on technical issues over jurisdiction, one of Haftar’s lawyers, Paul Kamenar, said Haftar denied any role in the deaths of civilians.
“He’s not this ruthless figure that everyone wants to portray him as,” Kamenar said in a phone interview Sunday.
Faisal Gill, a lawyer for plaintiffs in one of the three lawsuits that Brinkema tossed out Friday, said he plans to appeal the dismissal.
Mark Zaid, lawyer for another set of plaintiffs, called Brinkema’s ruling perplexing and said he believes that the court’s jurisdiction to hear the case had already been established at an earlier phase of the case.
“A US citizen committed war crimes abroad and thus far has escaped civil accountability,” Zaid said Sunday in an emailed statement.
In court papers, Haftar tried to claim immunity from the suits as a head of state. At one point, the judge put the cases on pause because she worried that the lawsuits were being used to influence scheduled presidential elections in Libya, in which Haftar was a candidate. Those elections were later postponed.


Israel army says Hamas holding hostages in Gaza’s Rafah

Israel army says Hamas holding hostages in Gaza’s Rafah
Updated 15 April 2024
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Israel army says Hamas holding hostages in Gaza’s Rafah

Israel army says Hamas holding hostages in Gaza’s Rafah
  • The move comes just days after the army pulled out all troops from southern Gaza’s main city of Khan Yunis, leaving just one brigade to carry out operations across the Palestinian territory

JERUSALEM: Israel said Sunday that Hamas is holding hostages in Rafah in southern Gaza, where Prime Minister Benjamin Netanyahu has vowed to launch a ground invasion despite international outcry.
“Hamas is still holding our hostages in Gaza... We also have hostages in Rafah, and we will do everything we can to bring them back home,” Israeli military spokesman Rear Admiral Daniel Hagari said at a briefing.
In a separate statement, the army said it was calling “approximately two reserve brigades for operational activities on the Gazan front.”
It did not specify whether the brigades would be deployed inside Gaza.
The move comes just days after the army pulled out all troops from southern Gaza’s main city of Khan Yunis, leaving just one brigade to carry out operations across the Palestinian territory.