Browsing by Author "Kowash, Mawlood B."
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Publication Assessment of the knowledge of United Arab Emirates dentists of Child Maltreatment, protection and safeguarding(2018-05) El-Halabi, Manal; Kowash, Mawlood B.; Hassan Khamis, Amar; Hussein, IyadAim: Child safeguarding is society’s responsibility. Dentists are uniquely positioned to recognise Child Abuse and Neglect (CAN) in dental practice and the wider society. The United Arab Emirates (UAE) introduced a child protection law in 2016. We aimed to assess the awareness of UAE dentists of child maltreatment, protection and safeguarding. Study Design: A cross-sectional survey. Methods: We surveyed 381 UAE dentists about the knowledge and practice of CAN and safeguarding issues using a self-administered anonymous questionnaire. Statistical analysis was carried out using Chi-square, t-test, ANOVA and Pearson’s correlation test and statistical significance was set as p <0.05. Results: Over 39 % (n=152) of the responders suspected CAN; male dentists suspected more CAN than females (p=0.015). Orthodontists, paediatric dentists (p<0.001) and female dentists (p=0.001) were more knowledgeable about diagnosing CAN. Paediatric dentists attended more CAN-related postgraduate training (p<0.001) than other specialties. Over 90% (n=346) believed that CAN should be addressed, 58.1% (n=224) and 54.1% (n=206) had CAN undergraduate and postgraduate training respectively but 53.5% (n=204) were unaware of local child protection guidelines. Dentists barriers to child protection reporting were; fear of family violence (59.6%, n=227), lack of knowledge of referral process (60.2%, n=228) and lack of diagnosis certainty (54.9%, n=206). UAE dentists qualified in Western and Asian countries had fewer barriers for child protection reporting (p=0.022) than the Arab and Gulf Cooperation Council qualified dentists. Conclusions: A large minority of UAE dentists suspected CAN. Factors influencing child protection reporting were identified. Dentists’ gender, specialty, and country of qualification affected their knowledge of CAN and practice of safeguarding. Child protection training is recommended.Publication An Audit on the Quality of Intra-Oral Digital Radiographs Taken in a Postgraduate Paediatric Dentistry Setting(2017-02-01) Salami, Anas A.; El-Halabi, Manal; Hussein, Iyad; Kowash, Mawlood B.Abstract: Background: Quality assurance (QA) for radiographs sustains accurate diagnostic information while maintaining radiation doses as low as reasonably achievable (ALARA). Aims: To audit the quality of digital intraoral periapical (IOPAs) and bitewings (BWs) radiographs taken in a postgraduate paediatric dentistry setting. Standards: The National Radiological Protection Board (NRPB) guidance describes three grades of radiograph quality. Excellent (Grade 1 >70% of total exposures), diagnostically acceptable (Grade 2 <20%) and unacceptable (Grade 3 <10%). Methodology: A pilot study was performed on 10 IOPAs and 10 BWs. 50 IOPAs and 50 BWs were reviewed in 2 audit cycles with a 6 month interval (total of 200 X-rays). Results: First Cycle: Of 50 IOPAs: 18 (36%) scored Grade 1, 25 (50%) Grade 2 and 7 (14%) Grade 3. Of 50 BWs: 10 (20%) scored Grade 1, 33 (66%) Grade 2 and 7 (14%) Grade 3. Second Cycle: Of 50 IOPAs: 28 (56%) scored Grade 1, 15 (30%) Grade 2 and 7 (14%) Grade 3. Of 50 BWs: 27 (54%) scored Grade 1, 17 (34%) Grade 2 and 6 (12%) Grade 3. Rejection rate of Grade 3 was analysed in both cycles. A clear improvement in radiograph quality was demonstrated between both cycles, but the standard was not met. Action plan and recommendations: Results were disseminated to all staff and recommendations to improve radiograph quality were made to use film holders and paediatric film sizes. Conclusion: Although a significant improvement was observed in the 2nd cycle, the overall standard of radiographs fell short of the guidelines. Thus, the quality of radiographs requires continuous auditing to reach the gold standard. An audit spiral is planned.Publication Comparison of residual salivary fluoride retention using amine fluoride toothpastes in caries-free and caries-prone children(2016-04-21) Kowash, Mawlood B.Aim: This was to compare the salivary fluoride levels following tooth brushing with amine fluoride toothpastes containing three different concentrations of F (250 ppm F, 500 ppm F and 1250 ppm F) and to evaluate the effect of rinsing with water on the oral fluoride levels up to 90 min. Methods: A double blind randomised six-arm crossover study was conducted with 32 child participants. Patients were divided into two groups depending on their caries experience with caries-free group (n = 17, mean age = 72.9 months) and caries-prone group (n = 15, mean age = 69.6 months, mean dmfs = 12.3). Each participant brushed their teeth with a smear of dentifrice containing (250 ppm, 500 ppm and 1250 ppm F toothpastes) for 60 s. After spitting out the dentifrice/saliva slurry, participants either rinsed with water or did not rinse at all. Samples of whole mixed unstimulated saliva were collected at 0 (baseline), 1, 15, 30, 45, 60 and 90 mins post-brushing/ rinsing. Results: After completing the study on residual fluoride concentration it was found that caries was not a significant variable (p = 0.567) while every other variable was (all p values \0.001). Time, toothpaste F concentration and rinse had significant effects (p \ 0.001). In general, higher residual salivary F concentrations were found with increased F concentration in toothpastes and when no rinsing was performed after brushing. Conclusion: The results of this study support the current recommendation of using toothpastes with [1000 ppm F concentration in children with an increased caries risk in addition to spitting excess toothpaste with no rinsing following brushing.Publication Contemporary dental caries management concepts in paediatric dentistry: A survey of awareness and practice of a group of gulf cooperation council dentists.(2017-03-08) Hussein, Iyad; El-Halabi, Manal; Kowash, Mawlood B.; Hassan Khamis, AmarIntroduction: Debatable clinically relevant child dental caries management concepts exist; restoring a carious primary molar (RCM), the choice of pulpotomy medicament (PM), the “Hall Technique” (HT), and sealing of dental caries (SDC). Our aim was to assess the knowledge and practice of dentists treating children in the Gulf Cooperation Council (GCC) region of the aforementioned contemporary concepts. Methodology: Paediatric Dentists (PDs) and General Dental Practitioners (GDPs) who treated children completed a questionnaire (N=150) covering: RCM choices; choice of PM; knowledge and practice of HT and acceptance of SDC in primary and permanent teeth. Statistical analysis was conducted using Chi-Square test (p<0.05). Results: For RCM: 76% of those surveyed would remove non-pulpal caries in an asymptomatic lower D and restore with composite (33%), glass ionomer or conventional stainless steel crown (SSC) (17.4%), amalgam (7.4%) and zirconia (0.7%). The remaining 24% would seal caries (HT SSC). For PM: 40.7% chose Ferric Sulphate, followed by Formocresol (36.7%), Mineral Trioxide Aggregate (14%) and Calcium hydroxide (8.7%); For HT: 60.6% had knowledge of HT but 81.5% never used it. For SDC: sealing caries in primary & permanent teeth was rejected by 56.6% & 53.1% respectively. GDPs and PDs choices differed significantly with RCM, HT (knowledge and practice) (p=0.007, 0.003 and 0.003 respectively). Conclusion: Overall the surveyed dentists practicing in the GCC disagreed on RCM, PM with reluctance to accept new concepts like the HT and SDC. PDs choices of RCM differed from GDPs, and their awareness of HT and practice of HT were more favourable.Publication Correction to: Children’s dental anxiety (self and proxy reported) and its association with dental behaviour in a postgraduate dental hospital(2020) Algharebi, Safeya; Al Halabi, Manal; Kowash, Mawlood B.; Hassan Khamis, Amar; Hussein, IyadCorrection to: European Archives of Paediatric Dentistry: https ://doi.org/10.1007/s4036 8-020-00517 -x In the original publication of the article the third author’s name “M. Kowash” was submitted as “K. Mawlood” which was left unnoticed in the later stages. The correct name is as published in this erratum and the original article has been corrected. Correction to: https://repository.mbru.ac.ae/handle/1/636Publication Dental Implications of Down Syndrome (DS): Review of the Oral and Dental Characteristics(2017-05-27) Ghaith, Batool; El-Halabi, Manal; Kowash, Mawlood B.Abstract: A literature search was conducted to identify the key oral and dental manifestations of DS. These findings are discussed and used to suggest recommendations for treatment planning in DS patients for the practicing dental practitioner and also to help other medical professionals in understanding the oral health status of DS patients and the importance of liaison with dental professionals.Publication Dentists knowledge of the guidelines of traumatic dental injuries in the United Arab Emirates(2018-12) El-Halabi, Manal; Hussein, Iyad; Hassan Khamis, Amar; Kowash, Mawlood B.Aim: This study aimed to assess general dental practitioners’ (GDPs) knowledge within the United Arab Emirates (UAE) regarding the management of traumatic dental injuries (TDIs), and to compare their level of knowledge with that of paediatric dentists (PDs). Methods: Dentists were asked to complete a two-part questionnaire (seven questions covering demographic data and 13 questions about trauma cases scenarios) in electronic and paper format. A total of 296 returned questionnaires were analysed to identify GDPs’ knowledge in managing TDIs, and to compare the score of GDPs’ knowledge with that of PDs’. Results: Out of a total score of 13, the mean knowledge score (MKnS) for GDPs was 4.87±1.82 (only 37.5% of the 13 questions were answered correctly) while the MKnS of paediatric dentists was 5.56±1.47 (with 42.8% correct answers); both scores indicated poor knowledge and the difference was statistically significant (p=0.005). Conclusions: There was poor knowledge of TDIs among the surveyed UAE GDPs as well as the PDs, although PDs scored higher, indicating the need for further training.Publication Early childhood caries and associated risk factors among preschool children in Ras Al-Khaimah, United Arab Emirates(2017-02-27) Kowash, Mawlood B.; Hassan Khamis, AmarAim: To investigate the prevalence and contributing factors of early childhood caries (ECC) in preschool children of Ras Al-Khaimah (RAK), United Arab Emirates (UAE). Study design: Cross-sectional. Methods: The sample consisted of 540 healthy preschool children between four and six years of age attending 10 nursery schools in RAK, UAE. A structured questionnaire was distributed to the mothers of children who gave consent for their children to be included in the study. The questionnaire was used to collect information regarding child and mother’s demographic data, children’s feeding and dietary habits, oral hygiene practices and frequency of dental visits. The dental examination of children was conducted by one investigator using a mouth mirror and a torch light source. Results: Five hundred and forty children with a mean age of 5.1 (SD = 0.71) years were included in the study. The prevalence of ECC was 74.1%, the mean dmft was 3.07 ± 0.135. The significant caries index (SiC) was very high (13.3) and the care index was very low (3.8%). A high proportion of caries-free children and those with ECC were either never or only visited dentists when in pain. However, the difference in frequency of dental visits was statistically highly significant (p\0.001). There was also a statistically significant difference in frequency of tooth brushing between children with and without caries and more than two-thirds of children with ECC spent less than two minutes when brushing their teeth. The difference in sweet consumption was not statistically significant. Conclusion: The prevalence of dental decay and the mean dmft were high and the care index was extremely low. There is a great need for prospective studies and community preventive programs to solve the problem of ECC and set plans to treat open cavities in RAK preschool children.Publication Emergency Management of Traumatic Dental Injuries: Knowledge of Dubai School Nurses(2019-07-15) El-Halabi, Manal; Kowash, Mawlood B.; Hussein, IyadObjective: To assess the knowledge of school nurses in Dubai, United Arab Emirates, about the emergency management of Traumatic Dental Injuries (TDIs) at schools. Material and Methods: A cross-sectional questionnaire survey was conducted amongst 68 school nurses (SN) prior to inviting them to an educational workshop on the emergency management of TDIs. The educational workshop covered all the topics in the questionnaire and provided basic necessary information to the SN regarding the emergency management of TDIs. Descriptive statistics were used to describe the characteristics of the sample; the Kolmogorov-Smirnov test was used to test normality for the score of knowledge and Mann-Whitney U test to correlate score of knowledge with different demographical variables (p<0.05). Results: An overall lack of knowledge about the emergency management of TDIs was observed. The overall average for the score of knowledge for all the participants was 10.75 out of a total of 16 correct answers. Female participants had significantly higher scores of knowledge compared to males (p=0.02). None of the other demographic variables were significantly associated with the score of knowledge. Conclusion: More training programs are essential for school nurses to improve their knowledge and awareness for better future handling of traumatic dental injuries.Publication Knowledge and Attitude of Northern Emirates Dental Practitioners towards Antibiotic Prescription and its Resistance(2016-02-05) Kowash, Mawlood B.Abstract: Emergence of bacterial strains resistant to antibiotics has been a major concern to medical and dental profession. Irrational antibiotic prescription by dental professionals is well documented. The aim of this study was to explore the knowledge and attitude of dental practitioners (DP) working in northern emirates of UAE towards antibiotic prescription and resistance development. Methods: A questionnaire was distributed to 200 DP working in Northern emirates dental clinics. The questionnaire sought answers to clinical and non-clinical conditions for which antibiotic would be prescribed and the potential contributing factors in development of antibiotic resistance. Results: Out of the 200 questionnaires sent out154 (77%) responded. 54.5% were females. The majority of DP would prescribe antibiotics for elevated temperature (87.7%), diffuse swelling (94.1%) and swelling causing eye closure (83.1%) conditions. Antibiotic prescription would be considered for pericoronitis, cellulitis and trismus by 76.0%, 90.9% and 47.4% of the DP respectively. However, 53.3% would prescribe antibiotics for fluctuant localized swelling, 72.5% to reduce postoperative complications and 67.8% for surgical extraction procedures. Generally, amoxicillin was the most preferred drug. 44.6% of the DP preferred augmentin in treatment of cellulitis. DP with less than 5 years in practice showed higher mean knowledge with regard to antibiotic indications (p=0.039). 70.8% thought widespread use of antibiotics was an important factor in development of antibiotic resistance. Conclusion: In spite of the DP fair knowledge, a considerable percentage continued to prescribe antibiotics irrationally. The study highlights on the importance of promoting knowledge on antibiotics use and abuse through continuous dental education forum.Publication Medical and Dental Implications of Autism Spectrum Disorder: A Review(2017-05-26) El-Halabi, Manal; Kowash, Mawlood B.; Mansoor, DinaAbstract: Globally 1 in every 68 child is diagnosed with Autism. Autism spectrum disorder (ASD) or Autism is a group of neurodevelopmental disorders, affecting the normal development and functioning of the brain in three core domains; reciprocal social interactions, verbal and non-verbal communication and the presence of restricted or repetitive behaviors. Typically it appears in the first three years of life and affects males four times more than females but females are more likely to show more signs of mental retardation. Other medical problems can co-exist along with Autism such as psychiatric illnesses, epilepsy; sleep disturbances, feeding problems, gastrointestinal problems and voiding problems. Autism cannot be cured, but the earlier the intervention the better the results. Medications, therapies and behavioral interventions can only alleviate Autism related symptoms and cause substantial improvement. Autism characteristics can have an impact on three different perspectives of dental care, which are oral care at home, oral care at the dentist and access to oral care. This paper aims to review and discuss the literature on the general and oral characteristics of children with Autism Spectrum Disorder in order to help the dental practitioners as well as the medical professionals in providing them with better oral and health services.Publication Medical and Dental Implications of Cerebral Palsy: Part 1 General and Medical Characteristics: A Review(2017-06-07) Alhashmi, Haifa; Kowash, Mawlood B.; El-Halabi, ManalAbstract: Cerebral palsy (CP) is a group of neuromuscular disorders that affects the development of movement and posture, causing activity limitations. CP is classified into three main groups: spastic, dyskinetic and ataxic. Population-based studies from around the world report estimates of CP prevalence ranging from 1.5 to more than 4 per 1,000 live births. The commonest cause of CP remains unknown in 50% of the cases; prematurity remains the common asterisk factor. CP children suffer from numerous problems and potential disabilities such as mental retardation, epilepsy, feeding difficulties, and ophthalmologic and hearing impairments. This paper reviews and critically discusses the definition, epidemiology, aetiology, classifications, treatments and associated manifestation and complications of CP.Publication Medical and Dental Implications of Cerebral Palsy: Part 2: Oral and Dental Characteristics: A Review(2017-06-07) Alhashmi, Haifa; Kowash, Mawlood B.; El-Halabi, ManalAbstract: Cerebral palsy (CP) is a group of neuromuscular disorders that affects the development of movement and posture, causing activity limitations. CP is classified into three main groups: spastic, dyskinetic and ataxic. Population-based studies from around the world report estimates of CP prevalence ranging from 1.5 to more than 4 per 1,000 live births. CP children suffer from numerous problems and potential disabilities such as mental retardation, epilepsy, feeding difficulties, and ophthalmologic and hearing impairments. Intra orally, Patients with cerebral palsy are reported to have several oral health problems such as poor oral hygiene, bruxism, drooling, traumatic dental injuries, and malocclusion. A literature search was conducted to identify the key oral and dental manifestations of CP. These findings are discussed and utilized to suggest recommendations for treatment planning in CP patients for the dental practitioner. The findings might also help other medical professionals in understanding the oral health status of CP patients and the importance of liaison with dental professionals.Publication Medical and Dental Implications of Patients with Beta Thalassaemia Major. Part 2: Orofacial and Dental Characteristics: A Review(2017-06-20) Al Raeesi, Shaikha; Kowash, Mawlood B.; El-Halabi, ManalAbstract: Thalassaemia, one of the most common genetic disorders, often causes serious medical, social, and psychological problems. Beta thalassaemia major is a life-threatening disorder that presents with a vast variability in the systemic signs and symptoms. In addition, orofacial and dental tissues are also affected. The common orofacial features among thalassaemic patients include: frontal bossing, skeletal overgrowth with characteristic appearances known as chipmunk faces, upper lip retraction, protrusion of pre maxilla bone associated with alveolar enlargement that causes malocclusion in the dentition with the clinical appearance of protrusion, flaring, spacing of anterior teeth and anterior open bite. The oral mucosa appears pale or a lemon yellow colour due to deposition of bilirubin pigmentation and anaemia. Sometimes the gingival colour tends to be dark, caused by high ferritin level in the blood. Current reports show a significant improvement in thalassaemia major patients’ survival rates. With increased life expectancy, the need for improved oral healthcare is very important to ensure a high quality of life for this patient population. This paper reviews the literatures and discusses briefly the dento-facial manifestations, radiographic features, dental caries, periodontal and soft tissue conditions related to beta thalassaemia major as well as dental management and considerations of thalassaemia patients.Publication Medical and Dental Implications of Patients with Beta Thalassaemia Major. Part1: General and Medical Characteristics: A Review(2017-06-12) Al Raeesi, Shaikha; Kowash, Mawlood B.; El-Halabi, ManalAbstract: Thalassemia is one of the most common inherited haemoglobinopathies characterized by either a partial or a complete suppression in the production of normal haemoglobin as a result of defective synthesis of one or more of the globins chains. Thalassemia is the most widely distributed genetic disorder. Approximately 5 % of the world’s population was found to have a globin variant, with only 1.7 % having an alpha or beta thalassemia trait. The Mediterranean region, the Middle East, the Indian subcontinent and Far East Asia show the highest rates of prevalence of beta thalassemia. Beta thalassemia is considered to be a major public health issue, as well as a life threating condition characterized by severe anaemia, hepatosplenomegaly, growth retardation, endocrine dysfunction, cardiac failure and skeletal changes. Management strategies using blood transfusion and chelation therapy will improve the control of anaemia, suppression of erythropoiesis, and inhibition of gastrointestinal iron absorption of beta thalassaemia major patients. Bone marrow transplant is considered an excellent curative therapy in thalassaemic patients during childhood, which will provide prolonging life expectancy. This paper reviews the literatures and discusses briefly the definition, history, epidemiology, classification, aetiopathogenesis, general manifestation and general management of beta thalassaemia major.Publication Oral and Dental Considerations in the Management of Leukemic Children(2014-09) Alnuaimi, Eman H; El-Halabi, Manal; Kowash, Mawlood B.Abstract: An incidence of overall oral sequelae in leukemic children of 54% has been reported in the literature. Oral complications include mucositis, fungal and viral infections, salivary gland hypofunction, dental caries, and others. Mucositis accounts for the most common complication followed by fungal infections and viral infections. It has also been reported that the quality of life of these children is affected. Dental healthcare professionals play a very important role in assessing the patient’s oral health needs before, during, and after cancer therapy. A multidisciplinary approach between the medical and dental team will help prevent, stabilize, and treat the oral and dental problems at an early stage. This paper reviews briefly the oral health problems in leukemic children as well as dental considerations and recommendations for optimal oral health care.Publication Oral health challenges facing Dubai children with Autism Spectrum Disorder at home and in accessing oral health care(2018-06) El-Halabi, Manal; Hassan Khamis, Amar; Kowash, Mawlood B.Aims: To investigate the challenges faced by Autism Spectrum Disorder (ASD) children and their families in Dubai from three different perspectives of dental care: oral care at home, oral care at the dentist and access to oral care, and to compare the results to their normally developing peers. Methods: A case-control comparative study of 84 ASD and 53 healthy children attending special needs centres and schools in Dubai including siblings of the autistic children. Data collection was by a survey questionnaire completed by parents or guardians. Results: More parents of ASD children compared to parents of healthy children reported difficulties across almost all oral care variables explored. The majority of ASD children’s parents (83.3%) reported that their children need assistance in brushing their teeth compared with 15.4% of the healthy controls (p-value < 0.001). The ASD children’s uncooperative behavior increased during dental visits and significantly more parents (37%) rated their child’s experience as negative compared with 9.5% among the parents of control children (p-value=0.006). The autistic children had visited a dentist mostly for extractions. Conclusion: This study indicates that autistic children in Dubai experience more challenges and barriers to oral care than their typically developing healthy peers.Publication Oral Health Knowledge, Attitude, and Practices of Sharjah Mothers of Preschool Children, United Arab Emirates(2017-12-17) Kowash, Mawlood B.; Hussein, Iyad; Hassan Khamis, Amar; El-Halabi, ManalObjective: The improvement of children’s oral health, a world global health target, is essential to general health and quality of life. Hence, the aim of this study was to assess the knowledge, attitude, and practices of mothers toward their children’s oral health in Sharjah, United Arab Emirates (UAE). Materials and Methods: A cross sectional interview based study was conducted among 383 mothers of preschool children (average age 3.49 [+1.63 years]) attending Sharjah Dental Center, UAE. Statistical analysis was performed using SPSS software for Windows, version 20.0 (SPSS Inc., Chicago, IL, USA). Results: Adequate knowledge was found among 58.2% of mothers, 99% exhibited excellent attitude, and only 20% followed good practices toward their children’s oral health. Poor knowledge and practice of mothers were significantly associated with mothers’ occupation and education. Employed mothers had a significantly higher score of knowledge. Mothers with secondary education and university qualifications had significantly higher scores of practice compared with mothers with primary education. Conclusions: Although mothers had better than average knowledge and excellent attitude toward their children’s oral health issues; most of them carried out improper practices. Mothers’ educational and employment backgrounds were significant influencing factors.Publication Oral health of children with special health care needs (SHCN)(2017) Kowash, Mawlood B.Abstract: The management of children with special health care needs (SHCN) creates hesitation and anxiety among health professionals including dentists because it re¬quires specialized knowledge acquired through special training, increased awareness, ac¬commodative measures and resources. A literature search was conducted to identify updated and evidence-based recommendations and dental management options available for children with SHCN. These recommendations will assist dentists in determining the most appropriate dental management and also help other medical professionals in understanding the need to maintain optimaloral health for children with SHCN and the importance of liaison with dental professionals.Publication Oral Health Status among Children with Cerebral Palsy in Dubai, United Arab Emirates(2017-11-17) Alhashmi, Haifa; Kowash, Mawlood B.; Hassan Khamis, Amar; El-Halabi, ManalObjectives: The purpose of this study was to assess the oral health status of children with cerebral palsy (CP) in Dubai, United Arab Emirates (UAE). Materials and Methods: Eighty four CP and 125 healthy children were recruited from special needs centers and private/public schools in Dubai. A dental examination for decayed missing filled teeth in primary dentition (dmft)/Decayed Missing Filled teeth in permanent dentition (DMFT) indices, simplified oral hygiene index, calculus index (CI), and oral debris index was conducted. In addition, assessments of occlusal, dentofacial, soft tissue anomalies and erosion were conducted. Statistical analysis was conducted using SPSS for Windows, version 20.0 (SPSS Inc., Chicago, IL, USA). Results: DMFT/dmft scores were comparable in both groups. CI was significantly higher among children with CP. CP patients had a significantly higher proportion of anterior open bite, anterior spacing, Class II molar Angle malocclusion, trauma, high arched palate, tongue thrust, lymphadenopathy, angular cheilitis, macroglossia, drooling, and erosion as compared to controls. Conclusions: The study highlighted peculiar characteristics and needs for the CP patients in Dubai, UAE.