Although competency-based medical education has become the standard for physician training in the West, many developing countries have not yet adopted competency-based training. In 2009 in the United Arab Emirates, the government regulatory and operational authorities for healthcare in Abu Dhabi mandated a wide-scale reform of the emirate’s postgraduate residency programs to the competency-based framework of the newly formed Accreditation Council for Graduate Medical Education-International (ACGME-I). This article briefly describes the rationale for competency-based medical education and provides an overview of the transition from traditional, time-based residency training to competency-based postgraduate medical education for the Pediatrics residency programs in Abu Dhabi. We will provide data on the initial impact of this transition on resident performance and patient outcomes in a Pediatrics residency program in an academic medical center in the United Arab Emirates.

Gianotti-Crosti syndrome (GCS) is viral exanthema of childhood. It typically presents with a symmetric erythematous papular and papulovesicular eruption. It has been classically associated with hepatitis B virus, as well as rarely with Epstein-Barr virus (EBV). We report a case of GCS related to EBV infection without the classical systemic symptoms in a five-year-old male patient.

Objectives To evaluate the utilisation of intravenous immunoglobulin (IVIG) at Tawam Hospital, a tertiary care teaching hospital, over a 1-year period. Methods Patients who received IVIG from March 2010 to April 2011 at Tawam Hospital were identified retrospectively using the hospital computer system. Their charts were subsequently reviewed and data were collected on patients' demographics, indication, dose regimen, adverse drug reactions and physician specialty. Indications were placed into three main categories: US Food and Drug Administration (FDA) labelled; off-label indications with evidence favouring IVIG efficacy; and off-label indications with lack of evidence for efficacy. Results A total of 134 patients (74 paediatric and 60 adult) were identified. In 39%of paediatric versus 46% of adult patients, IVIG was dispensed for appropriate indications (US FDA labelled and off-label with support for use). However, 61%of paediatric patients and 54% of adult patients received IVIG for inappropriate indications (off-label use without support). The estimated annual cost of IVIG is US$1.25 million, of which US$0.7 million was considered as inappropriate use. Conclusions A significant amount of IVIG was prescribed for inappropriate indications, resulting in a large financial burden on the institution.

Stenotrophomonas maltophilia is an environmental bacterium of growing concern due to its multidrug resistance and pathogenic potential. It is considered an opportunistic pathogen of nosocomial origin most of the time, targeting a specific patients' population. We describe a case of a previously healthy full-term neonate who was found to have S. maltophilia meningitis and was successfully treated with a combination of Trimethoprim-Sulfamethoxazole and Ciprofloxacin.

Lemierre's syndrome (LS) is a serious rare complication of oropharyngeal infections. It is characterized by thrombosis of internal jugular vein that rapidly progresses into sepsis and is typically caused by anaerobes. Most of the reported cases have been linked to Fusobacterium necrophorum; however, there are a handful of reported cases due to aerobes. It is primarily the disease of healthy young adults and can present in school-aged children. The early recognition and treatment of this complication results in resolution of the illness; nevertheless, there have been some concerns about chronic venous insufficiency as a long-term complication. We report a case of a 6-year-old boy, who presented with fever and headache with a history of sore throat. His blood culture was positive for group A Streptococcus (GAS) and was subsequently found to have internal jugular vein, sigmoid, and transverse sinus vein thrombosis.