Day :
- Diabetes and Its Complications
Session Introduction
Ami Makwana
Manipal hospital, India
Title: Indications, efficacy and safety of chemoport in children: A study from a tertiary center
Biography:
Ami Makwana is Employee at Manipal hospital old airport road, hall, Bangalore as final year General surgery residency.
Abstract:
Introduction: Long term venous access is cumbersome in the pediatric age group due to thinner caliber veins, easy compromisation of venous integrity and less co-operative nature of children. Few studies are available that look at the use of chemoports in children and their complications.
Method: A retrospective analysis of children who underwent chemoport insertion from January 2008 to December 2017 was carried out.
Results: A total of 159 children (169 chemoports) were included in the study. The most common indication for chemoport insertion was acute lymphoblastic leukemia (52%). The mean chemoport days were 746±666 days. Among the 169 chemoports, 55% underwent chemoport removal as they completed the treatment. Chemoport hasn't been removed in 35% patients as 28% patients are still under treatment and 7% patients expired during the treatment. Sixteen (0.1 per 1000 chemoport days) patients had a premature removal of chemoport. The indications were port-related bloodstream infection (12 patients), port pocket infection (one patient), exposed chemoport (one patient) or blockage of the chemoport catheter (two patients). There were a total of 22 (0.15 per 1000 chemoport days) complications with port-related bloodstream infection (0.09 per 1000 chemoport days) being the commonest. Other complications include blockage, fracture, arrhythmias, avulsion, bleeding and decubitus over port, and port pocket infection.
Conclusion: The safe, reliable and low complication rate of chemoport helps us save more children from deadly illnesses. A standard technique of insertion, use of imaging modality, and well-trained nursing staff can bring down the complication rate to a negligible amount.
- Diabetes and Foot Complications
Session Introduction
Rachel Xuan
The Liverpool Hospital, Australia
Title: The Footrest as a Helpful Adjunct for the Below Knee Amputation
Biography:
Ms Rachel Xuan is a medical student in her final year of training from the University of New South Wales. She is currently posted at the Liverpool Hospital in Western Sydney in Australia and is rotating through her vascular surgery term. She has a keen interest in diabetic foot complications and their surgical management.
Abstract:
The below knee amputation (BKA) is one of the oldest and most effective surgical procedures (1). It is often a critical component in the management of diabetic foot disease to obtain souce control in the setting of sepsis (2). Its technique has been refined from the first century to deal more effectively with haemorrhage, infection and pain. The introduction of ligatures, tourniquets, antibiotics and reonstructive flap techniques have all been beneficial technical adjuncts (3). Multiple factors contribute to good post-operative outcomes including, but not limited to, adequate blood supply, meticulous haemostasis, tension free closure, the appropriate selection of the amputation level and an atraumatic and efficient surgical technique with minimisation of electrocautery.
The operative positioning has classically been with the patient in a supine position with their knee extended. Although this has not changed, modern surgical tables and accessories can improve surgical outcomes. Herein, we discuss the use of a surgical 12” long footrest and a hip brace as an adjunct for BKA. They facilitate the sterile surgical prep of the leg, give easier access to the posterior flap and minimise the need for assistance during bony transections. The core principles of major limb amputation still apply for a good outcome and these adjuncts represent an incremental improvement to the classical setup for a BKA. We hope that this article will help the surgical community and doctors who perform this operation infrequently.
- Diabetes and Skin Complications
Session Introduction
Shamaki B Usman
University of Maiduguri, Nigeria
Title: Novel ethno-therapeutic agent against squamous cell carcinoma in sheep using wild Ganoderma species based petrolatum paste in Nigeria
Biography:
Dr. Bala Usman Shamaki was born in May, 1969 at Kaltungo in Gombe State. He attended Nassarawa Pri. Sch. Kaltungo 1976-1978, Jama’are Centarl Pri. Sch. 1979-1980, Jekadafari Pri. Sch. Gombe, 1980-1982. He was among the pioneer students of the then Pilot Junior Secondary Sch. Gombe (1982-1985). after passing the JSSCE in 1985, he then proceeded to Govt. Sci. Sec. Sch. Darazo (1985-1987). He secured admission to remedial programme at the University of Maiduguri same year, and was admitted into Faculty of Veterinary Medicine, after successfully completing the remedial programme. He is currently an Associate Professor of Pharmacology, and the Pioneer Head of Department of the newly created Department of Veterinary Pharmacology and Toxicology, University of Maiduguri.
Abstract:
Squamous Cell Carcinoma (SCC) or skin cancer is the most common type of cancer in animals worldwide. There are claims of anticancer potentials of the wild Ganoderma sp., that is currently undergoing research, however, most of these researches involved in vitro studies methods using cell lines. Three sheep (Balami breed) were observed with cauliflower-like growths on various locations on their skins, and histopathological analysis from the skin biopsies revealed that it was squamous cell carcinoma. Using wild Ganoderma sp. based jelly at 6.7 mg/Ml. It was applied daily for two consecutive weeks on the specific growth areas on the treated sheep, while one of the sheep served as positive control with only the petrolatum jelly applied for the same period and the third sheep served as negative control and was not administered any topical treatment. Results from this study showed progressive regression of the tumorous growth in the treated sheep following topical application of the Ganoderma sp., based jelly treatment until completely cured after two weeks of topical application, while progressive growth of the tumor on the skin of both controls was observed within the same treatment periods. In conclusion, this study demonstrated that wild Ganoderma sp., based petrolatum paste preparation alone, can cure squamous cell carcinoma in sheep when compared to the control and may be a potential novel, ethno-therapy based anticancer agent for veterinary use.
- Diet and Weight Management
Session Introduction
Nermeen El Beltagy
Alexandria University, Egypt
Title: Effect of breakfast intake on body mass index of females at one year after delivery in Alexandria, Egypt
Biography:
Dr. Nermeen El Beltagy MD, PhD, MS, MPH, Professional C is a Professor in the Department of Obstetrics and Gynecology, Alexandria University, Egypt. She is a member of the International weight management in pregnancy (I-WIP collaborators of the European Union). She received her medical degrees from Egypt, but the PhD in environmental health, and MPH in epidemiology degrees were from Saint Louis University in the USA. She earned her Professional Certificate in women's heath from Exeter University, UK. She participated in the Risk Communication Challenges workshop”, Harvard School of Public Health, Boston, Massachusetts, May 2003 and, attended “Evidence Based Public Health workshop”, CDC, March 2003.She received the award of the best poster for the 1st International Conference in Quality in Obstetrics, Lyon France, 2011. She authored and coauthored over 10 peer reviewed publications mainly on the subjects of Causes and recommendations of maternal mortality and morbidity in Egypt, preeclampsia, maternal obesity and contraception. She is an editor of the American journal of cancer prevention. She is involved in a number of research projects investigating the role of exercise in disease prevention (especially diabetes and obesity) and the assessment of the role of breakfast intake during pregnancy on the rate of post-partum obesity. Also, she participated in a research project of the lipid profile in obese women.
Abstract:
Introduction: Gestational weight gain(GWG) along with weight retention 1 year postpartum is associated with long-term obesity. Assessment of potential risky dietary behaviors might prevent weight retention and obesity.
Aim: To determine the effect of breakfast intake, beverages and snake among postpartum females attending family health centers in Alexandria on the body mass index at one year after delivery.
Methods: One hundred postpartum cases with BMI>25 at one year after delivery were matched with one hundred normal weight control mothers for age between January and December 2014. All study participants were interviewed and dietary behavior was assessed using the Snack and Beverage Food Frequency Questionnaire (SBFFQ).Seven days recall of breakfast and snack intake was done. Mothers’ intake of certain sweet and salty items during the prior seven days was assessed by asking how many days, how many times per day, and how much of the item the mother consumes. Finally, the intake was converted into the total calories consumed for each individual item and was summed to obtain the total daily caloric intake.
Results : Almost half (51%) of overweight and obese mothers ate breakfast six to seven days per week compared to almost one two third( 68% )of the females with normal BMI . GWG was between 8-16 kg in the cases while the range in the normal weight mothers was between 9-14 kg. Women with BMI>25 consumed 937 higher calories per week from salty snake and sweetened drinks, and a lower BMI compared to normal weight mothers (p<0.05). The mean caloric intake in overweight and obese mothers per day was2367.25 ± 572.91 compared to 1430.63 ± 333.23 in females with normal body weight (p<0.05).
Conclusion: More effort is needed to motivate regular breakfast intake and dietary behavior modification among postpartum mothers.
- Diabetes and Endocrinology
Session Introduction
Cintia do Couto Mascarenhas
Catholic University, Brasilia
Title: Pre, during and post colorectal cancer (CRC) screening age and differences in pathology and mutational status among patients
Biography:
Cintia do Couto Mascarenhas has completed her PhD at the age of 29 years from Faculty of Medicine - University of Campinas and postdoctoral studies from Catholic University of Brasília. She was a coordenator of clinical research center at Hematology and Hemoterapy Center at UNICAMP. She was a professor at Catholic University of Brasília since 2013 until 2019 july. Currently she is a CEO of 1Health Services a early startup, Ad hoc at Department of Science and Technology of the Brazilian Ministry of Health and also making her second undergraduate in Medicine.
Abstract:
Even though the screening protocols are eficient and widely recommended in reducing mortality for colon-rectum cancer the populations from different age groups can have distinct pathological and molecular profiles what can influence by screening and polyp resection, especially in older ages. A retrospective analysis was performed in tumors from stage IV CRC patients from a central pathology laboratory in Brazil that is a reference for mutational profiling countrywide. The study population was classified as pre-screening (PrSA; <45yo), screening(SA; 45-75yo) and post-screening age (PoSA; >75yo). Every tumor has been centrally reviewed by the pathologist. Groups were compared regarding clinicopathologic features and presence of RAS and BRAF mutations. Was included 1244 pts (164 PrSA, 919 SA and 161 PoSA) and have no significant difference among groups regarding sidedness (p= 0.68) and KRAS mutations (p=.0.97). Stage IV at diagnose (p =.001), presence of signet-ring cell component (p< .001) along with poorly differentiated tumors (p= .006) were most found on young patients, while BRAF and NRAS mutations where significantly more common among PosSA (table). PosSA and PreSA CRCs seem to present a distinct profile from SA populations, including molecular and pathologic differences what can impact the frequency of screening tests among different age groups.
- Diabetes and types of Diabetes
Session Introduction
Angelique Dukunde
University of Rwanda, Rwanda
Title: Prediction of Prevalence of type 2 Diabetes in Rwanda using the Metropolis-Hasting Sampling.
Biography:
Abstract:
The most common known Non-communicable diseases (NCDs) are cardiovascular disease, cancer, diabetes and chronic respiratory diseases. World Health Organization had reported that 63% of total deaths, were due to NCDs, where diabetes count 3.5% and (2%) in 2008 and 2010 respectively [8]. Non-communicable diseases account for 36 percent of deaths in Rwanda, of which diabetes accounts 2%, in 2013 (, 2013). Researchers have worked on this problem using several approaches but in Rwanda the models to predict the future dynamics of diabetes do not exist yet. In this work, we predict the prevalence of type 2 diabetes among adult people. Metropolis-Hasting method was used to calculate the metropolis ratio. Data reported by World Health Organization in 2015 was used. Considering Suffering from diabetes, Overweight, Obesity, Dead and other subject as states of mathematical model, the transition matrix whose elements are probabilities is generated using Metropolis-Hasting sampling. The numerical results show that the prevalence of type 2 diabetes increases from 2.8% in 2015, 12.65% in 2020 to 22.59% in 2025. Therefore, this indicates the urgent need of prevention by Rwandan health decision makers who have to play their crucial role in encouraging physical activity, regular checkups and sensitization of the masses.
- Diabetic Neuropathy
Session Introduction
Catherine Maurice
University of Toronto, Canada
Title: Nutrition: The Impact on Brain and Cancer
Biography:
Catherine Maurice completed her residency training in Neurology at the University of Montreal in 2013. She then started a 2-year fellowship in neuro-oncology at the Pencer Brain Tumor Centre of Princess Margaret Hospital, Toronto, under the supervision of Dr Warren P. Mason. In 2015, University of Toronto Health Network recruited Dr. Catherine Maurice to work as an attending physician and clinical teacher. She developed a new neuro-oncology clinic focusing on the to assessment of neurologic complications resulting from systemic cancers and novel therapies. She also manages another clinic focused on primary brain tumors and is enrolled in the multidisciplinary Gamma-Knife Clinic of the Krembil Neuroscience Centre. Dr. Maurice is actively involved in teaching, trying to incorporate new technologies and virtual reality into medical education.
Abstract:
It is estimated that thirty to forty percent of all cancers can be prevented by lifestyle and dietary measures alone. The main goal is to potentially interfere with the development of precancerous tumors. Even healthy people have a certain number of latent cancerous cells in their tissues. Spontaneous formation of small tumors happens frequently over a lifetime. However, the growth process is interrupted by our defense mechanisms. Those tumors remain microscopic and harmless, until they vanish. Free radicals, environment or diet-associated chemicals can severely damage DNA, leading ultimately to cancer. Certain fruits and vegetables can neutralize carcinogens, increase their excretion and inhibit tumorigenesis. Food also plays a crucial role on the development and maintenance of the central and peripheral nervous system. This presentation aims to identify key concepts and interesting historical facts related to the impact of food in the field of Neuro-Oncology.
Michael Retsky
Harvard T H Chan School of Public Health, USA
Title: Method to prevent early relapses in cancer
Biography:
Michael Retsky has completed his PhD in Experimental Physics from University of Chicago 1974. He is currently working as a Staff at Harvard TH Chan School of Public Health. He has 3 patents pending on methods to prevent late relapses. His over 100 papers in Physics and Oncology have been cited over 2500 times.
Abstract:
Most current cancer research aims to prevent cancer patients from dying from metastatic disease. To solve the problem upstream, i.e., to prevent relapses, with the unexpected observation of bimodal relapse patterns in breast and a number of other cancers. This was not consistent with the current cancer paradigm that has guided early detection and therapy for many years. Our multidisciplinary colleagues include surgeons, medical oncologists, anesthesiologists, biologists and physicists.
After much analysis including computer simulation and input from these medical and scientific specialists, we eventually came to the conclusion that surgery to remove the primary tumor produces systemic inflammation for about one week after the surgery. This systemic inflammation caused dormant single malignant cells and avascular micrometastases to exit from dormancy and result in relapses in the 3 years after surgery. Those relapses comprised the early peak. We have determined that in breast cancer 50 to 80% of relapses (increasing with tumor size and positive nodes) are in the early peak so an effective method to prevent these relapses would be extremely important. It was then determined in a retrospective study that the common inexpensive perioperative NSAID ketorolac can prevent the early relapses. A second retrospective study strongly confirmed this result but a small prospective study found no advantage. The Pangrahy, ovarian and colon papers are very recent and not mentioned in the video to be presented at this conference.
- Gestational Diabetes (GDM)