Annual Congress & Medicare Expo on Primary Healthcare April 25-27, 2016 Dubai,UAE

Sadia Munir has completed her PhD in 2008 from York University, Toronto, Canada. She completed her Post-doctoral studies from the Department of Kinesiology at York University. She is working as a Teacher, teaching nursing students at the University of Calgary in Qatar, Doha since 2012. Her research interests is in biomedical sciences focusing on epidemiology of gestational diabetes and preeclampsia. She is taugt human anatomy and physiology and statistics for several years. She has mentored undergraduate and graduate students in their research. She is also a member of World Academy of Science, Engineering and Technology. She has presented in several national and international conferences.

Gestational diabetes mellitus (GDM) is one of the most common complications of the pregnancy and affects 15% of pregnant women worldwide. Prevalence of GDM has increased from 10-100% in several race/ethnic groups over the last 20 years, reflecting the underlying increase in type 2 diabetes. Five of the top 10 countries for diabetes prevalence in 2010 were in the Gulf region. There were 303,700 known cases of diabetes in Qatar in 2014 and the number is growing each year. Children of women with GDM have an increased risk of development of cardiovascular and metabolic diseases which include obesity, type 2 diabetes and metabolic syndrome. GDM also increases the risk of development of neurologic dysfunction in offspring born to women with GDM in their childhood or adulthood. Children of women with GDM are more likely to be obese and diabetic in childhood and adulthood. GDM also increases the risk of adverse pregnancy outcomes, including preeclampsia, birth injuries, macrosomia and neonatal hypoglycemia, respiratory distress syndrome, neonatal cardiac dysfunction and stillbirth. The human placenta is located at the interface between mother and fetal blood circulation and has a central role both as a producer as well as a target of several molecules that are involved in placental development and function. We have investigated the role of cytokines and growth factors in the pathophysiology of placenta in the GDM. We have performed a Pubmed search with key words placenta, GDM, placental villi, vascularization, cytokines, growth factors, inflammation, hypoxia, oxidative stress and pathophysiology. We have investigated differences in the development and vascularization of placenta, their underlying causes and impact on feto-maternal health through literature review. We have also identified gaps in the literature and researched questions that need to be answered to completely understand the central role of placenta in the GDM. This study is important in understanding the pathophysiology of placenta due to changes in the location and expression of cytokines and growth factors in the placental cells of women suffering from GDM. It is necessary to understand these mechanisms in order to develop treatments to reverse the effects of cytokines and growth factors on placental malfunctioning, which in turn, will result in improved mother and child health.

Marina Polić-Vižintin completed her graduation from the School of Medicine, University of Zagreb in 1982 and PhD thesis defended in 2015, at the same School of Medicine. She passed a specialist exam in Social Medicine in 1989. She is currently working at Dr Andrija Štampar Teaching Institute of Public Health. She did her Post-graduate study in Gerontology and in Public Health. She is also a Senior Lecturer at the University of Applied Health Studies in Zagreb, subject Public Health. She participated in a number of research projects and took active part in many congresses and seminars in Croatia and abroad. She has published numerous professional and scientific papers in Croatian and international periodicals.

Rational drug utilization is an important segment of every national health policy. The aim was to determine distribution and trends in the outpatient utilization of generic versus brand name psychopharmaceuticals and to evaluate the rationality of prescribing psychopharmaceuticals during a ten-year period. Using the World Health Organization Anatomical-Therapeutic-Chemical classification/Defined Daily Doses (ATC/DDD) methodology, the number of DDD was calculated from data collected from all Zagreb pharmacies on the number and size of drug packages, during the 2001-2010 period. The ratio of generic and brand name drug costs served as an indicator on assessing the rationality of drug utilization. Total cost for psycho pharmaceuticals increased by 20.1%, more for brand name than for generic agents (32.7% vs. 7.4%). The highest share of generic psychopharmaceuticals as compared with brand name drugs according to DDD per 1000 inhabitants per day (DDD/1000/day) was in the group of psycholeptics (83.6% in 2001 vs. 82.2% in 2010), most in hypnotics and sedatives, and least in antipsychotics. The share of generic psychopharmaceuticals in total drug utilization according to DDD/1000/day was decreased by 12%. The greatest decrease was in antidepressants, i.e., by 46% according to DDD/1000/day; and in antipsychotics by 30.9%. In the therapeutic subgroup of mood stabilizers, the share of generic drugs in total drug utilization declined by 32% according to DDD/1000/day. There is a potential to achieve some savings with generic psychopharmaceuticals. Combining the initiatives to lower the price of generics with demand-side measures to enhance their prescribing is important to maximize prescribing efficiency.

Salisu Abdullahi Sani, 26 year student of pharmacy from SHIATS Deemed University Allahabad UP India. He publishes more than six papers both national and international conferences. and he's one of the hundred student out of the thousand which select from the Kano state of Nigeria to study pharmacy in difference university in the world under the leadership the his excellency Gov. Rabiu Musa Kwankwaso (baba).

Zika is a viral infection that is spread by the bite of an infected mosquito. Zika virus is a member of the virus family Flaviviridae and the genus Flavivirus, transmitted by day mosquitoes, such as A. aegypti and A. albopictus. The infection, known as Zika fever, often causes no or only mild symptoms. Since the 1950s it has been known to occur within a narrow equatorial belt from Africa to Asia. In 2014, the virus spread eastward across the Pacific Ocean to French Polynesia, then to Easter Island and in 2015 to Mexico, Central America, the Caribbean, and South America, where the Zika outbreak has reached pandemic levels. Zika virus is related to dengue, yellow fever, Japanese encephalitis, and West Nile viruses.The illness it causes is similar to a mild form of dengue fever,is treated by rest, and cannot yet be prevented by drugs or vaccines. There is a possible link between Zika fever and microcephaly in newborn babies by mother-to-child transmission, as well as a stronger one with neurologic conditions in infected adults, including cases of Guillain–Barré syndrome. Who gets Zika? Anyone who gets bitten by an infected mosquito can become infected with Zika. How do people get Zika? Pika is transmitted to people through the bite of an infected Aedes mosquito. This is the same mosquito that transmit dengue and chikungunya. What are the Symptoms of zika? About one in five people develop symptoms and infection is usually mild. The most common symptoms are fever, rash, joint pain or red eyes. other common symptoms include muscle pain and headache . Symptoms usually begin 3-12 days after being bitten by an infected mosquito and last several days to a week. Hospitalisation and death from zika are rare. What are difference between zika, and dengue and chikungunya? All these viruses cause similar symptoms, but certain symptoms suggest one disease or another. Most zika patients have skin rashes; most dengue patients have a higher fever and more severe muscle pain; most chikungunya patients have a higher fever and more intense joint pain in the hands, feet,and back. What is the treatment for zika? There is no specific treatment for zika. Symptoms are treated by getting rest, drinking fluids to prevent dehydration and taking medicines such as acetaminophen or paracetamol to relieve fever and pain. Aspirin and other non-steroidal anti-inflammatory drugs (NSAID), like ibuprofen and naproxen,should be avoided until dengue can be ruled out to reduce the risk of increased bleeding. Can people with zika pass the illness to other? Zika need a vector (a means of transportation) to infect people; generally, that vector is the mosquito. However, zika virus has been found in semen and person-to-person sexual transmission has been documented, although this uncommon. if you have zika , avoid mosquito bites for the first week of your illness. During the first week of infection, zika virus can be found in the blood and passed from an infected person to another mosquito through mosquito bites. An infected mosquito can then spread the virus to other people. How can Zika be prevented? No vaccine or preventive drug is available at this time. The best way to prevent Zika is to avoid mosquito bites when traveling to an area where Zika is present. 1. Use insect repellent. Repellents containing DEET, picaridin IR3535 and oil of lemon eucalyptus PMD provide long lasting protection against mosquitoes that may transmit virus such as Zika, dengue and chikungunya. 2. When indoors, use air conditioning, window screens or insecticide-treated mosquito netting to keep mosquitoes out of the home. 3. Reduce the number of mosquitoes outside the home or hotel room by emptying or routinely changing standing water from containers such as flowerpots, pet dishes and bird baths. 4. Weather permitting, wear long sleeves and pants when outdoors. For information on how best to be protected against all diseases related to travel, visit- ing a clinician with expertise in travel medicine is recommended before a planned trip. 5. Consider postponing travel to any area where Zika virus transmission is ongoing. 6. If you must travel to one of these areas, talk to your doctor first and strictly follow steps to prevent mosquito bites during your trip. Women who are trying to become pregnant: What is the risk of Zika in pregnancy? Zika can be spread from a pregnant woman to her unborn baby. There have been reports of a serious birth defect of the brain called microcephaly and other poor pregnancy outcomes in babies of mothers who were infected with Zika while pregnant. Until more is known about the link between Zika and these outcomes, CDC recommends the following special precautions: Women who are pregnant (in any trimester): 1.consider postponing travel to any area where zika virus transmission is ongoing. 2. If you most travel to one of these areas, talk to your doctor first and strictly follow steps to prevent mosquito bite during your trip. Woman who are trying to become pregnant: 1.Before you travel, talk to your doctor about your plans to become pregnant and the risk of zika virus infection. 2. Strictly follow steps to prevent mosquito bite during your trip.

Samy Abdel Samad Nasef is the Dean of Faculty of Physical Therapy, Pharos University, Alexandria. He is a PhD holder (1993) (channel emission between Cairo University and Indian University, USA). He is the Associate Editor of the Journal of Advanced Research, Cairo University and has published more than 30 papers in conferences and Journal of Physical Therapy, Cairo University.

Purpose: This study was conducted to determine the efficacy of aerobic exercises using treadmill with diet modifications in reducing hot flushes in post-menopausal women. Subjects: Thirty post-menopausal women complaining from hot flushes were chosen from out-patient clinic of Gynecology and Obstetrics Department, at El-Shatby Hospital, Alexandria. Their age ranged from 48-55 years old and their body mass index ranged from 30-32 kg/m2 all of them were at least 2 years post-menopausal. They were divided randomly into two equal groups. Group (A) (study group): 15 women who received treadmill exercise program for 30 minutes at 60% to 70% of maximum heart rate, 3 times per week for 12 weeks. In addition to daily intake of diet, modification contains soy products (phytoestrogen) 100 milliliter soy milk and 100 gram soy bean daily for 12 week. Group (B) (control group): 15 women who received diet modification contain soy products (phytoestrogen) 100 milliliter soy milk and 100 gram soy bean daily for 12 week. Measurements: All participants were assessed before and after the treatment program through using diary card for hot flushes to detect its severity. Hormonal analysis of FSH and LH for both groups was carried. Results: The results revealed that the severity of hot flushes at the end of study post 12 weeks for group (A) were significantly lowered than group (B) also, FSH and LH showed a statistical significant reduction in group (A) than group (B) Conclusion: Regular physical activity with diet modifications appears to be effective, safe and successful alternative method to decrease hot flushes that occur during post-menopausal period.

Khalid Faisal Al Ghadam is a senior medical student at Al Imam Mohammed Ibn Saud Islamic University. He is interested in medical research. He has attended a biomedical research course at Florida International University and conducted a research there. He also participated in 2 more researches, one was conducted at the University of Arizona and the other was at Al Imam Mohammed Ibn Saud Islamic University.

In this project we sat out to determine the effect of Dasatinib on the JNK KO MEFs metabolism (ATP levels, oxygen consumption rate (OCR) and toxicity. Unfortunately we didn’t see adverse effects until we increased the drug dosage 10 times the normal. We observed the levels of ATP, OCR and the live cells drop after applying the drug. We also observed the effect of the Dasatinib on the JNK KO’s mitochondria and the results showed that mitochondria become more filamentous upon the fluorescent stain.

Rosa Gimenez-Garcia is working as a Clinical Assistant in Hospital Universitario Rio Hortega, Valladolid, Spain and Associate Professor in the Faculty of Medicine in Valladolid Spain. She has completed her residency during 1981-1985 at Hospital Clinico Universitario de Valladolid. He worked as Consultant Dermatologist in Hospital Clinico Valladolid and its area of health from May 1985-November 1987. He obtained the Post of Clinical Assistant at Hospital Virgen Blanca" de León and at "Hospital Rio Hortega" Valladolid from 06-11-90 to present.

Background: Cutaneous odontogenic fistulas or sinus tracts are frequently misdiagnosed and incorrectly treated, leading to unnecessary procedures and patient suffering. An understanding of the draining cutaneous sinus tracts will lead to a more appropriate treatment. Most cases will respond to conservative, non-surgical root canal therapy. Objective: To report a case of cutaneous sinus tract secondary to chronic periapical dental infection which has been recently observed at our hospital? Case report: We present a case of recurrent suppurative facial lesions that were initially misdiagnosed and treated with oral antibiotics without response. Clinical findings: palpable facial nodules with drainage, palpable intraoral cords, and a poor dentition with gingivitis as well as radiologic examination showing a periapical disease process were consistent with dental sinus tracts. He was referred to maxilla facial department where extraction of the cyst and non-restorable teeth were performed. After appropriate dental therapy, the sinus tract resolved within a few weeks. Discussion: The most common cause of draining cutaneous sinus tracts on the face is a chronic peri-radicular abscess. Cutaneous lesions may appear early or up to 30 years after a primary dental problem has occurred. Cutaneous odontogenic sinus is an uncommon disease and may be easily misdiagnosed. An injury or disease of the tooth may result in degeneration of the pulp and periapical abscess. Only half patients have registered a history of toothache. The majority of dental sinus tracts develop intraorally. When an extra oral odontogenic sinus tract occurs, it most often develops in close proximity to the offending tooth. Patients often seek treatment from a physician and referred with chronic suppurative lesions that resemble a cyst, furuncle or ulcer. Diagnosis is established by tracing the sinus, dental examination and radiologic evaluation. Most cases will respond to conservative, non-surgical root canal therapy. Endodontic treatment is recommended. Conclusions: As patients with cutaneous facial sinus tracts of dental origin often do not have obvious dental symptoms, a possible dental etiology may be overlooked. If dental origin is suspected, the diagnosis is easily confirmed by dental examination and dental roentgenograms of the involved area. Early correct diagnosis, based on radiologic evidence of a periapical root infection and treatment of these lesions can help prevent unnecessary and ineffective antibiotic therapy or surgical treatment, reducing the possibility of further complications such as sepsis and osteomyelitis.

Muath Alsaidan has received a Bachelor of Medicine, Bachelor of Surgery (MBBS) degree from Imam Mohammed bin Saud Islamic University Riyadh, Saudi Arabia in 2015. He is a Medical Intern. He has represented his college in national and International conferences with medical research papers. This is his first published paper.

Background: Patients satisfaction is increasingly being recognized as a central element in monitoring quality of health care services; the assessment of which may offer ways of optimizing health care delivery and preventing waste of medical resources. This study was designed to assess satisfaction and its determinants among patients attending governmental primary health care clinics. Methods: This was a cross-sectional study of a representative sample of patients attending two governmental clinics in Riyadh, Saudi Arabia. Data was collected via a self-administered questionnaire and stratified random sampling with equal allocation was adopted to select a significant number of patients of equal gender representation. Results: A total of 200 patients participated in the study, 71% were 21-40 years old with equal gender distribution, 77% were Saudis and 72.5% were satisfied with the services provided. The only factor that had a significant impact on overall satisfaction was the waiting time between registration and consultation, with those waiting over 30 minutes more often reporting to be dissatisfied with the service provided. (p=0.002). Conclusion: Overall, participants were satisfied with the services they received. However, those who had longer waiting time between registration and consultation showed higher rate of dissatisfaction.

Mehul Derick Lal is pursuing his GNM (General Nursing and Midwifery) from Christian College of Nursing, Faculty of Health Sciences, SHIATS Allahabad, U.P, India. He has participated in various health camps and various health care activities in the community.

MERS-CoV is a new novel coronavirus that caused severe acute respiratory infection, first identified in Saudi Arabia in September 2012. Current incidence rate reports 1625 infected, 585 died and 36% case fatality rate worldwide. MERS-CoV is a type of coronavirus, similar to the one that caused SARS (severe acute respiratory syndrome). It has been detected in camel meat, organs, milk and urine. Initially, the illness resembles influenza with fever and a mild cough followed by breathing disorder often progresses to severe dyspnoea and hypoxia. MERS can be detected in any age group. Elderly people and people underlying medical conditions such as diabetes, heart diseases and liver diseases are at risk of severe infection. The progression may be rapid, or may take several days. Severely affected people develop a potentially fatal form of respiratory failure, known as adult respiratory distress syndrome (ARDS). In addition to attacking the alveoli in the lungs it also causes kidney failure, pericarditis and disseminated intravascular coagulation. Although most cases of MERS have occurred in Saudi Arabia and UAE, cases have been reported in Europe, USA and Asian people who travelled from Middle East or their contacts. Recent travellers returning from the Arabian Peninsula and neighbouring countries should be tested for MERS-CoV. MERS-CoV is detected using a reverse transcriptase polymerase chain reaction (PCR) test. Frequent hand hygiene using soap and water, an alcohol-based hand sanitizer, avoidance of close contact with sick people and avoidance of touching one's eyes, nose and mouth can prevent the spread of viruses. No vaccine is commercially available till date.

Gulnaz Karatay is an associate professor in Public Health Nursing, in the Tunceli University Health High School in Turkey. I completed my master and doctorate program Hacettepe University Faculty of Health Science in Ankara, Turkey. My academic background and work experience as a Nurse-Researcher has enabled me to develop a range of skills. Accordingly I have been in Prato Hospital in Italy-Florence for 3 months and US-Wisconsin Madison University for 3 months. My research focuses on motivational interviewing for smoking cessation, improving congnitive function of the elderly, prevention of substance use in adolescent period and women health.

Objective: The aim of this study was to evaluate the practice, knowledge and attitudes of mothers with children under-5 age at fever management. Material & Methods: This descriptive study was performed in a state hospital in Eastern Turkey between September-February 2016. The sample consisted of 180 mothers with under-5 age children who admitted the child clinics with any reason and accepted participate the study. Data were collected with a questionnaire prepared by researcher. The questionnaire was applied face to face interviewing techniques and was taken about 10-15 minutes. Data were analyzed in computer based SPSS program by using numbers, percentiles and chi-square tests. Results: In the study, the average age of mothers’ was 30.03±5.25 and 42.8%of them had high school graduates, 86.7% of them had the nuclear family type, 85.0% of them had social security and 70.6% of them assessed income status as middle. The average age of children was 3.12±1.41. The mothers stated that 88.3% of children had fewer problems at least once in last year. Also 87.2%of mothers stated that they have special thermometer for their children at home, 96.7% of them stated that they can measure the fever of children with thermometer and 70.7% of them stated that “fever is 38 degrees or above of body temperature”. There were statistically significant difference between mothers' employment status, family type, social security, family income and to keep a thermometer at home (p<0.05). Also, there were statistically significant difference between mother’s education, having social security and the ability to measure of children body temperature (p<0.05). Conclusions: According to the findings, it was seen that the mothers with low education and income levels haven’t got adequate knowledge and appropriate approach about fever management in home condition.

Majeedah Alotaibi has Graduated from king Saud university (Saudi Arabia) –collage of medicine and surgery on 2014, she is now ophthalmolgy resident on King Saud medical

Background: Childhood and adolescent overweight and obesity undertaking at primary health care (PHC) level was assessed by studying knowledge, attitudes and practices (KAP) of physicians as first line of control. Methods: A survey of PHC physicians working at eight major hospitals in Riyadh was done in 2011 on management of childhood and adolescence overweight and obesity. Physicians who always recommended and involved patient, parents, and others, for weight management, when encountering overweight or obese children and/or adolescence during the past one year were defined to have appropriate KAP. Questionnaires were distributed through administrative staff and were collected after one week from each hospital keeping the confidentiality of respondents. Results: Of the 58 physicians who responded; 35 were males; 50% had more than 10 years of working experience for 10-40 hours per week, and 51.7% had appropriate KAP. Physicians in appropriate KAP group (52.6%) differed from other physicians by; being a female (p<0.016), attending workshops, seminars, and continued medical education sessions (p<0.026), referring patients to pediatric obesity specialist (p<0.041), reported lack of clinician time (p<0.055), did not lack clinical knowledge about overweight/obesity (p<0.039), were not of opinion that recommendations for managing overweight/obesity were ineffective (p<0.017), had concerns for precipitating eating disorders (p<0.019), did not feel uncomfortable when examining an obese patient (p<0.02), and always considered patient’s readiness to make a weight change (p< 0.007). Conclusion: PHC level desires enhanced KAP to deal with overweight and obese children and adolescence to check the increasing risk factors for chronic diseases in Saudi population