Day 2 :
Keynote Forum
Tochi Iroku-Malize
Hofstra Northwell Health School of Medicine, USA
Keynote: Utilizing simulation and gaming to teach primary care providers to prepare for a global health issue
Time : 09:00-09:25
Biography:
Tochi Iroku-Malize is a Professor and Chair of Family Medicine at Northwell Health (formerly North Shore LIJ Health System). She received her medical training at the University of Nigeria, did her internship in Trinidad & Tobago, completed her Master’s in Public Health at Columbia University and her Master’s in Business Administration at the University of Massachusetts. She is board certified in both Family Medicine and Hospice & Palliative Care. She has developed a curriculum for global health and has been involved in Academic Medicine and Primary Care for two decades. She has presented and published on multiple topics internationally.
Abstract:
Recently, those in various health care settings have had to develop educational opportunities to update health care workers on the guidelines to follow, when faced with a potential patient who may have Ebola Virus Disease (EVD) and hence is classified as a person under investigation (PUI). Having familiarity with curriculum development, an obvious method of providing education in an interactive format presented itself to me. Creating case based scenarios with audience participation to review guidelines. The addition of audience practice in donning and doffing personal protective equipment (PPE) would help reinforce the information. An ideal session would have all of the participants gathered at a venue and the start of the session is an overview of what EVD is as well as the current data regarding its spread and current global guidelines for managing the illness. You would then participate in several different scenarios which would be played out as cases in which the participants are asked to answer how they would manage the situation. The correct information is provided per current guidelines. A quick review of current institutional policies as well as international policies is completed and you move onto the next case. During the session, participants will actually engage in filling out paperwork, donning and doffing PPE, answering patient and family member questions, etc. Having an interactive educational session, allows for better assimilation of information.
Keynote Forum
Nick Richards
SEHA Dialysis Services, Abu Dhabi
Keynote: Primary care based automated detection and algorithm driven online decision support improves outcomes for patients with chronic kidney disease
Time : 09:25-09:50
Biography:
Dr Richards qualified in medicine at St Bartholomew’s Hospital London in 1981; he undertook a period of research looking at the effects of cyclosporine-A on endothelial function at St Thomas’ Hospital London prior to being appointed as Consultant Physician and Nephrologist at The Queen Elizabeth Hospital in Birmingham in 1992. During his time in Birmingham he was actively involved in the development of an electronic patient record with associated drug prescribing system. He went into medical management as Clinical Director, Divisional Director and finally Director of Operations in Birmingham before leaving the NHS and taking up the position of Medical Director for the UK and Ireland for Fresenius Medical Care in 2004. He moved to his current position as the CEO and CMO of SEHA Dialysis Services in 2012. He remains actively interested in clinical research particularly in relation to epidemiology and prevention of chronic kidney disease. He has published more than 50 papers in peer reviewed journals.
Abstract:
Historically, more than 95% of patients presenting for dialysis in Abu Dhabi do so as an emergency. This is far higher than would be seen in Western Europe where the figure is 15-30%. Late presentation is associated with poorer outcomes and worse rehabilitation than in those patients who present early and are followed prior to commencing dialysis. In addition, importantly, late presentation does not allow for the implementation of preventative strategies which may postpone or even avert the need for dialysis in upwards of 80% of patients. This is of major benefit to the patients themselves but in addition represents a significant financial saving to the health economy. The SEHA health system in Abu Dhabi has a single unifying electronic patient record (Malaffi). This is an extremely powerful tool. In 2012, we examined the renal function of all patients seen in the Emirate which allowed us to describe the epidemiology of chronic kidney disease and to look at the time taken from identification within primary care to presentation at a secondary care clinic. This analysis demonstrated that at all age groups the prevalence of CKD was higher in the local population when compared to a Western population with a significantly older age profile. In addition, the time taken from identification to presentation to a nephrologist was excessive at all stage of CKD. To address these issues an algorithm was introduced into Malaffi which automatically calculates an estimate of kidney function (eGFR) and in addition offers online, live, decision support concerning patient management, in particular medication and indications for referral. Patients are risk stratified for the likelihood of progression on the basis of their level of kidney function and the amount of protein in their urine. In addition a team of renal nurses was placed within primary care to act as an education resource for both patients and primary care staff and to ensure that patients navigated their way through the system in a timely manner. In the 16 months to May of 2015 we have identified 53,000 patients from primary care 20,000 of which with an eGFR and a urine protein estimation, 25% of which are at high risk of progressive decline in their renal function. Since introduction of the programme, we have demonstrated that treatment with an angiotensin converting enzyme inhibitor is associated with a 35% reduction in the likelihood of progression whilst treatment with certain types of Non-Steroidal Anti-Inflammatory Drug (NSAID) is associated with a 63% greater risk of progression. The introduction of the programme has seen a reduction in the use of NSAIDs in primary care of some 30% from peak. This programme demonstrated the power of the unified electronic patient record and its ability to assist in the management of chronic disease within primary care.
Keynote Forum
Fahad Alkherayf
University of Ottawa, Canada
Keynote: Association between cigarette smoking and low back pain in adult population
Time : 09:50-10:15
Biography:
Fahad Alkherayf is an Associate Professor and a neurosurgeon at University of Ottawa. He is also a neuroscientist at the Ottawa Hospital Research Institute (OHRI) with a cross appointment to the Clinical Epidemiology Program. He also directs the clinical research at the Division of Neurosurgery at the Ottawa Hospital. Additionally he directs the Spine Fellowship Program at University of Ottawa. After graduating from medical school he completed his neurosurgery training at University of Ottawa in 2010. He also completed two fellowships in complex spine surgery and minimally invasive skull base surgery. Additionally he obtained training in clinical epidemiology and biostatistics (MSc, Epidemiology and Biostatistics 2011) and he has completed the clinician investigator program by the Royall College of Physician and Surgeons of Canada (RCPSC). His clinical practice focus on complex spine surgery, minimally invasive cranial surgery and complex cranio-cervical reconstruction. His clinical research interests lie in translational primary brain tumor research, clinical trials, and spinal cord injury. He has authored and co-authored many research papers and abstracts, and spoken at many international conferences. He has been serving as an Editorial Board Member of many journals.
Abstract:
Low back pain (LBP) is a very common problem with up to two-thirds of adults suffering from LBP at some time in their lives. Each year between 2% to 5% of the population seek medical attention for LBP. Reported risk factors for chronic LBP include: age, sex, genetics, education level, activities, socioeconomic status, lifestyle and smoking. Unfortunately, most of those factors are unable to be modified. Nevertheless, lifestyle factors such as smoking can be modified with effective interventions. We examined the association between smoking and risk of chronic LBP among adults (20 to 59 years). We took in consideration the most likely covariates (age, sex, BMI, physical activity and education). To the authors’ knowledge, this is the first study to assess the relationship between chronic LBP and smoking exposure among adults, based on a large sample size. Our study included 78,239 participants. Back pain status, smoking level, age, gender, height, weight, level of activity and level of education were identified as well. Back pain secondary to fibromyalgia or rheumatic disease was excluded. Stratified analysis and Logistic regression analysis were used to detect effect modification and to adjust for covariates. Population weight and design effects associate with complex survey design were taken into consideration. The prevalence of chronic LBP was 20.8%. Male to female ratio was 1: 1.15. About 51% were current or former daily smoker. About 21% are classified as obese, using WHO classification. The adjusted odds ratio for former or present daily smokers was 1.57 with 95% confidence interval (1.52,1.63) and P value of <0.001 while for former or present occasional smokers was 1.1 with 95% confidence interval (1.04,1.16) and P value of < 0.001. Smoking effect seems to have a dose response, where occasional smokers have higher risk than non smoker but less than daily smokers.
- Track 5: Primary Care Services
Track 6: Primary Care Pediatrics
Location: The Oberoi Dubai, Dubai
Chair
Tochi Iroku-Malize
Hofstra Northwell Health School of Medicine, USA
Co-Chair
Brian Littlechild
University of Hertfordshire, UK
Session Introduction
Kaye Ervin
The University of Melbourne, Australia
Title: Care giver distress in dementia in rural Victoria
Time : 10:15-10:35
Biography:
Kaye Ervin has been a registered nurse for over thirty years, practicing predominantly in rural Victoria. Her passion is aged care and the focus of her research interests for the past 6 years. She is a member of the rural health department, the University of Melbourne. She has published 20 papers in international peer reviewed journals and regularly presents her research at National and International forums.
Abstract:
Aim: The aim of this study was to explore the levels of stress, anxiety and depression of informal carers caring for someone with dementia in a rural setting. The study also sought to determine carer’s primary source of stress and their use of dementia specific services. Methods: Carers of people with dementia were recruited to complete a survey that incorporated the Depression, Anxiety Stress Scales (DASS) to measure carer emotional well-being. The survey also included the Neuropsychiatric Inventory Questionnaire (NPI-Q), which assesses the presence and severity of behavioural and psychological symptoms of dementia (BPSD) of care recipients and their effect on the carer. They were also asked through an open ended question what they found most stressful in their caring role and what services they utilised. Results: A total of 39 carers completed surveys. Almost half of the respondents reported levels of stress and depression in the moderate to severe range as measured on the DASS. BPSD exhibited by care recipients, such as agitation, anxiety, aggression and nocturnal disturbance, showed a relationship to the level of stress reported by the carer as measured with the NPI-Q. Despite 84.6% reporting use of the Aged Care Assessment Service and 61.5% reporting provision of printed information on the services available, less than half of the carers utilised commonly available support services. Only 46.2% received financial compensation for their carer role. The predominant source of stress reported was the unremitting burden experienced when caring for someone with dementia.
Mariely Lima
Escola Superior de Educacao de Paula Frassinetti, Portugal
Title: Dogs on the front line of care: Timely information for family physicians
Time : 10:35-10:55
Biography:
Mariely Lima completed her degree in Speech Therapy and PhD in Biomedical Sciences. She is an invited Professor at two Universities in Portugal, where she lectures Post-Graduate and Master’s courses and supervises academic research. She is a founding member of ÂNIMAS, a Portuguese association, accredited by the Assistance Dogs International, which implements dog-assisted interventions and educates assistance dogs. She has been responsible for a number of dog-assisted activities and therapy programs for individuals with different diagnoses. She has attended different conferences as an invited speaker and published a number of scientific papers in peer-reviewed journals with good impact factor.
Abstract:
Recent years have witnessed a surge of interest in the relationship between dogs and human health with a concurrent emergence of new and exciting ‘medical’ roles for these animals. Not only studies show that owning a pet dog can have prophylactic and therapeutic value, but that incorporating these animals into clinical practice, can have a number of benefits for different types of patients. Dogs can also fill the role of assistants for people with disabilities, bringing important physical, psychological and social positive effects for their handlers, and even be trained to alert to seizures in epileptic patients and to changes in blood sugar levels in diabetics. In light of this, a significant “push” is currently being made by a number of researchers to integrate dogs into mainstream healthcare, notably through family medicine. Data, however, suggest that family physicians do not explicitly enquire their patients about dog ownership and feel uncomfortable to discuss the benefits of acquiring assistance or alert dog, and recommend dog-assisted interventions. In this communication, a timely and comprehensive update on the scientifically stronger evidence supporting the positive effects of dogs for human health will be provided. With it, one aims at calling for the attention of family care practitioners on the clinical potential of pet dogs, namely as motivators for adherence to treatment plans and on the importance of ensuring their patients knowledge about the possibility of engaging in dog-assisted interventions and/or acquiring an assistance or alert dog.
Naser Salihu
University Clinical Center of Kosovo, Kosovo
Title: Unusual orbital trauma
Time : 11:10-11:30
Biography:
Naser Salihu finished his residency in Medical Faculty in Ljubljana. He has completed his PhD in Medical Faculty at University of Prishtina. His interests in ophthalmology are anterior segment surgery, oculoplastic surgery and ocular trauma. He has published a lot of papers in International Journals. He also is the president of Kosovo Association of Ophthalmologists and head of trauma department in Eye Clinic, University Clinical Center of Kosovo.
Abstract:
Every orbital trauma represents a serious condition, because in most of the cases is associated with face and head trauma. We represent an unusual case of 12 years old boy with multiple face trauma associated with bilateral globe avulsion and optic nerve transection. He was involved in a tractor accident while driving it. The first signs to be notice as a serious condition from the GP are bilateral globe luxation and acute loss of vision. In this situation we have to pay attention about these signs as they may be caused by fracture of midface and orbit. Because of the closely related anatomy between orbit and midface with brain and blood vessels, this kind of injury may be life threatening. This situation is an emergency which needs multidisciplinary approach. This case should raise awareness on preventing injuries caused by driving agriculture machines from children, especially in developing countries where these injuries are more often.
Belinda Pustina
University Clinical Center of Kosovo, Kosovo
Title: Life threatening eyelid infection after minor trauma
Time : 11:30-11:50
Biography:
Belinda Pustina was born in 1982 in Prishtina, Kosovo. She has started the residency in Ophthalmology in 2011 in University Clinical Center of Kosova, Eye Clinic and the PhD in Neuroscience in University Hospital Center of Tirana, Albania. During this time she participated in many trainings and congresses as active participant. She participated every year in training programs organized from ESCRS (European Society of Cataract and Refractive Surgery) and SOE (European Society of Ophthalmologists). She is now a national representative of Young Ophthalmologists in SOE (European Society of Ophthalmologists) and treasurer in KAO (Kosovo Association of Ophthalmologists). Interests in Ophthalmology are Cornea, Cataract and Refractive Surgery.
Abstract:
Eyelid infections usually are not an emergency in ophthalmology and this is the reason of misdiagnosing necrotizing fasciitis as one of the rarest disease after minor trauma of eyelids. Necrotizing fasciitis is a life threatening soft tissue infection characterized by necrosis of fascia and subcutaneous tissue. If diagnosis and treatment is delayed it can become fatal. It tends to occur in patients in which host defenses are compromised or in healthy individuals after trauma. In periorbital region is very rare because of the excellent blood supply in that area. We present a case of an old farmer female that had a minor trauma in her lower eyelid. First cutaneous anthrax of eyelids was considered in differential diagnosis, because of the contact of patient with animals. But, culture taken from the wound resulted positive for Streptococcus viridians. Treatment with Ceftriaxone + Penicillin was initiated immediately. Patient responded to intravenous antibiotics and after 2 days the edema began to regress. After 2 weeks patient was discharged from the hospital and the clinical outcome was good. Based in this case the treatment of early diagnosed and uncomplicated necrotizing fasciitis may be treated with conservative therapy only. Prompt diagnose from the GP and immediate start of the treatment may be lifesaving in this disease.
Kirti Katherine Kabeer
Apollo Specialty Hospital, India
Title: Post-traumatic long segment small bowel stricture – A diagnostic dilemma
Time : 11:50-12:10
Biography:
Kirti Katherine Kabeer has completed her MS in General Surgery from Mahatma Gandhi Medical College and Research Institute, Pondicherry, India and is currently working with Apollo Specialty Hospital, Chennai, India. This paper that we would like to present has already been accepted and published by the Journal of Surgical Science in 2014.
Abstract:
Delayed post-traumatic small bowel stricture is rare and differentiation from other more common causes of small intestinal stricture is difficult. Presentation may be delayed up to years after the injury. Very often the findings mimic those of other causes of long segment strictures such as Tuberculosis, Crohn's disease, lymphoma, etc. This study analyzes two cases of post-traumatic small bowel stricture, with different presentations and different therapeutic challenges. The literature on this condition is not well recognized and will be reviewed. Resection and reconstruction are diagnostic and therapeutic in patients who present with post-traumatic small bowel stricture, as inflammatory and neoplastic causes cannot be ruled out without histological diagnosis.
Samy Abd Elsamad Nasef
Pharos University, Alexandria,Egypt
Title: The effect of restricted diet with olive oil versus fish oil combined with endurance exercise on dyslipidemic females
Time : 12:10-12:30
Biography:
Samy Abd Elsamad 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 an 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.
Abstract:
Introduction: Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have a negative effect on health, leading to reduced life expectancy and/or increased health problems. Lifestyle behaviors, including diet and exercise, are the cornerstone of weight control. Purpose: To compare between the effect of restricted calorie diet containing olive oil or containing fish oil combined with endurance training exercise on lipid profile in obese female. Subjects: Sixty obese females aged 20-40 years are included in the present study. Their Body Mass Index (BMI) ranged from (30:34.99). They were randomly divided into three groups (A, B and C) each group included twenty subjects. Methods: Group (A) included those on restricted calorie diet (1200 cal/day daily) containing olive oil (40.5 ml/day three times a week) and a program of endurance training exercise (moderate intensity 3 times/week), group (B) included those on restricted calorie diet containing fish oil (in form of 204 gram mackerel fish to supply the patient with 3.6 gram omega-3/day three times a week ) and a program of endurance training exercise as group (A) and group (C) included those on restricted calorie diet and endurance training exercise only. The biochemical changes in serum total cholesterol (TC), Triglyceride (TG), Low Density Lipoproteins cholesterol (LDL-C) and High Density Lipoprotein cholesterol (HDL-C) were measured at the beginning of the study and after twelve weeks. Results: Results showed a significant improvement in both lipid profile and weight in the three groups. Dyslipidemic females showed significant improvement in lipid profile of restricted calorie diet combined with exercise more than exercise alone where there was a challenge between group A and Group B in all measured items. Weight was significantly reduced in all groups but group c demonstrated a greater reduction compared with other groups. Conclusion: Restricted calorie diet with olive oil and fish oil, combined with endurance exercise had shown significant improvement in the blood lipid profile and body weight in obese subjects.
Nezla Duric
Helse Fonna Hospital, Norway
Title: ADHD children and adolescents: Long-term randomized controlled study
Time : 12:30-12:50
Biography:
Duric N S is Child and Adolescent Psychiatrist and Clinical Researcher at Helse Fonna Hospital in Norway. She obtained her Medical degree from the University of Sarajevo in 1980 after which she pursued specializations in ear, nose and throat from the Clinical University Center of Sarajevo (1988) and child and adolescent psychiatry from Mental Health Clinic Kristiansand, Norway (2001). She completed her PhD from the University of Bergen. She has published many articles in prestigious journals and has served as a scientific reviewer of repute. She has a long engagement as a member and leader of charity work.
Abstract:
ADHD is one of the largest groups in psychiatric health care for children and adolescents in Norway. Early recognition and diagnosis, proper organization and appropriate treatment have a positive effect on the self-esteem and development of the child as well as probable socioeconomic benefits for society. The need for mental health support for ADHD children is one of the upcoming issues and needs to address whether the detection and treatment can be given to primary health care (PHC). Different treatment approaches aimed at improving ADHD core symptoms have been assessed. Despite the beneficial effects of most treatment approaches, existing problems with those that do not respond well to treatment or have adverse drug reactions, call for alternative or complementary treatments. A randomized controlled clinical study was performed to explore the ability of PHC to identify ADHD symptoms and to evaluate the use of short and long-term efficacy of standard stimulant medication and neurofeedback as the single and multimodal treatment to treat ADHD in children and adolescents. The high referral rate and low incidence of ADHD-diagnosed children and adolescents at the Child Adolescent Mental Health Clinic demonstrated a need to improve the understanding of ADHD in PHC. Pre-referral screenings and additional screening guidelines in the community and PHC environments is recommended. Findings provide new evidence for the long-term efficacy of multimodal treatment of stimulant medication and NF. However, more research is needed to explore if multimodal treatment is suitable for ADHD children and adolescents with insufficiently response to single MED treatment.
Maysoun Al Rushood
Kuwait University, Kuwait
Title: Anaphylaxis management: Knowledge and practice among pediatricians
Time : 12:50-13:10
Biography:
Maysoun Al Rushood is an Assistant Professor at the department of pediatrics in Kuwait University. After graduating from Kuwait Medical School, she joined the pediatric residency program in McGill University in Montreal, Canada. She did further training in the specialty of pediatric allergy and clinical immunology in McGill University, Canada. She has the following certificates: The American Board of Pediatrics, The Canadian Board of Pediatrics and The Canadian Board of Allergy and Clinical Immunology. She is a member in many medical associations in the field of pediatrics and allergy and immunology, such as The American Academy of Pediatrics and The American Academy of Allergy, Asthma and Immunology. Her special interests are primary immunodeficiency and various allergic diseases as well as medical education. She is actively involved in research and teaching at the Faculty of Medicine besides her clinical work in the hospital.
Abstract:
Anaphylaxis is a serious allergic reaction that is rapid in onset and might cause death. It is fatal in around 1% of cases. Studies have shown that there is underuse of intramuscular epinephrine as a first-line treatment despite the international guidelines. It has been demonstrated that many pediatricians have difficulties in anaphylaxis diagnosis and management. My personal observation is that there is delay or failure to use IM epinephrine, which is lifesaving, in cases of anaphylaxis. This is the first study on anaphylaxis in Kuwait. The aim of which is to assess the knowledge on anaphylaxis management among pediatricians and pediatric emergency physicians and factors influencing their practice. The ultimate goal is to be able to provide appropriate tools (updated ER protocol, scientific days, and workshops) to improve patient care and outcome. This is a survey questionnaire that will cover aspects on management based on the international guidelines. The study population is going to be pediatricians in the wards, clinics, ER or PICU, where they might encounter anaphylactic reactions.
Ghada Mohammad Abu Shosha
Zarqa University, Jordan
Title: Perceived challenges of mothers having a child with Thalassemia major: A phenomenological study
Time : 13:10-13:30
Biography:
Lamia K Alsenaidi is a 6th year Medical student in United Arab Emirates University/College of Medicine and Health sciences. The expected date of her graduation is May 2016. She has published 2 papers in reputed journals and she is currently working in a new research about cancer awarness
Abstract:
Thalassemia is a genetic blood disorder that requires a life-long treatment of blood transfusion and chelating drugs. It poses a range of stressors and challenges for patients, their families, and health care team. Mothers are the primary caregivers and therefore, understanding their perceptions of having a child with thalassemia is very important. This study aimed to explore challenges of having a child with thalassemia major as perceived by Jordanian mothers. A descriptive phenomenological approach was used. Twenty three Jordanian mothers were selected purposefully from two major thalassemia treatment clinics in Jordan to participate in this study. Semi-structured, face-to-face interviews were used to obtain the participants' perspectives. Interview sessions were transcribed verbatim, and translated from Arabic to English. Data were analyzed using Colaizzi’s process of descriptive phenomenology. The study revealed that thalassemia has a significant impact on mothers' lives. Many forms of challenges associated with rearing children with thalassemia were illustrated using four major themes: “Psychosocial problems"," Financial problems", "Inadequate information", and “Disease consequences". Participants expressed their worries and fear resulting from the complications of the disease and its treatment. They voiced their needs for more information about the disease and managing the side effects of treatment. Therefore, nurses are advised to address the needs of mothers caring for children with thalassemia and to provide psychosocial support and sufficient information about the child's disease and its treatment.
Rosa Gimenez-Garcia
Hospital Rio Hortega, Spain
Title: Photodistributed hyperpigmentation induced by antihypertensive drugs: Two case reports
Biography:
Rosa Gimenez-Garcia is working as a Clinical Assistant in Hospital Universitario Rio Hortega, Valladolid, Spain and Associate Professor as Faculty of Medicine in Valladolid Spain. She done her residency 1981-1985. Hospital Clinico UNiversitario de Valladolid, DEPARTMENT OF DERMATOLOGY. Worked as Consultant Dermatologist in Hospital Clinico Valladolid and its area of health May 1985-Novembre 1987. Post of Clinical Assistant .Hospital Virgen Blanca" de León (Obtained through public competitive examination) 04-11-87 y el 06-11-90. Post of Facultativo Especialista de Ãrea (Clinical Assistant) (obtained through public competitive examination) "Hospital Rio Hortega" Valladolid 06-11-90- present.
Abstract:
Introduction: Drug-induced skin pigmentation is estimated to account for 10-20% of all cases of acquired hyperpigmentation. Antihipertensive drugs induced hyperpigmentation has been rarely described. Calcium channel blockers are commonly prescribed cardiovascular agents and have been associated with skin reactions in sun-exposed areas. No case of cutaneous hyperpigmentation associated with lercanidipine has been formally reported up to date. We present two cases of photo distributed hyperpigmentation induced by telmisartan- hydrochlorothiazide combination and lercanidipine. Case Reports: Case 1: A 79-year-old man was referred to us for evaluation of hyperpigmented lesions. He had been given telmisartan 80 mg and hydrochlorothiazide 12.5 mg daily for essential hypertension for 3 years and he has noticed hyperpigmentation and pruritus on sun exposed areas a few months after starting therapy. Discontinuation of the drug caused gradual reduction of photo distributed pigmentation. Case 2: A 68-year-old woman, with personal history of frontal fibrosing alopecia, presented to us with a 4 months history of photosensitivity (during the previous summer) and increasing pigmentation on her face. She had been given lecardinipine for essential hypertension for approximately 4 years. Physical examination revealed a dark-brown reticulated pigmentation on the malar area and superior eyelids. A skin biopsy specimen showed interface changes with vacuolar degeneration and pigmentary incontinence. Discussion: Drug-induced hyperpigmentation has been associated with many different types of medications, including anti-malarials, amiodarone, cytotoxic drugs, tetracyclines, heavy metals or psychotropic drugs (phenothiazines and imipramine). Clinical features are very variable with a large range of patterns, colors and distributions. The interval from the initiation of treatment through the onset of hyperpigmentation is markedly longer (even several years) than the intervals for other types of drug eruption. Antihypertensive drugs are very commonly prescribed. Photodistributed hyperpigmentation associated with diltiazem, a calcium channel blocker widely used in the treatment of cardiovascular disease, has been described. Oral mucosal and cutaneous hyperpigmentation associated with amlodipine, and telmisartan induced hyperpigmentation have been reported. Conclusions: Drug-induced cutaneous pigmentation, in particular with antihypertensive medications, must be considered in unexplained pigmented lesions, especially in the elderly. Cessation of the suspicious drug typically results in a gradual fading of the rash, although in some cases it never completely resolves.
Litty Varghese
Ambulatory Healthcare Services-SEHA, UAE
Title: Barriers to adult immunizations and strategies to improve coverage
Biography:
Litty Varghese; RN; MSN is working as A/Head of Nursing Education, AHS/SEHA, UAE. She has 34 years of experience in the field of PHC, UAE and has expertise as JCIA chapter lead and tracer team member, quality improvement coordinator, diabetic clinic project coordinator, community program organizer, nurse educator, newsletter editor and researcher. She holds Master’s Degree in Community Nursing, Post Graduate Diploma in Nursing Administration and obtained certification in Principles of Epidemiology and Biostatistics from CDC, Atlanta. With her continuance in excellent professionalism, she won the First SEHA BEST EMPLOYEE Award 2012, the 3rd Best Abstract Award at The Pan Arab Hypertension Conference in Abu Dhabi Feb. 5-9, 2000, and actively participated in winning the following Awards: 2009 ARAB HEALTH AWARD FOR PHC Chronic Disease program; 2010 ARAB HEALTH AWARD FOR Nursing HR development.
Abstract:
Vaccination against childhood communicable diseases through the Expanded Program on Immunization (EPI) is one of the most cost-effective public health interventions available. Most causes of vaccine preventable illness among children are relatively uncommon due to high rates of vaccination and very effective vaccines. Adult vaccination is one of the most important tool for reducing morbidity and mortality not just in the elderly but in other members of the society by increasing herd immunity, reducing severe clinical outcome and helping in eradication of the disease. The immunization program overall has been very successful with kids. We are not doing so well with adults. Adults are recommended to receive vaccinations based on their age, underlying medical conditions, lifestyle, prior vaccinations, and other considerations. Although provider recommendation is a key predictor of vaccination, more often clients report not receiving vaccine recommendations at healthcare provider visits. Other barriers for vaccinating adults include the cost of providing vaccination services, inadequate or inconsistent payment for vaccines and vaccine administration, and acute medical care taking precedence over preventive services. Despite these challenges, a number of strategies have been demonstrated to substantially improve adult vaccine coverage, including patient and provider reminders and standing orders for vaccination. Providers are encouraged to incorporate routine assessment of their adult patients' vaccination needs during all clinical encounters to ensure patients receive recommendations for needed vaccines and are either offered needed vaccines or referred for vaccination.
Mariamma Kuriakose
Malankara Orthodox Syrian Church Medical College, India
Title: Can Insects Transmit Hepatitis B virus?
Biography:
Mariamma Kuriakose is working as a Professor and consultant Physician at M.O.S.C Medical college, Kolenchery. She has done 3 major clinical and epidemiological studies in leptospirosis and published that in international journals and co-author of six journals on leptospirosis in international journals.
Abstract:
Hepatitis B virus is known to spread only through close contact with tissues or body fluids of an infected person either directly or indirectly. No known insect transmission of the virus has been reported in literature, although the virus has been found to survive in bed bugs for up to 6 weeks after feeding on infected hosts. But it has not been successfully transmitted in animal models. Two villages close to MOSC Medical College Hospital have shown an unusual clustering of hepatitis B cases for the last 3 years. Many of them do not have a likely route of exposure from analysis of patient history. They attribute the infection to bite from a blood sucking fly found in large numbers around their habitat. This study analyses probable routes of transmission of hepatitis B in these villages and seeks to investigate the possible insect transmission of the virus through the bite of the said blood sucking fly.
Madhusudan B Jani
Gujarat Adani Institute of Medical Sciences, India
Title: Rhythmic inversion exercise techniques: Healthier approach to hypertension
Biography:
Madhusudan B Jani completed his PhD from Medical College, Baroda which is affiliated to M S University of Baroda, Gujarat, India. He has teaching and research experience {MBBS, Dental, Physiotherapy, MSc (Medical)} of 34 years at Medical College, Baroda. His fields of research work are Exercise Physiology Applied to Health, COPD, Hypertension, PAD and Obesity. He has been a life Member of Indian Science Congress and Indian Journal of Physiology and Pharmacology. He is invited as a Guest Speaker at national conferences in India. Currently, he is working as a Professor of Physiology at Gujarat Adani Institute of Medical Sciences, BHUJ, Gujarat, India.
Abstract:
Inversion therapy has been around from a long time – inversion has been talked about since 400 BC when Hippocrates, the father of modern medicine, monitored patients being hung from a ladder in the interests of their health. Very recently, there has been a little interest in the West, in objectively documenting the effects on health, especially for the more advanced or esoteric practices, such as inversions. Inversion can act positively on the cardiovascular system, as blood flow in some parts aided, and in other parts challenged, which can lead to a mild cardiovascular workout. Regular inversion can have a positive effect in fighting varicose veins, and, as blood helps to infuse the brain, the increased oxygen it carries may have positive impact on maintaining brain function in later years. Those that swear by inversion and its benefits say that inversion therapy helps in correcting the imbalances affected by gravity. Because we spend most of our life sitting or standing, blood is pulled down into our lower body and our circulation progressively grows sluggish. Hanging upside down, reverses the blood flow temporarily, which allows more blood and oxygen to reach the brain. Pre and post rhythmic inversion exercise, on floor and under water, blood pressures were registered and concluded as healthier ways to control hypertension.
Geeta Ahlawat
Pt B D Sharma PGIMS Rohtak, India
Title: Airway management in emergency and trauma patients
Biography:
Geeta Ahlawat is a Graduate and Post-Graduate of Gujarat University, Ahmedabad, presently working as a Professor in Anaesthesiology and Critical care, Rohtak, Haryana. She has 26 publications to her credit and her areas of interest are innovations in the field of emergency and trauma, airway management and cardiac anaesthesia.
Abstract:
Airway management forms the vital component of treatment for emergency and trauma patients. A timely secured airway for injured patients is directly proportionate to the effectiveness of the treatment provided and hence the outcome achieved. Though a lot of advanced techniques have come up worldwide in this field, many are not available in emergency settings as well as in areas with only primary health care facilities especially in developing countries like India. I wish to correlate the best available options for airway management with primary health care settings in emergency and trauma patients in my talk.
Galya Ghalib Al Ghalib Alsharif
King Abdulaziz University Hospital, Saudi Arabia
Title: The Benefit of pre- and post- operative instructions
Biography:
Galya Ghalib Al Ghalib Alsharif has completed her MBBS from King Abdulaziz University Hospital. She is currently a medical intern.
Abstract:
Millions of people each year undergo surgery. Despite the development in the surgical field; patients remain in fear of the complications that may take place. 140 patients were randomly selected from the clinics at King Abdulaziz University Hospital, in Jeddah. A questionnaire was used to test their knowledge of the instructions before and after a surgery; ear nose and throat specialty in particular. Another questionnaire was given after educating the patients of the instructions in one of the surgical operations in this specialty. The aim is to educate the patients about these instructions in the event of undergoing any future operations. The result was: 64% of patients knew the existence of instructions before and after operations, while 36% didn’t know the existence of such instructions. The most known instruction by 86% was: to stop eating at midnight on the night of the operation. And the least known by 34% was: to stop taking Aspirin 7 days before the operation. The benefit rate from the explained instructions was 100%. 54% of these patients received only verbal instructions, while 10% received both verbal and on paper instructions, and the remaining 18% of patients didn’t receive any instructions.
Kaye Ervin
The University of Melbourne, Australia
Title: Care giver distress in dementia in rural Victoria
Time : 10:15-10:35
Biography:
Kaye Ervin has been a registered nurse for over thirty years, practicing predominantly in rural Victoria. Her passion is aged care and the focus of her research interests for the past 6 years. She is a member of the rural health department, the University of Melbourne. She has published 20 papers in international peer reviewed journals and regularly presents her research at national and international forums.
Abstract:
Aim: The aim of this study was to explore the levels of stress, anxiety and depression of informal carers caring for someone with dementia in a rural setting. The study also sought to determine carer’s primary source of stress and their use of dementia specific services. Methods: Carers of people with dementia were recruited to complete a survey that incorporated the Depression, Anxiety Stress Scales (DASS) to measure carer emotional well-being. The survey also included the Neuropsychiatric Inventory Questionnaire (NPI-Q), which assesses the presence and severity of behavioral and psychological symptoms of dementia (BPSD) of care recipients and their effect on the carer. They were also asked through an open ended question what they found most stressful in their caring role and what services they utilized. Results: A total of 39 carers completed surveys. Almost half of the respondents reported levels of stress and depression in the moderate to severe range as measured on the DASS. BPSD exhibited by care recipients, such as agitation, anxiety, aggression and nocturnal disturbance, showed a relationship to the level of stress reported by the carer as measured with the NPI-Q. Despite 84.6% reporting use of the Aged Care Assessment Service and 61.5% reporting provision of printed information on the services available, less than half of the carers utilized commonly available support services. Only 46.2% received financial compensation for their carer role. The predominant source of stress reported was the unremitting burden experienced when caring for someone with dementia.
- Track 7: Community Primary Care
Track 8: Primary Healthcare Management
Track 9: Primary Care Epidemiology
Location: The Oberoi Dubai, Dubai
Chair
Fahad Alkherayf
University of Ottawa, Canada
Co-Chair
Brian Littlechild
University of Hertfordshire, UK
Session Introduction
Gulnaz Karatay
Tunceli University, Turkey
Title: Effect of scenario-based school based prevention program to the abilities of students to say
Time : 14:10-14:30
Biography:
Gulnaz Karatay is an Associate Professor in Public Health Nursing in the Tunceli University Health High School in Turkey. She completed her Master and Doctorate program from Hacettepe University Faculty of Health Science in Ankara, Turkey. Her academic background and work experience as a Nurse-Researcher has enabled her to develop a range of skills. Accordingly, she has been in Prato Hospital in Italy-Florence for 3 months and US-Wisconsin Madison University for 3 months. Her research focuses on motivational interviewing for smoking cessation, improving cognitive function of the elderly, prevention of substance use in adolescent period and women health.
Abstract:
Objective: To develop students' ability to say "No to Substances" in order to prevent substance use. Method: A pre- and post-test study design was used with a single group. All of the 8th graders (n=282) in 3 schools located in an Eastern Province of Turkey were included in the study; however, the study was completed with n=249 students, who responded to both pre- and post-tests. The scenario-based training, developed by the researchers, was applied school counselors for 4 weeks. For this purpose, a teaching booklet was prepared for the teachers as well as a supportive material in a comic book format for students. The scenarios were to improve adolescents' abilities to say "No" to substance offers, to prevent addictive substances, and to call for help if needed. The pre-test of the study was applied in November 20-25, 2015, and the post-test was applied in January 4-8, 2016. The data of the study were collected using personal information form, self-efficacy scale in protection against substance abuse for adolescents, and Rosenberg self-esteem inventory (ROSE). The obtained data were assessed using percentages, Chi-square, t-test and F-test in the SPSS software. Results: The average age of the students was 13.53±0.57. Of the students, 8.5% stated they tried smoking, and 25% stated that they used alcohol. The mean score in the self-efficacy scale in protection against substance abuse for adolescents was found to increase significantly (103.20±20.00) after the training compared to the situation before the training (92.11±17.08) (t=6.374, p=0.001). Similarly, the mean Rosenberg self-esteem inventory score was increased after the training (1.51±0.85) compared to the pre-training score (1.29±0.79), and the difference was statistically significant (t=2.828, p= 0.005). Conclusion: Short-term outcomes of the class-based scenario training were observed to be effective in the development of self-efficacy for substance abuse prevention.
Rosa Gimenez-Garcia
Hospital Rio Hortega,Valladolid,Spain
Title: Photodistributed hyperpigmentation induced by antihypertensive drugs: Two case reports
Time : 14:30-14:50
Biography:
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.
Abstract:
Introduction: Drug-induced skin pigmentation is estimated to account for 10-20% of all cases of acquired hyperpigmentation. Antihipertensive drugs induced hyperpigmentation has been rarely described. Calcium channel blockers are commonly prescribed cardiovascular agents and have been associated with skin reactions in sun-exposed areas. No case of cutaneous hyperpigmentation associated with lercanidipine has been formally reported up to date. We present two cases of photo distributed hyperpigmentation induced by telmisartan- hydrochlorothiazide combination and lercanidipine. Case Reports: Case 1: A 79-year-old man was referred to us for evaluation of hyperpigmented lesions. He had been given telmisartan 80 mg and hydrochlorothiazide 12.5 mg daily for essential hypertension for 3 years and he has noticed hyperpigmentation and pruritus on sun exposed areas a few months after starting therapy. Discontinuation of the drug caused gradual reduction of photo distributed pigmentation. Case 2: A 68-year-old woman, with personal history of frontal fibrosing alopecia, presented to us with a 4 months history of photosensitivity (during the previous summer) and increasing pigmentation on her face. She had been given lecardinipine for essential hypertension for approximately 4 years. Physical examination revealed a dark-brown reticulated pigmentation on the malar area and superior eyelids. A skin biopsy specimen showed interface changes with vacuolar degeneration and pigmentary incontinence. Discussion: Drug-induced hyperpigmentation has been associated with many different types of medications, including anti-malarials, amiodarone, cytotoxic drugs, tetracyclines, heavy metals or psychotropic drugs (phenothiazines and imipramine). Clinical features are very variable with a large range of patterns, colors and distributions. The interval from the initiation of treatment through the onset of hyperpigmentation is markedly longer (even several years) than the intervals for other types of drug eruption. Antihypertensive drugs are very commonly prescribed. Photodistributed hyperpigmentation associated with diltiazem, a calcium channel blocker widely used in the treatment of cardiovascular disease, has been described. Oral mucosal and cutaneous hyperpigmentation associated with amlodipine, and telmisartan induced hyperpigmentation have been reported. Conclusions: Drug-induced cutaneous pigmentation, in particular with antihypertensive medications, must be considered in unexplained pigmented lesions, especially in the elderly. Cessation of the suspicious drug typically results in a gradual fading of the rash, although in some cases it never completely resolves.
Manjula A Rao
Kasturba Medical College, India
Title: Assessment of emotional problems faced by people living with HIV/AIDS (PLWHA) and to study the need for family support to manage the emotional problems
Time : 14:50-15:10
Biography:
Manjula A Rao has completed her MPhil in Social Work from Coimbatore University and PhD scholar from the same University. She is working as a Counselor in Kasturba Medical College, Mangalore. She has 20 years experience in HIV field. She has presented 15 scientific papers in national and international conferences. She has published papers on HIV and received Best Paper Award in Practitioner Category. She is the Director of RUDES and ADHAR charitable trust. She is a national level master trainer for different organization and member of many organizations which works in welfare of the community.
Abstract:
HIV/AIDS is one of the most alarming social challenges faced by the people in the Universe. It has been described as the “most devasting epidemic humanity has ever known”. Human immunodeficiency virus (HIV) is a lentivirus that causes the infection and acquired immunodeficiency syndrome (AIDS). As on today the disease is fatal, but it is totally preventable. AIDS is the end result of a viral infection, caused by a group of viruses known as Human Immunodeficiency viruses. UNDP 2010 reports that India had 2.39 million people living with HIV at the end of 2009. The present study highlights the effect of emotional problems faced by the person with HIV and AIDS. HIV infection has a major impact on the mental health of the person which has a chance of causing cognitive impairment, mood and anxiety disorders, and even psychotic manifestations. Various psychological issues leading to manifestations among PLWHAs are acute-stress reactions, anxiety disorders, depression, mania, psychosis and neuro-psychiatric manifestations of HIV associated neurological illness. Testing for HIV is itself evokes a lot of anxiety. It is very general that most of them take lot of time to muster up courage to undertake the test. Not all will react in a positive way. The first reaction is anger, depression and failure to cope up with life. Suicidal thoughts will occur. At this time there is a need for proper counseling. Appropriate counseling or absence of any other social support can devastate an individual. They experience a lot of stress mentally as many emotional problems occur to them. To cope up with these stressors there should be a need for social support for which the PLHWHA could be able to tell them about the sero-status for moral, emotional and psychological support. Majority of our study population included males (52.2%) and rest are females (37.8%). Majority of them had primary (58.6%) and secondary (37.8%) level of education. 99.1% are infected through sexual contact. 38.7% of respondents receive support from spouse, and secondary family members. 95.5% respondents are satisfied with the support they get from family members. Most of our respondents (41.4%) always and sometimes (55.9%) get financial support for their medication, only 2.7% will never get support. 94.6% of respondents feel they have someone to listen their feelings and thoughts. 41.4% respondents get reminder to take ART medication from their family members. 81.1% of the respondents felt that they can always participate in family function. The present study highlighted the fact that adherence of ART treatment is better when family support is high.
Madhusudan B Jani
Gujarat Adani Institute of Medical Sciences, India
Title: Rhythmic inversion exercise techniques: Healthier approach to hypertension
Time : 15:10-15:30
Biography:
Madhusudan B Jani completed his PhD from Medical College, Baroda which is affiliated to M S University of Baroda, Gujarat, India. He has teaching and research experience {MBBS, Dental, Physiotherapy, MSc (Medical)} of 34 years at Medical College, Baroda. His fields of research work are Exercise Physiology Applied to Health, COPD, Hypertension, PAD and Obesity. He has been a life Member of Indian Science Congress and Indian Journal of Physiology and Pharmacology. He is invited as a Guest Speaker at national conferences in India. Currently, he is working as a Professor of Physiology at Gujarat Adani Institute of Medical Sciences, BHUJ, India.
Abstract:
Inversion therapy has been around from a long time – inversion has been talked about since 400 BC when Hippocrates, the father of modern medicine, monitored patients being hung from a ladder in the interests of their health. Very recently, there has been a little interest in the West, in objectively documenting the effects on health, especially for the more advanced or esoteric practices, such as inversions. Inversion can act positively on the cardiovascular system, as blood flow in some parts aided and in other parts challenged, which can lead to a mild cardiovascular workout. Regular inversion can have a positive effect in fighting varicose veins, and, as blood helps to infuse the brain, the increased oxygen it carries may have positive impact on maintaining brain function in later years. Those that swear by inversion and its benefits say that inversion therapy helps in correcting the imbalances affected by gravity. Because we spend most of our life sitting or standing, blood is pulled down into our lower body and our circulation progressively grows sluggish. Hanging upside down, reverses the blood flow temporarily, which allows more blood and oxygen to reach the brain. Pre and post rhythmic inversion exercise, on floor and under water, blood pressures were registered and concluded as healthier ways to control hypertension.
Biography:
Essam Mahran has completed his MD degree in April, 2010 from Cairo University. From that date, he is working as lecturer of Anesthesia and pain therapy in National Cancer Institute, Cairo University. He has published more than 5 papers in reputed journals and has active participation in many conferences including ESA, 2012 in Paris, European Congress of Airway Management, 2013 in Istanbul, WIP, 2014 in Mastricht and AOSRA, 2015 in Bangkok.
Abstract:
None Steroidal Anti-Inflammatory Drugs (NSAIDs) are analgesic, antipyretic and anti-inflammatory drugs. NSAIDs are commonly used drugs with more than 13 millions chronic users in USA with direct cost more than 2 billion dollars per year. They have serious side effects up to mortality representing 15th commonest cause of death in USA. The NSAIDs are present in the 3 steps of the WHO step ladder analgesic pattern. NSAIDs are classified according to their degree of selectivity on cyclo-oxygenase enzyme into non-selective drugs and newer Cox 2 selective NSAIDs. They vary in their potency, duration and elimination. Because of their CVS risks both Roficoxib and Valdicoxib are withdrawn from the market. GIT risks of gastric erosion and peptic ulcer are more with non selective NSAIDs. Renal side effects result mainly from vasoconstriction of afferent arteriole. Other side effects include allergy and prolonged labor. NSAIDs choice should be tailored to each patient according to his/her age and medical status. In hepatic patients paracetamol can be used in mild to moderate impairment with reduction of the maximum daily dose. In renal impairment NSAIDs, dose adjustments are made according to creatinine clearance. NSAIDs during pregnancy can result in early closure of fetal ductus arteriosus and preterm birth, So NSAIDs are contraindicated in 3rd trimester in France and their FDA approval is category D in third trimester and category C in first and second trimester. During lactation paracetamol, ibuprofen and diclofenac are safe. They vary in their pediatric doses. Celecoxib has also anti-cancer effect.
Anil Kumar Chhotalal Mithani
Omdurman Teaching Hospital, Sudan
Title: PHC Sudan- Knowledge exchange to improve primary healthcare outcomes from a Urologist’s perspective in Sudan
Time : 15:50-16:10
Biography:
Anil Kumar Chhotalal Mithani completed his MBBS from Alexandria University and obtained MD from China. He is carrying over 30 years of clinical experience and also worked as the Director of Government Hospitals. Currently, he is working as an Associate Professor at University of Bahri and Head of Urology at Omdurman Teaching Hospitals which has 600 beds and treat the maximum number of patients in Sudan. He attended Urological Conferences in Iraq, Egypt and many other countries. Also, he is the Treasurer of the Sudan Urology Association and the President of the Indian Community in Sudan.
Abstract:
The highly skilled Urologist Surgeons of Primary Health offer a comprehensive approach to urological care, including an array of treatments for urinary tract infections, prostate problems, bladder disorders, kidney and ureteral stones, urethral strictures, undescended testes, erectile dysfuntion, infertility, cancer of bladder, kidney, prostrate and testicular and all other conditions related to the genito-urinary tract system. Specialists provide primary health care expertise in health promotion, prevention and screening, and treating various conditions. Primary care providers play an important role in caring for cancer and metastasis. Sudan health system is based on the district health system approach, which emphasizes the principles of primary health care (PHC). Nevertheless, the decentralization of the public sector resulted in more deterioration of the PHC system particularly in rural and peripheral areas due to lack of financial resources and managerial capacities. The local health system act gave the responsibility of management of PHC level to the localities while, this was not accompanied by ensuring availability of sufficient financing resources to localities to run this function. We have carried out a study by coordinating with a few PHC authorities by creating awareness of the urological care and wish to share our findings and learn from other’s experiences.
Neeraj Bedi
Jazan University, Saudi Arabia
Title: Research ethics and regulatory reforms
Time : 16:25-16:45
Biography:
Neeraj Bedi is a highly experienced medical professional having 26 years of teaching, training, research and administrative experience in the field of Public Health/Community Medicine. He obtained his MD in 1986, MPH and MBA administrative qualifications. He is involved in Quality Assurance and Risk Management Activities related to the Hospital Management. He has been awarded WHO fellowships in “Hospital Administration” and “Management of Malaria Field Operations”. He has published 50 research publications and is a reviewer of many journals. Currently, he is working as full time Professor in Faculty of Public Health and Tropical Medicine, Jazan University, Saudi Arabia.
Abstract:
The medical research misconduct has become a big global problem. Research misconduct is being defined as the “Behavior by a researcher, intentional or unintentional that do not meet or fulfill the scientific and ethical standards”. The accurate data about research misconduct are not available except from countries like the USA, China and Germany. The research misconduct include fabricating the data, falsifying the data and plagiarism. The various irresponsible research practices are publishing research data more than once, non-disclosure of conflict of interest, selective reporting of data and inappropriate authorship. The most scrutinized literature for medical research misconduct was collected from different electronic sources including PubMed. About 19 references were found. 2% of scientists have been found to admit fabricating the data and 33% researchers were involved in different types of irresponsible research practices. There is no formal regulatory programs available to monitor the research projects in different countries. Few developed countries like the USA, Germany and China tried to develop programs which can monitor the medical research misconduct. There is a need to develop a regulatory system at national and institutional level to regulate the research activity to ensure that good ethical and scientific standards are practiced by medical researchers. All academic institutions must have teaching and training sessions for ethical issues to update the students and staff at regular periodical intervals. Similarly, the medical education curriculum for medical students must have the chapters on research ethics and good research practices to deal effectively with the research misconduct problem.
Kamar Tanyan
Mary Begg Clinic, Zambia
Title: Primary health care challenges in remote medical setting
Time : 16:45-17:05
Biography:
Kamar Tanyan has worked in a number of Middle Eastern and Arab countries (Tunisia, Lebanon, Saudi Arabia and Iraq) and therefore has a deep-rooted understanding of the challenges related to the primary healthcare industry in the region. She holds the international diploma in Humanitarian Assistance from Fordham University- New York and a Master’s degree in Disaster Medicine from University of Piedmont Orientale, Italy. In 2003, she actively contributed to the implementation of pre-hospital medical emergency care program in North Lebanon in collaboration with Lebanese Red Cross. She participated several times with military hospital medical team in the response to Hajj mass gathering in Saudi Arabia. In 2014, she joined a humanitarian mission in Iraq, as Health Project Manager in response to the Syrian refugees’ crisis. Managing a WHO and ECHO financed health programs including health programs design, implementation and monitoring, capacity building of local doctors to insure a better health care of this vulnerable population. Currently, she is the Chief Medical officer of remote hospital operated by an international mining company in Zambia, where she is confronted to all aspects and challenges of remote medicine as well as dealing with African epidemic diseases such as malaria, TB, HIV with minimal resources. Her current focus is the development of an emergency response planning guidelines in low setting resources.
Abstract:
Providing healthcare in remote locations means working without the level of medical support that most health professionals are used to have at their disposal. It requires a different mindset to that of an urban medical facility. Illnesses which can be easily managed in the urban setting may initiate a crisis at a remote health facility. Operating in resource-limited primary health care settings presents a multitude of health challenges especially in the third world such African countries. Remote healthcare professionals face major challenges, including a critical shortage of specialized health workers, poor state of health facilities and equipment; add to it the high burden of epidemic disease such as HIV/AIDS, malaria and TB. Remote medical practitioners require a broad range of competencies in several specialties, including emergency and critical care, primary care mental health, public health, occupational health, pharmacy, dentistry, health management and interpersonal skills. They are forced to utilize more basic physical examination skills, clinical impression and overall clinical experience. Likewise, not having necessary diagnostic testing, remote medical practitioners may feel the need to be more aggressive in treatment and act faster. Not having the luxury of being able to definitively assign a diagnosis to an illness, they may feel the need to cover the patient for the worse potential diagnosis as possible. Not only do these factors increase the risk of worsening illness or injury due to delays in diagnosis and treatment, they also confront remote medical clinicians to the key question “where responsibility for providing care starts and stops”? These issues have made providing higher standards of care in remote third world countries an infinite complex challenge. This presentation provides an oversight into some of the key issues facing the delivery of primary healthcare and doctors’ challenges in remote medical setting and describes the role remote primary health care professional can play in delivering a lifesaving care.
Pawlin Vasanthi Joseph
Nirmala College for Women, India
Title: Probability mapping to determine the spatial risk pattern of acute gastroenteritis in Coimbatore district, India, using geographic information systems (GIS)
Time : 17:05-17:25
Biography:
Pawlin Vasanthi Joseph completed her PhD in the field of Environment Management and Biotechnology from the Defense Research and Development Organization – Centre for Life Sciences, Bharathiar University, Coimbatore, India. She has published 10 papers in peer reviewed journals and has presented 14 papers in national and international conferences. Currently, she is the Head of the Department of Zoology at Nirmala College and Co-ordinates the Career Oriented Program in Vermitechnology and the Star College Scheme for strengthening of Life Sciences, Department of Biotechnology, Government of India.
Abstract:
Background: Maps show well the spatial configuration of information. Considerable effort is devoted to the development of Geographical Information Systems (GIS) that increase understanding of public health problems and in particular to collaborate efforts among Clinicians, Epidemiologists, Ecologists, and Geographers to map and forecast disease risk. Objectives: Small populations tend to give rise to the most extreme disease rates, even if the actual rates are similar across the areas. Such situations will follow the decision-makers attention on these areas when they scrutinize the map for decision making or resource allocation. As an alternative, maps can be prepared using P-values (probabilistic values). Materials & Methods: The statistical significance of rates rather than the rates themselves are used to map the results. The incidence rates calculated for each village from 2000 to 2009 were used to estimate λ, the expected number of cases in the study area. The obtained results are mapped using Arc GIS 10.0. Results: The likelihood of infections from low to high is depicted in the map and it is observed that 5 villages namely, Odanthurai, Coimbatore Corporation, Ikkaraiboluvampatti, Puliakulam and Pollachi Corporation are more likely to have significantly high incidences. Conclusion: In the probability map, some of the areas with exceptionally high or low rates disappear. These are typically small unpopulated areas, whose rates are unstable due to the small number of problems. The probability map shows more specific regions of relative risks and expected outcomes.
Mariamma Kuriakose
Malankara Orthodox Syrian Church Medical College, India
Title: Can insects transmit hepatitis B virus?
Time : 17:25-17:45
Biography:
Mariamma Kuriakose is working as a Professor and consultant Physician at M.O.S.C Medical college, Kolenchery. She has done 3 major clinical and epidemiological studies in leptospirosis and published that in international journals and is the co-author of six international journals on leptospirosis.
Abstract:
Hepatitis B virus is known to spread only through close contact with tissues or body fluids of an infected person either directly or indirectly. No known insect transmission of the virus has been reported in literature, although the virus has been found to survive in bed bugs for up to 6 weeks after feeding on infected hosts. But it has not been successfully transmitted in animal models. Two villages close to MOSC Medical College Hospital have shown an unusual clustering of hepatitis B cases for the last 3 years. Many of them do not have a likely route of exposure from analysis of patient history. They attribute the infection to bite from a blood sucking fly found in large numbers around their habitat. This study analyses probable routes of transmission of hepatitis B in these villages and seeks to investigate the possible insect transmission of the virus through the bite of the said blood sucking fly.
Christos Stefanou
Limassol General Hospital ICU of Cyprus
Title: Electrical muscle stimulation: Essential in health and disease, in primary and secondary prevention
Time : 17:45-18:00
Biography:
Christos Stefanou is an Internist and Intensivist in Limassol General Hospital ICU of Cyprus, where he is in-charge of the educational program; and an Honorary Associate Professor of Medicine at St George’s University. He was ranked first class in his Medical School of Athens University; and finished his fellowship at Evangelismos Hospital of Athens, Greece; and his internship in the USA. He is a PhD candidate and researcher in the pathophysiology and regenerative properties of electrical muscle stimulation. He has also been the President of psychosocial support and health group of Cyprus Red Cross.
Abstract:
Electrical muscle stimulation (EMS) is just following the steps and evolution of exercise: one of the enormous accumulations of evidence about its possible medical benefits and high safety and feasibility profile. EMS is nearing inclusion at contemporary essential guidelines for health maintenance, primary and secondary prevention and rehabilitation, with a range of actions extending from healthy people to various categories of chronic patients. It appears to exert regenerative and reparatory effects on the endothelium, to mobilize endothelial progenitor cells; to favorably affect the microcirculation; to induce mesenchymal stem cell potentiation; to exert multilevel beneficial immune, metabolic and endocrine actions related to cytokine, hormonal, neural, anti-inflammatory and anti-oxidant modifications. By these pleotropic pathophysiologic mechanisms, it is evidenced that, EMS improves cardiovascular fitness and overall health; prevents ICU- acquired weakness or sarcopenia, pressure ulcers and venous thromboembolic disease; decreases pathological cardiac remodeling in heart disease, and sympathetic activity; alleviates dyspnea in malignancy or COPD; improves glucose metabolism in metabolic syndrome or diabetes patients; reinforces post injury neuroregeneration; improves spasticity, urinary/fecal incontinence, pelvic floor dysfunction, and chronic pain syndromes; enhances tissue perfusion; and assists in muscle reeducation. Further emerging applications relate to psychological health (such as depression); to post-surgical prevention of atelectasis and cough reinforcement; and to dysphagia in stroke or anorexia nervosa patients. Many applications of this endless list are FDA approved already. EMS needs to be considered as part of numerous medical conditions, and any health-care professional needs to be aware of its indications.