3^rd Annual Congress & Medicare Expo on Primary Healthcare, Clinical & Medical Case Reports April 17-19, 2017 Dubai, UAE

Biography:

Norma Ponzoni is a Faculty Lecturer at the McGill Ingram School of Nursing, Quebec, Canada. She is the Academic Coordinator for the Nurse Practitioner Programs. She has graduate degrees in Nursing and Education and is completing her PhD in Educational Psychology at McGill. She has several publications in peer-reviewed journals and is nationally and internationally well-known in the area of nursing education and advanced practice. Her research is focused on primary care and the process by which it can be facilitated and the delivery of professional development to rural regions that make this care possible to isolated populations.

Abstract:

Nurse Practitioner (NP)-led clinics, where NPs retain administrative control, have the potential to address current issues of access to primary care services. In Canada, the government of Ontario successfully established 26 publicly-funded clinics over a 5-year period; while in the neighboring province of Quebec, where similar problems exist, the government has only recently funded one NP-led clinic in 2016 after significant political pressure. Inspired by Ontario’s story, this study aimed to understand the initial context and the factors that eventually made conditions favorable; something that can guide Quebec in its struggles to get NP-led clinics off the ground. Using a scoping approach, we retained 8 papers, of which only one was a published ethnography. We used the Edward’s Whole System Change Model to explain the profound effect and interrelatedness of all contributing factors. Core to explaining this dynamic within the healthcare system is the pervasiveness of the biomedical model and a lack of understanding of the NP’s scope of practice; this influences the conditions by which publically-funded care is remunerated and the level of inter-professional collaboration. NPs ‘rallying’ around the cause and engaging in political lobbying and networking is what seemed to make the difference historically in Ontario, and more recently in Quebec. In conclusion, NP-led clinics are a viable and effective option for a large number of Canadian patients who do not have access to primary care providers.

Biography:

Carla Veiga Rodrigues has completed her Master in ‘Risky behaviors on a student’s population from Vila Nova de Gaia’ from the Health Sciences School at University of Minho. She is currently a GP resident at UCSP São Neutel, Chaves and is an emergency Doctor on the Medical Vehicle of INEM (National Institute of Medical Emergency). She takes a special interest in adolescence and sexuality, being a founding member of FIMS (Iberic Federation of Medicine and Sexuality), an active member of the European Society of Sexual Medicine (ESSM) and the Coordinator of the Sexuality Studies Group from the Portuguese National Family Practitioners Association. She focuses her work on communication skills, presented a workshop on Motivational Interviewing in Wonca Europe 2016 and is currently finishing a book on the subject. She's also Editor of the Scientific Open Access journal 'MGF&Ciências'.

Abstract:

According to the World Health Organization, sexuality is a key aspect of the human being, encompassing sex, gender identity, sexual orientation, eroticism, intimacy and reproduction. Sexuality is broader than the individual experience of sex and it can and should be addressed on consultations as part of a person-centered medical approach. Despite the elevated prevalence of sexual related problems, Sexuality-related Communication (SRC) is often neglected by the General Practitioner. How can we do it and why are we so oblivious to this issue? Are we prepared to do so? Pre-graduate training is scarce and heterogeneous between the profusion of Medical faculties. Post-graduate training is expensive and mainly focused on dysfunction rather than functionality or part of a relationship. Nevertheless, patients expect their doctors to address the topic and studies show that sexual health concerns may never be voiced if the patient is left with the responsibility to introduce it. The lack of comfort, the reluctance to talk about sexuality or the fear of offending the patients limits our performance and makes SRC less clear or objective than it should be, decreasing our ability to educate our patients regarding Sexual Health. Sexual health should be a cornerstone of preventive medicine. In order to improve our skills we must bring SRC to light, face our limitations. Only then we’ll be able to enhance our performance on consultation and create strategies to improve our quality of care to populations.

Biography:

Veerachai Sachdev is a Family Physician specialised in Palliative Medicine and currently studying Master’s in Medical Ethics and Law at the University of Edinburgh, UK. Following completion of Bachelors of Medicine and Surgery at the University of Adelaide, he went into General Practice training in rural parts of South Australia. He returned to Thailand and joined Ramathibodi Hospital, Mahidol University as a part time Consultant involved in Post-graduate and Under-graduate teaching and Palliative Care service. Organ transplantation has shown to benefit patients who receive the organ by having a better quality of life, with renal transplant being the most common transplanted organ worldwide. Whilst most of the patients interviewed had little to no objection towards organ donation, however there is still a lack of understanding of the difference between cadaveric donors towards organ donor for transplantation. Buddhist teaching had also supports altruism and a minority of patient still belief in reincarnation and had they donated their organs and this may have implication in their next life.

Abstract:

Objective: To understand the belief in regards to the attitudes and awareness about organ donation amongst patients visiting a tertiary hospital in Bangkok.

Design: An in-depth interview was conducted on 38 participants at Family Medicine Department; participants were aged between 18-78 years. Participants were identified as Buddhist (92%), Islam (5%) and Christian (3%).

Recruitment: Patients were recruited randomised and unselected similar to “real life practice” and consent was obtained prior to conducting interview.

Results: 6 themes were identified which aimed to address the attitudes and awareness of organ donation amongst patients visiting Ramathibodi Hospital. The themes include: Perception on organ donation; Personal view on death and dying; General knowledge about organ donation; Understanding the law and regulation about organ donation; Religious belief and implication on organ donation and; “opt-in” organ donor on national identity card.

Conclusion: An organ transplant may represent a new life for an individual receiving the organ, at the same time a sense of hope removed from the depths of sorrow and grief in the case of a dead donor. Today, the major obstacles regarding organ transplantation in Thailand is the lack of organ donor. In 2014, there were over 4.431 patients registered with Thai Red Cross to receive organ donation and only 432 people actually received which accumulated to 9.7% of total patients waiting to receive an organ.

Biography:

Ghena Shabana has MD with honor from Debrecen Medical University, Hungary. She Qualified as Specialist in Family Medicine by Swedish National Board of Health and Welfare. She works as Cosmetic Medical Consultant and as SAVA Project researcher (Survery of Atherosclerosis in Västmanland). She is an Expert group member of Heart/Vascular and Gastrointestinal Västmanlands Medicine Committee.

Abstract:

Background & Objectives: Patients with high cardiovascular risk should receive statin drugs as primary prevention of cardiovascular events according to current guidelines. This study aimed to determine the prevalence of AMI patients on statin treatment at hospitalization. The prevalence of statin treatment among AMI patients with known diabetes, known angina pectoris and previous AMI were studied separately. We also investigated blood lipids upon admission of patients with AMI in relation to national guidelines of recommended levels of lipids.

Methods: Consecutive patients (n=771) ≤ 80 years of age hospitalized for AMI during the period 2005-2012 were included in the study. ECG and biomarkers according to criteria recommended by the European Society of Cardiology (ESC) were used to diagnose AMI. Blood lipids and blood pressure were taken when patients were enrolled in the study at admission. Previous myocardial infarction, angina, stroke, diabetes, smoking habits and hypertension were diagnosed by self-reports verified by medical records.

Main Results: More than half of the statin treated had a LDL cholesterol level below the recommended level 2.5 mmol/L. LDL cholesterol level is 1.0 mmol/L lower among statin-treated than non-statin treated. 30% of diabetics, 22% of previous myocardial infarction patients and 31% of angina patients were not on statin therapy as primary prevention, when they were hospitalized for their first AMI. There is a large potential for improvement of statin therapy of patients at high risk for AMI. A study on why some AMI patients with known diabetes, known angina pectoris and previous AMI are not on statin treatment is needed.

Biography:

Nadira A Al-Baghli is a consultant in family & community medicine graduated from King Faisal University, KSA, and having a Master’s degree in Medical Education from Arabian Gulf University, Bahrain. She was the Director of Infection Control in Eastern Province, KSA for 5 years. Currently, she is working in consultation clinics in Dammam, Directorate of Health Affairs, EP, KSA. She has published more than 15 papers in reputed journals about chronic diseases and medical education programs. She has special interests in biostatistics, EBM, and infection control.

Abstract:

Objectives: To assess the effect of Evidence Based Medicine (EBM) workshop on knowledge and skills of physicians towards EBM use in the near future as well as in the long run.

Methods: This is a randomized controlled trial conducted in the primary health care administration center in Dammam, Saudi Arabia between October and November 2008. Fifty-nine primary care physicians in the intervention group participated in the EBM workshops, while 89 physicians from the control group attended other primary health care activities other than EBM workshop. The main outcome was to measure the change in the participants’ level of awareness and competencies in EBM components (including formulation of questions, literature searching, critical thinking and appraisal) using a pre-designed questionnaire before, immediately after, and 4 months after the workshop.

Results: Evidence Based Medicine workshops improved physician’s scores in all components of EBM, from 38.9%±20.0% at pre-test to 81.4%±10.6% post-test, and sustained this improvement to a lesser degree to 66.8%±10.0% 4 months post-intervention test (p<0.001 for the differences in all scores).

Conclusion: Participating in EBM workshop significantly enhanced physicians’ ability to formulate questions, performed literature search, critical appraisal, and applied best-evidence in clinical practice, which retained up to 4 months post-test.

Biography:

N J Ramakuela is a Healthcare Professional who specialized in Community Health Care with her PhD Model entitled, “A model to facilitate women’s coping with menopause”. Her model is being utilised by rural community based women to help cope with menopausal challenges they encounter. She is also a Lecturer in the university providing teaching and learning to undergraduate students, while supervising research to both Master’s and PhD students and other postgraduate students. She is an active researcher who publishes papers every year in accredited journals. She travels in and around the country to present scientific research papers at national and international conferences. She also empowers rural community women with reproductive health issues.

Abstract:

The purpose of the study was to explore the consequences of substance abuse on the life of teenagers in Vhembe District of Limpopo Province in South Africa. A qualitative approach and explorative design were used to conduct the study. The population consisted of mothers raising teenagers from the ages of 13 to 19 years who abused substances such as alcohol, tobacco and other substances. The study used non-probability convenience sampling to select participants. The records at the social worker’s office in Tshisaulu showed 11 cases of mothers complaining about their children abusing substances and all the reported cases were included in the study. Semi-structured interviews were used to gather data from participants’ and Tesch’s model of data analysis was used. Measures to ensure trustworthiness and ethical considerations were ensured. Results revealed that participants were concerned about the late home coming of their teens who had started abusing alcohol, especially during weekends and, sometimes, they do not come back home at all. It was also discovered that teenagers engaged in unprotected sex after abusing substances. The study recommends that parents should discipline their teens and the district should open rehabilitation centres for substance abuse victims. The study also recommends that in-service education for school principals and teachers should be done.

Biography:

Neeraj Bedi is a dedicated and experienced Medical professional with a teaching, training, research and administrative experience of 26 years in the Public Health domain in the field of epidemiology, preventive medicine, community medicine, hospital administration and management. Presently, he is working as Senior Faculty in Community Medicine, Medical College, Bhopal. He is having many research articles published in national and international journals.

Abstract:

The role of health informatics is becoming significantly crucial in every part of the health sector. Rapid advancement in information technology has made it mandatory as well desirable to use e-Health in patients care and in public health. The main issues in providing patients care arise from incomplete information, exchanging the information, duplicating investigations and monitoring the response to treatment. Accordingly WHO has set goals of comprehensive patients’ information including investigations; treatment accessible at all places by health care providers irrespective of the location, to be achieved by 2012. The use of ICT in the form e-Health technology in health care sector can help achieving this target. The e-Health components includes Electronic Medical Records (EHR), Electronic Health Records (HER), Electronic Personal Health Records (PHR), Tele health, telemedicine, m-health i.e. use of mobile smart i-phone apps for health purposes and e-learning. The e-Health improves the efficiency, equity, the quality of health care, empower consumers and patients, encourages bonding, educates , enabling the information exchange and take care of Ethical issues in health care. The impact of e-Health on stakeholders enables them to have health care available at home, at work or in school. It focuses on prevention, education and self-management, availability of complete information and improves patients’ safety. Medical researchers and Policy makers i.e. Government too derive benefits by e-Health. At International level Australia, Canada, USA and most European countries have adapted the use of e-Health in health care. In India too the beginning has been made by corporate group of hospitals /private hospitals and Government has also initiated e-Health plan but still a long journey ahead to implement e-health in entire country.

Biography:

Carla Veiga Rodrigues has completed her Master in ‘Risky behaviors on a student’s population from Vila Nova de Gaia’ from the Health Sciences School at University of Minho. She is currently a GP resident at UCSP São Neutel, Chaves and is an emergency Doctor on the Medical Vehicle of INEM (National Institute of Medical Emergency). She takes a special interest in adolescence and sexuality, being a founding member of FIMS (Iberic Federation of Medicine and Sexuality), an active member of the European Society of Sexual Medicine (ESSM) and the Coordinator of the Sexuality Studies Group from the Portuguese National Family Practitioners Association. She focuses her work on communication skills, presented a workshop on Motivational Interviewing in Wonca Europe 2016 and is currently finishing a book on the subject. She's also Editor of the Scientific Open Access journal 'MGF&Ciências'.

Abstract:

Introduction: Adolescence is a transforming period, when physical, psychological, cognitive and emotional changes happen and autonomy from parental control is demanded. The adolescent faces the task of self-discovery, often resulting in the adoption of sexual exploration and experimentation that may constitute Risky Behaviors (RB). These can translate into health decline, not only during adolescence but also into adulthood.

Objectives: The objectives of the study are to increase awareness for adolescent’s susceptibility to RB, discuss strategies to decrease health decline and to capacitate doctors on the management of RB.

Methodology: The methodology includes theoretical introduction to adolescence and its characteristics, brief exposition of global statistics on RB; brainstorm on 4 main types: tobacco smoking, alcohol consumption, drug abuse and risky sexual practices; presentation and discussion of strategies for each topic and take-home messages.

Discussion: Adolescents are prone to experimentation, testing the limits of themselves without much account into consequences. As family doctors, we ought to be capacitated on techniques and strategies to use on consultations with adolescents engaging on RB. Ideally, a multi-disciplinary approach should be used, enrolling parents, teachers and the school community into preventing their perpetuation into adulthood.

Biography:

Silverio Di Rocca has completed his Graduation in Dentistry, Post-graduate degree in Functional Orthopaedics both from the University of Buenos Aires, Argentina. He has also done a degree in Dentistry and Prosthetic at the University of Turin, Italy and a Doctorate in Dentistry and Prosthetic at University of Turin, Italy. He is the Director of the M P R International School, Vice President International representative and Founder of API Swiss (International Association of Posturology Switzerland). He is also a Professor in Amocoac Diplomate in Mexico and COMEI, College of Dentistry in Mexico, Associate Professor in I.C.O.M (International College of Osteopathic Medicine) Milan, Italy and an International Honorary member of AMOCOAC

Abstract:

The Myofunctional Postural Rehabilitation (M P R) is a method that seeks balance between the stomatognathic system and the rest of the body; which can be used at any age, in dysfunctional and stroke patients. In physiotherapy, we commonly witness relapses in our treatments, and we are not aware that patients with chronic pain are sometimes visited by several specialists, without results. After a long and winding journey passing through many specialists in search for a solution, patients are sometimes even considered as psychiatric patients, and the specialist is disappointed with the outcomes. This happens because there isn’t a holistic optic in ours therapies. A major cause for which this happens is the negative action of the stomatognathic system on the static posture that goes to alter and disrupt the function of other receptors like the eye and foot. Dysfunction treatment should be carried out by identifying the origin of the disease and establishing the therapeutic priority. The M P R will teach you to identify these and treat the disease with natural and physiological treatments. At the seminar, diagnosis and treatment methods of the M P R will be discussed and explained.

Biography:

Angela Schwarzboeck is working in King Abdulaziz Medical City - National Guard Health Affairs Riyadh, Saudi Arabia with Specialty in Critical Care

Abstract:

Background: Code blue nurse coordinator role was created by nursing executive in response to a patient care event.

Methods: The Code Blue Nurse Coordinator (CBNC) undertook an extensive review of all aspects of resuscitation care from point of activation to care at the bedside. Through observation, participation, education, support, advocacy, behavioral modification and change of team dynamics, resuscitation care was transformed at the bedside and introduced multidisciplinary debriefing sessions immediately post Code Blue events.

Results: Successful establishment of a standardized process of resuscitation care delivery was observed and established a role for Code Blue Nurses and developed an advanced role for them in the use of Automatic External Defibrillator (AED). A first responder program was developed for ward staff with 2500 graduates. 98% of crash carts are ready for use within 60 minutes. We have achieved standardization of all resuscitation equipments throughout the hospital.

Conclusions: Education and consistent training has transformed resuscitation care at the bedside. Identifying the specific roles of each team member in a Code Blue Situation enhanced the delivery of resuscitation care. Continual clinical training of resuscitation skills ensures the retention of skills and knowledge.

Biography:

Andrea Kadlckova is a highly qualified and educated nurse with 9 years’ education of Nursing Science. Currently she is working as a Resuscitation Clinical Practice Facilitator at King Abdulaziz Medical City and King Abdullah Specialist Children Hospital in Riyadh, Saudi Arabia. Lived and worked in Riyadh for over 3 years embracing the strong cultural and family values. She has Experience as intensive care nurse with a passion for medical research studies and education.

Abstract:

Background: Despite Advanced Life Support courses every two years and Policies & Procedure Guidelines; we had proven that system failure can prohibit us getting the right people with the right equipment and right training to the right person at the right time. This Nursing Led QI Project is aimed at improving bedside resuscitation care and optimising patient safety.

Methods:

Developed First Responder BLS and PALS guidelines and standardized multidisciplinary simulation training. Using check list and monitoring data tool during multidisciplinary simulations for measuring each team member’s performance during the simulation to be able to create a high-quality education plan to improve their knowledge retention. Setting a gold standard of 60 minutes Crash Cart Ready for Use. Departmental policy and procedure developed and implemented, sustained by reviews every two years, updating and auditing compliance. Standardisation of resuscitation equipment and establishing hospital resuscitation response zones to ensure ALS initiation within 5 minutes. Empower Critical Care Nurses to use the Automatic External Defibrillator. Auditing process of Code Blue Record.

Results: After extensive Root Cause Analysis, multidisciplinary simulation training and continued support following achievements: standardised resuscitation simulation training for Physician Team Leaders and Critical Care Nurses, Crash Cart ready for use at all times, achieving the 5 minutes ALS response time and increased confidence of all resuscitation involved team members.
Conclusion: Standardisation of all resuscitation equipment has given reassurance and proven across the board high quality and prompt resuscitation care. The process of team building, occurring in the early and most vulnerable phase of resuscitation is of particular importance. This early time point is difficult to capture in real cardiac arrests and these simulator-based studies have provided important insights. Results demonstrated a faster response to patients requiring resuscitation care, greater efficiency in the provision of advanced life support and a more effective multidisciplinary resuscitation response team.

Biography:

Silverio Di Rocca completed his Graduation in Dentistry and Post-graduation in Functional Orthopaedics from University of Buenos Aires, Argentina. He has also done a degree in Dentistry and Prosthetic at the University of Turin, Italy and a Doctorate in Dentistry and Prosthetic at University of Turin, Italy. He is the Director of the MPR International School, Vice President International representative and Founder of API Swiss (International Association of Posturology Switzerland). He is also a Professor in Amocoac Diplomate in Mexico and COMEI, College of Dentistry in Mexico, Associate Professor in ICOM (International College of Osteopathic Medicine) Milan, Italy and an International Honorary member of AMOCOAC.

Abstract:

The Body Equilibrium System (B.E.D.): The first and only appliance designed exclusively for rehabilitation therapists (physiotherapists, osteopaths, chiropractors, etc) for postural rehabilitation, capable of overriding the stomatognatic system. It is the first device on the market able to counteract the negative effects of the stomatognatic system during rehabilitation.

Objectives/Learning Outcomes:
Participants should be able to:
• Perform a detailed bedside clinical postural and posturometric diagnosis
• Based on the clinical observation and clinical history to evidence: Postural deseases
• Relation between stomatognatic system and tonic postural system, how to avoid the negative effect in posture.
• Relation between diet , alimentation and intolerances related with postural deseases
• Recognize the etiology of the postural alteration (main receivers of posture)
• Use of the B.E.D Body Equilibrium Device practically the only device for posture and tmj problems , for rehabilitation
therapist.
The intended audience includes:
• Physiotherapists
• Primary Physicians
• Physiotherapy intern/student
• All rehabilitation therapist

Biography:

Pankaj Gupta come with a rich combination of medical background, IT experience and specialization in General Management from Indian Institute of Management Bangalore. For over 2 decades I have been working in Healthcare/Pharma Technology business and Healthcare/Pharma process standardization. I started with running my primary care clinics for 8 years before getting into Healthcare IT and Management roles globally. I came back full circle to lead the total IT and process transformation of Max Healthcare Group of Hospitals. My global experience includes starting and leading Business Units @ US/ Global Corporations e.g. Cerner, FCG/CSC, Perot/Dell, Infosys. I have managed IT and Quality Departments of US Hospitals and delivered business transformation by process standardization. Also worked in Bioinformatics, Large Pharma IT, Clinical Trials IT. I was instrumental in writing the Meta Data and Data eHealth Standards for MoHFW Govt of India.

Abstract:

The Public Health System in India is struggling with multiplicity of information systems being used at central as well as at state level. Each of these systems is unable to exchange data and information with each other. To overcome similar challenges across ministries, the Ministry of Communication and Technologies initiated semantic standardization across various domains under Metadata and Data Standards (MDDS) project. The intent was to promote the growth of e-Governance within the country by establishing interoperability across e-Governance applications for seamless sharing of data and services. MDDS for Health domain was created by adopting global standards in such a way that existing applications could be easily upgraded to the MDDS standards. The exercise yielded approximately 1000 data elements. These data elements were expected to serve as the common minimum data elements for development of IT applications for various sub domains of health care.

The Need:The need for the CDE arose because most of the primary and public health IT applications are being developed without any standards by different agencies and vendors in public and private sector in India. Each application is developed for standalone use without much attention to semantic interoperability. Later when the thought of interoperability emerges – it becomes difficult to connect the primary and public health systems and make them talk to each other because they were never designed for that purpose. Even if technical and organizational interoperability is done the semantic interoperability may remain a challenge.  For example – all primary and public health applications must have the same Facility Master. When Application A sends the ANC data for Facility 123, the receiving Application B should understand ANC and uniquely identify Facility 123. Another example is if a hospital application sends the insurance reimbursement bill to insurance company/government, the recipient application should be able to understand and represent the same meaning of bill information.

Pilot Test:Ministry of Health & Family Welfare has initiated development of the national health facility registry. The registry was intended to standardize facility masters used across public health information systems. Standardization of facility masters is required for two purposes, first when exchanging data the sending and receiving applications should be able to identify health facility similarly. For example – when Application A sends the maternal health data for Facility 123, the receiving Application B should understand maternal health data and uniquely identify Facility 123.

Second, in public health, performance of each of the facility is assessed using aggregate indicators and facility master serve as the secondary data source on which primary program specific data is aggregated. For example- data from number of doctors from system A and total outpatient attendance data from system B could be analyzed to get per doctor patient load across health facilities only when both applications use common facility masters.

Biography:

Mustafa Afifi held his Medical Bachelor, Master of Internal Medicine and three Post-graduate Diplomas in Mental Health, Primary Health Care and General Administration. Then he terminated his Doctorate in Public Health followed by another Master’s in Health Professional Education. He had his Postdoctoral training in the American University Beirut. He worked in many countries, of them is the UAE. In the UAE, he worked as a Consultant of Mental Health for the Ministry of Health (Head Quarter) for six years, where he integrated mental health services in Primary Health Care. Then, he got his post as Assistant Professor in RAK Medical & Health Sciences University. He has over 80 PubMed publications in non-communicable diseases, mental health, gender issues and health professional education. He is also a Member of many Editorials or Referee Boards of many PubMed indexed medical journals.

Abstract:

Primary Health Care (PHC) settings are unique in its nature because it deals with an entire family across the life span. Our aim in this study was to help the PHC doctors to identify and respond to cases of Violence Against Women (VAW) all over her life cycle. A PubMed based mini review was conducted based on papers published the last 20 years. We found that VAW usually starts even before the girl is born. Gender preference for males affect the survival, nutritional status of daughters, their physical development and differential access to education and health facilities. Then, in her early years of childhood, female genital cutting (FGC) is practiced in Africa and Asia. Its long-term complications include pain and scarring. Some of the adult women experienced the negative reproductive health effects. Being an adolescent, the girl could be exposed to forced marriage. Then, they may be subject to repeated domestic violence from their partner. In both forced and normal marriage arrangements, women could be prone to domestic violence. Suicide and self-harm could follow domestic violence. Moreover, during marriage, polygamy is another moral threat to wives and is associated with poor women mental health regardless of their socioeconomic position and education. Even after aging, women could be subjected to elderly abuse. The PHC doctor should be oriented about the 9 steps of VAW intervention (R9). He should know his role with victimized patients and express his readiness to listen to them and manage them. Doctors should be trained to recognize symptoms of violence, keeping in their mind its risk factors. Usually, the patient needs to be reviewed several times, even after her first visit or even after being referred to higher levels of care. Doctors should be reflective in their management with a respecting attitude to their patients.

Biography:

Norma Ponzoni is a Faculty Lecturer at the McGill Ingram School of Nursing, Quebec, Canada. She is the Academic Coordinator for the Nurse Practitioner Programs. She has graduate degrees in Nursing and Education and is completing her PhD in Educational Psychology at McGill. She has several publications in peer-reviewed journals and is nationally and internationally well-known in the area of nursing education and advanced practice. Her research is focused on primary care and the process by which it can be facilitated and the delivery of professional development to rural regions that make this care possible to isolated populations.

Abstract:

Legislation supporting Nurse Practitioner (NP) practice has allowed the role to expand in Canada; however the introduction of this new role to health care teams has not always gone smoothly. Since NPs provide direct care to patients and have an expanded clinical role, the literature has indicated that the overlapping nature of their scopes of practice with Clinical Nurse Specialists (CNSs) are often a source of tension and that at times, they work in competition. On the other hand these two roles are complementary and collaboration between them can provide improved patient-centered primary care services. A focus group was conducted to explore the relationship between these advance practice nurses, working in two community health centers in Quebec, for the purpose of exploring the facilitators and barriers to their intra-professional collaboration. After content analysis, the data from these nurses, 2 NPs and 4 CNSs, indicated that after an initial period of confusion due to a lack of understanding of roles and overlapping scopes, the advanced preparation of the NPs and their constant presence within the team was a strong and comfortable source of support to CNSs’ practice. Since the majority of community care in Quebec is offered by CNSs, it is logical to assume that better support from their colleagues would have a direct impact on the primary care services they provide.

Biography:

Nadira Abbas Albaghli is a consultant in family & community medicine graduated from King Faisal University, KSA, and having master degree in professions medical education from Arabian Gulf University, Bahrain. She was Director of infection control in Eastern Province, KSA for 5 years. Currently working in consultation clinics in Dammam, Directorate of Health Affairs, EP, KSA, She has published more than 15 papers in reputed journals about chronic diseases and medical education programs. Have Special interests in biostatistics, EBM, and infection control.

Abstract:

Objective: To assess the pattern of follow-up and level of hypertension control according to sociodemographic, and clinical risk factors in the participants of a screening campaign.

Research Design & Methods: In 2004, all Saudi residents in the Eastern Province, aged 30 years and above, were invited to participate in a screening campaign for the early detection of diabetes and hypertension. A structured questionnaire was completed during a face-to-face interview. The presence of hypertension and the place of follow-up were recorded. Blood pressure was measured by trained nurses using a mercury sphygmomanometer, according to the recommendations of The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VII).

Results: Thirteen point one percent of the participants had been previously diagnosed as having hypertension. In 34.3% of them, blood pressure was controlled, while 40.8% had combined uncontrolled SBP and DBP, 14.4% had isolated uncontrolled SBP, and 10.5% had isolated uncontrolled DBP. The blood pressure control was inversely associated with age. It was higher in women, singles, the educated, in those with BMI of less than 25 kg/m², and in those with positive history of CVD (p<0.001).

Conclusion: Co-morbidities relevant for hypertension are very prevalent, so aggressive BP control is mandatory.

Biography:

Tayebeh Ilaghi has completed her PhD and is an expert in qualitative and quantitative research in adults and paediatric and neonatal nursing. Currently, she is a Faculty in Kermanshah University of Medical Sciences, Iran.

Abstract:

Type II diabetes is one of the most prevalent chronic diseases that reduce happiness. Group hope therapy can be used to increase happiness of such patients. The present research aims to determine effectiveness of group hope therapy on happiness of patients with type II diabetes who referred to a diabetic clinic at southeast of Iran. This is a quasi-experimental study. Statistical population is all patients with type II diabetes who referred to a diabetic clinic at southeast of Iran. Among them, 40 individuals were selected based on inclusion criteria and they were placed in intervention and control groups using random numbers’ table. Intervention group received group hope therapy within 8 sessions. Oxford happiness questionnaire was used. Data were analysed using descriptive and inferential statistics such as independent t and paired t tests. Happiness was significantly increased in intervention group after group hope therapy (P<0.001). Moreover, mean happiness in control group was increased after group hope therapy but it was not significant (P=0.22). Results showed that group hope therapy improved happiness of diabetic patients and it can be used by healthcare team.

Biography:

Altuntas  has completed his PhD at the age of 25 years from Dicle  University School of Medicine. In 2007 he received family physician expertise from the Harran University School of Medicine. He has taken an active role in the project of "Effectiveness of chlorokine in malaria and malaria epidemiology".

Abstract:

Aim: The aim of this study was to evaluate the relation between the body composition characteristics and metabolic parameters in patients with PCOS those known to have increased metabolic risks and having no study done before about body fat ratios and other body compositions with “Bioelectrical Impedance Analysis” (BIA).

Material and Method: 23 non-obese PCOS patients (BMI≤27 kg/m²) and 20 matched healthy controls (BMI≤25 kg/m²) were involved to this prospective study. Antropometric parameters, metabolic parameters, 75 gr OGTT and Ferriman-Galwey score were investigated at 3^rd and 8^th day of the menstrual cycle. Insulin resistance was calculated. Body compositions (fat mass, body fat ratio(BFR),Lean Body Mass(LBM) and Total Body Water(TBW) and basal metabolic rate(BMR) were measured by BIA.

Signs: Lutenizan hormone(LH), total testesterone(Tt),free testesterone(fT) and Dehydroepiandrosterone Sulphate (DHEAS) levels were found to be significanlty high and Sex Hormone Binding Globulin levels were found to be significantly low.(p<0.05). A negative relation between insulin sensitivity index and tT, sT, TBW and BMR was found. There was a positive significant correlation between AUC insulin and sT. There was a strong negative correlation found between area under the curve AUC insulin and SHBG. There was a negative significant relation between BFR and tT. A strong negative relation was present sT and DHEAS. There was a positive significant relation present between LBM and tT, sT and DHEAS. A positive significant correlation was present between  BFR and BMI. There was a negative significant relation found between LBM and BMI.

Results: We found significant correlations between body compositions and metabolic parameters with BIA method in our hypothesis. This makes the use of BIA in PCOS patients suitable. On the other hand, for a better comprehesion of the relation between the body composition characteristics and metabolic parameters with BIA, we need long term studies with high number of patients.

Biography:

Mustafa Afifi held his Medical Bachelor, Master of Internal Medicine and three Post-graduate Diplomas in Mental Health, Primary Health Care and General Administration. Then, he terminated his Doctorate in Public Health followed by another Master’s in Health Professional Education. He had his Postdoctoral training in the American University Beirut. He worked in many countries, of them is the UAE. In the UAE, he worked as a Consultant of Mental Health for the Ministry of Health (Head Quarter) for six years, where he integrated mental health services in primary health care. Then, he got his post as Assistant Professor in RAK Medical & Health Sciences University. He has over 80 PubMed publications in non-communicable diseases, mental health, gender issues and health professional education. He is also a Member of many Editorials or Referee Boards of many PubMed indexed medical journals.

Abstract:

Child abuse is a public health problem worldwide. Even witnessing domestic violence is a sort of violence against the child. Our aim was to help the Public Health Center (PHC) doctors to understand the cycle of violence in child abuse. A PubMed based mini review was conducted based on papers published in the last 10 years. Almost a decade ago, logistic regression models showed that exposure to marital violence increased nearly two times the odds (OR=1.89) of hitting or slapping the child on the body and/or the face to address his behavior problems. Another study proved the associations of unhealthy beliefs about female genital cutting with maternal physical abuse. That means a victim of violence would be a future victimizer. Similarly, more recent studies proved that child maltreatment leads to aggressive social behavior adopted by the children and adolescents later on in their lives. Violence against women usually starts even before the girl is born and extends all over life cycle. Mothers with personality disorders are less able to resolve their experience of abuse. The lower sensitivity and higher hostility of those mothers could be transmitted again to their offspring being adolescents. Regardless of the way or process, parenting programs could have a positive effect on risk factors of child maltreatment. Higher-quality child rearing environments and experience of positive changes among the participants of some of these programs are noticed along with individual change with its probable implications on child maltreatment prevention. Yet, evaluation of these parenting programs yields unsatisfactory results. To conclude; besides the need to evaluate the current parenting programs and assess its impact on child maltreatment prevention, participation in it needs to be normalized and seen as a routine part of the child-rearing process.

Biography:

Anshul Govila is a trained General Surgeon with a membership to the Royal College of Surgeons, Edinburgh and an MBA from London Business School. As passionate as he is about evidence based surgical practices, he is equally passionate about establishing healthcare practices which improve access, accountability and quality of care. To that purpose in his current role as Deputy COO of Universal Hospitals, he has been fundamentally involved in the growth of the network with the relevant accreditation.

Abstract:

Primary Care Physicians have always been the funnel through which all patients reach to the tertiary care facilities. This is a more so established dictum in old established healthcare networks like the NHS, the US, continental Europe, Canada and Australia. This model has always seen that strong trained General Practioners cognizably take care of a patient population of 1500-2000. In the process they not only deal with emergent conditions the patients go through but run several risk assessment clinics and several outreach programs for disease prevention. In the geographies mentioned above Practioners are incentivized through schemes to prevent smoking, ask patients to loose weight, maintain compliance to medications and so much so that they are involved in the social wellbeing of the family. The primary care network in the UAE is also being shaped on similar lines but a majority of the expat population cannot avail of this. This population has its own peculiarities, it is underinsured, migratory and is more or less demographically in the middle age bracket with children. Traditionally it has not had any geriatric patients or severely medically compromised patients in its mix. Creating facilities which will cater to this population in an evidence based manner has always been a challenge. To incorporate this in to the bigger plan of a growing hospital is another challenge. The challenges primarily are deployment of human resource, keeping the physicians engaged and seeing that they are not incentivized to over prescribe or over investigate. The model suggested in the presentation is a model we follow to get accountable care and will be detailed in the presentation.

Biography:

Khaldoun Hamdan is assistant professor at the faculty of nursing Al-Ahliyya Amman University. He is assistant dean for clinical affairs

Abstract:

Introduction: Insufficient physical activity is a risk factor for many non communicable diseases. Perceived benefits and barriers to exercise are important factors that affect individuals’ engagement in physical activity. The purpose of this study was to examine Jordanian university students perceived benefits and barriers to exercise.

Material and Methods: This cross-sectional descriptive study used Exercise Benefits/Barriers Scale to examine perceived benefits and barriers of exercise in a convenience sample (N = 525) of university students in Jordan.

Results: The mean age of the students was 20.7 ± 2.4 years and 71.8% of the students were female. Participants reported significantly higher perceived barriers to exercise than perceived benefits from exercise (t (523) = 27.9, p < 0.001). I am too embarrassed to exercise was the most important perceived barrier to exercise. I will live longer if I exercise and exercising increases my acceptance by others were the most important perceived benefits from exercise.

Conclusion:Physical activity and promotion programmes designed for university students should assist them to overcome any perceived barriers, and to further highlight the multiple health and other benefits of regular exercising.

Biography:

Abstract:

Biography:

Vedaste Baziga a holder of Masters in Mental Health Nursing form University of KwaZulu Natal; Lecturer in University of Rwanda, College of Medicine and Health Sciences, School of Nursing and Midwifery, in the Department of Mental Health Nursing. I am an experienced teacher/ Nurse educator and specialized in Mental Health Nursing and I am actively involved in academic activities including mainly teaching modules such as Health Measurement and Research, Mental Health Nursing, Psychiatry, Fundamentals of behavioral sciences, clinical placement and he is also an experienced clinician in the field of psychiatric/ mental health and has worked as practitioner and supervisor in the Psychiatric Reference Hospital and District Hospitals. Also, I am involved in research activities having many research projects (1 already published, and another 1 accepted for publication and remaining 3 in the process of data collection). In addition, I participate also in community outreach and he is always increasing knowledge and skills through Continuous Professional Development (CPD) in different areas".

Abstract:

Aim: The purpose of the study was to describe mental disorder stigmatising attitudes held by nurses, in a selected district hospital in Rwanda, and to analyse the potential mediating effects of person variables, specifically familiarity, on these stigmatising attitudes.

Methodology: A quantitative, non-experimental, descriptive research design was used. A self-report questionnaire included person and two scales; Level of Contact Scale (LOC) and Community Attitudes towards Mental Illness - Swedish version (CAMI-S). A sample of 104 (n=102) was achieved and ethical approval was obtained. Data were analysed using the Statistical Package for Social Sciences (SPSS) Version 21 whereby non parametric tests were used, Mann–Whitney U Test, Kruskal-Willis H Test and Spearman’s rho correlation
coefficient test and significance was determined by Cohen’s guide lines.

Results: Participants reported negative stereotypes, in all items on the CAMI-S, related to persons with a mental disorder. Statistical results indicated associations between negative stereotypes and; the younger age group and the less experienced participants are reported as statistically significant. Also, a negative correlation is reported between familiarity and stigmatizing attitudes.
 

Conclusion & Recommendation: Results suggest that familiarity has a positive mediating effect on negative stereotypes. To address the issue of stigma, curriculum for undergraduate nursing education should be reviewed to include mental health nursing and clinical practice within psychiatric health facilities. Also, the School of Nursing and Midwifery should organize workshops, seminars, conferences and discussions which could include MHCUs to provide testimonies, which will in turn increase the level of contact amongst students and their lecturers.

Biography:

Abstract:

Biography:

Abstract:

Biography:

Ahmed Al-Mandhari is a Graduate from College of Medicine & Health Sciences at Sultan Qaboos University, Oman in 1993. He is the holder of DTM&H and PhD from University of Liverpool in 1996 and 2002 and MRCGP (International) in 1998. He worked as Head of Quality Management Department in 2005-2006 and then as Deputy Director General for Clinical Affairs, from 2006-2010. He also served as Director General of Sultan Qaboos University Hospital (SQUH) from 2010-2013. Currently, he is the Director General of the Quality Assurance Center at the Ministry of Health. He runs one day/week clinic as Senior Consultant Family Physician at SQUH. He had 3 WHO-EMRO funded projects carried out for the Ministry of Health (Oman). He is the Member of Editorial Board and reviewer for some journals and universities websites such as McMaster Online Rating for Evidence (MORE), Canada. He has published several articles on health care quality and health care seeking behavior. He is running workshops such as “how to conduct successful clinical audit” and “disclosure of medical errors”. 

Abstract:

Healthcare systems are striving towards improving quality of health care services and secure patient’s safety. Various tools have been implemented, however, the success of these tools depends on how valued and reliable measure these tools are using. Therefore, it has been expressed by many accrediting and certifying systems that healthcare institutions must create a monitoring system that is relying on evidence-based indicators. The healthcare system in Oman is no exception from such track. Ministry of Health worked on developing a list of indicators that are used to assess the level of quality and patients’ safety. These were developed following a systematic and scientific manner. The paper will share this experience and the impact of such exercise on outcome of care.

Biography:

Farah Muhammad A. Mansuri is a public health physician. She has been working actively in the field of epidemiology for over 25 years.  She has contributed not only in public health research but also has showed her deep interest in medical education. The research presented here highlights the importance of inter-professional education in primary care setting by experiencing course of research methodology to a variety of primary health care providers. 

Abstract:

Objectives: Public Health research demands a participatory approach while working with communities to combat expected challenges in the field. Therefore a  training program on research methodology was introduced at Karachi Medical and Dental College, focusing on the principles of IPE, in order to improve primary care services. The objectives of this study were to assess level of learning by the participants in domain of communication and to explore participants’ opinion regarding evaluation of training program.

Methods: Total 96 participants of the research methodology course were selected during March and September 2010. It included faculty members, medical students, social works students and health technicians. The results were obtained through reflection of students and faculty, responded the first time the course was offered. It was a mixed method research where communication competencies of research course and participants’ perception on course evaluation were analyzed and findings were triangulated. 

Results: It was noted that 87% of faculty enjoyed contributing to ‘inter-professional relationship’; ‘team work’ in community focused areas was learnt to greater extent by 90% of students. 78% of students and 70% of faculty identified ‘active listening’ and ‘communicating information to families’ respectively as been learnt to lesser extent. These findings were defended by their deliberations on course evaluation.

Conclusion: The learning was found to be maximal on contribution at inter-professional relationship among faculty as compared to team work  best learnt by students. Moreover, it was evident that though active listening was learnt lesser but information was better communicated to families by students than faculty.

Biography:

Mininim Oseji became a Consultant Public Health and Community Physician at the age of 34 years after being awarded the Fellowship of the National Postgraduate Medical College of Nigeria (Public Health). She also is a Fellow of the Royal Society of Tropical Medicine and Hygiene and the West African College of Physicians (Community Health). 
She is currently the Permanent Secretary of the Delta State Primary Health Care Development Agency as well as the Executive Director of Public Health Impact Research Centre. She has made 29 scientific presentations at national and international conferences and has 8 published original articles.

Abstract:

Introduction: Quality primary health care services are required for achieving universal health coverage in Nigeria. Universal health coverage will not only improve health indicators but also reduce poverty and inequity. In 2015, a new administration took over the helm of affairs in Delta state of Nigeria. A retreat was organized for policy makers and one of the outcomes was the development of key performance indicators for each sector including health.

Methodology: The Delta state Primary Health Care Development Agency began tracking key performance indicators for monitoring primary health care services in Delta state in 2016. Ten indicators were identified and tracked monthly. They include: Immunization coverage; Number of supplemental immunization activities organized; Number of social mobilization activities organized; Number of information, communication materials distributed; Number of cases of severe acute malnutrition identified and rehabilitated; Percentage of children under five that received vitamin A; Number of treatment protocols developed and enforced; Number of PHC workers trained on immunization, health education/social mobilization, basic life support, neonatal resuscitation training and data management; Number of public private partnerships established and; Number of public private partnership projects completed.

Results: Immunization coverage as at August 2016 for BCG was 94% while that of measles was 96%. Tetanus toxoid coverage was 37%. Six cases of severe acute malnutrition were identified and the percentage of children under five that received vitamin A was 92%. Four public private partnerships were established with three projects completed.

Discussion: The key performance indicators currently being tracked do not require funding. Other key performance indicators that require funding for tracking include number of patients attending health facilities for antenatal care, deliveries and child welfare; number of households experiencing maternal deaths and immunization defaulting visited; income generated from sale of essential drugs. When policy decisions are based on the key performance indicators, the quality of primary health care services being rendered improves and the hope for achieving universal health coverage is in sight.

Biography:

Batool Pouraboli has completed her PhD and is an expert in qualitative and quantitative research in adults and paediatric and neonatal nursing. Currently, she is a Faculty in Tehran Nursing University, Iran.

Abstract:

Type II diabetes is one of the most prevalent chronic diseases that reduce happiness. Group hope therapy can be used to increase happiness of such patients. The present research aims to determine effectiveness of group hope therapy on happiness of patients with type II diabetes who referred to a diabetic clinic at southeast of Iran. This is a quasi-experimental study. Statistical population is all patients with type II diabetes who referred to a diabetic clinic at southeast of Iran. Among them, 40 individuals were selected based on inclusion criteria and they were placed in intervention and control groups using random numbers’ table. Intervention group received group hope therapy within 8 sessions. Oxford happiness questionnaire was used. Data were analysed using descriptive and inferential statistics such as independent t and paired t tests. Happiness was significantly increased in intervention group after group hope therapy (P<0.001). Moreover, mean happiness in control group was increased after group hope therapy but it was not significant (P=0.22). Results showed that group hope therapy improved happiness of diabetic patients and it can be used by healthcare team.

Biography:

Alok K Mathur has professional background of research, evaluation, program management and documentation in various innovative projects. He has done his PhD in Commerce, Master’s in EAFM, MBA in HRD and Bachelor’s in Journalism and Mass Communication. He has many international and national publications to his credit. He has developed and managed HIV prevention, care and support demonstration project “Saksham” addressing rural traditional female sex workers with the approach of empowerment. He has the credit of initiating first two sex workers collectively through ICHAP and first block level ‘Prevention of parent to child transmission centre’ through UNICEF in Rajasthan.

Abstract:

The present study was accomplished to examine the level of stress, anxiety and depression faced by the adolescents who were taking coaching for pre-medical and pre-engineering exams in Kota. The broad objective of the study was to assess the level of depression, anxiety and stress among students preparing for competitive exams like IIT, CPMT, RPMT, AFMC, AIEEE, RPET etc. and also to find out the difference in the level of sBackground: The present study was accomplished to examine the level of stress, anxiety and depression faced by the adolescents who were taking coaching for pre-medical and pre-engineering exams in Kota.

Objective: The broad objective of the study was to assess the level of depression, anxiety and stress among students preparing for competitive exams like IIT, CPMT, RPMT, AFMC, AIEEE, RPET etc. and also to find out the difference in the level of stress, anxiety and depression between those who are preparing for engineering and medical entrance exams.

Methods: The total population from 8 sample coaching institutes is 800 adolescents of which 400 students were from pre-medical and 400 were from pre-engineering coaching institutions of Kota city. The tool used to measure three negative emotional states was DASS (Depression, anxiety and stress scale). The anxiety level of adolescents was measured on four constructs: autonomic arousal, skeletal muscle effect, situational anxiety and subjective experience of anxious effect.

Results: The major findings suggested that nearly about one third of adolescents of the sample reported moderate level of anxiety, which was followed by normal, severe, extremely severe and mild level of anxiety. A substantially large number of students (approximately 30 percent) were found to be depressed at moderate level. The girls were found to be more depressed and having the feeling of hopelessness, sadness, decreased level of enthusiasm, anhedonia, inertia, etc.

Conclusion: The final analysis of stress, anxiety and depression reveals that extremely severe cases were found more in Medical students than in Engineering students.stress, anxiety and depression between those who are preparing for engineering and medical entrance exams. The total population of the 8 sample coaching institutes is 800 adolescents of which 400 students were from pre-medical and 400 were from pre-engineering coaching institutions of Kota city. The tool used to measure three negative emotional states was DASS (Depression, Anxiety and Stress Scale). The anxiety level of adolescents was measured on four constructs: autonomic arousal, skeletal muscle effect, situational anxiety, and subjective experience of anxious effect. The major findings suggested that near about one third of adolescents of the sample reported moderate level of anxiety, which was followed by normal, severe, extremely severe and mild level of anxiety. A substantially large number of students (approximately 30 percent) were found to be depressed at moderate level. The girls were found to be more depressed and having the feeling of hopelessness, sadness, decreased level of enthusiasm, Anhedonia, Inertia, etc. The final analysis of Stress, Anxiety and Depression reveals that extremely severe cases were found more in medical than Engineering.

Biography:

Harsha has his expertise on reproductive and health issues in developing country context. His open and contextual evaluation of reproductive health issues in emergency context help several of the organization to design the intervention in Nepalese context.  He has an enthusiasm to build the capacity of the students, social work and identification of gaps in health service delivery.

Abstract:

Biography:

Nehal Shata MD, MPH began her career in Public Health as a paediatrics teaching assistant at king -Abdulaziz University Jeddah, Saudi Arabia. She obtained her Masters of Public Health at the Johns Hopkins University Bloomberg School of Public Health. Her capstone project on child abuse outlined an overview of the situation in Saudi Arabia. After completing her degree, she did a year at Johns Hopkins School of Medicine as a postdoctoral research fellow investigating how sleep disturbance during critical illness modulates outcomes in children. She is currently a Pediatric resident at McGill University in Montreal, Canada, where she will continue her work as a child advocate in Public Health.

Abstract:

Statement of the Problem:In Saudi Arabia, child abuse still having underreporting problem, and remains a common problem in the country. Professionals and public servants of all child-focused fields must combat this problem through the implementation of an awareness program to increase reporting and easy detection of abuse.

Methodology & Theoretical Orientation: The search engines used for this review were: PubMed databases, PsycINFO, and Google Scholar. The research limited results to within Saudi Arabia and utilized the following keywords: maltreatment, Child Protective Services, reporting child abuse, child abuse types.

Findings & Conclusion: Child abuse is a public health concern globally, as well as within Saudi Arabia. A reporting system to indicate its prevalence was introduced to Saudi Arabia in 2010, and served as the first annual registry report for the region. Since that time, through the efforts of the National Family Safety Program, the reporting data has improved. According to current literature, physical abuse and neglect are currently the most common types of abuse, followed by sexual and emotional abuse. Parents are the most common perpetrators. The most common risk factors include: large family size of more than six people, paternal unemployment, and/or divorced parents. Although child protection teams now exist and notify the social protection department, police, and regional principals, under-recognition and under-reporting continue to pose major challenges.

Recommendations: The recommendations put forth at the conclusion of this review are as follows: first, that public child abuse prevention programs be implemented which apply to all thirteen regions of Saudi Arabia, including rural areas. Secondly, those health care providers receive training to recognize and report child abuse through implementation and follow-through on guidelines, workshops, and mandatory training programs. Additionally, to implement a large-scale parenting education program for parents, as they are the most common perpetrators. Implementation of school curriculum which teaches children how to protect themselves from abuse will also be vital. Finally, to conduct and evaluate the effectiveness of these preventive programs regularly, with emphasis on sustainability and regular follow ups as key elements of a successful program.

Biography:

Sergey Suchkov has completed his graduation from Astrakhan State Medical University and awarded with MD, then in 1985 completed his PhD at the I M Sechenov Moscow Medical Academy and in 2001 maintained his Doctorship Degree at the Nat Inst. of Immunology, Russia. From 1987 to 1989, he was a Senior Researcher, Koltzov Inst. of Developmental Biology, from 1989 to 1995 he was the Head of the Lab of Clinical Immunology, Helmholtz Eye Research Institute in Moscow. From 1995 to 2004, he served as a Chair of the Dept. for Clinical Immunology, Moscow Clinical Research Institute (MONIKI). He has been trained at: NIH; Wills Eye Hospital, PA, USA; Univ. of Florida in Gainesville; UCSF, S-F, CA, USA; Johns Hopkins University, Baltimore, MD, USA. He was an Ex Secretary-in-Chief of the Editorial Board, Biomedical Science, an international journal published jointly by the USSR Academy of Sciences and the Royal Society of Chemistry, UK. At present, he is the Chair of Dept. for Personalized and Translational Medicine, I M Sechenov First Moscow State Medical University. He is a member of the: New York Academy of Sciences, USA; ACS, USA; AHA, USA; EPMA, Brussels, EU; ARVO; ISER; PMC, Washington, USA.

Abstract:

A new systems approach to disease, to pay its crucial attention on the trend would result in a new branch in the healthcare services, namely, personalized medicine (PM). To achieve the implementation of PM concept, it is necessary to create a fundamentally new strategy based upon the subclinical and/or predictive recognition of biomarkers of hidden abnormalities long before the disease clinically manifests itself. This strategy would give a real opportunity to secure preventive measures whose personalization could have a significant influence on demographics. The key benefits of PM would include: to detect disease at a subclinical stage; to stratify patients into groups that enable the selection of optimal preventive treatment; to reduce adverse drug effects by more effective early assessment of individual drug responses; to improve the selection of new targets for drug discovery and; to shift the emphasis from illness to wellness. The decision to utilize PM-related tools and targeted therapeutics is made at a level of targeting whilst depending on the type of intervention it could be ordered by administration of hospitals and infirmaries, laboratories or clinics, by doctors, and sometimes directly by individuals/patients to suit the patient-centric mode. Coordinated measures to optimize the progress should be well-focused on solving the accumulating problems in healthcare and the concomitant economic burden that societies across the globe are facing more and more. PM offers great and real promise for the future, and next generations will speak about the XXI century as a time, when healthcare services became predictive and preventive, and its outcomes – secured and guaranteed.

Biography:

Sergey Suchkov graduated from Astrakhan State Medical University and awarded with MD, then in 1985 maintained his PhD at the I.M. Sechenov Moscow Medical Academy and in 2001, maintained his Doctorship Degree at the Nat Inst of Immunology, Russia. From 1987 through 1989, he was a senior Researcher, Koltzov Inst of Developmental Biology. From 1989 through 1995, he was a Head of the Lab of Clinical Immunology, Helmholtz Eye Research Institute in Moscow. From 1995 through 2004, a Chair of the Dept for Clinical Immunology, Moscow Clinical Research Institute (MONIKI. Dr Suchkov has been trained at: NIH; Wills Eye Hospital, PA, USA; Univ of Florida in Gainesville; UCSF, S-F, CA, USA; Johns Hopkins University, Baltimore, MD, USA. He was an Exe Secretary-in-Chief of the Editorial Board, Biomedical Science, an international journal published jointly by the USSR Academy of Sciences and the Royal Society of Chemistry, UK. At present, Dr Sergey Suchkov is a Chair, Dept for Personalized and Translational Medicine, I.M.Sechenov First Moscow State Medical University. He is a member of the: New York Academy of Sciences, USA; American Chemical Society (ACS), USA; American Heart Association (AHA), USA; EPMA (European Association for Predictive, Preventive and Personalized Medicine), Brussels, EU; ARVO (American Association for Research in Vision and Ophthalmology); ISER (International Society for Eye Research); PMC (Personalized Medicine Coalition), Washington, USA

Abstract:

A new systems approach to disease to pay its crucial attention on the trend would result in a new branch in the healthcare services, namely, personalized medicine (PM. To achieve the implementation of PM concept, it is necessary to create a fundamentally new strategy based upon the subclinical and/or predictive recognition of biomarkers of hidden abnormalities long before the disease clinically manifests itself. This strategy would give a real opportunity to secure preventive measures whose personalization could have a significant influence on demographics!

The key benefits of PM would include:

(i)          to detect disease at a subclinical stage;

(ii)        to stratify patients into groups that enable the selection of optimal preventive treatment;

(iii)      to reduce adverse drug effects by more effective early assessment of individual drug responses;

(iv)      to improve the selection of new targets for drug discovery;

(v)        to shift the emphasis from illness to wellness.

The decision to utilize PM-related tools and targeted therapeutics is made at a level of targeting whilst depending on the type of intervention it could be ordered by administration of hospitals and infirmaries, laboratories or clinics, by doctors, and sometimes directly by individuals/patients to suit the patient-centric mode. Coordinated measures to optimize the progress should be well-focused on solving the accumulating problems in healthcare and the concomitant economic burden that societies across the globe are facing more and more. PM offers great and real promise for the future, and next generations will speak about the XXI century as a time, when healthcare services became predictive and preventive, and its outcomes – secured and guaranteed!

Biography:

Dr. Abdulkarim had completed his postgraduate training in radiology in Leicester training scheme UK where he obtained the FRCR. Currently he is a Consultant Radiologist at George Eliot Hospital and a visiting fellow to Warwick medical school. Dr Abdulkarim’s current research interest is in the field of reduction of intravenous contrast in CT examination and the effects on renal function where he had published several papers.

Abstract:

Recognition of pancreatic anomalies on imaging is essential as they may be of clinical relevance and are potential causes of recurrent pancreatitis or gastric outlet obstruction in patients.

We describe a ‘V shaped pancreas’, a pancreatic anomaly that resembles canine pancreatic anatomy that, to the best of our knowledge, has not previously been described in humans.

We will also review pancreatic embryological development and anatomy, including common variants.

Biography:

Adla Bakri Hassan has been graduated from Gezira University in Sudan. She did her postgraduate studies and training at Karoliniska Institute and Karoliniska Hospital in Sweden, also at Hope Hospital in United Kingdom. She has experiences over 20 years in different hospitals and countries treating rheumatic disease patients; Sudan, Sweden, UK and Bahrain. She has over 10 years’ experience in teaching medical students. She is currently working as assistant professor at department of internal medicine at Arabian Gulf University (AGU) in Kingdom of Bahrain and as Consultant Rheumatologist at the University Medical Centre (UMC). She has over 20 publications in peer reviewed journal and also a reviewer peer journals.

Abstract:

Statement of the Problem: Rheumatoid arthritis is a systemic autoimmue disease. However, organ-specific rheumatoid arthritis (monoarthritis) has rarely been reported. It is not uncommon to see a rheumatoid arthritis patient who has only one single joint involvement (monoarthritis). Hence, there are no guidelines to demonstrate how to treat such patients. The purpose of this study is to describe the experience of encountering a rheumatoid arthritis patient with monoarthritis. Methodology & Theoretical Orientation: A 34 years old Bahraini female referred to my clinic on 2nd September 2014 from an orthopedic clinic, complaining of pain and swelling of her right knee, her symptoms started 6 months previously with only pain in her right knee and overtime she it developed swelling. No history of trauma, rest of history is insignificant except for mild fatigability and maylgia. Physical examination is significant only for the right knee which was swollen on the medial aspect, mildly tender, but not red or hot, quite the opposite; it was colder than the left knee. Findings: Extensive laboratory evaluation revealed positive rheumatoid factor, high anti-CCP (763.6 U/ml), high ESR (30), high CRP (17), high ANA (1:320), ENAs was negative, Plain X-ray was normal, patient refused to do MRI. Accordingly, the patient was diagnosed as seropositive rheumatoid arthritis (? organ-specific) and started on MTX (12.5mg Once/week), folic acid (5mg once/week) and plaquinil (400mg OD). After 9 months on therapy and up-to-date the patient was improved on all aspects, she became completely asymptomatic and all labrotary parameters went down, but still not normal. Conclusion & Significance: Early detection and treatment of the rheumatoid arthritis patient presents with monoarthritis could promise early remission.

Biography:

Anas A Alghamdi has completed his Bachelor of Medicine from College of Medicine, King Saud University at Riyadh, Saudi Arabia. He is a member of Saudi Diabetes & Endocrine Association, and is currently on Postgraduation Residency training program at King Fahad Medical City.

Abstract:

The aim of reporting this case is to highlight the association of two disorders: Primary hyperparathyroidism and slipped capital femoral epiphysis. They are usually seen in two different age groups and rarely together. Primary hyperparathyroidism is a rare cause of slipped capital femoral epiphysis and only 10 cases have been reported in the literature worldwide. The patient in our report is a 13 year old girl who presented to our clinic with bilateral knee pain and a waddling gait. Subsequent investigations showed that she had primary hyperparathyroidism and slipped capital femoral epiphysis with low bone mass. On admission, a parathyroidectomy was performed; then, the slipped femoral epiphyses were fixed with satisfactory results. A systematic algorithmic approach that was illustrated in a previously published case was used. Such cases should be managed in a systematic approach based on the patient’s clinical status to prevent future morbidity. A literature review was conducted by performing a medline search of all reported cases of primary hyperparathyroidism and slipped capital femoral epiphyses.

Biography:

Yoshiko Hasebe has been working at Nayoro City University School of Health Science. She is a Professor of Adult Nursing, and has her expertise in evaluation and passion in improving the nursing practice. She has published many textbooks and DVDs about nursing arts in Japan.

Abstract:

Many cancer patients on outpatient chemotherapy complain of dysgeusia. Thus, we searched the literature database of four journals that publish articles related to anti-cancer chemotherapy and taste perception, and reviewed knowledge useful for nursing care of cancer patients. We found that dysgeusia frequently occurred at a relatively early stage when FOLFOX/FOLFIRI combined with 5-FU, or regimens involving a taxane and related agents were used. The risk of dysgeusia was significantly higher with DTX than with other regimens. This can be explained by the formation of a chelate between 5-FU and zinc, which in turn elevates urinary excretion of zinc, leading to zinc deficiency. Perception of all basic tastes (saltiness, sweetness, sourness, and umami), except bitterness, tend to be impaired. The frequency of impairment of saltiness perception appeared to be relatively high. Taxanes and related regimens were associated with a high occurrence rate of impairment of umami perception and with severe changes in saltiness perception. Considering the report showing the link between the impairment of saltiness perception and low plasma zinc levels, regimens involving 5-FU is likely to cause disorders in saltiness perception. Possible causes of dysgeusia attributed to anti-cancer agents include inhibition of taste bud metabolism, lingual nerve disorder and zinc deficiency. It is likely that dysgeusia in patients receiving a taxane and related agents is attributed to peripheral nerve disorders, since these agents do not cause zinc deficiency. Experimental S-1 administration in rats suggested the possibility that dysgeusia is caused by damage to the gustatory nerve but not mucosal epithelia and taste buds. Regimens involving relatively low doses of 5-FU, for example CMF and FEC therapies, can cause dysgeusia, although it did not appear severe enough to influence patients’ appetite. The frequency of dysgeusia in patients receiving gemcitabine (GEM) was also significantly low.

Biography:

Siham M Al-Momani is an Associated Professor in the area of Primary Health Care, Midwifery and Nursing Education in the Faculty of Allied Medical Sciences, and the past Assistant Dean for staff development and continuing education at Zarqa College in Al-Balqaa Applied University, Jordan.  She holds a Doctoral degree from Amman Arab University for Post-Graduated Studies, Jordan. Her area of specialty is nursing learning and instruction, while her research interests include; clinical nursing learning, community service and educational technology. She has several publications and conference papers. She received her BS and Master’s degree in Nursing Education from University of Jordan and has been taught in Princess Muna College of Nursing Mutah University (1987 – 2000). She is a member in the Jordanian Nursing Council (JNC) and the Jordanian Nursing Council for Nurses and Midwifes (JNCM).

Abstract:

Primary health nurses are the largest profession working in primary health. The importance of improving the quality of care provided to primary health care consumers had been identified by health organization worldwide. In order to achieve this improvement, primary health nurses need to take the lead in developing the culture of compassionate care. Compassion- Includes managing every client’s as an individual and taking time to ensure that all clients feel their needs are being addressed in dignified and respectful way. Compassionate care, must be accompanied by professionalism at all times. Six action areas which include; care, compassion, competence, communication, courage and commitment to ensure developing the culture of compassionate care in primary health care services will be discussed.

Biography:

Retno Asti Werdhani is an academic staff from Department of Community Medicine, Faculty of Medicine Universitas Indonesia since 2001. She joined the faculty member because she has passion in primary care and wanted to involve in primary care physicians (PCP) development through education, health service, and research. Her current dissertation on development of care coordinator instrument measurement for PCP got cumlaude results and on process for intellectual license’s right

Abstract:

Statement of the Problem: Modern medical care requires teamwork, therefore it requires leadership competency. As a care coordinator, Primary Care Physician (PCP) requires planning, organizing, implementation, and evaluation for their works. Therefore, a model of leadership in medicine is needed to be implemented in Primary Care.

Methodology & Theoretical Orientation: A literature search was conducted during research about developing care coordinator instrument and its relationship with leadership. All keywords was collected and formed into framework.

Findings: Transformational leadership was stated as a leadership style that is suitable for health services. It is similar to patient centered approach which understands ideas, concerns, and expectations of patients. A transformational leadership was also explore ideas, concerns, and expectations of followers, open to aspirations and needs of followers, provide stimulation, explain vision and objectives, encourage followers to pursue these objectives, and reach mutual agreement for goals achievement. It was identical to the interaction of physicians (as leader) and patient (as follower). Patients generally need encouragement and motivation, and physician should understand the real needs of patient. Thus, patient’s case management should be well prepared and explained in accordance to patient's needs and can be agreed upon as well as implemented with the appropriate respective roles. A leader needs to do various aspects related to the managerial process for carrying out the implemented activities. The same management process can also be done by PCP in carrying out various activities required to achieve patient’s target management. Such activities include planning up to building networks.

Conclusion & Significance: Primary Care Physicians are expected to have leadership competencies and transformational leadership to support their performance as care coordinator. This capability can be gained through capacity strengthening based on patient’s needs with holistic, comprehensive, integrated, and continuous approach, as well as building relationships with other stakeholders.

Biography:

Zeynep Altuntas has completed his PhD at the age of 24 years from  Selcuk University , Meram School of Medicine. In 2005 she worked at the Mayo Clinic as a research fellow. In 2007 she received Plastic and Reconstructive Surgery expertise from Selcuk Universty. She has published more than 20 papers in reputed journals. Her studies on wound healing and regenerative medicine continue.

Abstract:

Statement of the Problem: Recently, autologous platelet rich plasma  are being used to treat  acute and chronic  injuries in an attempt to jump start healing due to being too much growth factor source. However, the homologous (allogenic) platelet rich plasma has been investigated  in several studies to treat chronic wounds. To the best of our knowledge, it has not been studied  as injection for articular and soft tissue injuries.  In this study, our objective was  to treat  different kinds of soft tissue and joint disorders with homologous platelet rich plasma and investigate the effects  of it.

Methods: We applied 164  injection of homologous PRP to 109 patients. 63 patient had knee pain, 12 patients had temporomandibular joint pain,  7 patients had tennis elbow, 9 patients had shoulder pain, 15 patients had lumbar pain,  3 patients had pain on the Achilles tendon.  The 139 injection were made intra-articulary  and 25 injections were applied into the the  soft tissue.  We repeated the injection in 16 patients. All of the patients were followed  for one year.

Findings: No severe adverse events or complications related to the injections were observed during the treatment or follow-up period. All of the patients were very satisfied with the treatment and  had  reported pain relief  and  increase of their life standarts. Second session were performed to the seventeen  patients after six months due to the resumption of their aches.  However , they were also reported significant increase in the quality of their lives .

Conclusion & Significance: This  study showed Homologous PRP could be safely used without complications or adverse effects. Additionally all of the patients reported a significant satisfication from the treatment.

Biography:

Manal Ali Ghandour is currently working with DHCR with expertise in health informatics, quality and healthcare management. She has attained her Master’s degree in Quality Management in 2008 from UOWD and her BSc degree in Nursing from Jordan University in 1994. In 2012, she worked as Adjunct faculty in Al Ain Men’s College of Higher technology and was a Project manager for Fatima College of Health Sciences. She has led the Health Education Program implementation in Abu Dhabi and Al Ain ADEC schools in 2011. She helped DOHMS to implement the fully integrated HIS system in Dubai in 2003. She had yearly presentations in the International Conferences as Health Informatics, Wireless Technology, Health Management, Clinical Effectiveness, Hospital Management & Quality Management.

Abstract:

Primary health care doctor should be the essential access to any care and most of the healthcare. Currently and due to many socio-economic reasons, the patients have the freedom to see consultants and specialists thinking that they can get a better care. In this presentation i will discuss multi factors that lead to this conclusion. My discussion will not definitely get the cure or the golden answer for this dilemma but it will enlighten the regulators, policy makers, service providers and doctors on what is happening and why it is happening. The cost of healthcare is rising and this will make it difficult for low socio economic classes to cope with or get treated. Many medical errors are going unnoticed due to this bizarre situation. We will explore together some solutions and recommendations.

Biography:

Nas Al-Jafari graduated from The University of Nottingham in 2004. He has a broad range of experience in a variety of specialties, and became a member of The Royal College of General Practitioners in 2009. He has gone on to obtain further specialist qualifications, and it is this wide range of clinical experience that has proved invaluable for his holistic and integrative approach to patient care. He has a particular focus on modifying lifestyle factors influencing long-term health and chronic disease. He has brought the same ethos to Abu Dhabi, offering safe and effective care with maximal patient comfort and satisfaction.

Abstract:

In 1970, Ancel Keys published the ‘seven countries study’, which systematically examined the relationship between lifestyle and cardiovascular disease. Strong associational findings from Key’s study forged the way for the first US dietary guidelines in 1980. In a changing tide of opinion, dietary cholesterol has since been agreed and is of no relevance, according to the 2015 US dietary guidelines, and LDL-cholesterol has been shunned as a predictor of cardiovascular disease. Yet, statins, aimed at reducing total and LDL-cholesterol, have revolutionized the way we treat cardiovascular disease, and continue to forge the way for more novel treatments, like the PCSK9 inhibitors. This talk examines the evidence behind the diet-heart hypothesis and leads on to questioning the validity of current approaches to medical therapy.

Biography:

Nehal Shata MD, MPH began her career in Public Health as a Paediatrics Teaching Assistant at King -Abdulaziz University Jeddah, Saudi Arabia. She obtained her Master of Public Health at the Johns Hopkins University Bloomberg School of Public Health. Her capstone project on child abuse outlined an overview of the situation in Saudi Arabia. After completing her degree, she did a year at Johns Hopkins School of Medicine as a Post-doctoral Research Fellow investigating how sleep disturbance during critical illness modulates outcomes in children. She is currently a Pediatric Resident at McGill University in Montreal, Canada, where she will continue her work as a Child Advocate in Public Health

Abstract:

Statement of the Problem: In Saudi Arabia, child abuse still having underreporting problem, and remains a common problem in the country. Professionals and public servants of all child-focused fields must combat this problem through the implementation of an awareness program to increase reporting and easy detection of abuse.

Methodology & Theoretical Orientation: The search engines used for this review were: PubMed databases, PsycINFO, and Google Scholar. The research limited results to within Saudi Arabia and utilized the following keywords: maltreatment, child protective services, reporting child abuse, child abuse types.

Findings & Conclusion: Child abuse is a public health concern globally, as well as within Saudi Arabia. A reporting system to indicate its prevalence was introduced to Saudi Arabia in 2010, and served as the first annual registry report for the region. Since that time, through the efforts of the National Family Safety Program, the reporting data has improved. According to current literature, physical abuse and neglect are currently the most common types of abuse, followed by sexual and emotional abuse. Parents are the most common perpetrators. The most common risk factors include: large family size of more than six people, paternal unemployment, and/or divorced parents. Although child protection teams now exist and notify the social protection department, police, and regional principals, under-recognition and under-reporting continue to pose major challenges.

Recommendations: The recommendations put forth at the conclusion of this review are as follows: first, public child abuse prevention programs must be implemented which apply to all thirteen regions of Saudi Arabia, including rural areas. Secondly, health care providers should receive training to recognize and report child abuse through implementation and follow-through on guidelines, workshops, and mandatory training programs. Additionally, it is important to implement a large-scale parenting education program for parents, as they are the most common perpetrators. Implementation of school curriculum which teaches children how to protect themselves from abuse will also be vital. Finally, to conduct and evaluate the effectiveness of these preventive programs regularly, with emphasis on sustainability and regular follow ups as key elements of a successful program.

Biography:

Meral Abualjadayel completed her medical education from King Abdulaziz University, KSA. She is currently Pediatric Students Club Co-founder, Academic Education Unit President At King Abdul-Aziz University-faculty of Medicine. She also Volunteers in the Clinical skills mentoring program. She is the Organizer In "World Kidney Day" Event Held in King Abdulaziz University Hospital

Abstract:

Renal oncocytoma was first described by Zippelin 1942 as a malignant entity, however, Klein and valensi were able to demonstrate its benign characters in the year 1976. The current the World Health Organization have classified renaloncocytomas as benign renal neoplasms in 2004. Renal oncocytoma is the second most common benign renal neoplasm after angiomyolipoma, comprising 3-7% of all renal tumors, usually occur during the seventh decade of life varying from 20 to 86 years of age with males predominance. Zhou defined renal oncocytoma as a benign epithelial neoplasm composed of round-to polygonal-cells with abundant mitochondriarich eosinophilic cytoplasm, thought to arise from the intercalated cells in the kidney. The size of the tumors varies from 0.6 to 14 cm(7). Unfortunately, most oncocytomas are very difficult to be differentiated from renal cell carcinoma both clinically and radio graphically. Development of renal oncocytoma in pediatric age group is very uncommon with no cases found within our review of the world literature. We report herein the first case of renal oncoytoma in a 14 year old young lady.

Biography:

Musfer ALshalawi joined Al Jafel International Hospital, Riyadh as an Executive Director responsible for overall business operation development and strategic plans. He has more than 20 years of experience in healthcare management in government, private and overseas hospitals, like the New Castle General Hospital/Royal London Hospital in UK, Royal Commission Hospital Yanbu KSA, Al-Hada Military Hospital Taif KSA etc. Over the course of his career, he has taken over various roles such as Quality Director/Patient Affairs Director, Project Manager/Human Resources Director and other management positions. He graduated at John Hopkins University, as Quality Specialist and has participated in 27 international symposium and summits in the healthcare management as a speaker (lecturer). He gives various lectures on healthcare and quality/leadership/strategy & planning/ communication/teamwork. He has also been giving lectures in all hospitals (CBAHI/JCI standards) as a part of his job. He is a member of ISQUA (International Society for Quality in Health Care) and Saudi Management Association.

Abstract:

The objective of this study was to highlight the system’s thinking perspective to ensure quality health care, thereby transforming the healthcare delivery system, changing healthcare design, structure and processes to correct inherent structural deficiencies. Around the world, healthcare organizations are encountering growing pressures to simultaneously improve the quality and safety of health and well being of the public, cut costs and remain competitive. To achieve these goals, a number of assessment mechanisms have been used to address quality in medical care organizations. The most common are JCI/ISO/EFQM and another accreditation. However, evidence from hospitals and PHC-based studies, suggests that external evaluation may be effectively used to complement internal processes. The value added is optimal when there is a clear, mutual understanding of purpose, a teamwork approach and a commitment to use the results of all forms of evaluation to shape a change agenda. But the success of TQM is constrained by many variables such as, poor commitment from leadership and inadequate information system. There is also a decline of attention to the diseases, instead of addressing the patients’ needs and experience. As a direct consequence, there is an increasing fear for lack of focus on patient-centered quality and safety. Nevertheless, implementation focuses more on the individual part, whereas organizational and managerial aspects are minimized or even neglected altogether. From system thinking perspective, the foundations of quality are functions of several variables. Accreditation programmers are most effective when they are in conjunction with other strategies to address patient needs, accessibility, information, service costs, accountability and compliance. The implementation of successful TQM requires a fundamental shift in thinking - from how to best provide a wide variety of independent services to how to effectively combine individual service components into an integrated health care experience that meets patient needs and preferences. Extensive redesign of the basic work processes, advocates may result in significant changes, in scope, task responsibilities, professional autonomy and reporting relationships. Health care/system redesign involves making systematic changes to primary care practices and health systems to improve the quality, efficiency and effectiveness of patient care. The focus should be on two aspects, first understanding the interdependencies of different dimensions existing in the healthcare delivery experience and the changes identified to improve quality care which is measurable and accountable for. Conceptualizing the healthcare services as a structured system is the essential prerequisite to the management of effective changes and excellence. Second, is to drive change and improve healthcare performances, as it is critical and vital to know what matters to the customers by maximizing the patient’s care experience, this not only includes respect, the bond of trust, the shared decision making, but also the well-coordinated correspondences and overall efficiency. It goes without saying that understanding your organization as a system is the essential prerequisite to the management of effective change, as it enables leaders and workers to understand that the majority of performance is caused by how the system has been designed.

Biography:

Neeraj Bedi is a dedicated and experienced Medical professional with a teaching, training, research and administrative experience of 26 years in the Public Health domain in the field of epidemiology, preventive medicine, community medicine, hospital administration and management. Presently, he is working as Senior Faculty in Community Medicine, Medical College, Bhopal. He is having many research articles published in national and international journals. 

Abstract:

The role of health informatics is becoming significantly crucial in every part of the health sector. Rapid advancement in information technology has made it mandatory as well desirable to use e-Health in patients care and in public health. The main issues in providing patients care arise from incomplete information, exchanging the information, duplicating investigations and monitoring the response to treatment. Accordingly WHO has set goals of comprehensive patients’ information including investigations; treatment accessible at all places by health care providers irrespective of the location, to be achieved by 2012. The use of ICT in the form e-Health technology in health care sector can help achieving this target. The e-Health components includes Electronic Medical Records (EHR), Electronic Health Records (HER), Electronic Personal Health Records (PHR), Tele health, telemedicine, m-health i.e. use of mobile smart i-phone apps for health purposes and e-learning. The e-Health improves the efficiency, equity, the quality of health care, empower consumers and patients, encourages bonding, educates , enabling the information exchange and take care of Ethical issues in health care. The impact of e-Health on stakeholders enables them to have health care available at home, at work or in school. It focuses on prevention, education and self-management, availability of complete information and improves patients’ safety. Medical researchers and Policy makers i.e. Government too derive benefits by e-Health. At International level Australia, Canada, USA and most European countries have adapted the use of e-Health in health care. In India too the beginning has been made by corporate group of hospitals /private hospitals and Government has also initiated e-Health plan but still a long journey ahead to implement e-health in entire country.

Biography:

María del Pilar Marcos Martínez has completed her studies from University of Alicante and Post-doctoral studies about tobacco addiction from Barcelona University School of Medicine. She is the Director of a Public Medical Centre in Petrer (Alicante). She has worked in different projects about Public Health such as tobacco control, violence against women and community activities for more than 20 years. She usually takes part in national and international scientific congresses as Speaker or as a Member of the scientific committee. She is implicated in teaching young doctors in Primary Healthcare these days.

Abstract:

Positive health is a way of looking at the actions with care in order to improve everything that people, families and communities can do to take care of their own health. Positive health and wellbeing of our population should be one of the most important targets nowadays. As Michael Marmot said, “If the major determinants of health are social, so must be the remedies”. This social understanding is central to the process of change to reduce the burden of disease. How we can make it possible and why it is so important is the purpose of my intervention. It’s really essential to reduce inequalities in health and wellbeing by attending our communities in a complete perspective. I live in a town which has 35,000 citizens. It has two public medical centers and I work in one of them. It is mostly an urban population, but it also has a big rural region. The nearest hospital is at about 10 minutes by car. We try to prepare and develop activities to our community at any time during the year; but we specially perform an intensive week of community activities once a year. The main goal is to improve conditions of life referring to wellness. It is essential to look at the population, to review the overarching principles of good practice, detect local needs and priorities, identify the available assets and choose the kind of actions to implement. Other relevant element is the involvement of different members of society such as politicians and the education system. How we educate and socialize our children is really important to get a future healthy population. Making strong links between all of them could be interesting to be successful. Community activities are essential to obtain efficient interventions.

Biography:

Dr. Elias is a graduate of Harvard Medical School with 2 certificates of fellowship in cornea and refractive surgery from the Eye Center and Eye Foundation for Research, and The Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, USA and Head of the Cornea and Refractive Surgery department at Beirut Eye Specialist Hospital. Dr. Elias is heavily involved in the practice and research of cornea, cataract, refractive surgery and cornea transplant and has to his record more than 50 peer reviewed scientific papers, chapters and reviews. Also, presenter and invited faculty in the field of cornea and refractive surgery at international meetings. Dr. Elias has been serving as an editorial board member of the Journal of Refractive Surgery, Expert board member of the International Journal of Ophthalmology, Guest editor of the Journal of Ophthalmology (current concept in corneal collagen crosslinking), Lead Guest editor for a special issue of Bio Med Journal, International Advisory Board for the Saudi Journal of Ophthalmology and a County liaison and regional representative of “Tear fil and Ocular Surface Society “TFOS”.

His research interest includes: Refractive surgery, Corneal transplant, ocular surface disease, keratoconus, and retinal degenerative disease. Dr. Elias is leading a registered clinical trial for the treatment of Retinitis Pigmentosa, new treatment modalities of keratoectasia and new glaucoma filtering procedure.

Abstract:

Purpose: To report a new treatment strategy of grade IV diffuse lamellar keratitis (DLK) based on topical 10% sodium citrate and oral doxycycline.

Methods: Six eyes of 3 patients with stage IV DLK after LASIK, were treated with the same treatment protocol of 10% topical sodium citrate 6 times a day for 4 weeks and 100 mg oral doxycycline twice daily for 2 weeks then once daily for three months, along with topical steroid drops for one week then tapered gradually over one month. Assessment of response to treatment was done in terms of visual acuity, anatomical and keratometric recovery for the period of follow up ranging from 1 to 8 years.

Results: Follow-up visits showed improvement in all eyes, starting at 2 weeks, with an improvement in UCVA, a decrease in hyperopia and in the central corneal infiltrates. Progressive improvement was documented during the follow up. At 1 year, the outcome regarding UCVA, hyperopia and clinical findings was excellent reaching 20/30 to 20/20 OU, with residual hyperopia of +0.25 D to +1.25 D and a complete resolution of the central infiltrates.

Conclusion: This is the first report of successful treatment of stage IV DLK. Topical sodium citrate 10% and oral doxycycline seem to target the main pathophysiology of the disease through their mechanism of anti-collagenolytic activities. This new treatment strategy might be considered in the treatment of corneal inflammatory conditions characterized by increased collagenolytic activities after LASIK.

Precis: In stage IV DLK, stromal collagen is digested by collagenolytic enzymes. We report a new treatment strategy of grade IV DLK, based on topical sodium citrate and oral doxycycline with good anatomical and functional outcomes.

Biography:

Anukriti Sood had completed her MBBS at the age of 25 years from SSR Medical College, University Of Mauritius and postdoctoral studies (M.S. General Surgery) from Government Medical College, Amritsar, India in 2014. She had been trained in Tata Memorial Centre, Mumbai, a premier institute of oncology in India. She had completed few years of senior residency in S.M.S Medical College, Jaipur, in Department of Surgical Oncology. Presently, she is working as MCh resident in Department of Breast and Endocrine surgery, AIIMS, New Delhi.  She has presented lot of papers in various national and international conferences.

Abstract:

Multicystic nephroma is a relatively rare , non genetic  , unilateral ,  lesion of the kidney which has a bimodal  distribution . The nonspecific clinical findings and the poor contribution of imaging examinations make the preoperative diagnosis a diagnostic dilemma  and difficult to differentiate from other cystic renal neoplasia.

We report a case of cystic nephroma in a 40 yr old female who presented with a right sided abdominal lump and pain abdomen since 6 months . After a series of examinations including abdominal ultrasound and computed tomography , she underwent right partial nephrectomy and diagnosis was confirmed on histopathology.

Conclusion: Final diagnosis can be only established by the histopathological examination of the completely excised tumour in the pathology laboratory

Biography:

Dr. Abdulkarim had completed his postgraduate training in radiology in Leicester training scheme UK where he obtained the FRCR. Currently he is a Consultant Radiologist at George Eliot Hospital and a visiting fellow to Warwick medical school. Dr Abdulkarim’s current research interest is in the field of reduction of intravenous contrast in CT examination and the effects on renal function where he had published several papers.

Abstract:

Polyorchidism is a rare congenital anomaly described as the presence of more than two testes. The aetiology of this condition is unknown but it was first described by Blasius in 1670 as an incidental finding during an autopsy. This is an uncommon condition particularly with an undescended testis and usually diagnosed at early life. We present a case report of 81 year old with undescended supernumerary testis and to our knowledge this is the oldest age at presentation. We will also discuss the relevant embryological development.

Biography:

Dr. Spandan Chaudhary is team leader of Medical Genetics, Diagnostics and Next Generation research divisions of Xcelris Labs, India. He has six years of professional experience in genomics industry specifically in the medical genetics segment. He has developed more than 30 very important diagnostic, sports and nutrition health related assays. He has designed the beta thalassemia mutation screening assay based on whole gene sequencing of HBB gene including all the mutations and indels. He has screened more than 200 individual samples and 25 trio samples as prenatal screening for beta thalassemia. This approach is very useful in diagnosing prenatal thalassemia in combination with regular screening methods.

Abstract:

β-Thalassemia is a genetic disease characterized by reduced or non-functionality of β-globin gene expression, which is caused due to number of genetic variations and indels (insertions and deletions). In the present case study, we have reported a rare occurrence of compound heterozygosity of two different variants, namely, HBBc.92G>C and HBBc.92+5G>C in maternal amniotic fluid sample. Prenatal β-thalassemia mutation was detected using nucleotide sequencing method. After analysis, the father was found to be heterozygous for HBBc.92G>C (Codon 30 (G>C)) mutation (β0 type) and the mother was heterozygous for HBBc.92+5GNC (IVS I-5 (G>C)) mutation (β+ type). When amniotic fluid sample was analyzed for β- globin gene (HBB), we found the occurrence of heterozygous allelic pattern for aforesaid mutations. This compound heterozygous state of fetus sample was considered as β+/β0 category of β thalassemia which was clinically and genotypically interpreted as β-thalassemia major. The probability of occurrence of both mutations is very low, because mutations are only 5 base pairs apart on HBB gene.  Segregation of compound heterozygosity has occurred twice in this family.  Along with the present case, we will share our experience of analyzing 21 unrelated families (trios samples) for detection of β-thalassemia using whole gene sequencing and RT-PCR assays. We will share few interesting case studies like co-inheritance of sickle cell anemia and β-thalassemia traits, compound heterozygosity of beta thalassemia major and normal in the case of twin pregnancy.  Prenatal diagnosis helps the parents to know the thalassemic status of the fetus in the first trimester screening.

Biography:

Snigdha Rao is a final year Post-graduate student of the prestigious Post-Graduate Institute of Medical Research, Chandigarh, India. She was the best out-going student of her batch in her MBBS from the prestigious Osmania Medical College, Hyderabad. She was the Joint Secretary of OSMECON-12, Undergraduate National Conference and the Editor-in-chief of the conference magazine. She is interested in pursuing fetal medicine.

Abstract:

Hydrocephalus is one of the most common major congenital anomalies occurring in approximately 0.3 to 1/1000 live births. The etiologies of congenital hydrocephalus include infections, vascular abnormalities, mechanical obstruction and chromosomal abnormalities.  In genetic terms, the isolated (non-syndromic) form of hydrocephalus is a primary and major phenotype caused by a specific faulty gene. It is estimated that about 40% of hydrocephalus cases have a possible genetic etiology. It can be X-linked or autosomal recessive or even autosomal dominant. The recurrence risk excluding X-linked hydrocephalus is low. Empiric risk rates range from <1% to 4%. Here we present two cases of non-consanguineous couples with no previous family history presenting to us with fetal hydrocephalus in consecutive pregnancies associated with aqueductal stenosis. In our first case the mother had one neonatal loss due to hydrocephalus, termination of second pregnancy due to same defect and a third live birth with the same defect. In our second case the mother had one neonatal loss due to hydrocephalus, termination of second pregnancy for the same and she came to us for pre-conceptional counseling. Genetic analysis was not done in either case. The correct molecular diagnosis can provide the parents with the recurrence risk together with the possibility of prenatal genetic diagnosis for a future pregnancy. 

Biography:

Dr. Shadab Shireen is pursuing her MD in Pathology in Bombay Hospital Institute of Medical sciences and Research Centre, Mumbai, India. She has done one international publication. Interested in research work.

Abstract:

Diamond-Gardner Syndrome or autoerythocyte sensitization is a rare syndrome characterised by spontaneous development of painful edematous skin lesions progressing to ecchymosis over the next 24 hours. Severe stress and emotional trauma always precede the skin lesion. It is regarded primarily as an autoimmune vasculopathy with sensitization to phosphatidyl-serine, a component of erythrocyte stroma.

We present here a case of 15 years old girl who presented with multiple ecchymotic patches over body. Baseline biochemical, hematological and immunological investigations were normal. Skin biopsy showed no evidence of vasculitis. All routine coagulation investigations were normal. Diagnosis of Gardner-Diamond syndrome was made clinicaly, it was therefore diagnosis of exclusion. A high index of suspicion was necessary to make the diagnosis.

Biography:

Will be updated soon...

Abstract:

A 31  year  old  male  patient  not  known  to  have  any comorbidities or chronic medical illnesses underwent open appendicectomy presented in day 10 postoperatively with the complain of dull epigastric pain associated with dark stool since day 1 post operatively. The stool  was semi solid not fuel smelling with passage frequency of 1 per day associated with flatus. There is no history of fever, nausea or vomiting. The abdomen was distended, tense and rigid. No masses were palpable, shifting dullness positive. Per rectal examination showed a normal tone with ballooned rectum and liquid brown colored stool was seen. Otherwise systemic examination was unremarkable. X- ray abdomen and CT scan was done and showed small bowel obstruction. The patient was taken for diagnostic laparoscopy that showed massively dilated small bowel and so the decision was taken to proceed with diagnostic laprotomy. The Laparotomy revealed a large mass in the cecum extending to the ascending colon. The mass was soft to hard in consistency and causing ileocecal obstruction.  After  small  bowel  deflation,  right limited hemicolectomy was done with removal of terminal ileum, cecum and 10cm of         the ascending colon, No mesenteric lymph nodes were appreciated. Post operatively the patient was started on 750mgCefurixime with 500mg metronidazole TID for 7 days. His symptoms has improved and continued to have       normal vitals, active bowel sounds, and brown color stool.    

Biography:

Zoha Khademi has completed her Diploma from National Organization for Development of Exceptional Talents (NODET) and is a 4-year-Medical Student at Arak University of Medical sciences. She has worked on more than 20 papers. She is so interested in neurosurgery and neuropathology and other fields related to tumors. She has 2 presentations before such as 5th symposium of world federation of neurosurgical societies, with presidency of prf. Madjid Samii, the 7th international neurosurgery congress, the 1st international neuroscience congress, MASSIN interim meeting- 2016. Diploma of honor is awarded to her on the chosen student article of international congress of pathology and laboratory medicine-2017.

Abstract:

The presence of cartilaginous component in gliomas including ependymoma is a unique phenomenon. We herein report a further 8-year-old boy suffered from a tumor in the fourth ventricle that histopathologic evaluation proved its uncommun ependymoma with cartilage within the tumor tissue. Derivation of this mature chondrocytes is unkown and immunohistochemical labling for GFAP, EMA, cytokeratin and ki-67 could not support their possible origin from glial cells. Radiation role in chondroid metaplasia was rejected during this present case. At the end of article, we investigated cartilaginous ependymomas have more aggressive behavior than classic ependymomas.

Biography:

Taha Fereydouni has completed his Diploma from National Organization for Development of Exceptional Talents (NODET) and is a 6-year-Medical Student at Arak University of Medical sciences. He has worked on more than 20 papers. He is so interested in neurosurgery and neuropathology and other fields related to tumors. He has presented 2 oral articles. Diploma of honor is awarded to him on the chosen student article of international congress of pathology and laboratory medicine-2017.

Abstract:

Intradural teratoma is an exceedingly unique phenomenon. They are tumors with the cellular constituent source of all the three germ cell layers. We herein report a case of an 18‑year‑old male with special pathological features. There was no history of spinal dysraphism, congenital spinal abnormalities, previous spinal surgery, or lumbar puncture. Lumbosacral spine magnetic resonance imaging revealed a well-delineated, intramedullary mass at the L2-L3 levels of the lumbar spine. Histopathologic examination of the resected tumor revealed cystic spaces lined with simple columnar epithelium as well as mucus secreting epithelium, adipose tissue, salivary gland like serous cell and bundles of smooth muscle cells. Unusual histopathologic features have been seen in the case for example there were no cartilage components which are mostly found in mature teratomas, abundant  pacinian corpuscle nerve endings and nerve trunks. There were no immature elements or malignant cells Teratomas should be taken into consideration in the differential diagnosis of intramedullary lesions even when the imaging reveals tissue homogeneity.