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

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:

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:

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.