Day 2 :
Keynote Forum
Mohamad Miqdady
Sheikh Khalifa Medical City, UAE
Keynote: Congenital diarrhea syndromes
Time : 9:40 AM to 10:20 AM
Biography:
Mohamad Miqdady is American Board certifi ed in Pediatric Gastroenterology, Hepatology and Nutrition. He is the Division Chief, Ped. GI, Hepatology & Nutrition Division at Sheikh Khalifa Medical City in UAE. Program Director, Pediatric Gastroenterology Fellowship Training program, SKMC, Abu Dhabi, UAE. Also an Adjunct Staff at Cleveland Clinic, Ohio USA. Expert member of the FISPGHAN Council (Federation of International Societies of Pediatric Gastroenterology, Hepatology, and Nutrition); Malnutrition/Obesity Expert team.He completed his Fellowship in Pediatric Gastroenterology at Baylor College of Medicine and Texas Children’s Hospital in Houston, TX, USA. He held the position of Assistant Professor at Jordan University of Science and Technology in Jordan for six years prior joining SKMC.Main research interests include nutritional disorders, feeding diffi culties, picky eating, obesity, procedural sedation, allergic GI disorders and celiac disease. He has 20 publications in peer reviewed journals.
Abstract:
Congenital diarrhea is a term used to describe diarrhea that develops early in life, typically, within the fi rst two months of life classically associated with dehydration, failure to thrive and electrolyte disturbances. Some of these infants with secretary type might have prenatal fi ndings of dilated bowel loops. While in infants with malabsorptive type it starts with the fi rst feed. Th e diagnosis is usually established with endoscopic biopsies with electron microscopy evaluation and the appropriate genetic testing. While it might be puzzling and challenging even to the most prudent physician, we will discuss a practical approach that allows you to have a provisional working diagnosis and management plan helping your infant to back on track in a timely approach. Treatment is usually with long term parenteral nutrition with special attention to avoid long term complication associated with TPN.
- Bacteriology | Virology | Global Spread of Viruses | Clinical Immunology | Neglected Tropical and Rare Infectious Diseases
Location: MENA Plaza Hotel Albarsha
Chair
Kokila Selvaraj
Meenakshi Medical College Hospital and Research Institute, India
Co-Chair
Ayman Noreddin
University of Sharjah, UAE
Session Introduction
Joyvonne Kwamboka Ombega
Rare and Chronic Diseases Foundation, Kenya
Title: Challengers facing the Rare and Chronic disease patients
Time : 11:30 AM -12:00 PM
Biography:
As a rare disease patient and Advocate she is on the know on the challenges facing the rare community and also what can be done to impact the positive change that is highly important for the health professionals, the rare disease patients and their care givers in our communities. The great vision and immense passion to support others is what drove her to start the non profit organisation. The Rare and Chronic Diseases Foundation Kenya. She's on the forefront raising awareness on rare diseases of which many are debilitating and life threatening also leading to invisible disabilities which is a great challenge in Kenya Africa and the world as a whole. She's been on media and also trying to involve the health professionals in this great movement towards eradicating and proper management of rare diseases. She's a diploma holder in pharmacy and clinical psychology. Been a pharmaceutical entrepreneur till 2017 when she couldn't do it anymore due to her health condition. No life should be lost due to an economical status.
A health world is a wealth world.
Abstract:
Primary Hyperaldosteronism Patient.There are several challenges facing the rare patients, care givers and the health professionals.
Lack of diagnosis: Well these conditions are rare therefore most end up undiagnosed due to lack of adequate information and few research centres misdiagnosis; This is in the sense that some symptoms end up being confused as the disease itself and also most of these conditions have several and similar symptoms which makes it harder for the patient to get a diagnosis. Lack of adequate treatment due to lack of access to treatment facilities especially in developing countries where some health facilities are quite a distance. Orphan drug challenges; Most rare diseases have few drugs to none for the treatment of such conditions. This is due to business minded manufacturers who concentrate on what can sale Visa vie what is available for the rare community.
Economic challenges: These patients run from one health facility to another in search of an answer to their puzzle which is rare therefore they end up financially drained before they even get a diagnosis. It takes approximately 5 to 15 years to get a proper diagnosis which makes it a great challenge for the patient and their care givers. These leads into emotional challenges which can cause other health problemsLack of information and support system for such patients becomes a major hurdle in getting a diagnosis which leads to the health deterioration of the patient. Limited or non existing treatment options due to lack of research and treatment protocols for most of these rare diseases which most often than not leads to loss of life.
Social challenges: These rare diseases makes the patient live in isolation and loneliness which is fatal.We are social beings in nature and this leads to stigma from the community.
Cultural challenges: This is a major factor that is uniquely to the African context that prevents one from seeking for medical care since there are believes that such diseases a curse or have spiritual existence and connections. Disabilities; These diseases cause both physical and invincible disabilities which robs the patient their independence leading poverty. Theres is a major challenge of lack of preventive and curative therapies for rare diseases due to their rare nature and these mostly affect the developing countries who are in dire help with proper health equipments and facilities to help with research and therefore saving lives. Lack of rare patient registry is equally a major challenge and we are looking forward to creating more awareness in getting the government involved in developing it.
Nilanjana Ghosh
North Bengal Medical College, India
Title: Potable water and uncontaminated food at every household: Dream or reality? A study among tribal population of Naxalbari Block, Darjeeling district, West Bengal, India
Time : 12:00 - 12:30 PM
Biography:
Nilanjana Ghosh has completed her MBBS, MD in Public Health, DNB, MNAMS and DHM and PGDEPI. She is an Elected Member of National Editorial Board IJPH and State Executive Committee Member of IAPSM.
Abstract:
Introduction & Objective: Water quality, water behavior along with food quality, food behavior, domestic environment and food handler’s hygiene play pivotal role in preventing food and water borne diseases. Working women seemingly face more hazards and perceived negligence is higher in hilly tribal population. Thus the pilot study was undertaken. Th e objective of the study is to assess water quality at source and household level and cooked food quality, immediate domestic environment along with determining their existing knowledge/practices regarding water and food handling techniques.
Method: Descriptive community based cross-sectional study was conducted in collaboration with department of microbiology from May-July 2018 in Kiranchandra Tea Estate. Water quality was assessed among all five sources and selected 50 households using PA Coliform Kit. Water behavior was assessed in 187 households. All 120 houses with women as permanent workers were studied for food behavior, food handler hygiene and domestic environment. 50 selected houses were assessed for cooked food quality using PA H2SHi-Dip Media Kit. Results were interpreted aft er 48 hours incubation and confi rmed by culture.
Results: Contamination was noted in both open wells and 33 houses with E coli and Klebseilla. Improper water carriage, storage and treatment were found in 67.2%, 76.3% and 88.2% cases respectively. Food quality and domestic environment were inappropriate in 56.3% and 68.4% cases respectively. Illiteracy and lack of administrative support were signifi cantly associated.
Conclusion: Water and food was unfi t for consumption in vast majority. Water and food behavior was inappropriate. Identifi ed causes need sustainable and viable solutions. A larger study is recommended.
Indranil Chakrabarti
North Bengal Medical College, India
Title: Incidental detection of parasites: A Pathologist’s viewpoint
Time : 12:30-13:00
Biography:
Indranil Chakrabarti has completed his Graduation in MD Pathology. He is an Ambassador of European Association for Cancer Research. He has more than 58 publications in national and international journals of repute. He is a regular Reviewer of several international journals including Diagnostic Cytopathology and BMJ-Case Reports. He is also a Member of International Editorial Board of various pathology related journals and a contributor to pathology outlines.
Abstract:
Parasitic infestation is a serious health problem in developing countries. Lack of proper sanitation, close proximity with cattle and pets as well as overcrowding are some of the causes that lead to the spread of parasitic diseases. Some parasitic infections do parasites in routine blood and bone marrow is the job of a pathologist. But oft en, fi ne needle aspiration cytology smears of superfi cial and deep lesions, histopathological specimens of various organs, urine and stool specimens carry an element of surprise to the unsuspecting microscopist.
Ruchika Butola
Rajiv Gandhi Super Speciality Hospital, India
Title: Lophomonas blattarum infection in an immune-competent patient and its misdiagnosis: A case report
Time : 15:00-15:30
Biography:
Ruchika Butola has completed her MD Microbiology from Swami Vivekanand University, Meerut, India. She is currently working as a Senior Resident in the Department of Clinical Microbiology of Rajiv Gandhi Super Speciality Hospital, Delhi, India.
Abstract:
Introduction: Lophomonas Blattarum is a round-oval shaped protozoan, 20-60 μM diameter with apical tuft of numerous fl agellate. It resides as an endocommensal in the hindgut of insects such as cockroaches. It’s increasingly being recognized as one of the cause bronchopulmonary infection.
Case Report: A 22-year-old female presented with complaints of cough with blood clots in expectorant, breathlessness on exertion, wheeze and low-grade fever, for past one year. Before arriving to our Outpatient Department (OPD), patient had consulted other medical centers. Th ere she was diagnosed with tuberculosis. In our OPD she was reviewed with previous reports, advised new investigations, continued on Antitubercular Therapy (ATT) and was planned for bronchoscopy. The Bronchoaleveolar Lavage (BAL) was sentfor laboratory testing. Wet mount of the sample revealed a motile multifl agellate protozoan resembling ciliated respiratory epithelium. Aft er further assessment, it was reported as Lophomonas blattarum. Th e patient was kept on ATT, while awaiting Mycobacterium Tuberculosis (MTb) test results. Ongoing ATT had no positive eff ect patient’s condition. Patient was admitted and started on Anti-protozoan treatment.
Discussion: It is diffi cult to diff erentiate Lophomonas blattarum symptoms from other respiratory infections displaying similar symptoms. Laboratory diagnosis relies on identifi cation of morphological features under light microscopy. Missed identifi cation could be due to delayed sample processing and its close resemblance to bronchial epithelium. With development of serological and molecular methods of identifi cation, diagnosis and treatment can improve.
Kavitha M
Kilpauk Medical College, India
Title: Changing trends in gonococcal infections-shift to MSM: Emerging resistances
Biography:
Kavitha M has completed her MD Microbiology at the age of 34 years from Stanley Medical College 14 years of teaching experience.Area of interest immunology, Infection Control, Sexually Transmitted infection, and medical education. Has worked in Regional reference Lab for STI for 2 years, State reference Lab for HIV for 5 years and State reference Lab fro Dengue and Chickungunya for 3 years.I am undergoing Advanced Course In Medical Education At Regional Center Sri Ramachandra Medical University. She Has been in Bio-Medical Waste Management Traning And Monitoring for more than10 years. Published 5 Articles and Presented 4 Topic in National Conferences Has been a speaker in National Conference for STI.
Abstract:
Introduction: Gonococcal infections are a major part of sexually transmitted infections among MSM. The rising trend of gonococcal infections in male is alarming and screening of antibiotic resistance is important to treat them. The objective is to isolate gonococci and detect the resistance of gonococci by phenotypic methods from patients attending venereology department.
Method: All the patients with cervical discharge or urethral discharge attending venereology department were screened by grams stain and culture was done on Th ayir Martin medium. Antibiotic resistance was detected by disc diff usion method as per CLSI guidelines.
Results: A total of 50 gonococcal isolate were identifi ed from males with urethral discharge. None were isolated from females. Out of 50 isolates 60% (30) were B-lactamase producers and resistance to penicillin and 34% (17) to tetracycline. 64% (32) of isolates had developed chromosomal resistance to Ciprofl oxacin and 12% (6) were resistance to Azithromycin. 4% (2) of the isolate was resistant to Cephalosporins. One isolate was resistant to four drugs.
Conclusion: Th e isolation of gonococci from male has been increasing along with resistance to penicillins, fl uoroquinolone and tetracycline. Resistances to Cephalosporins are beginning to appear. Emergence of multidrug resistance makes treatment of gonococcal infections a challenge. Hence it is mandatory to screen for resistance and treat the infections so as to prevent spread of infections especially in male with multiple sex partners all of whose identity may not be known to treat the partner as well.
Raimundo Dos Santos
Hospital Nacional Guido Valadares, East Timor
Title: Unusual cause of owel obstruction in children in East Timor
Biography:
Raimundo Dos Santos has done his graduation from Paiol Primary School in dili, the capital of Timor Leste. He was awarded a scholarship by Ausaid to Study English for Academic Purposes at University of Wollongong in 2002. He completed his MBBS at FSM. He is currently working as a General Practitioner at the Hospital Nacional Guido Valadares (HNGV) the Hospital Of Timor Leste.
Abstract:
Intestinal duplication cyst is a rare condition and may be the cause of small bowel obstruction in children. In pediatric age group it should be considered as an important diff erential diagnosis in children who presented with recurrent abdominal pain and or recurrent obstruction. Diagnosis of duplicated intestinal cyst is clinically always diffi cult; therefore, defi nitive diagnosis may only be made at laparotomy. Gastrointestinal Duplication (GIDs) is rare congenital malformation, which can arise from mouth to the anus. May vary greatly in presentation, size, location, and symptoms. It t prevalence of 1:4500 births, predominantly in white males2/3 of all intestinal duplication discovered in within fi rst 2 years of life with 1/3 identifi ed in the new born period. Due to its rarity of these lesions, they frequently present at both diagnostic and therapeutic Challenges. Duplication of the gastrointestinal tract are cystic or tubular structures whose lumen are linked by a mucous membrane usually supported by smooth muscle and intimately associated with the alimentary tube. Th e histology reveals the characteristic lining of intestinal mucosa. They occur because of congenital aberration during gut development which may be found anywhere from the tongue to the lower rectum. Although they both arise from a redundant morphogenesis, the dorsal non-vitelline enteric malformation of the duplication cyst have a diff erent embryological origin to those associated with the vitellointestinal duct (Meckel's diverticulum), and, about a half present within a month of birth and two-thirds in the fi rst year. The most common site is the small intestine (50%), particularly the ileum (35%) with the cystic type being more common than the tubular type. Jejunum (10% and duodenum (5%). Although rare, intestinal duplication cyst is an important diff erential diagnosis for recurrent abdominal pain in the pediatric age group, and rarer in adulthood.
- Epidemiology of Re-Emerging Infectious Diseases| Causes, Symptoms and Diagnosis of Infectious Diseases | Advances in Antimicrobials, Vaccines and Therapeutics | Bacterial and Viral Genomics | Case Studies | Antiviral, Antibacterial, Antifungal Agents | Clinical Case Reports
Location: MENA Plaza Hotel Albarsha
Chair
Robert O Young
PH Miracle Centre, USA
Co-Chair
Hoda Mansour
GHD/EMPHNET Contractor, Egypt
Session Introduction
Sivasankari Murugan
Meenakshi Medical College Hospital and Research Institute, India
Title: Resistogram pattern of Escherichia coli isolated from various clinical samples in & around Kanchipuram
Time : 11:50 AM -12:20 PM
Biography:
Sivasankari Murugan has completed MBBS from Rajah Muthiah Medical College and Post graduation MD (Microbiology) from Madras University, Tamil Nadu, India. She is Associate Professor in Microbiology at Meenakshi Medical College & RI, Kanchipuram, Tamil Nadu, India. She has published more than 30 research papers in reputed journals. Her areas of interest include Hospital Infection Control, Anti Microbial resistance surveillance . Under gone training in NABL & NABH accreditation courses & Currently working as NABH Co-ordinator.
Abstract:
E.coli is one of the main cause of nosocomial infection in humans. E.coli being one of the common organism causing hospital acquired infections exhibits ESBL production Causing resistant to Beta lactam group of drugs resulting in limited treatment options. Hence, this study was done to know the resistance pattern in E.coli and their virulence factors. Materials and Methods: Samples (urine, pus, sputum) were collected & processed as per standard protocols E.coli were isolated. Antibiogram done as per CLSI guidelines. ESBL & MBL screening done, Biofi lm formation of E.coli was studied in correlation to antibiotic resistance. Result: 235 E.coli were isolated from various clinical samples. Out of 235, 148 (62.97%) showed resistance to ceft azidime & cefatoxime, 53 (22.55%) were ESBL producers, 19 (8.8%) showed resistance to imipenem, 32 (1.27%) were MBL producer. E.coli were resistant to nalidixic acid, 119 (50.6%) followed by Cotrimoxazole 98(41.7%), Ciprofl oxacin resistance was 135 (57.6%) and MIC ranged from 8- 64 μg/ml. Among 235 E.coli isolates 169 (46.38%) were MDR of which 29 (12.34%) were strong biofi lm producers.
Conclusion: Th is study highlights that all isolated ESBL producers were resistant to 3rd Gen. cephalosporins. Th is increase in resistance to number of commonly used antibiotics shows the emerging drug resistance. In view of this, ESBL testing and MBL screening should be made as a routine testing which will help in the shuffl ing of antibiotics and for proper treatment and to prevent further development of bacterial drug resistance
Senthamarai Thiyagarajan
Meenakshi Medical College Hospital and Research Institute, India
Title: Detection of mecA gene by PCR among coagulase negative Staphylococci (CoNS) from various clinical samples in a tertiary care hospital
Time : 12:20-12:50 PM
Biography:
Senthamarai Thiyagarajan has completed her MD in Microbiology from Stanley Medical College. She is currently working as Professor in Meenakshi Medical College Hospital and Research Institute, India. Her areas of interest are Mycology, HIV, Antibiotic Resistance, Infection Control and Medical Education. She has received the Medical Excellence Award by Indian Solitarity Council at New Delhi and also has won many best paper awards to her credit. She has published more than 30 articles in reputed journals.
Abstract:
Introduction & Aim: Coagulase Negative Staphylococci (CoNS) are now emerging as important pathogen and its resistance to antibiotics are worrisome. Methicillin resistance among CoNS causes an important therapeutic threat associated with increased morbidity and mortality. Th is study was aimed to isolate the coagulase negative Staphylococci from various clinical specimens, evaluate its antibiotic susceptibility pattern and to detect the prevalence of mecA gene among coagulase negative Staphylococci.
Method: All the clinical samples were collected with aseptic precautions and processed as per standard protocol. All the coagulase negative Staphylococcal isolates were subjected for antibiotic susceptibility testing as per CLSI guidelines. Screening of methicillin resistance was done using cefoxitin disc (30 μg) as per CLSI recommended disc diff usion method. Genotypic analysis for methicillin resistance (mecA gene) was done.
Results: A total of 89 clinically signifi cant non-repetitive coagulase negative Staphylococcal isolates were identifi ed. S. epidermidis was most frequently isolated, among various species of CoNS. 15/89 (16.8%) were methicillin resistant but only 9 CoNS isolates showed mecA genes.
Conclusion: Coagulase negative Staphylococci, which were previously dismissed as contaminants are now emerging as important pathogen. Th ere is necessity for continued surveillance to determine the extent of emerging resistance in CoNS to reduce inappropriate use of antibiotics and to allow policies to be established for adequate and rational use of antibiotics. Th is study insists the need of continuous monitoring the prevalence of methicillin resistance among CoNS in a given population and to frame the antibiotic policy because it can vary from region to region.
Prashanthi Rayapati
Lynbrook High School, USA
Title: The effect of G lucidum on the lifespan of caenorhabditis elegans modeling Duchenne muscular dystrophy
Time : 13:50-14:20
Biography:
Prashanthi Rayapati is currently pursuing her High School at LYNBROOK HIGH SCHOOL, San Jose, CA. Her Research of interests are Evolutionary Cell Biology research in gene modifi cations using DNA methods, Cognitive Artifi cial Intelligence modeling of Duchenne Muscular Dystrophy using the C.elegans effect on G.Lucidium on the Life Span of Patients. She got awards like Shri Krupa Volunteer of the Year, Synopsis Science Fair Honorable Mention, Leukemia and Lymphoma Society Award, JEENA recognition Award.
Abstract:
Duchenne muscular dystrophy (DMD) is an X chromosome-linked disease characterized by progressive physical disability, immobility and premature death in aff ected boys. Underlying the devastating symptoms of DMD is the loss of dystrophin, a structural protein that connects the extracellular matrix to
the cell cytoskeleton and provides protection against contraction-induced damage in muscle cells, leading to chronic peripheral infl ammation. However, dystrophin is expressed in neurons within specifi c brain regions, including the hippocampus, a structure associated with learning and memory formation. Linked to this, a subset of boys with DMD exhibit progressing cognitive dysfunction, with defi cits in verbal, short-term, and working memory. Furthermore, in the genetically comparable dystrophin-defi cient mouse model of DMD, some, but not all, types of learning and memory are defi cient, and specifi c defi cits in synaptogenesis and channel clustering at synapses has been noted. Little consideration has been given to the cognitive defi cits associated with DMD compared with the research conducted into the peripheral eff ects of dystrophin defi ciency. Th erefore, this review focuses on what is known about the role of full-length dystrophin (Dp427) in the hippocampal neurons. In this experiment, I hypothesized that 100 ug/ml of G. Lucidum would extend the lifespan and too much concentration of this herbal medicine would lose its effi cacy in treating this disease. A study was conducted through the reactions and lifespan of Caenorhabditis Elegans exhibiting the lack of dystrophin to the diff erent concentrations of G. Lucidum. As a result, the eff ect of G. Lucidum on the Caenorhabditis Elegans modeling Duchenne Muscular Dystrophy was astonishing as 100 ug/ml of G. Lucidum helped prolong the lifespan of these nematodes by 20%. Th is data can be refl ected onto the lifespan of humans with DMD as the 20% increase in lifespan of these nematodes could mean the prolonged life of 6-8 years for humans. However, too much concentration of G. Lucidum was shown not to aff ect the life of the worms. The hypothesized argument was proven correct as the results show the 20% increase of lifespan for the 100 ug/ ml of G. Lucidum concentration and the eff ect of too much concentration of this herbal method. Moreover, the use of herbal medicine like G. Lucidum could be a new inexpensive and attainable method of treatment for those diagnosed with DMD. Th e importance of dystrophin in learning and memory is assessed, and the potential importance that infl ammatory mediators, which are chronically elevated in dystrophinopathies, may have on hippocampal function is also evaluated.
C Anitha
Meenakshi Medical College Hospital and Research Institute, India
Title: Screening of invitro activity of antimicrobial and antibiofilm property of Mesenchymal stems cells against MDR gram negative organism isolated from urinary tract infections in tertiary care hospital
Time : 14:20-14:50
Biography:
C Anitha has completed her PhD from Dr ALM PGIBMS, University of Madras, India. She is currently working as Assistant Professor of Microbiology in Meenakshi Medical College Hospital and Research Institute. Her areas of interest are Biofi lm studies using Confocal Laser Scanning Microscope, Antimicrobial resistance and rare Infectious diseases. She has published more than 30 papers in reputed journals and also has 15 Data sequences submitted in PUBMED/NCBI Genebank. She is also serving as an Editor, Associate Editor, Editorial Board
Member and Review Board Member of reputed journals.
Abstract:
Introduction & Objective: Recent studies had showed that Mesenchymal Stem Cells (MSCs) have beneficial effects on bacterial infections. Treatment with MSCs has proven bacterial clearance. Th is study was undertaken to study the in vitro activity of antimicrobial and antibiofi lm activity of stems cells against gram negative multidrug resistant organism from urinary tract infections.
Method: The samples will be processed according to standard protocol following standard guidelines. All the isolates obtained will be identified by standard guidelines. Total of 50 isolates were collected. The antibiotic susceptibility testing will be done for all the isolates by Kirby Bauer disc diffusion method following CLSI guidelines. All the isolates are screened for production of biofi lm by tissue culture plate method. The antimicrobial activity of mesenchymal stem cells was done by micro broth dilution method.
Results: Among the 50 gram negative isolates 22 (44%) were Pseudomonas species 12 (24%) were E coli 8 (16%) were Klebsiella spp and 8 (16%) were Proteus species. Among the 50 isolates 32 (64%) were multi drug resistant to the antibiotics tested. Among the 50 isolates 43 (86%) produced biofi lm of which 28 (65%) were strong producer 8 (18%) were moderate biofi lm producer and 7(16.27%) were weak biofi lm producers. All 43 isolates showed sensitivity for the mesenchymal stem cells with MIC range of 32-0.25μg.
Conclusion: So far only very few or no studies have been reported on anti-biofi lm activity of mesenchymal stems cells. From our study stem cell, therapy with MSC will be eff ective and alternate for antibiotic resistance in chronic urinary infection there by can serve as therapeutic options for treating drug resistant organisms.