Biography:
ABC
Abstract:
ABC
Scientific Program
Day 1 :
- Chronic Diseases
Session Introduction
Sasidharan P K
Govt. Medical College, India
Title: ‘Kozhikode Criteria’ for diagnosing SLE
Biography:
Abstract:
SLE can present with hematological manifestations alone or along with musculoskeletal, skin or other system involvement. In cases with hematological abnormalities as the predominant or only manifestation, the diagnosis is often delayed or missed at the time of presentation, this is especially so if the index of clinical suspicion is low or if there is improper and inadequate follow up. An observational study was conducted in our institution with the purpose of estimating the proportion of SLE with hematological manifestations as the initial presentation of the disease. It was observed that 76.8% of the patients had hematological manifestations at first presentation. Thus hematological manifestations were found to be the most common presenting manifestation of SLE in people of North Kerala which is not given due importance in the ACR criteria for diagnosing SLE. One of the common coexisting abnormalities in patients with initial hematological presentation was autoimmune hypothyroidism, which also is not included in the ACR criteria. The most common hematological abnormalities at presentation were ITP, autoimmune haemolysis and APLA. In addition there was an inverse association of arthritis with hematological manifestations. Thus it appears that SLE is more of a Hematological disorder rather than a Rheumatologic disorder. A significant number did not satisfy the ACR criteria at the time of diagnosis but did so on follow up. The ACR criteria are weak to diagnose such patients and therefore needs revision. We have developed an alternative to ACR criteria as “Kozhikode Criteria for SLE” which was validated in another study and was published. The outcome of both these studies and on how to make diagnosis and management of SLE easy for general physicians will be presented in the talk. In addition our observations regarding etiology of SLE will be discussed; We have observed that, like any other chronic disease, there are important abnormalities in diet and lifestyle of patients with SLE.
Rocco Minelli
Università degli studi di Milano, Italy
Title: Abnormal presentation of a myeloid sarcoma in a non-leukemic pediatric patient
Biography:
Abstract:
Myeloid sarcoma is a rare tumor composed of proliferation of myeloid precursors cells in an extramedullary site; it can be located in any part of the body, but is most frequently encountered in the bone, periosteum, skin and soft tissues, orbit, lymph nodes, gastrointestinal tract and central nervous system, while involvement of the kidney is uncommon. The associated clinical symptoms depend on the localization of the tumour. Myeloid sarcoma is often the extramedullary manifestation of acute myeloid leukemia and is less commonly associated with myelodysplastic syndrome, chronic myeloid leukemia and other myeloproliferative diseases. Myeloid sarcoma generally manifests concurrently or during the course of acute myeloid leukemia, but may present as initial manifestation in the absence of bone marrow involvement; moreover, it can also be expression of the relapse of the hematological disease. In children with diagnosis of acute myeloid leukemia the incidence rate of myeloid sarcoma reaches 40%. Myeloid sarcoma shows slight predilection for males and is most frequent in young children than in adolescents and adults. In this article, we report a case of an 11-year-old boy with myeloid sarcoma of the kidney without bone marrow involvement.
Abdul Hei
L.H. College, India
Title: Fish as a health food with special reference to chronic diseases
Biography:
Abstract:
Fish is one of the healthiest functional foods from the aquatic ecosystems of the world. Fish is uniquely more beautiful when it grows older in age. The saying-“ eat fish and live longer “ might have many reasons. Fish is a rich source of many vital nutrients such as high quality protein, peptides, lipid, carbohydrate, minerals and vitamins. Fish lipids contain essential fatty acids that have many roles not only in human growth and development but also in prevention and amelioration of chronic diseases. Fish protein consists of all the essential amino acids. All these components along with minerals and vitamins with their different functions and antioxidant properties make fish an important functional food. On the other hand with the development of modern civilization, technology, agribusiness involving dry food grains and food production, and changing environment have resulted in changes of our foods and life styles depriving us of our physical works. Foods containing saturated fats, cholesterols, trans fats, toxic substances have resulted in health problems. Incidence of chronic diseases such as heart diseases, diabetes, cancer, dementia, autoimmune and anti-inflammatory diseases etc. are now common in both developing and developed countries of the world. Right nutrition and physical activities are the key to good health. Hence the present paper is to review and discuss the benefits of fish consumption in prevention and amelioration of chronic diseases and promotion of human health.
Olena Plotkina
Life University, USA
Title: Little Known Effective Alternative Diagnostic Methods and Treatment of the Musculoskeletal Pain
Biography:
Abstract:
While examining a patient with complaints of musculoskeletal pain, a physician often fails to detect any objective pathological findings at the area of pain. Usually a doctor considers this complaint or as a result of inflammation, even if there is no clinical or laboratory confirmation of the inflammatory process, or makes a diagnosis of osteoarthritis. Based on our extensive medical (rheumatological), chiropractic experience, and literature data we found that in the majority of cases the musculoskeletal pain is not associated with inflammation, and is caused usually by slight misalignment of articular surfaces within joints. These misalignments are small and barely noticeable without special clinical or radiological analysis. We name them “microsubluxations” to distinguish them from the large subluxations typical for orthopedic or surgical cases.It was found that these microsubluxations could be responsible for a number of the clinical problems, where the medical treatment is limited, ineffective, or non-existent: 1. First of all, this is pain, sometimes strong enough to make the patient’s life very uncomfortable, and it usually brings a patient to a medical office. 2. Impairment of the function of a microsubluxated joint, and a decrease of its range of motion. 3. Automatic, often significant, weakness, of the muscles around the microsubluxated area. 4. Loss of articular surface congruency; that is one of the most important factors for the development and progression of degenerative processes both in the peripheral joints and the spine. 5. Impairment of the skeleton biomechanics leading to the uneven loading the musculoskeletal structures; that becomes an additional factor promoting the progression of osteoarthritis. Our clinical experience and review of literature show that this sort of microcirculations is responsible for development of a number of the serious clinical painful syndromes and diseases: a) moderate to severe chest pain which is often diagnosed as intercostal neuralgia, or spondylosis, or even myocardial infarction. Failure to identify the disease causing this pain is frequently considered as “unspecified chest pain”; b) neurological disorders in the hands and forearms, e.g. pain and numbness in so-called carpal tunnel syndrome, although in this pathology the similar clinical manifestations are often caused by the problems outside the carpal tunnel itself – in the elbow or cervical spine; c) pain in lower legs which health care providers may consider as venous pathology; d) “foot drop” which could be caused by microsubluxations; e) arch or heel pain, often mistakenly considered as calcaneal spurs or achillobursitis; f) shoulder pain and restriction of its motion, which is usually considered as shoulder arthritis or rotator cuff tear, and the corresponding anti-inflammatory or surgical treatment follows; g) jaw pain, which in many cases is associated with temporomandibular joint microsubluxations; h) various types and locations of back pain, often without obvious radiological confirmation of spinal pathology; i) certain types of headaches, part of which is associated with occipital microsubluxation, promoting formation of “trigger points” within the cervical or occipital muscles, and which can be relieved relatively fast and easy; j) lower abdominal pain, not associated with visceral pathology; k) hip and knee pain. In our presentation we will introduce the pathogenesis, anatomical changes, and simple procedures used for diagnosis and management of the afore mentioned diseases caused by microsubluxation. We also will show that they could be diagnosed and treated relatively quickly, safe, and cost effectively.
Marina Komaroff
Noven Pharmaceuticals, Inc. USA
Title: Anti-Hypertensive Medications and Change in Stages of Chronic Kidney Disease in American Adults: NHANES 1999-2014
Biography:
Abstract:
Question: Is there change in the association between treatment of hypertension and stages of chronic kidney disease (CKD) in American adults from 1999 through 2014?
Background: It is known that hypertension is a comorbid condition of chronic kidney disease (CKD) that can damage the kidneys and accelerate progression ending in kidney failure. The prevalence of CKD has remained relatively flat (13-14%) since 2000, but the prevalence of advanced stages of CKD has increased. Recent studies have suggested a potential relationship between anti-hypertensive medications and kidney damage.
Objective: The goal of this study was to estimate the relationships between treatment of hypertension and chronic kidney disease (CKD) stages among American adults, and determine if the relationships have changed from 1999 to 2014. The role of classes of anti-hypertensive medications in these relationships was also examined.
Methods: The U.S. National Health and Nutrition Examination Survey data sets were analyzed from 1999 to 2014. Inferential analyses to determine the change in relationships between CKD stages and treatment of hypertension was done with multinomial logistic regression models.
Results: The odds of CKD stage 3 versus 1 was greater for treated compared to untreated for hypertension, or the odds ratio was consistently greater than one which was expected. However, the odds ratios increased significantly (p= 0.012 in the model without covariates), and (p= 0.026 in the model with the covariates) over 16-years. For example, in 1999 the odds ratio was 1.34 (95% CI: 0.87, 2.09), and by 2014 increased to 3.42 (95% CI: 2.00, 5.84). This increase in the odds ratios was driven by the increase in prevalence of stage 3 of CKD among treated of hypertension while prevalence of early stages decreased or remained stable. Similarly, from 1999 through 2012 there was significant increase in odds ratios for advanced (3, 4, and 5 combined) versus early CKD stages (1 and 2 combined) among users of Angiotensin Receptor Blockers (ARB) compared to not users of ARB (p=0.0069 for any, and p=0.0023 for poly-therapy users) where the prevalence of advanced CKD stages increased, whereas prevalence of early stages decreased or remained stable among ARB users.
Conclusion: There has been significant increase in the association between treatment for hypertension and advanced CKD stages. Furthermore, it appeared that aggressive pharmacological management of hypertension, particularly with ARB as add-on therapy, may have accelerated kidney damage in American adults; however, this hypothesis requires more investigation.
Public Health Significance: Chronic kidney disease is a public health problem associated with significant mortality and morbidity. However, aggressive medical treatment for hypertension during the last decade may perhaps have had unintended consequences by accelerating kidney damage.
Barbara E Gonçalves
University of the West of Scotland, United Kingdom
Title: Exploring the psychosocial impact of living with advanced chronic obstructive pulmonary disease on those attending two different models of palliative care services
Biography:
Abstract:
The daily life of patients with advanced COPD may incorporate living with a high symptom burden, facing a life which is compromised by reduced physical and social activities, and hence reduced QoL. Anxiety and depression are common in COPD but often not recognised or left untreated. To date, there is little evidence about which model is the most suited to reduce anxiety and depression and improve quality of life. Different models of palliative care are available for patients with advanced COPD.
This mixed-method study will explore the narratives of patients’ experience and investigate the factors influencing patient experience and satisfaction in palliative care that affect patients’ quality of life and the psychological burden. The quantitative part is a cross-sectional study, in which the focus in on an objective rate of quality of life and anxiety and depression. The qualitative part uses semi-structured interviews being conducted to explore the views of patients about their experiences in palliative care from a psychosocial perspective. Patients with advanced COPD, in Scotland, are being recruited from two different models of care; secondary care and hospices. Currently, data collection is in process, and the study will recruit participants until the end of November 2019.
This study aims to provide a range of factors that aid patients’ access to palliative care services, and on how to manage the system in order to overcome anxieties. In the future, these findings may be implemented in opportunities and good practices in palliative care for patients with advanced COPD.
Day 2 :
- Chronic Diseases
Session Introduction
Jeremias L. Convocar
West Visayas State University, Philippines
Title: Moving Away Persons with Asthma from Geopathic Zone (Dowsing Technique): How Are They After?
Biography:
Abstract:
No one really knows what exactly caused asthma. However, recent studies revealed that exposure to magnetic fields increases asthma risk and make asthma victims worst. This case study was aimed at determining the extent of the symptoms of asthma among victims when they stayed within and were moved away from the geopathic zone. A combined qualitative-quantitative technique employed the questionnaire checklist, interview, observation, and medical reports in gathering data. Likewise, Y-dowsing rod was used to locate the crossing points of earth grids where geopathic zone is found. The mean was used to describe the extent of the health problems and matrices for the comparison of commonalities, patterns and variances in the analysis and interpretation of qualitative data. The findings revealed that asthma is triggered when one’s head and breast is directly exposed within geopathic zone for a longer time. The illness remains incurable or become unresponsive to any medical treatment while the victims stayed within the zone of radiation. However, when one moved away from the said zone it ceases to be a problem. Thus, asthma is a disease of location primarily triggered by geopathic stress and could be effectively addressed when a victim moved away. Unless the people recognized the existence this unseen negative earth energy in selected location and its adverse effect on their health, the exact cause and cure of asthma remained a mystery.
Biography:
Abstract:
Objective: to evaluate the achievement of targets for mortality rates and prevalence of exposure to risk and protection factors defined in the Strategic Action Plan for Coping with Noncommunicable Diseases in Brazil, 2011-2022.
Methods: evaluative study, analyzing trends in mortality and risk factors for NCD according to data from the Global Burden of Disease and the phone survey. Linear regression and significance level of 5% were used.
Results: the premature mortality rate for all NCDs in the period of 2011 to 2014 was higher than the reduction target of 2% per year. In 2016 and 2017, the trend reversed and mortality rates increased. there was an increase in mortality. Different projections were made for the NCD mortality rates for 2022. In scenario 1 and 2, considering the trends that occurred until 2014, it is projected to reduce rates and reach the goals of the year. In scenario 3, considering the trends between 2015 and 2017, the projection resulted in a reversal of the trend and an increase in the premature NCD mortality rate of 22.7%, or not meeting the targets. Possibly due to the austerity measures implemented in Brazil and the increase in poverty. (Figure 1).
Regarding the risk factors, favorable trends in the period from 2010 to 2014 were reversed in 2015 to 2018. It was verified from the data trends that the goals of reducing obesity, alcohol consumption, hypertension and diabetes as well as increased of the Papanicolau exam should not be met by 2022.
Conclusion: Observation time is still short, but the increase in mortality rates and worsening risk factors presented here, together with other existing evidence, indicate that the economic crisis, the austerity measures implemented by the Brazilian government have made the NCD worse. indicators. Choosing not to apply regulatory measures for the control of ultra-processed foods, coping with alcohol and tobacco may result in negative effects on the control of NCDs and their risk factors and may also affect the achievement of the targets set in the NCD Brazil plan, the WHO NCD Global targets and SDG targets.
Asmaa Azizi
Hassan University, Morocco
Title: Assessment of quality of life, anxiety and depression in Moroccan women with cervical cancer
Biography:
Abstract:
Statement of the Problem: Cervical cancer and its treatment is one of the most serious threats in women's lives, affecting their physical as well as psychic, somatic and social terms. The aim of the present study was to determine the quality of life and psychological distress in Moroccan women with cervical cancer treated with Concurrent Chemoradiation. Methodology: A cross-sectional study was carried out in a University Hospital Center Ibn Rochd, Casablanca, Morocco. One hundred and three women with cervical cancer were recruited. Quality of life was assessed using the EORTC-QLQ-C30 Questionnaire, depression and anxiety using the Hospital Anxiety and Depression Scale questionnaire, and pain using the Visual Analogue Scale. The multiple and pair comparisons were carried out using Kruskal-Wallis and Mann-Withney or chi-square tests, respectively. The p-values were corrected by Bonferroni-Holm. Findings : Women with cervical cancer had a diminished quality of life for functional dimensions "emotional functioning", “physical functioning” and “role functioning” and had a high level for the symptomatic dimensions “Appetite loss’, “financial difficulties”, “insomnia”, “fatigue”, "pain" and “depression/anxiety”. In addition, our results showed that the anxiety had a negative influence on the quality of life. Women who had severe anxiety reported lower score of global health status, physical function, emotional function; and a higher score of fatigue and insomnia compared to women with mild or no anxiety. Conclusion: According to our findings, the quality of life of women with cervical cancer undergoing Concurrent Chemoradiation should be improved mainly by psychological support, prevention and management of treatment complications.