5^th World Heart and Brain Conference September 24-26, 2018 Abu Dhabi, UAE

Biography:

Salah A Mohamed is an Associate Professor of Experimental Cardiac Surgery. He has published in many reputed scientific journals on the topics of aortic and aortic valve disease, genetics and biomarker discovery. His laboratory also focuses on understanding the causes of atrial fibrillation. He is an Editorial Board Member of many scientific and medical journals.

Abstract:

Biography:

Khin Bo is a Lecturer in Hull and York Medical School teaching CNS and Musculoskeletal Blocks. He has presented many poster and oral presentations in international neurorehabilitation conferences. He is currently working on developing hypertonic hand monitoring scale.

Abstract:

Demyelination affects highly myelinated structures like Corpus Callosum (CC). CC is unique in function that it connects right and left hemisphere. It synchronises bimanual or bipedal activities. Affecting CC can disturb synchrony between the two hemispheres will affect bimanual and bipedal tasks. The aim is to see if speed of clapping (bimanual activity) can reflect the involvement of CC in multiple sclerosis. Consecutive 70 multiple sclerosis patients from outpatient clinics and home visits were tests for bimanual hand function (clapping) exclusion criteria are upper limb power<3/5 MRC scale, pain, visual impairment, intentional tremors, stroke or cognitive impairment. Study period started from 01 Sep 2016. Comparison of speed between rapid supination/pronation of left and right hand separately and then clapping of both hands (supination/pronation of each hands alternatively). Patients had to do as fast as they could. Noticeable slowing of clapping comparing to single hand supination/pronation was taken as a sign slowing down of conduction through CC. 31 patients were excluded, 34 patients showed no noticeable difference, 2 patients were difficult to make conclusions and 3 patients showed definite slowing down in clapping. Positive patients will have difficulties in doing bimanual activities like using two sticks for mobility, typing using keyboard, pushing wheel chair bimanually, etc. It is possible to detect CC involvement by doing above bedside test and can be used in rehabilitation setting. Sample size is not large enough and larger studies need to follow to validate the finding.

Biography:

Samer Ellahham has served as the Chief Quality Officer for SKMC. He has worked as a Chief Quality Officer and Global Healthcare Leader, focusing on ensuring that that implementation of the best practices lead to breakthrough improvements in clinical quality and patient safety. He is a Certified Professional in Healthcare Quality (CPHQ) by The National Association for Healthcare Quality (NAHQ). He is certified in Medical Quality (CMQ) by The American Board of Medical Quality (ABMQ). He is the recipient of the Quality Leadership Award from the World Quality Congress and Awards and the Business Leadership Excellence Award from World Leadership Congress.

Abstract:

Dementia and heart failure both represent growing social, healthcare and economic problems. The most common form of dementia is Alzheimer’s disease and the major risk factor for its development is increasing age. Other known risk factors includes family history, hypertension and hypotension, high cholesterol levels, low levels of physical activity and of education, obesity, genetics and recently heart failure. Decreased cerebral blood flow and neurohormonal activation due to heart failure may contribute to the dysfunction of the neurovascular unit and cause an energy crisis in neurons. The impaired clearance of amyloid beta and hyperphosphorylation of tau protein results in the formation of amyloid beta plaques and neurofibrillary tangles. An interdisciplinary approach towards elderly patients is needed. A better understanding of such newly understood relationships may result in a benefit for elderly patients from appropriate evidence-based treatment. Neuro-cardiology field helps integrates medical knowledge of interactions between chronic degenerative and cardiovascular diseases and applies this knowledge in clinical practice.

Biography:

Branislav Milovanic Professor of Internal medicine and Cardiology,Medical faculty,University in Belgrade,Serbia. He has his expertise in cardiology, internal medicine and evaluation of autonomic nervous system. 

Abstract:

Introduction & Aim: The predictive power of used statistical models is limited, so the alternative modes have been arisen, like Artificial Neural Networks (ANN). Artificial neural networks are an excellent candidate for a classifier with multiple input parameters. The aim of the study is use of ANN structure for modeling complex causal relationship between the selected predictive variables obtained on the basis of standard cardiologic examination and diagnosis of syncope.

Method: Data were obtained using short ECG analysis (Shiller AT-10), non-invasive beat-to-beat heart rate variability and baroreflex sensitivity (Task Force monitor) and 24 hour ambulatory ECG monitoring with long term HRV analysis. ECG parameters were obtained from the signals of all 12 ECG channels over the past 5 minutes using commercial software (Schiller AT-10, Austria). Total number of predictive variables is 53, from the categories of ECG time domain and spectral domain variables and parameters. The state of a sample of 496 adult patients was characterized by predefined set of 53 variables, diagnosed in accordance with the following distribution control (negative) group comprising 131 individuals while positive group includes 365 patients who experienced syncope. The available set of patients was divided into two groups training group of 284 patients, of which 50 in the control group, and test group of 262 patients, of which 131 represent complete control group.

Results: The results of this procedure are shown in Figures (1, 2), which present the relationship of the most important predictor variables and the state of patient groups. The onset of syncope is in direct correlation with higher value of LF ms, heart rate, QTc, lower value of QT interval, pNN50%, SDNN, higher positive value of P axis.

Conclusion: In this particular case the ANN structure enabled us a highly reliable discrimination of patients with syncope and patients without risk, based on standard cardiologic examination procedure.

References

1.  Acharya U R, Bhat P S, Iyengar S S, Rao A and Dua S (2003) Classification of heart rate data using artificial neural network and fuzzy equivalence relation. Pattern recognition; 36(1): 61-68.

2. Williams E S, Thomas K L, Broderick S, Shaw L K, Velazquez E J, Al-Khatib S M and Daubert J P (2012) Race and gender variation in the QT interval and its association with mortality in patients with coronary artery disease: results from the Duke Databank for Cardiovascular Disease (DDCD). American heart journal; 164(3): 434-441.

3. Parati G, Ongaro G, Bilo G, Glavina F, Castiglioni P, Di Rienzo M and Mancia G (2003) Non-invasive beat-to-beat blood pressure monitoring: new developments. Blood pressure monitoring; 8(1): 31-36.

4. Puddu P E and Menotti A (2009) Artificial neural network versus multiple logistic function to predict 25-year coronary heart disease mortality in the Seven Countries Study. European Journal of Cardiovascular Prevention & Rehabilitation; 16(5): 583-591.

5. Patel M, Lal S K, Kavanagh D and Rossiter P (2011) Applying neural network analysis on heart rate variability data to assess driver fatigue. Expert systems with Applications; 38(6): 7235-7242.

Biography:

Tatjana Gligorijevic is a PhD student and Resident of Internal Medicine, working at the cardiology department, Neurocardiological Laboratory, Belgrade. She has her expertise in research of heart rate variability in different patient groups. Her research field of interest is risk stratification, classification and clustering algorithm using data mining.

Abstract:

Artificial Neural Networks (ANN) is learning models that mimic the principles of morphological and functional organization of biological neurons, which has the capacity to promote and facilitate current statistical methods. The aim of this paper is to identify individuals with high risk of all causes of mortality after acute myocardial infarction using ANN, and to assess their survival rates. A total of 1,705 consecutive patients who underwent 24-hour ECG monitoring, short ECG analysis, non-invasive beat-to-beat heart rate variability and baroreflex sensitivity were followed for 3 years; of these, 286 patients died. Depressed baroreflex sensitivity BRS (≤5.33 ms/mmHg) was independently related to increased risk of mortality. The proposed neural network classifier showed good performance for survival prediction. Neural network architecture with 25 neurons in the first hidden layer and 30 neurons in the second hidden layer showed the best classification performance 88% accuracy, 81% sensitivity, 93% specificity and 0.85 F-measure. The error threshold value of 0.03 showed the nest results. These findings support the theory that patients with high sympathetic activity have an increased risk of mortality independent of other risk factors. The artificial intelligence infrastructure can reliably identify individuals with higher risk.

Figure-1: Kaplan-Meier survival curves for cardiac death in patients with reduced BRS at or below 5.33 ms/mmHg in early phase after acute myocardial infarction.

References

1.  Bigi R, Gregori D, Cortigiani L, Desideri A, Chiarotto F A and Toffolo G M (2005) Artificial neural networks and robust Bayesian classifiers for risk stratification following uncomplicated myocardial infarction. International Journal of Cardiology; 101(3): 481-487.

2. Choi W S, Cho Y, Kim N Y, Kang J K, Kim K H, Park, S H and Jun J E (2010) Prognostic value of standard electrocardiographic parameters for predicting major adverse cardiac events after acute myocardial infarction. Circulation; 122: 21.

3. Exner D V (2009) Noninvasive risk stratification after myocardial infarction: rationale, current evidence and the need for definitive trials. Canadian Journal of Cardiology; 25, 21A: 27A.

4. Lin J F, Hsu S Y, Wu S, Teng M S, Chou H H, Cheng S T and Ko Y L (2015) QT interval independently predicts mortality and heart failure in patients with ST-elevation myocardial Infarction. International Journal of Medical Sciences; 12(12): 968.

5. Raji C G and Chandra S V (2016) Graft survival prediction in liver transplantation using artificial neural network models. Journal of Computational Science; 16, 72-78.

Biography:

M Habeeb Ghatala has completed his Bachelor’s degree from Osmania University followed by Masters in Kansas, PhD in Wisconsin and MHA in Texas. He was the Professor of Sociology at universities in the USA. He has over 25 years of experience in tertiary care hospitals in USA, Saudi Arabia and India. He is currently, serving as a Member of Board of Directors of Hospitals, India.

Abstract:

Neurology is the study of nerves or the medical specialty related to human nervous systems. According to WHO, there are over 600 diseases of the nervous system. Neurological diseases in developing geographies including rural India present public health challenges. It is estimated that for the current population of India of 1.36 billion (2018), there are over 30 million people who suffer from neurological disorders. There is need for more neurologists in India as the current ratio of one neurologist for 1,250,000 population is very low. One of the known reasons for the shortage of neurologists and neurosurgeons is due to the fact that, at least in the USA, almost one in five neurosurgeons (19.09%) each year risk malpractice suits followed by cardiothoracic/vascular surgeon (18.9%) each year. There is need to initiate preventive programs to reduce the risk factors as cardiovascular diseases, hypertension and stroke. The aim of the study is to briefly review the neurological scenario in India discuss the mal-distribution of neurologists and neurosurgeons and its relevance to adoption of telemedicine, major reasons for neurological disorder are medico-legal issues, Doctrine of Res Ipsa, Loquitur protection against litigation, vicarious liability, brain death, important medical negligence cases, challenges in neurological practice and organization of neurology services, unmet needs and way forward. Neurological disorders affect all groups. There is evidence of physicians, hospitals and healthcare organizations ignoring the importance of malpractice insurance and vicarious liability. Furthermore, there is lack of basic knowledge of how judicial forums deal with cases relating to medical negligence. Neurological disorders are clinical, economic and public health issues mandating immediate attention. The efforts of Indian Council of Medical Research (ICMR) must be supported and strengthened so that the needs of the patients even in the most underserved remote and rural areas are met.

Biography:

Dipesh Raj Panday has completed his Master’s in Pharmacology from B.P. Koirala Institute of Health Sciences, Nepal.

Abstract:

Statement of the Problem: Ischemic Heart Disease (IHD) is a condition resulting from reduced blood supply to the myocardium. An accurate documentation and analysis of IHD clinical profile, investigation, prescription pattern and resulting Adverse Drug Reactions (ADRs) in a specified population is essential for the implementation of education and better treatment. The study was carried out with the objective of describing the clinical profile, investigation findings, prescription-pattern and ADRs of IHD inpatients of a tertiary hospital of eastern Nepal in the previous year.

Method: It was a record-based descriptive cross-sectional study carried out during 19th April to 16th May, 2017. 165 physician-diagnosed IHD were the sampling frame. CCU files of past one year were obtained from hospital record section. Any inpatients with IHD in the hospital were included. Patient Leaving Against Medical Advice (LAMA) were excluded. Data entry software epidata ver. 3.1 was employed for data-entry and analysis was done using Microsoft excel sheet and the latest available SPSS software.

Findings: Most patients were from Dharan (29%) where the hospital was located, mostly male (60.37%) and dependent (62.42%). ST Elevation Myocardial Infarction (STEMI) was the most common diagnosis (58.79%). Median age was 62 years with IQD 54-70 and patients stayed mostly for 4 days with IQD 2-6.7. Tobacco consumption (50.3%), alcohol use (22.8%), diabetes (25%) and hypertension (43.1%) were frequent among the patients. Typical chest pain (60.6%), dyspnea (42.0%) and diaphoresis (23.7%) were very common. 54.0% patients had anemia and 41.6% had leukocytosis. Aspirin (100.00%), Clopidogrel (97.55%) and HMG-CoA inhibitor (97.55%) were used in almost all patients.

Conclusion & Significance: Our study established conventional clinical profile, investigation findings and prescription pattern among the IHD inpatients of the hospital. However, adequate ADR documentation and reporting could not be appreciated.

Biography:

Abstract:

We report the case of a 36 year old woman, diagnosed with arterial hypertension at the age of 34, with difficult control of blood pressure values under treatment with beta-blocker, ACE and diuretics. She was referred to us for evaluation. No history of cardiac problems or family history of hypertension. The clinical examination showed an overweight woman, a blood pressure of 165/80 mmHg in the right arm and 100/60 mmHg in the left leg, large pulsations in the suprasternal notch, normal heart sounds, 60 bpm. A systolic murmur was audible at the parasternal right and left area and at the paravertebral interscapular area bilaterally. The radial pulses were palpable but femoral pulses were extremely weak and at transthoracic echocardiography, showed mild LVH. From the suprasternal view, we found the signs of an aortic coarctation, without significant systolic gradient but diastolic run-off at Doppler evaluation. Confirming the diagnosis CT angiography examination showed very tight coarctation with interruption just distal to the left sub clavian artery, with post-stenotic dilatation of the descending aorta, with some collateral vessels. After multiple trials to cross retrograde the trials of antegrade, recanalization of the interrupted aorta was performed using a rigid coronary wire and we managed to cross the lesion. The guide wire was captured with a snare and kept fixed. This allowed crossing with MP4 F catheter was interchanged and angiography was performed in the proximal arch of the aorta. Measurements were confirmed and a rigid guide wire was used to allow interchanging the angiographic catheter to 14-F Cook sheath (Cook Medical, Bloomington, Indiana). A covered Cheatham was implanted. Angiography post stent showed successful stent of the COA and the residual gradient of 2-3 mm across the stent. The patient was transferred to the CCU, she was stable clinically. Next morning, pallor was observed and we asked for urgent blood picture which showed hemoglobin dropped 2 grams compared to before the procedure and follow up after 2 then 4 hours showed continue of the dropping in the blood hemoglobin. Blood replacement and urgent CT thoracic and abdominal showed a nice stent without dissection or aneurysm but a large left perinephric hematoma (7×8 cm) was detected. That has put us in a conundrum since the procedure was smooth and there was no apparent injury to any renal vessel; on asking the patient gave history of falling down in the toilet on her side without telling someone or asking for help. After discussing with the surgical team, she was managed conservatively and she was safely sent home after 7 days. Dropping hemoglobin after stenting COA has many causes which include dissection, aortic rupture, bleeding during the procedures and injury of vascular structure. Meticulous history taking, careful examination and multi-disciplinary imaging modalities would pretty much help detect the cause of the bleeding early and prevent its incidence in future cases.

Biography:

Pandey K R is an Assistant Professor in the Department of Basic and Clinical Physiology at B.P. Koirala Institute of Health Sciences, Dharan, Nepal. Her areas of research interests are on neurophysiology, cardiovascular physiology and respiratory physiology.

Abstract:

Statement of the Problem: Nicotine in tobacco smoke causes demyelination. Again, hypoxia in long-term smokers is linked to neuropathy. Visual receptors are considered to be early sufferer of this neuropathy. Visual-Acuity and other ocular tests often fail to detect subtle changes of neuropathy which, however, can be detected by VEP test. Literature review shows that changes in Visual Evoked Potential (VEP) come earlier than PFT changes in smokers. Ironically, smokers claim that smoking improves their reaction time which can be assessed by VRT. Our study, therefore, was performed to relate smoking status with VEP as well as Visual Reaction Time (VRT). We also tried to correlate PFT variables with VEP and VRT, respectively.

Method: 56 subjects (smoker group=28 and non-smoker group=28) whose age and sex were matched, were included in the study (9^th May-17^th July 2016). Their PFT, pattern VEP of both eyes and VRT were recorded. The data were compared between the two groups using unpaired t-test, considering statistical significance at p<0.05. Pearson’s correlation was applied to correlate PFT variables with VEP and VRT, respectively.

Findings: The Forced Vital Capacity (FVC) (4.35±0.83 vs. 5.32±1.18 l, p=0.022), FEF 25% (7.40±2.38 vs. 8.74±3.90 l/s, p=0.019) and FEF 50% (6.11±1.52 vs. 7.74±2.57, p=0.010) were significantly lower in smokers compared to non-smokers. There was no significant difference in P100 wave latency of VEP between the groups. But, VRT of smokers were significantly shorter (431.69±60.29 vs. 441.14±123.54 ms, p=0.010). Pearson’s correlation did not reveal any correlation between PFT variables and VEP or VRT.

Conclusion & Significance: P100 wave latency, the VEP parameter, was shorter (better) in smokers but was not significant. Smokers have faster visual reaction time.

Biography:

Statement of the Problem: Nicotine in tobacco smoke causes demyelination. Again, hypoxia in long-term smokers is linked to neuropathy. Visual receptors are considered to be early sufferer of this neuropathy. Visual-Acuity and other ocular tests often fail to detect subtle changes of neuropathy which, however, can be detected by VEP test. Literature review shows that changes in Visual Evoked Potential (VEP) come earlier than PFT changes in smokers. Ironically, smokers claim that smoking improves their reaction time which can be assessed by VRT. Our study, therefore, was performed to relate smoking status with VEP as well as Visual Reaction Time (VRT). We also tried to correlate PFT variables with VEP and VRT, respectively.

Method: 56 subjects (smoker group=28 and non-smoker group=28) whose age and sex were matched, were included in the study (9^th May-17^th July 2016). Their PFT, pattern VEP of both eyes and VRT were recorded. The data were compared between the two groups using unpaired t-test, considering statistical significance at p<0.05. Pearson’s correlation was applied to correlate PFT variables with VEP and VRT, respectively.

Findings: The Forced Vital Capacity (FVC) (4.35±0.83 vs. 5.32±1.18 l, p=0.022), FEF 25% (7.40±2.38 vs. 8.74±3.90 l/s, p=0.019) and FEF 50% (6.11±1.52 vs. 7.74±2.57, p=0.010) were significantly lower in smokers compared to non-smokers. There was no significant difference in P100 wave latency of VEP between the groups. But, VRT of smokers were significantly shorter (431.69±60.29 vs. 441.14±123.54 ms, p=0.010). Pearson’s correlation did not reveal any correlation between PFT variables and VEP or VRT.

Conclusion & Significance: P100 wave latency, the VEP parameter, was shorter (better) in smokers but was not significant. Smokers have faster visual reaction time.

Abstract:

Biography:

Samer Ellahham has served as the Chief Quality Officer for SKMC. He has worked as a Chief Quality Officer and Global Healthcare Leader, focusing on ensuring that that implementation of the best practices lead to breakthrough improvements in clinical quality and patient safety. He is a Certified Professional in Healthcare Quality (CPHQ) by The National Association for Healthcare Quality (NAHQ). He is certified in Medical Quality (CMQ) by The American Board of Medical Quality (ABMQ). He is the recipient of the Quality Leadership Award from the World Quality Congress and Awards and the Business Leadership Excellence Award from World Leadership Congress.

Abstract:

The cost of heart failure care is 1-2% overall healthcare spending in developed countries. In the United States, heart failure consumes more medicare dollars than any other diagnosis. Diabetes mellitus and preserved ejection fraction are independent predictors of higher lifetime costs. Costs are accrued more rapidly at the time of initial diagnosis and in the final months of life. The incidence of heart failure is high and increases with age. Readmission is an issue with heart failure. The burden of hospitalization is increasing. Heart failure is deadly and costly with much of the cost due to the burden of hospitalization. Effective evidence-based interventions should address gaps in care and promote effective transitions across sites and clinicians (e.g. single point person throughout episode of illness, transfer of information, focused patient/family caregiver education, coordinated follow-up services) and root causes of poor outcomes with a focus on longer-term value for both the patient and health care system. A heart failure readmission checklist before admission, during hospitalization and related to discharge. In summary a checklist and disease management program are key in reducing heart failure hospital readmission.

Biography:

Arghya Jana is a Paramedic in Cathlab and has his expertise in both pediatric and adult cardiac interventions. He is currently working on onco-interventions.

Abstract:

India with 1.30 billion population stand at the 2^nd position as the most populous country in the world after China. Children of today are tomorrow’s citizen. Hence it is very necessary to provide better healthcare facilities to them. Malnutrition and mortality among children are the two faces of a single coin. About 15%-23% of the present mortality may be accounted for congenital heart disease. From 1950 balloon angioplasty and device closure of ASD, VSD have been accepted as the procedure of choice in several congenital abnormalities. New generation of cathlabs, experience and technology also help in extremely difficult transcatheter interventions such as ductul stenting, RVOT stenting, hypoxia management after Glenn surgery, Norwood stage I. RF ablations and device therapies are done for to prevent sudden cardiac death from arrhythmia. Health systems and policies have a critical role in the manner in which healthcare services are delivered and its outcome. Pediatric cardiac interventions, decision and its complication management is a joint effort of the surgeons, interventionalists, paramedics and nurses.

Biography:

Hilla Ben-Pazi is a Child Neurologist and Medical Entrepreneur, Director of the Movement Disorders Clinic at Shaare Zedek Medical Center in Jerusalem and Founder of NeuroCan. She has completed her studies at Hebrew University Medical School and was trained in Pediatrics at Hadassah. She has completed her Fellowship in Pediatric Neurology at Shaare Zedek. She is specialized in Pediatric Movement Disorders from Stanford University, California, USA in Telemedicine (FutureMed, Singularity University; Telemedicine Management, University of Alaska).

Abstract:

Background: Most children have uncomplicated streptococcal tonsillitis. A minority develops Sydenham's Chorea (SC), a post-streptococcal, neuropsychiatric disorder associated with anti-neuronal antibodies. While several autoantibodies such as anti-Dopamine receptor antibodies were found elevated in children with SC compared to controls their existence and role in uncomplicated tonsillitis has not been studied. We hypothesized that unique autoantibodies would be detected in children with Sydenham's chorea and not in children with tonsillitis.

Method: We examined autoantibody profile from children with acute (aSC; n=35) and persistent (pSC; n=11) SC compared to age-matched controls with streptococcal tonsillitis within the past month (ST; n=28) and healthy children (HC; n= 32). Sera were examined for Anti-Streptolysin-O (ASLO) Anti-Dopamine-1-receptor (D1R), Anti-Dopamine-2-Receptor (D2R), anti-tubulin and anti-Lysoganglioside (LG) titers in respect of time for clinical presentation.

Result: ASLO titers were high but similar in children with tonsillitis and aSC (p=0.071-0.51). Anti-D1R antibody was higher in aSC than in tonsillitis after 2 weeks (p=0.02-0.078). Anti-D2R antibody titers were similarly high in aSC and tonsillitis (p=0.59) participants compared to controls. Anti- LG was higher among children with aSC compared to tonsilitis after 2 weeks (p=0.0081-0.026). Anti-tublin was lower in aSC compared to the tonsillitis group during the first 2 weeks only (p=0.01). Combined titers were higher in children with SC compared to controls from 2 weeks and beyond (Composite Measure of ASLO+ D1R+D2R+ LG was p=0.005-0.049).

Conclusion: Autoantibodies are higher in children with SC compared to children with tonsillitis beyond two weeks. A composite test may have implications on diagnosis and treatment of this autoimmune disorder.

Figure-1: Composite Measure (D1R+D2R+LysoGN) over time (months)

Recent Publications

1. Ben-Pazi H, Stoner J A, Cunningham M W (2013) Dopamine receptor autoantibodies correlate with symptoms in Sydenham's chorea. PloS One; 8(9): e73516.

2. Dale R C, Merheb V, Pillai S, Ben-Pazi H, et al. (2012) Antibodies to surface dopamine-2 receptor in autoimmune movement and psychiatric disorders. Brain: A Journal of Neurology; 135(11): 3453-3468.

References

1. Teixeira A L Jr, Maia D P, Cardoso F (2005) UFMG Sydenham's chorea rating scale (USCRS): reliability and consistency. Mov Disord; 20(5): 585-591.

2. Cardoso F, Vargas A P, Oliveira L D, Guerra A A, Amaral S V (1999) Persistent Sydenham's chorea. Movement disorders official. Journal of the Movement Disorder Society; 14(5): 805-807.

3. Garvey M A, Snider L A, Leitman S F, Werden R, Swedo S E (2005) Treatment of Sydenham's chorea with intravenous immunoglobulin, plasma exchange or prednisone. Journal of child neurology; 20(5): 424-429.

Biography:

Abstract:

Background: Studies that evaluated the effects of omega-3 polyunsaturated fatty acids (n-3) on cardiovascular diseases have yielded conflicting results. We aimed at examining the association between plant/marine n-3 and Malignant Ventricular Arrhythmias (MVA) among patients benefiting from the best preventive strategy including Implantable Cardioverter Defibrillator (ICD).

Method: Consecutive patients in whom an ICD was implanted for primary or secondary prevention of MVA were eligible. All patients had blood fatty acid analysis. The method of Kaplan-Meier was used to estimate the survival curves in each quartile of the main plant (ALA) and marine (EPA and DHA) n-3.

Results: Among the 238 enrolled patients, 100 had a relevant endpoint recorded by the ICD or died from a cardiac cause during a mean follow-up of 30±12 months. No significant difference in MVA was observed between quartiles of ALA (log-rank test p=0.88), EPA (log-rank test p=0.58) and DHA (log-rank test p=0.97). In a multivariate cox proportional hazard model including age, sex, ischemic heart disease, diabetes, smoking, hypertension and high cholesterol as covariates, we found no association between MVA and n-3: Hazard ratio was 1.12 (95% CI 0.62-2.02) for ALA and 1.44 (95% CI 0.81-2.58) for the sum of main marine n-3.

Conclusion: Plant and marine n-3 do not seem to either increase or decrease the risk of MVA in patients who are not n-3 deficient and benefit from the most effective preventive treatment. Further studies are required to test whether n-3 deficient patients would still benefit from n-3 supplements. Finally, these data raise major questions regarding interactions between dietary n-3 and certain medications.

Biography:

Anmar Homeida is the Founder and Team Leader, Executive Director of Sudanese Medical Innovation Community, Medical Education Development and Research Centre, Faculty of Medicine, University of Gezira. He is a Facilitator, Organizer and Founder of Startup Weekend Health, Wad Medani, Founder, Curator and Primary Organizer of TEDx, University of Gezira.

Abstract:

As one of the developing countries, Sudan has just emerged from a protracted period of conflicts that has brought disaster on its people, directly and indirectly. While some areas have witnessed war, others have suffered from the strain of hosting displaced populations. Others have been affected as a result of the diversion of resources meant for development. Startup Weekend Health-Wad Medani is a new movement to accelerate cure, change and empower the access to health for all. Our goal is to bring together the healthcare community, designers, IT professionals and entrepreneurs to facilitate the formation of new ideas. Startup Weekend Health-Wad Medani was held on the 4^th-6^th/August/2016 at the Cultural Palace Main Hall of Wad Medani and the buildings of Wad Medani College of Medical Science and Technology. There were more than 30 projects with wide, multi-disciplinary areas of experience; there were doctors, medical students, engineers, IT experts, etc. There were about 80 participants with different skill sets, including IT, finance, marketing, medicine and healthcare. By the end of the final pitches on the first day of the event, only 10 projects continued on to form teams. Examples of the winners who participated in the Startup Weekend event are Safer Life; a project aimed towards ending poor drug interactions by doing proper counseling for patients. SudaCare; a project oriented to support spreading medical knowledge for citizens. Now we have established the first office in the MEA region to support medical innovation among medical societies. We are here to fuel the spread of entrepreneurship in the healthcare and medicinal industry in Sudan, influencing the youth, doctors, professors and medical field students. We fully support the movement for better care, with cost effective practices that support our poor societies using inexpensive technology. Although we have taken a step in the right direction, we need the push to continue in innovation and entrepreneurship in these field-fueling more innovative projects that will accelerate cures for our society and the world.

Biography:

Anmar Homeida is the Founder and Team Leader, Executive Director of Sudanese Medical Innovation Community, Medical Education Development and Research Centre, Faculty of Medicine, University of Gezira. He is a Facilitator, Organizer and Founder of Startup Weekend Health, Wad Medani, Founder, Curator and Primary Organizer of TEDx, University of Gezira.

Abstract:

Background: It is now well-appreciated that impaired fetal brain development and circulation, coexisting genetic syndromes, and pre-and postsurgical hemodynamic instability are equally important factors contributing to brain injury and neurodevelopmental outcome. Distinctive neurodevelopmental profiles in children with CHD are now recognized and include problems. With great advancements in the medical field and surgery, an impressive 90 percent of infants born with a congenital heart condition are able to survive until adulthood. The majority of these infants, however, often suffer from health problems including heart arrhythmia, neurodevelopmental deficiencies, autism and respiratory issues.

Method: We have started to work in Pediatric Cardiology clinic, checking the patients there, using cross-sectional study method after ethical approval from The Wad Madani heart center based on ethical committee of University of Gezira, Faculty of Medicine and Ministry of Health, which it may upgraded to large-scale longitudinal study and the measures will include behavioral data from 4-year-old neurodevelopmental evaluations and parent-report data from a later annual follow-up. We started to collect information from patients and co-patients after taking their permissions with a written consent.

Result: The results still under analysis and continuous collection of data.

Conclusion: With general positive results regarding the spreading of neurodevelopmental defects and Autism spectrum disorders which need focus from the medical teams throughout the world.