Day 1 :
Keynote Forum
Richard E Klein
Michigan Head & Neck Institute, USA
Keynote: Better awareness, better treatment for TMD and OSA
Time : 9:40-10:20
Biography:
Richard E Klein is a Clinical Professor at Michigan State Medical School, has lectured over 500 times in multiple countries about TMD and OSA. He has also written numerous articles to promote awareness of these disorders. Most notably was his contribution to The Anthology of Craniomandibular Orthopedics, in which his chapter was titled Radiology and Electromyography of TMJ Pathogenicity. He is the creator of the OSA educational model, invented and patented in 2009. Over the last 2 decades, he has been an Appointed Board Member to the American Academy of Craniofacial Pain, and the American Sleep and Breathing Academy. He has been awarded commendations from four Michigan governors: Milliken, Blanchard, Engler, and Granholm. Most recently, he has collaborated with US Congress members in Washington DC to raise awareness about OSA in transportation industries.
Abstract:
A worldwide under-diagnosis of TMD and OSA has created an enormous health problem that could easily be bettercontrolled by enhancing understanding of the signs, symptoms and effects of both TMD and OSA disorders. Everyone at this conference should be able to recognize the multiple possible deleterious situations that are not traditionally associated with TMD or OSA, and how certain medical concerns can pertain to various treatment options? Importance must be stressed on finding the source of the dysfunction and not just treating the symptoms. Treatment is successful only when the impairment and dysfunction abate, not when the symptoms improve. With this knowledge, conference attendees will be able to help countless individuals live healthier, longer, and more productive lives, while creating a scenario of interest with other physicians who they associate with, or know on a personal level. TMD is not a disorder that only affects the jaws. OSA is not a disorder that only affects overweight males. Stereotypes must be eliminated and minds must be opened to new treatment possibilities. A symbiotic relationship between physicians, sleep professionals and dentists can significantly improve the overall health and longevity of millions of people each year.
- Immunology | Obsterics and Gynecology | Cardiology | Healthcare Management | Healthcare Innovation
Location: Tuburon
Chair
Richard E. Klein
Michigan Head & Neck Institute, USA
Session Introduction
Samarth Burle
Doncaster Royal Infirmary, United Kingdom
Title: Managing risk of Reye’s syndrome in children on long-term Aspirin treatment
Time : 14:00-14:30
Biography:
Samarth Burle is a Paediatric speciality trainee from Yorkshire School of Paediatrics, NHS England, working toward becoming paediatric critical care specialist inUK. He is also doing his Masters in Clinical education from Edinburg University. He has completed his Paediatric Residency and Fellowship in Critical Care fromIndia, before relocating to UK. His practice focusses on Quality improvement and has special interest in investigating unexplained clustering of disease for root cause analysis as a part of his quality improvement projects.
Abstract:
Reye’s syndrome primarily affects children on aspirin recovering from viral illness most commonly varicella zoster and influenza virus. Though the incidence, Reyes syndrome has declined significantly after Centre for Disease Control (CDC) banned routine use of aspirin in children for fever, there has been increasing use of low dose aspirin in children with cardiac and hematological conditions. These children are prone for complications with viral illness. Literature review suggests differing practices and lack of clear evidence due to rarity of the problem. There is no clear evidence on safety of low dose aspirin and risk of Reyes syndrome following viral illness. In view of high risk of mortality, it would be prudent to stop aspirin and replace with other antiplatelet agent prior to vaccination or specific viral illness. Such children would benefit from vaccination against chickenpox and influenza but that also has its own risks. Patients, who are on long-term aspirin treatment could
do better by following a plan to reduce the risk of flu. Currently, children are routinely offered a single-dose intranasal live attenuated vaccine which is contraindicated in children even on low dose aspirin. There is a risk that some of these children may present to an acute pediatric setting following inadvertent vaccination with nasal vaccine and it will be useful to have a clear plan on continuation of the use of aspirin. Ideally, children on long-term aspirin treatment should receive yearly inactive flu vaccine. Develop an understanding of the risks involved for children on long-term aspirin treatment with varicella and influenza infection, as well as the risks of immunization for guideline development to improve safety and avoid medicolegal complications. All children with long-term aspirin treatment should be screened for varicella immunity and should receive yearly intramuscular inactivated influenza vaccine.
Tan Pei Ling
Singapore General Hospital, Singapore
Title: Rare Paraneoplastic Opsoclonus Myoclonus Syndrome (POMS) in a recurrent breast cancer patient: Importance of early recognition of POMS and initiation of rehabilitation intervention
Time : 14:30-15:00
Biography:
Tan is a Senior Resident in Rehabilitation Medicine at SingHealth in Singapore. She completed her M.D. at Duke-NUS Graduate Medical School (Singapore), and also holds a B.Sc. (2nd upper class honours) in the National University of Singapore, School of Pharmacy. She was awarded the SingHealth David Sabiston Gold Medal (2012), and received the Quality Service Award (2008) from the Singapore General Hospital. Currently the Chief Resident of the SingHealth Rehabilitation Medicine Senior Residency Program, she has published (as second author) a case report on Rare Paraneoplastic Opsoclonus Myoclonus Syndrome (POMS) in a Recurrent Breast Cancer Patient: Importance of Early Recognition of POMS and Initiation of Rehabilitation Intervention. She also presented on the Systematic Review of Use of PPIs vs H2RAs in Stress Ulcer Prophylaxis in the Critically Ill (19th Annual Scientific Meeting 2007, Singapore). An active member of the community with a passion for bringing healthcare to the needy, Pei Ling has been on several medical missions to Cambodia, China, India, Indonesia, Mongolia, Myanmar and the Philippines. She also currently provides pro bono medical services to foreign workers in Singapore at a community clinic.
Abstract:
Background: Opsoclonus myoclonus syndrome is a rare condition characterized by the amalgamation of multidirectional saccades of eye movements, involuntary myoclonus predominantly affecting trunk and limbs and cerebellar ataxia. Typical malignancies associated with paraneoplatic opsoclonus myoclonus syndrome (POMS) in adults are small cell lung carcinomaand breast cancer with variable outcomes.
Case Report: The authors report here a patient with stage IV recurrent right breast cancer, presenting to the hospital with unsteady gait, jerky movements of the limbs and body. She was clinically diagnosed with POMS with positive cerebrospinal fluid anti-Ri antibody. Medical treatment with intravenous methylprednisolone and early initiation of rehabilitation improved her balance, coordination and ataxia. This led to an overall improvement in her physical function.
Conclusion: This case illustrates the importance of early recognition, prompt treatment of POMS and initiation of rehabilitation in achieving better functional outcomes.
Njoh Andreas Ateke
Ministry of Public Health, Republic of Cameroon
Title: Congenital Malformation Alert in Cameroon
Time : 15:00-15:30
Biography:
Njoh Andreas Ateke is the District Medical Officer for Konye Health District in the South West Region of Cameroon. He has great passion in ensuring quality
healthcare, made accessible to all regardless of their economic status and geographic location. He has obtained his MD Degree in the Faculty of Medicine and Biomedical Sciences of the University of Yaounde and has published four articles in reputed journals.
Abstract:
Introduction: Congenital malformations like neural tube defects are a significant source of morbidity and mortality, and are responsible for a high psychological and economic cost worldwide. However, the impact of this diseases remains largely under-ascertained in middle income and low-income countries. This case report presents a fetal anencephaly in maternal toxoplasma and HIV co-infection in a resource limited setting, and the impact of the disease to the client and the healthcare provider.
Case presentation: A 39-year-old black Cameroonian female of Oroko origin, G2P1001 with a positive Toxoplasma and HIV serologic test on ARV from about 17 weeks of pregnancy consulted at a district hospital in the suburb of Cameroon. This client could not benefit from a fetal morphologic ultrasound partly because there were no trained personnel to perform the examination at the site of her antenatal clinic, and due to accessibility constraints to the nearest referral hospital with a radiologist about 150 km away. Twenty weeks later, she returned to the hospital in labor pains after being reported to have lost
a huge quantity of turbid liquor at home. Upon examination, the fetus presented with signs of acute distress. An emergency caesarian section was performed to safe this precious baby, but unfortunately, after about three minutes of intervention, a neonate with anencephaly was born weighing 1400g. After recovery from anesthesia, the frustrated parents of the baby
were counseled and given psychological support. The client was discharged from hospital eight days later and benefits from continual follow-up as outpatient. She was advised to adhere to her ARV, and to consult a gynecologist-obstetrician before her next pregnancy.
Conclusion: More attention should be paid to ameliorate the healthcare in middle and low-income settings where accessibility to quality healthcare remains a great challenge.
Gabriel Afonso Dutra Kreling,
University of São Paulo, Brazil
Title: Migrainous infarction: A rare and often overlooked diagnosis
Time : 16:20-16:50
Biography:
Gabriel Afonso Dutra Kreling is a Medical Doctor, Graduated from the State University of Londrina in 2015. He is the Resident of Internal Medicine at the Medical School of the University of São Paulo. He has an emphasis on studying the areas of Internal Medicine, Emergency Medicine and Intensive Care.
Abstract:
Migraine is a neurological entity and a well-known independent risk factor for cerebral infarction, which mostly afflicts the young female population. Researching focal neurological signs in this subset of the population with the diagnosis of a neurological ischemic event should always take into account the migraine as the etiology or as an associated factor. The etiology of central nervous system (CNS) ischemia is considerable. Migraine, although rare, also may be included in this vast etiological range, which is called migrainous infarction. In this setting, the diagnostic criteria required for this diagnosis is extensive. Herein, we present the case of a female adolescent who submitted to the emergency facility complaining of diplopia, dysarthria, and imbalance, which started concomitantly with a migrainous crisis with aura-a challenging clinical case that required extensive research to address all possible differential diagnoses.
Selyne E Samuel
Cleveland Clinic Akron General, USA
Title: Hidradenitis suppurativa of the breast during pregnancy: Presentation and management of an unusual complication
Time : 16:50-17:20
Biography:
Selyne Samuel completed her MD at Indiana University School of Medicine and completed her General Surgery training at the University of Arizona. She is currently a breast surgery fellow at Cleveland Clinic Akron General in Ohio under the leadership of program director, Dr. Mary Murray.
Abstract:
A 26 week G1 P0 36 year old AA woman with a 30 year history of hidradenitis suppurativa (HS) presented with lesions in her axilla, groin and breasts. Her condition was recalcitrant to steroid injections, TNF blocker, antibiotics and incision and drainage. On this presentation, she had numerous active, infected large interconnected lesions in her right breast. The decision was made to perform total excision of the infected area in the right breast. She underwent primary closure of the wound one week after excision. She is currently 39 weeks pregnant and has done well since the excision without recurrence in her breast or anywhere else in her body. In this patient, definitive but conservative pre-partum treatment was necessary to avoid milk fistula or chronic abscess formation, as the patient's desire was successful postpartum lactation. Our approach was successful.
- Workshop
Location: Tiburon
Session Introduction
Yoshiro Fujii
Shin Kobe dental Clinic, Japan
Title: Dental treatment for dementia: Can dentist treat brain sicknesses?
Time : 12:00-12:40
Biography:
Yoshiro Fujii has completed his PhD from Aich Gakuin University and been running Shin Kobe Dental Clinic as a Manager. He has published more than 13 papers in international academic journals and has been serving as Editorial Board Member of three international academic journals, special session Speaker and Organizing Committee Member of 5th International Conference and Exhibition on Metabolomics.
Abstract:
As average life expectancy has developed, dementia has become a major social issue, especially in developed countries. There is a close relationship between dental and general health. Oral conditions may also significantly affect the brain condition. The author has researched the efficacy of dental treatment as a method to improve overall health. Although severe dementia is seemed to be intractable, this study suggests that symptoms may be improved via dentistry. Underlining mechanism has not been clarified, so further research is required. The author believes this improvement is caused by stimulus of dental treatment
to the brain via trigeminal nerve, which is the biggest in the cranial nerves. The author tried also many diseases i.e. Parkinson’s disease, which might be caused by brain malfunction. Since I have had significant effectiveness in some cases, I would like to present the results of such cases.
- Special Session
Location: Tuburon
Session Introduction
Sameer Rehman
Hartford Hospital, USA
Title: Effective communication with patients and staff: Insights from negotiation and mediation literature to help resolve disputes & MACRA: The impact of hospital
Time : 12:40-13:20
Biography:
Sameer Rehman is a 4th year Postgraduate Radiology Resident Physician at Hartford Hospital in Connecticut. He has completed two years of surgical training
and healthcare focused MBA prior to starting Radiology Residency. He has published several research papers and written book chapters in disciplines of Surgery, Radiology and Healthcare Economics. He aims to improve healthcare delivery by developing an efficient healthcare model via research and innovation. His clinical interest lies in Interventional Radiology/Oncology.
Abstract:
We aim to identify barriers to effective communication with patients and staff. Illustrate key insights and techniques from Mediation and Negotiation fields that help in communicating effectively with patients and staff. We will review the mediation and negotiation literature to show the important insights and techniques to improve communication skills. We believe that these key insights and techniques from mediation and negotiation fields can help Physicians to improve their communication and relationships with patients and staff, leading to improved patient and employee satisfaction.