Day 2 :
American Hospital and Mohammed Bin Rashid Medical University, UAE
Keynote: Insight into antibiotic resistance and patterns of carbapenam-resistant Enterobacteriacea in the United Arab Emirates
Time : 09:00-10:00
Aaron Han has completed MD/PhD program from Baylor College of Medicine with a thesis in Immunogenetics. He is a practicing Pathologist with interest in tumor pathology and special expertise in breast, gynecologic and hematolymphoid tumors. He also is a board certified Clinical Informaticist.
Antibiotic resistance is a major global healthcare issue. Specifically there is a growing problem with Enterobacteriacea resistant to Carbapenam (CRE). United States Centers of Disease Control has prioritized this as a significant threat to public health. CRE organisms are seen with increasing frequency and resistance to a broad spectrum of antibiotics. This study presents clinical challenges for patients as well as public health concern. A collaborative project to look at resistant strains and their molecular signature was undertaken in the UAE. Initial studies of more than 70 strains showed interesting resistance pattern. The clinical microbiologic phenotype was ascertained and the resistance pattern to panels of antibiotics reported. Resistance to standard beta-lactam regimens were virtually always present. Increasing frequency of resistance to penams and colistin was seen. Genetic patterns clustered the strains into different groups and various strain families could be discerned. This is the first study in the country of this important emerging microbiolic threat. There are clinical benefits as well as epidemiological implications of these studies.
Southern Jutland Hospital, Denmark
Time : 10:00 - 10:45
Jalil Hariri is a Consultant Pathologist at Southern Jutland Hospital as well as SLB Hospital in Denmark. He has published several papers and oral presentations addressing primarily non-gynecological liquid-based cytology, immunocytochemistry and HPV.
Cervical cancer is the only malignancy with a well-defined, detectable and treatable precursor which can make the disease preventable. The Pap-test screening was the start-shot for the secondary prophylaxis of cervical cancer and has regardless the subjectivity in morphological evaluation and the inevitable false negative rate, contributed to the decline in the incidence and the mortality of lesion during the last five decades. Lack of well-organized screenings programs and low socio-economic conditions diminished, meanwhile, the efficiency of the screening in developing countries, which necessitated tailored screening-programs for these areas. The discovery of HPV’s role in developing cervical cancer in the 1980s added the molecular biology test for HPV to the screenings program, initially as a triage test for mild cellular changes and since as primary Human Papillomavirus (HPV) screening. Primary prophylaxis was then launched by the HPV vaccination a decade ago. Specimen sampling for cytology was also improved by adding the cotton swab to Ayers spatula in the late 1970s/ early 1980s, which again was replaced by the Cytobrush a decade later. Yesterday’s irrigation smear by using the cytopipette and the micropipette during 1960s, was the forerunner for today’s liquid-based cytology. Fully or semi-automated imaging systems that are widely used today, were also preceded by several attempts for screening’s automation in 1960s. But cervical cancer, despite improvements of primary and secondary prophylactic measures, despite quality improvements of specimen sampling and specimen processing and despite improvements of the quality of microscopy is not eradicated yet. Can we do it tomorrow?
National Institute for Genetic Engineering and Biotechnology, Iran
Keynote: Genetic diagnostic methods
Time : 10:45 - 11:30
Massoud Houshmand has completed his PhD in Medical Molecular Genetic from Gothenburg University, Gothenburg, Sweden. He is the Head of the Genetic Diagnostic Laboratory, Faculty Member of National Institute for Genetic Engineering and Biotechnology and Responsible Director of Personalized Medicine journal. He has organized about 22 workshops and seminars and has published more than 220 papers and 17 books. He is the Winner of Best Iranian Researcher in Medical Genetic 2010, Winner of ISESCO prizes in Science & Technology 2014 and winner of Best Iranian Researcher 2015.
The identify cation and characterization of the genetic basis of disease is often fundamental to diagnosis. Detection of cause of the disease in a blood or other tissues sample can lead to a diagnosis, possible prognosis, and prospective therapy treatments. Over the years, a variety of cytogenetic (Karyotyping) Molecular Cytogenetic (FISH-CGHarray-Cish) and molecular biology techniques (PCR-RFLP-ARMS-Dot Blot-Sequencing-MLPA-Western, Norden and southern blot-Real Time PCR, PGD) have been utilized in clinical diagnostic laboratories in the analysis of patient samples. The recent development of next-generation sequencing (NGS) techniques has revolutionized the field of clinical molecular diagnostics. Here, we review the development of molecular diagnostic approaches and some of the most commonly used assays prior to different kind of techniques in this area and mention advantage and disadvantage of each technique. PCR-based testing methodologies still currently predominate most clinical molecular diagnostic laboratories. The choice of detection method used in the analysis of gene mutations depends on a variety of factors and can range from laboratory to laboratory. Sample volume, the spectrum of mutations in a given gene of interest, and equipment investment required can all play a role in what type of assays a molecular diagnostic laboratory chooses to perform.
- Molecular Pathology, Genomes and Epigenomes, Plant & Veterinary Pathology & Infections, Epigenetic Diseases and Clinical Applications, Anatomical Pathology, Gastrointestinal Pathology & Infections, Hematopathology, Epidemiology, Epigenetics and Biomarker, Biochemistry and Molecular Biology
Location: Conference Hall
American Hospital and Mohammed Bin Rashid Medical University, UAE
Charite University of Medicine, Germany and Consulting Medical Lab, Palestine
Time : 12:00 - 12:30
Jaber Haj-Ali has completed his Master’s degree from AL-Quds University and currently pursuing his PhD on telomere length measurements and pollution exposure at Charite University School of Medicine, Germany. He is the Founder and Director of consulting medical laboratory in Palestine.
Reduction in oxygen partial pressure in the air at high altitude leads to reduced oxygen saturation in the arteries and results in erythropoietin production, which stimulates erythropoiesis to restore the appropriate oxygenation status. There are many studies describing the acclimatization to high altitude and its effect on Complete Blood Count (CBC) parameters and on exercise. Most of these studies proved the increase in Hemoglobin (Hgb), erythropoiesis and erythropoietin secretion, while there is lack of available information about the effect of being below sea level on CBC test results. This study aims to evaluate the CBC parameters of people who live below sea level for the first time in Palestine, in comparison with those who live above sea level. Moreover, it is expected by the end of this study that we will be able to verify the applicability of the reference ranges that have been adopted from other sources and to assess if we need to establish new reference ranges for people living in Jericho and Ramallah. The study was conducted in February 2013, where four secondary schools were chosen for the study: Two in Jericho and two in Ramallah. Three hundred and twenty participants were randomly chosen from 11th and 12th grade male students during this study, where the age of students ranged from 16 to 19 years old. Twenty-three of them were excluded as they did not fit the given criteria. Blood samples CBC data and questionnaires were analyzed for the rest two hundred and ninety-seven participants using t-test between two means for independent samples. Results for the differences between means show that Red Blood Cell counts (P=0.005), Hgb (P=0.001) and Hematocrit (P=0.002) have mean values which are statistically higher among those who live about 900 meter above sea level than among those who live about 300 meter below sea level, while platelet count was significantly higher in those live below sea level (P=0.001). Results of t-test for normal ranges show that CBC normal ranges of Palestinians are different in comparison with the applied normal ranges that adopted from literature sources. Almost all CBC parameters in our study for both groups in Ramallah and Jericho differ significantly from those in the international studies. This justifies the need to establish our own reference ranges for this age group and for adult male population in general. In conclusion, we found significant difference in hematological parameters (Hgb, Hct, RBC count, and platelet count) in healthy adult students living above and below sea level in a representative population sample which is also the first study from people living below sea level in Palestine.
King’s College Hospital NHS Foundation Trust, UK
Time : 12:30 - 13:00
Royce P Vincent is a Consultant Chemical Pathologist at King’s College Hospital NHS Foundation Trust and an Honorary Senior Lecturer at King’s College London, UK. He has a special interest in nutrition and endocrinology and is the Clinical Lead for Biochemistry and Parenteral Nutrition Services. He has obtained his MD (Res) at Imperial College London and his research interests are in obesity, endocrinology and clinical nutrition. He has published multiple original and review articles and is serving as an international Editorial Board Member for Translational Metabolic Syndrome Research.
Non-Alcoholic Fatty Liver Disease (NAFLD) has become increasingly common worldwide over the last decades due to the obesity epidemic. By definition NAFLD requires that there is evidence of hepatic steatosis, either by imaging/histology or there are no causes for secondary hepatic fat accumulation-significant alcohol consumption, steatogenic medication, hereditary disorders etc. and is characterized by liver steatosis (accumulation of triglycerides >5% in liver weight). NAFLD is strongly associated with metabolic syndrome (insulin resistance, obesity and dyslipidemia). The disease reaches a peak in the fifth and sixth decades of life and at present nearly 25% of adults in Europe with fatty liver have NAFLD. NAFLD is a clinic-pathological entity that comprises a liver disease spectrum spanning from non-inflammatory isolated steatosis to Non-Alcoholic Steatohepatitis (NASH), a more aggressive form of the disease, which is characterized by steatosis, inflammatory changes and varying degrees of liver fibrosis to end-stage liver disease. Furthermore, NAFLD may be complicated by cirrhosis or Hepatocellular Carcinoma (HCC). It is now set to become the major cause of liver transplantation in adults as it is the most important cause of cryptogenic cirrhosis. The pathogenesis of NAFLD is multifactorial but is yet to be fully elucidated. This session will explore our current knowledge about the pathophysiology of obesity associated liver disease, its management strategies and the role of metabolic surgery to address this global health problem.
University of Benghazi & Biotechnology Research Centre, Libya
Title: Survivin and livin expression as prognostic markers in the primary breast cancer and their lymph node metastases
Time : 13:00 - 13:30
Adam Elzagheid is a Professor at Biocenology Research Centre (BTRC), acting as a General Director of BTRC, Tripoli, Libya. He has worked as a Dean of Faulty of Medicine, Benghazi University, Benghazi, Libya, Head of Department of Pathology, Faculty of Medicine, University of Benghazi. Post-doctoral Fellow and Research Associate at University of Turku, Faculty of Medicine, Oncology and Pathology Departments, Turku, Finland.
Aim: To assess the prognostic significant of survivin and livin protein expression in primary invasive breast cancer and in metastatic breast cancer to lymph node.
Material & Methods: The present study consists of archival samples from 78 patients of invasive breast cancer during 2010-2014 diagnosed at Misurata Cancer Center, Misurata, Libya. Tumor biopsies were analyzed for expression of survivin and livin by immunohistochemical, different grading systems were tested for survivin and livin expression.
Results: Survivin expression in primary breast cancer shows a significant correlation between survivin expression and site of tumor (P=0.021), higher expression of survivin was in patients without recurrence (p=0.036), survivin expression correlated significantly with unifocal tumor (P=0.001), Moreover HER-2 negative tumor express survivin more than HER-2 positive tumor (P=0.047). There was no significant difference in survivin expression as regards histological grade, histological type, lymph node status, tumor stage, TNM classification, estrogen, progesterone receptors, distance metastases, chemotherapy, radiotherapy, hormone replacement, vascular invasion, surgical margin, positive family history. Livin expression in primary breast cancer shows a significant correlation (P=0.025) with positive family history. There was no significant association with other clinicopathological parameters. We further studied the association of survivin and livin expression with secondary breast cancer (lymph node metastases), we found that primary tumor show higher survivin expression (82%) compared with secondary breast cancer (34%) while livin expression did not differ between the primary (71%) and secondary breast cancer (84%).
Conclusion: Survivin expression in primary breast cancer is significantly associated with parameters of good prognosis. Livin expression in primary breast cancer is significantly associated with positive family history of breast cancer.
Hamid Reza Edraki has completed his Graduation in Neuro-Radiology (MRI) from LMU University, Germany). He has worked as an Associate Professor at Shahid Beheshti Medical University in Iran and Managing Director at Rare Diseases Foundation of Iran and the Chief Radiologist at RADOIR‘s Parsian Medical Center.
Applying MRI during pregnancy to detect fetus abnormalities. In this case the child is afflicted by phocomelia. A male fetus is detected in 32 week of gestational age by Trans abdominal sonography, right unilateral phocomelia is diagnosed for this patient. Right shoulder, arm and elbow are seen developed but just only proximal epiphysis of radius and ulna are seen. The rest of forearm bones and hand are not developed. The mother has not taken thalidomide or the other pills during pregnancy. After delivery, radiography was performed for newborn and this type of phocomelia was approved. Autosomal recessive genetic disorder is represented for this patient after sonography 2D and 3D. Fetal MRI was also performed and then phocomelia was detected after delivery. Pathology of the newborn, confirmed the phocomelia of right upper extremity. Radiography of right arm, elbow and forearm was done and epiphysis nuclei of proximal, of radial and ulnar bones. Hand surgeon visited him and planned for cleavage of soft tissue of right elbow for fork appearance functional forearm in 3 month later.
Islamic Azad University, Iran
Title: A spectroscopic report on the ingestion of carbonic anhydrase onto the nanoporous silica nanoparticle
Time : 15:00 - 15:30
Termeh Ghorbanian Bolouri has completed her bachelor degree in cellular and molecular biology, microbiology from Islamic Azad University, Pharmaceutical Sciences Branch; and master degree from Islamic Azad University, Tehran Medical Branch. She has been a student researcher in Motamed Cancer Institute, recombinant protein department, also she is a researcher in Dr. Houshmand Genetic Laboratory. She has published an article in nanotechnology in International Journal of Biological Macromolecule. She presented an abstract in European Breast Cancer Conference. Right now she is working on a project with Dr Houshmand. She is also planning to continue her studies.
Herein, KIT-6 nanoporous silica nanoparticles were used as a solid support for immobilization of bovine carbonic anhydrase, isoform II (BCA II). The zeta potential study revealed that KIT-6 and BCA II provided negative (-13.58±1.95 mV) and positive (4.23±0.72
mV) charge distribution, respectively. Dynamic Light Scattering (DLS) analysis also showed that the hydrodynamic radius of KIT-6 is less than 100 nm. In addition, the structural studies of free and immobilized BCA II against urea-induced denaturation were investigated by Circular Dichroism (CD) and fluorescence spectroscopy. CD studies showed that the absorbed BCA II, in comparison with the free enzyme, demonstrated higher stability against rising urea concentration. Fluorescence spectroscopy showed lower values of Stern-Volmer constant (KSV) for immobilized BCA II relative to free enzyme, reflecting the relative enzyme stability of BCA II after immobilization. Melting temperature (Tm) measurement of free and immobilized BCA II showed that immobilized enzyme had a more stable structure (Tm=71.9 ºC) relative to the free counterpart (Tm= 64.7 ºC). In addition, the immobilized BCA II showed pronounced stabilities against pH and thermal deactivation. This study may provide new and complementary details regarding the design and development of enzymes in industrial applications.
S M S Medical College, India
Title: Clinical, radiological and microbiological profile of pulmonary aspergillosis in treated cases of pulmonary tuberculosis
Time : 15:30 - 15:45
Jitendra Kumar Sharma is a senior resident in Sawai Man Singh Medical College. He has completed his MBBS. He is also State Coordinator of Jaipur Associations of Resident Doctors.
Introduction & Aim: Pulmonary aspergillosis continues to be one of the serious morbidity seen in clinical practice in patients with inactive pulmonary tuberculosis. There are very few studies regarding this. The present study conducted for detailed spectrum of aspergillosis in treated pulmonary tuberculosis patients.
Materials & Methods: This study is a hospital based observational study. In this study treated patients of pulmonary tuberculosis having symptoms of persistent cough and/or hemoptysis were enrolled after exclusion of active tuberculosis. Sputum for ZN stain, BACTEC culture for mycobacterium tuberculosis, fungal KOH and culture was done. Study duration was total of 18 months. Demographic details, predisposing factors and clinical findings were noted. X-ray and CT chest was done in all patients. FOB was done only in two patients (dry cough but CT suggested aspergilloma). Sample size after exclusions was of 70 patients whose sputum/bronchial wash showed isolation of Aspergillus.
Results: Presentation of pulmonary aspergillosis in treated cases of tuberculosis was most commonly aspergilloma, found in 57% of patients followed by CNPA that was detected in 36% patients and least common was ABPA found in only 7% of patients. Most common symptom was recurrent hemoptysis (73%). Most of the patients were farmers but no significant co morbid illness was seen. Most common species came out to be Aspergillus fumigatus.
Conclusion: Aspergillus is a common fungus growing on dead leaves, stored grain, bird droppings and compost piles. Many cavitary lung diseases are complicated by aspergilloma including TB, silicosis, bronchiectasis, etc. Presentation may vary from aspergilloma, chronic necrotizing pulmonary aspergillosis to ABPA in treated pulmonary TB patients.
Time : 15:45 - 16:00
Kavita Sharma has completed her MBBS, MD (Pathology) from Rajasthan University of Health Sciences. She is the Senior Resident in All India Institute of Medical Sciences, Jodhpur. She has published more five papers in reputed journals.
Introduction: Cervix is a gateway to numerous non-neoplastic and neoplastic gynecological lesions. Cervical cancer is the leading cancer in Indian women and second most common cancer in women worldwide next to breast cancer.
Objectives: The objective is to study the histopathological features of cervical lesions, the age distribution and relative frequency of various cervical lesions and to study the distribution of malignancy on the basis of parity.
Materials & Methods: This is four years retrospective study of all cervical biopsies received from 2014-2017 in the department of pathology.
Result: In a total of 1000 cases studied maximum number of cases on biopsy were those of infections (60.50%), squamous intraepithelial lesions were seen in 17% patients. Similar cases were those of frank malignancy with benign lesions comprising of only 5% in study population. Maximum number of patients was more than 60 years in age (36.50%). The mean age among cancer cases (51.94±12.30 years) was higher than in cases (39.53±9.66 years) who did not have cervical cancer. Association between age group of cancerous patients and non-cancerous patients were highly significant with p value<0.001. Maximum number of malignancy cases reported in parity 3 (284 cases) followed by parity 4 (212 cases) and minimum cases of cervical cancer were found in parity 1 (40 cases).
Centre Hospitalier Universitaire de la Guadeloupe, France
Title: Workshop: The importance of defining hanseniasis according its pathophysiological nature as a noncurable chronic autoimmune and autoinflammatory disease. Bridging the gap between individual and collective medicines based on the principle of complementarity of deep contradictory truths
Time : 16:30 - 18:00
Yohannes Negesse is a Pathologist trained in France and USA. He has worked for more than 20 years in Ethiopia in different institutions. He is presently working in the Centre Hospitalier Universitaire de la Guadeloupe. France. He has published more than 20 papers in the field of infectious diseases pathology.
Regarding hanseniasis the prevailing population medicine approach is more and more difficult being understood. Indeed, we see that important epidemiologic parameters are uncertain, confusing, non-contagiousness with cure, mode of transmission, duration of disease, incubation period, random incidence estimation and disease elimination concept. On individual medicine perspective it has been established that the bacillary load in the nerve (not in the skin) is an essential factor determining the cycle and spectrum of the disease. The disease may, therefore, be classified as paucibacillary (tuberculoid pole) and multibacillary (lepromatous pole) neural hanseniasis. This pathophysiological approach will allow for instance seeing immunological similarities between paucibacillary neural hanseniasis and sarcoidosis. We can also observe parallelism between the lepromatous neural hanseniasis with whipple disease. For instance, the erythema nodosum like lesions of Whipple disease have more in common clinically, pathologically and immunologically with type 2 reactions during hanseniasis. Thus, the information extracted from immunological study of hanseniasis compared to that obtained from the well-established autoimmune and auto inflammatory diseases might possibly be mutually useful in elucidating the basic pathophysiological mechanisms and treatment regimen. This immunological approach will serve reducing the stigma linked with hanseniasis and constitute as stepping stones to the way of integrating hanseniasis control activities into the general health services as any neurological illness (multiple sclerosis, polyneuritis) or any autoimmune disease.