15^th Global Experts Meeting on Pathology and Laboratory Medicine July 02-03, 2018 Bangkok, Thailand

Biography:

Anshoo Agarwal is currently working as Professor and In-charge of Pathology Department (female campus), Northern Border University, Kingdom of Saudi Arabia. She has received her Degree from King George’s Medical College. She had been Discipline Coordinator (Pathology Dept.) in University Technology MARA, Malaysia. She is a member of many associations like Indian Association of Pathology and Microbiology, International Academy Pathology, Indian Society of Hematology and Transfusion Medicine, Emirates Medical Association Pathology Society, International Economics Development Research Center etc. She has more than 100 publications. She is Editorial Member of three journals and is reviewer in many journals. She had organized many national and international CME’s, Workshops and Conferences.

Abstract:

Frozen section (FS) diagnosis has been used as an important factor in intraoperative decision making. FS are more difficult to interpret than examination of formalin-fixed, paraffin-embedded sections. Nevertheless, FS is regarded as an accurate means of diagnosis during surgery and often has a significant influence on the surgical operation being performed. Robotic tele-pathology is the practice of digitizing histological or macroscopic images for transmission along telecommunication pathways for diagnosis, consultation, or continuing medical education. In dynamic tele-pathology, the consultant examines a slide remotely with a robotic microscope that allows him or her to select different fields and magnification powers. Static tele-pathology relies upon images sent by the referring pathologist. Because the field selection is accomplished by the consultant, the information that he or she obtains is the same as he or she would obtain at the microscope in person. One of the most promising applications of tele-pathology is intraoperative consultation to be allowed with pathology support located elsewhere, allowing surgeries requiring an intraoperative histo-pathological diagnosis without a pathologist on site, thereby preventing medical errors, reducing costs and increasing quality. Also to submit histological slides to a remote pathologist requires packing and postage expenses. Additionally, increasing documentation between countries is necessary to ensure the lack of pathological risk associated with the submitted material which can be avoided by tele-pathology and also it can reduce the travel time of the pathologist, which is expensive, nonproductive professional time. Hence, the provision of pathologic care using tele-pathology for routine, emergent and FS diagnosis can support primary and second-opinion pathology diagnosis throughout the world.

Biography:

Dr fariha Kauser has received her Bachelor degree in dental surgery from Ras al khaimah medical and health sciences university, UAE, and Diploma in medical education, university of Dundee, Scotland.

Abstract:

The calcifying epithelial odontogenic tumor is a rare benign odontogenic neoplasm and it was explained by Pindborg in 1955. Such tumors constitute less than 1% of the odontogenic neoplasm. It presents normally as slowly growing intra osseous mass in the mandible during fifth decade of life. Etiology remains unknown with no predisposing factors known. Histopathology is very much significant confirming diagnosis. Histological features include polygonal cells epithelial, calcification deposits and eosinophilic matrix. Amyloids are abnormal proteins, found in tissues. Literature is very scarce for documentation of calcifying epithelial odontogenic tumor and here we present a rare case of CEOT of lower left mandible. A 54 years old patient presented with slurred speech and pain in the lower jaw since one month. This pindborg tumor is calcifying epithelial odontogenic tumor, treated with definitive surgical resection of affected side of mandible with tumor free surgical margins and long term follow up is recommended.

Biography:

Hatim Al Maghrabi is Deputy Regional Program Director for Saudi Board in Pathology at Saudi Commission for Health Specialties (SCFHS). And also Adj. Assisstant Professor at KSU-HS at King Saud bin Abdulaziz University for Health Sciences. Currently, he is a Program Director for Anatomical Pathology at Ministry of National Guard Health Affairs (MNG-HA). He got Clinical Fellowship in Liver/Kidney Pathology and cytopathology at University of Toronto

Abstract:

Background: Encapsulated follicular variant of papillary thyroid carcinoma (EFV-PTC) is a common subtype of papillary thyroid carcinoma (PTC) with low malignant potential. Based on capsular and vascular invasion they are divided into non-invasive and invasive subtypes (NIEFV-PTC and IEVV-PTC, respectively). Recently a proposal by international groups of thyroid disease experts has been made to re-classify non-invasive encapsulated follicular variant of papillary thyroid carcinoma (NIEFV-PTC) as a non-malignant thyroid neoplasm and to use the term: “Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features (NIFTP)”. In this study, we identified the clinic-pathological characteristics and management of NIEFV-PTC at King Abdul-Aziz Medical City, Jeddah between 2011-2015.

Methods: A retrospective review of all pathological reports of thyroidectomy specimen with a malignant diagnosis. All cases of EFV-PTC were included as well as other common variants of PTC for comparison. All pathological diagnoses were reviewed by a board-certified pathologist. Additional needed data were obtained by reviewing patient’s charts.

Results: A total of 69 EFV-PTCs (44 noninvasive, 25 invasive) accounting for 28% of all PTC. EFV-PTC had significantly larger tumor size than PTC (P<0.001). NIEFV-PTC tend to be uni-focal compared to invasive EFV-PTC (p=0.006). None of the NIEFV-PTCs showed peri-neural invasion/extra-thyroidal extension/lympho-vascular invasion/lymph node metastasis. 56.8% (n=25) of NIEFV-PTC were managed by surgery and radioactive iodine ablation with a mean dose of 92.82 MCI.

Conclusions: Our local institutional experience indicates that NIEFV-PTC tumors were over staged and treated as conventional thyroid cancer despite an indolent behavior. Adopting the NIFTP terminology in accordance with the recent recommendations might significantly reduce the over-treatment and its associated complications. Where are the conventional PTC cases?? NIEFV-PTC is an indolent thyroid tumor with very low-likelihood of metastases. To avid over-treatment, we recommend the incorporation of the recently coined term (NIFTP) into the diagnosis and management algorithms for patients with thyroid tumors.

Biography:

Shafi M Nizamani has his expertise in homicidal autopsies especially in exhumations. He had conducted more than 500 autopsies and more than 200 exhumations among them he had conducted autopsy after exhumation of the Daniel Pearl a Wall street Journal correspondent on 17^th May 2002 Karachi Pakistan. He had worked as Medico Legal Officer from 1981 to 1994 then Assistant and Associate Prof of F M Dow Medical College Karachi till 2007 after that he joined Faculty of Medicine MARA University of Technology Shah Alam Campus as Prof Madya from 2007 till date.

Abstract:

After 9/11 incident attacks, world Coalition forces tried to combat the terrorist by attacking them by using UAV (unnamed Arial vehicle ).Total incidents of the drone attacks reported to have been 330 in Pakistan from the year 2005 to 2017, as a result, 2851 people have died till now. As a response to the hatred created against the attacks, the youngsters to take the revenge volunteered to be trained as a suicide bomber (mule) on the Philosophy of the Jihad. As result of it, from 2011 to 2013 there had been 13721 incidents in Pakistan. From the year 2001 to 2005, there were 523 terrorist attacks incidents in Pakistan and from the year 2007 to 2013, the total number of incidents has resin to 13198. And the number of suicide bombers (mule) between 2001 to 2007 was 15 in number but from the year 2007 to 2013 the suicide attacks have been increased to 358 in number. This shows that with the increase in drone attacks the number of suicide bombing has increased a lot .These suicide attackers are actually not committing suicide but it is actually a homicide attack and these attacks are being managed by the other people who work behind the scenes through remote controls (handlers). So, the studies have to be done to explore and we have to investigate how actually these controlled terror attacks are being done by the use of the mechanism and control that the devices, such as cell phone or whether there are other wireless devices are being used by people who are controlling the suicide bombers. Awareness and understanding and an insight about Drone attacks may help the public and concerned authorities to help in preventing and controlling by initiating and implementing the policies and security measures for the safety of the mankind.

Biography:

Sin Chun Fung has obtained his Medical Degree in 2008 and is a qualified hemato-pathologist in Hong Kong. Currently he is working as Clinical Assistant Professor in University of Hong Kong. He had been working as Physicians in the past. He is interested in the work and research in various hematological malignancies and investigating the novel treatments. He is also passionate in the field of coagulating and hemostasis. With his experience and expertise in Internal Medicine, he had done work on the laboratory assay of new oral anti-coagulants, with the aim of improving the management of patients taking NOACs.

Abstract:

New oral anti-coagulants (NOACs) are getting more and more popular now and vast majority of patients are taking NOACs as thrombo-prophylaxis now. The merits of NOACs include wide therapeutic index and stable pharmacokinetics and hence there is no need for laboratory monitoring. However, there are some clinical situations that laboratory monitoring of NOACs is important for patient’s management. For example, patients undergoing invasive procedures or patients suffering from bleeding complications. Various platforms of laboratory assay are available for measuring the drug level of dabigatran, rivaroxaban and apixaban. The measurement of rivaroxaban and apixaban can be done by anti-Xa assay and dilute thrombin time can be used to measure the level of dabigatran. Some review articles mentioned that the value of specific assay of NOACs is uncertain, mainly because the precision and accuracy of the specific assay is not optimal, especially for low drug level. Nowadays, some companies provide kit with low-level calibrators to improve precision of measurement of low drug level.

In our study, we use the anti-Xa kits and dilute thrombin time kits from Werfen Company and Sysmex Company for evaluating the drug assay of dabigatran and rivaroxaban. The precision, accuracy, linearity and limit of detection are satisfactory for measuring various levels of dabigatran and rivaroxaban, including low drug concentrations and the performance of the kits provided by two companies are comparable. The relationship between the drug levels of NOACs with routine coagulation screening tests was also evaluated. The issue of quality control and some practical issues for implementation of the specific laboratory assay of NOACs will also be discussed.

Biography:

Dagmara Magdalena Poprawski has graduated from the University of Adelaide in 1992 and has done tropical, rural and remote medicine for many years. She has completed her Master’s degree in Clinical Tropical Medicine in 1998 from Mahidol University in Thailand. She has then returned to Adelaide to undertake Physician Training and Specialized in Medical Oncology. Since 2013, she had been working in regional South Australia and is currently the Acting Clinical Director of Country Health Services in SA. She has completed her Diploma in Geriatric Oncology in 2016 and is a Member of SIOG.

Abstract:

Colorectal cancer presentations are often seen with an isolated metastatic spread to the liver. These lesions may be amenable to surgical resection through hemi-hepatectomy or hepatic metastasectomy and in the skilled hands of a hepato-biliary surgeon, achieve down staging. This becomes a curative management for such patients. While there is evidence through surgical trials in younger patients, geriatric population has not been studied. It is only recently that patients of advanced age are being offered more complex management plans in cancer care. A case of Mr AC, who at the age of 86 years, presents with colorectal cancer and 3 FDG avid liver metastases on PET scan. Despite a number of comorbidities including CABG in 1995, he undergoes right laparoscopic hemicolectomy in April 2014. After discussions with colorectal and hepato-biliary surgical teams, he is offered quasi-neoadjuvant chemotherapy with modified FOLFOX in order to undergo right hemi-hepatectomy. This is followed by adjuvant chemotherapy with CAPIRI. Patient has been on active surveillance since, with no recurrence of his malignancy. He leads an active life playing competitive Bocce, and has been to Italy twice to visit his family. This case demonstrates that in selected cases, with fit geriatric patients, and multidisciplinary care provision, colorectal down staging with surgical procedures to the liver may provide the patient a potential cure of their malignancy.

Biography:

Dariusz Borys is a Professor of Pathology and Orthopedic Surgery, Head of Orthopedic and Pediatric Pathology and Director of Digital Pathology at Loyola University Chicago. He has received his Doctor of Medicine from the University of Wroclaw, Poland in 1994 and completed a residency program in anatomic pathology at County General Hospital in Wroclaw, Poland in 1995. He has completed his Postdoctoral research at the University of Arizona, Tucson, Arizona in 1998. He continued on with and completed residency training in both anatomic pathology and clinical pathology at University of Illinois at Chicago in 2001. He has received a Pediatric Pathology Fellowship at New York University, New York, New York in 2005 and followed that with an Orthopedic Pathology Fellowship at NYU Hospital for Joint Diseases, New York, New York in 2006. After completing his fellowships, he has become faculty member in the rank of assistant professor at University of California and then he finally moved to Loyola University Chicago in 2013. At LUMC he is appointed as a Professor of Pathology and Orthopedic Surgery and is serving as the Head of orthopedic and Pediatric Pathology and Director of Digital Pathology. Currently his research focuses on the molecular markers in diagnostic, prognostic and targeted therapy in osteosarcoma.

Abstract:

Digital pathology is a dynamic, image-based environment which enables the acquisition, management and interpretation of pathology information generated from a digitized glass slide. Healthcare applications include primary diagnosis, diagnostic consultation, intraoperative diagnosis, medical student and resident training, manual and semi-quantitative review of immunohistochemistry (IHC), clinical research, diagnostic decision support, peer review and tumor boards. In the last decade digital pathology was rapidly expanding as an essential technology tool to support medical education, tissue based research, drug development and the practice of clinical pathology. This presentation is to highlight application of digital pathology application in daily clinical practice, education and research.

Biography:

Dr fariha Kauser has received her Bachelor degree in dental surgery from Ras al khaimah medical and health sciences university, UAE, and Diploma in medical education, university of Dundee, Scotland.

Abstract:

This paper holistically represents the uncommon location of central giant cell granuloma due to its occurrence in maxilla. Central giant cell granulomas are benign, non-proliferative lesion and commonly seen in mandible. The aetiology is still unknown and not a true neoplasm but may be linked to its reactive, non-developmental and aggressive nature. This case report presents a 21 years old Asian male with moderate painful swelling in the left side of anterior maxilla. The lesion was more painful on palpation and adjacent tooth was having grad3 2 mobility. Tumor was located on anterior maxilla, close to the midline, separating the upper left lateral incisor from upper left canine. Medical, family and social history is non-significant.

Biography:

Anshoo Agarwal is currently working as Professor and In-charge of Pathology Department (female campus), Northern Border University, Kingdom of Saudi Arabia. She has received her Degree from King George’s Medical College. She had been Discipline Coordinator (Pathology Dept.) in University Technology MARA, Malaysia. She is a member of many associations like Indian Association of Pathology and Microbiology, International Academy Pathology, Indian Society of Hematology and Transfusion Medicine, Emirates Medical Association Pathology Society, International Economics Development Research Center etc. She has more than 100 publications. She is Editorial Member of three journals and is reviewer in many journals. She had organized many national and international CME’s, Workshops and Conferences.

Abstract:

Education and training in pathology remain essential to both undergraduate and postgraduate courses in pathology. Traditionally, education and training in pathology has been delivered using textbooks, glass slides and conventional microscopy but increasingly web-based resources have been developed to supplement or replace the more traditional methodologies. From an educational stance, the use of virtual slides ensures that all students see the same slide; that slide is the best and most representatives in the collection, rather than one of inferior quality and that poor microscope technique does not interfere with the learning experience. It also allows rare slides to be used without fear of breakage. Displaying the slide on a computer screen means that students can more easily discuss the content with each other, allowing for the use of group-work based approaches to teaching. This pedagogy was more difficult to pursue when students assessed a glass slide on their individual microscopes. Digital pathology has been shown to improve individual and group learning and enhance the overall learning experience. Digital pathology also has the benefit of delivering courses to students outside the classroom setting. On-line resources can be accessed by students anytime, anyplace allowing them to view slides that would have traditionally been restricted to the slide box and the classroom. The use of digital imaging for surgical pathology raises new safety and effectiveness issues that must be addressed. We recognize the many benefits the technology provides at the same time we need to be sure of its limitations to prevent the associated risk.

Biography:

Dagmara Magdalena Poprawski has graduated from the University of Adelaide in 1992 and has done tropical, rural and remote medicine for many years. She has completed her Master’s degree in Clinical Tropical Medicine in 1998 from Mahidol University in Thailand. She has then returned to Adelaide to undertake Physician Training and Specialized in Medical Oncology. Since 2013, she had been working in regional South Australia and is currently the Acting Clinical Director of Country Health Services in SA. She has completed her Diploma in Geriatric Oncology in 2016 and is a Member of SIOG.

Abstract:

An innovative model of care through provision of telemedicine clinics in medical oncology in South Australia has been introduced to improve the burden of the tyranny of distance. This system has been utilized in South Australia (SA) to deliver oncological care to rural areas for 5 years. A retrospective clinical review was performed in 2013-2017 with 999 patients seen in SA, 2 regional and 7 rural hospitals. Telemedicine included pre-therapy reviews 781, restaging 203 and 15 new consultations. Our model allowed more satisfaction to health workers and patients, accepting this as consultation option. Benefits of this innovative model of care are saving patient’s travel, decreasing the burden on metropolitan clinic appointments and improving hospital budgets. Also, to improve attendance rates and duration of therapy response by enabling patients to have cared near their home. Relative improved decision making/outcomes during consultations, especially in indigenous and patients with cultural and linguistic challenges. The challenges are phone interpreting service, patients with disabilities, having a nurse on the patient’s end of the consultation, and setting up new rural centers as part of this service provision. There are many similarities including the issues of distance to cancer care, centralized in metropolitan hospitals and overburdened clinics in many countries around the world including that of Asia. Most countries now have a metropolitan-centric model of specialist cancer of care, but they also have basic IT systems in regional and rural health facilities that can be adapted to suit a global development of telemedicine provision of care.