Day 1 :
Kursk State Medical University, Russian Federation
Keynote: Regulatory peptides:the mechanisms of effects on the pain-induced aggressive-defensive behavior
Time : 10:30-11:15AM
Severyanova L. Performed research at Kursk State Medical University and received her PhD at the age of 25 and later Russian "Doctor of Medicine" at the Pavlov Institute of Physiology of the Russian Academy of Sciences.Consequently : Head of the Department of Pathophysiology, Dean of the International Faculty, Professor of Pathophysiology, Honored Worker of Higher School. Scientific interest: the integration of nervous, endocrine and immune mechanisms in the systemic reactions of the body. She has published more than 50 articles in reputed journals and three monographs
For many years we have studied the regulatory peptides effects on the integration of nervous, endocrine and immune mechanisms in the pain-induced aggressive-defensive behavior in rats. 23analogues of the natural hypothalamic-pituitary peptides and other peptides synthesized in the Russian Academy of Sciences and "Serva" were administered in intraperitoneal and brain intraventricular injections.With the use of the modified foot-shock model the following regularities of peptide effects were revealed.( i) The key role in peptide effects is played by the L-arginine or L-lysine amino acids residues.In particular ,only the administration of arginine- containing peptides increased pain sensitivity and aggression.(ii) Binding of the tripeptide Pro-Gly -Pro to the amino acid (Arg) or oligopeptide (ACTH 4-7) essentially modifies the influence on the affective aggression. ( iii ) The intensity of aggression depends on the excitability of the brain emotional negative system more than on pain perception.This was demonstrated due to effects of encephalin analogues.( iy ) Peptide effects seemed to be dependent on the brain locus of their primary application. (y) Neuropeptide effects were more expressed in rats with the higher excitability of nociceptive, emotional,opioid and M-cholinergic systems.Since analogues of the natural peptides have been used, there is a reason to believe that obtained data make it possible to elucidate the mechanisms of the development of the pain-induced affective aggression and to develop means for its correction.
Loyola University Chicago, USA
Time : 9:45-10:30AM
Dr. Dariusz Borys is an Associate Professor of Pathology and Orthopaedic Surgery, head of Orthopaedic and Pediatric Pathology and Director of Digital Pathology at Loyola University Chicago. He 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 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 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, Dr. Borys 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 an Associate Professor of Pathology and Orthopaedic Surgery and is serving as the head of orthopaedic and pediatric pathology and director of digital pathology. Currently Dr. Borys' research focuses on the molecular markers in diagnostic, prognostic and targeted therapy in osteosarcoma.
Osteosarcoma (OS) is a malignant primary tumor of bone affecting adolescents and young adults. There are few if any molecular markers to predict its behavior and prognosis. In our study we investigated the relationship of expression of different molecular markers in osteosarcoma tumors before treatment to pathologic necrotic response after neoadjuvant chemotherapy. In summary, deletion of RB1 (72%), gain of RUNX2 (68%), deletion of TP53 (52%), deletion 18q23 (48%) by molecular studies and p16-negative by IHC (38%) were common findings. Most abnormalities, particularly RB1 and TP53 deletions and RUNX2 gain, did not correlate with chemotherapy response. IHC p16-negative status correlated strongly with failed chemotherapy response (15/40). Alterations of 18q correlated slightly with poor response (p=0.0796). Poor response cases included 3 cases with deletion of 18q23, 3 cases with LOH for 18q23, and 1 case with copy gain (trisomy 18). Comparison of 18q genomic abnormalities in cases with a favorable versus poor response suggested a smallest region of overlap for a negative factor at 18q23. In conclusion we identified complex genotypes in the OS samples with frequent occurrence of previously identified biomarkers such as deletion RB1, deletion TP53, deletion 18q23 and gain of RUNX2. Comparison of genomic findings to p16-negative status and chemotherapy response revealed p16-negative status to be the best overall indicator of a poor chemotherapy response, with the poorest responders being both p16 negative and altered for 18q23. Additional studies are warranted to validate these findings and further characterize the role of CDKN2A and other factors that influence response to therapy in osteosarcoma patients.
Narayana Multispeciality Hospital India
Time : 11:15-12:00
Dr Shashikant Limbachiya is super specialist (MCh) Head & Neck Onco Surgeon working in Gujarat India. After his post graduation in Master of Surgery, he did super speciality from world renowned amrita Institute, kochi. He is founder of India’s first Dysphagia society, “Deglutology Research Foundation”. His area of interests are oral,laryngeal,sinonasal, skull base, thyroid, parotid & Neck surgeries as well as Reonstructive Platic & Microvascular procedures. He has authored 6 text book chapters and several publications in reputed journals. He has presented several award/ podium papers in various international conferences.
Dysphagia (swallowing dysfunction) is a debilitating, depressing, and potentially life-threatening complication in cancer patients that is likely neglected. In last two decades oncological outcomes has improved with advance in surgical and radiation methods, that’s why quality of life needs to be addressed among survivors. This keynote lecture is aimed to give precise information on dysphagia in head and neck with a focus on assessment tools, prevalence, complications, and impact on quality of life. Management of swallowing dysfunctions will be covered with recent advances and available evidences in all subsites of head and neck cancers who are treated with curative surgical / chemoradiation modality.
- Clinical pathology| Surgical pathology | Digital Pathology | Oral and maxillofacial pathology | Autopsy Pathology | Surgical Oncology | Cancer treatment and Therapeutics
Loyola University Chicago, USA
Northern Border University, Kingdom of Saudi Arabia
Title: Effectiveness and pitfalls of robotic tele-pathology in diagnostic confirmation and intraoperative consultation
Time : 13:30-14:00
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.
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.
University of Dundee, Scotland
Time : 14:00-14:30
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.
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.
King Abdulaziz Medical City, Saudi Arabia
Title: A recent paradigm shift in a common thyroid neoplasm diagnosis and management: A single institutional experience
Time : 14:30-15:00
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
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.
Universiti Teknologi MARA, Malaysia
Title: Terrorism in Pakistan through Drone attacks and its repercussion-an experience and review of literature
Time : 15:20-15:50
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 17th 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.
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.
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.
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.
Country Health South Australia Local Health Network, Australia
Time : 16:20-16:50
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.
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.