Day 2 :
Al Watany Eye Hospital, Egypt
Keynote: IOFB (Believe it or NOT !!!)
Time : 9:00-9:30
Ashraf Armia, Consultant , has more than 20 years experience in Ophthalmology. He has completed his MBBCh from Cairo University of Egypt. He completed his Master degree MSc in from Cairo University of Egypt. Finally, he finished his FRCS in Ophthalmology from Glasgow, United Kingdom. He became an Associate of the American College of Surgeons (AACS). He is a Consultant Eye Surgeon at the Egyptian Ministry of Health. He is a Consultant Eye Surgeon at Al Watany (WEH) in Egypt and a shareholder at the same hospital. He is a Consultant Cataract and Refractive Surgeonand Anterior Segment Reconstruction. He also has his own Eye Centre (www.ashrafarmiaeyeclinic.com). He is a Member of the (AAO), (ASCRS), E (ESCRS) and .
Statement of the problem: Neglected repaired rupture globe for two months on a huge foreign body in the anterior segment of a child age 8 years. Distorted anterior segment with traumatic cataract. The video represent how I tried to remove the foreign body with the least trauma and reconstruct the anterior segment for further implantation of an IOL. Methods: Male child who is 8 years old. History of penetrating trauma to the right eye by gunshot in the last two months. Repaired ruptured globe was done in the past 2 months. The pattern of his iris tissue has changed since the trauma. Vision was barely HM, with good macular function and his projection was fair. IOP was 17 mmHg. was in a good state with shallow AC and no pupil could be detected. Results: The eye was quiet and Mild SK. Formed AC with ++ flair; Vision was 30 cm second day, reached up to 5 meters on the first week with BCVA 0.2 at 2 weeks. Couldn't see clearly second day, but after one week it was clearly seen. IOP was digitally full.
Kuban State Medical University, Russia
Time : 9:30-10:00
Alexander G Zabolotniy is Head of the Scientific Department Interindustry Scientific-Technical complex of Eye microsurgery named after Sv. Fedorov, the Krasnodar branch and Professor of the Department of eye diseases of the Kuban State Medical University. His scientific activity include: Innovative treatment of AMD, ; organization and quality of ophthalmic medical care; high-tech methods of diagnosis. Field of innovative scientific interests – the study of possibility of applying THzR in diagnostics and treatment of in the anterior eye segment.
Studying the possibilities of applying terahertz radiation (THzR) in diagnostics and treatment of the anterior eye segment pathology determines the actuality of the research of THzR influence on cornea in normal and pathological conditions. Purpose: The analysis of THzR impact on cornea of in experiment in vivo. Materials & Methods: 10 eyes of 5 Californian rabbits were studied. During the experiment, we exposed one eye of each rabbit to a Terahertz photometer (Institute of Photonics and Optical Informatics), the second eye as control group. The sensitive innervation of was checked after 5 minutes of THz exposure with 25-68 nW power and 0.015-320 RUs intensity, Ø spots – 1.5-5.0mm. Analgesic effect was checked starting from 1 min after the onset by applying mechanical irritation at the main area of with von Frey hair (algesimeter). To evaluate the THz impact on epithelization rate of corneal erosion, the notch of 2.5mm had been made with a scarify superficially in the center of cornea. Photo registration of the corneal epithelization was performed immediately and after the exposure for 1.5 days. The corneas were stained with fluorescein solution. Results: The corneal sensitivity pre-and post THzR exposure was sustained and didn’t change. The corneal epithelization in the experimental group with low-power (26 nW) more intensive during the first 3-4 hours. The total epithelization time (24 hours) the same in both groups. The accelerated epithelization is related, our opinion, to the therapeutic effect of THzR-26 nW on the anterior epithelium of . Conclusion: The most representative was the experiment of applying low-power (26.0 nW) THzR. The radiation of 0.1-2.6 THz is well safe for rabbit eyes: it doesn’t change cornea innervation, doesn’t have analgesic effect and causes acceleration of epithelization of scarified corneas in the first few hours, without changing the total epithelization time.
- General Practice and Public HealthPrimary Care| Nursing Care| General practice and palliative care
Location: SERI, Switzerland
Hospital Sant Joan de Deu de Barcelona, Spain
Ashraf Armia Balamoun
Al Watany Eye Hospital, Egypt
University of Malaya, Malaysia
Norita is a Senior Lecturer in the Department of Primary Care Medicine at the University of Malaya, Malaysia. She received her PhD in 2016 from the University of Nottingham, United Kingdom. Her thesis focused on preconception assessment of genetic risk in primary care setting. Her special interest is primary care genetics especially developing strategies to improve genetic risk assessment among the reproductive women. She is also involved in the teaching and training of the postgraduate Master of Family Medicine at the University of Malaya.
Background: Reproductive health and pregnancy outcomes may be improved if reproductive risk assessment is moved from antenatal to preconception period. Primary care has been highlighted as an ideal setting to offer preconception assessment, yet the effectiveness in this setting is still unclear.
Objective: To evaluate the effectiveness of preconception interventions on improving reproductive health and pregnancy outcomes in primary care.
Method: MEDLINE, CINAHL, EMBASE and PsycINFO databases were searched from July 1999 to end of July 2015. Only interventional studies with a comparator were included.
Results: Eight randomized controlled trials were eligible. Preconception interventions involved multifactorial or single reproductive health risk assessment, education and counselling and the intensity ranged from brief involving a single session within a day to intensive involving more than one session over several weeks. Five studies recruited women planning pregnancy. Four studies involved multifactorial risks interventions; two were brief and the others were intensive. Four studies involved single risk intervention, addressing folate or alcohol. There was some evidence that both multifactorial and single risk interventions improved maternal knowledge; self-efficacy and health locus of control; and risk behaviour, irrespective of whether brief or intensive. There was no evidence to support reduced adverse pregnancy outcomes. One study reported no undue anxiety. The quality of the studies was moderate to poor.
Conclusion: The evidence from eligible studies is limited to inform future practice in primary care. Nevertheless, this review has highlighted that women who received preconception education and counselling were more likely to have improved knowledge, self-efficacy and health locus of control and risk behaviour. More studies are needed to evaluate the effects on adverse pregnancy outcomes.
Hussein N, Weng SF, Kai J, Kleijnen J, Qureshi N. Preconception risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease. Cochrane Database of Systematic Reviews 2015, Issue 8. Art. No.: CD010849. DOI: 10.1002/14651858.CD010849.pub2.
Hussein, N., Kai, J., Qureshi. N., 2015. The effects of preconception interventions on improving reproductive health and pregnancy outcomes in primary care: A systematic review. European Journal of General Practice. (In Press.)
S.S.L. Wong, C.J. Ng, S.M. Liew, N. Hussein. Effectiveness of a colour coded HbA1c graphical record in improving diabetes control in people with type 2 diabetes: A randomized control trial. Diab Res Clin Pract (2011), doi:10.1016/j.diabres.2011.11.001
Robson, NMH.,Aziz, N., Abdul Aziz, AF., Mohamed, M., Othman,S., Hussein, N. 2008. The need for Good Clinical Practice in health care research. South Africa Family Practice. In press.
Meir Medical Center, Israel
Avi Benov has been working as a Physician in Meir Medical Center. He is also part of Tel-Aviv University, Israel. He is also part of Israel Defence forces
Background: Sepsis, one of the major health system concerns worldwide, is characterized by changes in organ function, morphology, cell biology, biochemistry, immunology and circulation that can lead to low blood perfusion, multi-organ failure, and death. It is a leading cause of morbidity and mortality, accounting a third of hospital deaths. Sepsis has several levels of severity ranging from self-limited disease to severe sepsis and septic shock. The evaluation of a patient's condition is routinely performed by a number of objective criteria including vital signs as well as laboratory tests. The compensatory reserve measurement (CRM) represents a new paradigm that measures the total of all physiological compensatory mechanisms, using noninvasive photoplethysmography to read changes in arterial waveforms. This study aim was evaluating the applicability and the predicting value of the CRM during sepsis.
Methods: Study patients included prospectively enrolled patients with proven laboratory and / or imaging diagnosis of infectious disease hospitalized in department of Surgery. All of them were evaluated with CRM, hemodynamic and laboratory measurements. Waveform data were postprocessed by an algorithm to calculate the CRM, measured on a scale of 1 to 0, with 1 indicating fully compensated and 0 indicating no reserve, or decompensation. Those values were measured throughout hospitalization.
Results: During the study period, data were prospectively collected from 100 patients. Subjects were hospitalized from October 1, 2016 to December 30, 2016. Of the 100 patients enrolled, 84 patients were not septic. The remaining 16 patients were in sepsis (SOFA score > 2), six of which were in septic shock. Groups had similar in age and gender, and statistical differences were wound in disease distribution when septic patients had higher incidence of mesenteric events and peri-appendiceal abscess (p=0.02). When Non-septic patients were compared to control patients, statistical differences were found only in CRP (P<0.0005), SOFA score (p<0.0005) and CRM (p<0.0001). When septic patients were compared with those in septic shock, differences were found in HR (p=0.03), SOFA score (p=0.01) and CRM (p=0.03). The remaining measurements did not show any significance among groups.
Conclusions: A novel computational algorithm that recognizes subtle changes in PPG waveforms can quickly and non-invasively discern which patients are in sepsis or in septic shock with high sensitivity and specificity in acutely sick patients.
1.Avi Benov Elon Glassberg Yitshak Kreiss Roy Nadler Role I trauma experience of the Israeli Defense Forces on the Syrian border DOI: 10.1097/TA.0000000000000377
2.Avi Benov Elon Glassberg Yitshak Kreiss Roy Nadler Tranexamic acid at the point of injury: The Israeli combined civilian and military experience DOI: 10.1097/TA.0000000000000325
3.Avi Benov Elon Glassberg Yitshak Kreiss Roy Nadler Intravenous access in the prehospital settings: What can be learned from point-of-injury experience DOI: 10.1097/TA.0000000000000723
National Institute of Paediatrics, Mexico
Judith Barrientos Sánchez has her experience in evaluation and passion for improving the health and well-being of the pediatric patient. She worked as a pediatric nurse in the clinical area for 20 years. She studied master's degree and is currently Coordinator of research in the area of management, clinic, and managed care. She is in charge of the development projects of students of nursing, as well as professionals interested in developing derivative works of the needs of the practice. She works in conjunction with the network of ENEO-UNAM research institutions and national institutes of health, pediatric research network and international network of nursing in child health, developing projects that improve care through evidence.
Introduction: A significant number of patients who attend health institutions have a risk of fall anytime during their hospitalization. Taking care of these patients requires diverse interventions and clinical assessments. Objective: To adapt and validate a hospitalized pediatric patient fall risk assessment instrument. Methods: The J. H. Downton instrument was adapted and validated. Specificity and sensibility tests, negative and positive predictive value, and Kuder-Richardson (KR) and ROC curve analysis internal consistency were all assessed using the SPSS® v. 15 and Epidat® 3.1 statistics programs. Results: KR internal consistency of 0.92, specificity of 99.4, PP of 99.56, and PN of 81.52 with a confidence interval of 95% were obtained. Conclusions: Validated scales such as the St. Thomas have good sensibility and specificity values (93% and 88%), but this scale is adapted for elder patients. The validated scale of this study had better sensibility and specificity values than two other hospitalized pediatric population scales: the Humpty Dumpty and the CHAMPS, suggesting that the modified H. Downton scale is highly sensible and specific to predict hospitalized pediatric patient fall risks.
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3. Estrategia de prevención, detección y actuación ante el riesgo de caídas. [En internet] [Consultado 24 Septiembre 2012] Disponible en: http://www.slideshare.net/observatorioseguridad/estrategia-de-deteccin-prevencin-y-actuacin-ante-el-riesgo-de-cadas
4. Joint Commission/JCR Reviewers. Front line of defense second. Edition Improving Health Care Quality and Safety 2007; pp. 73–86.
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8. Mora M C, Ramírez B I .Optimización de las medidas de prevención de caídas durante la hospitalización del paciente. Revista de Enfermería. [En internet] [Consultado 4 Julio 2012]. Disponible en: http://encolombia.com/medicina/enfermeria/Enfermeria9306Optimizacion.htm
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10. Salameh F, Cassuto N, Oliven A. Una herramienta de evaluación de riesgo de caída simplificada para pacientes hospitalizados en servicios médicos. [En internet] 2008 [Consultado 24-04-13]; 2:125-9. Disponible en: http://www.microsofttranslator.com/bv.aspx?from=&to=es&a=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpubmed%2F18432025
Aisha Sehari has been graduated from Tripoli University in January 1981 as Medical Doctor (MBBCh), with the specialties and Diploma in pediatric (DCH) from the same University. Later she obtained post-graduation from Alexandria University and got Master degree and Doctor of pediatrics (MD) in pediatric gastroenterology. Aisha started working at government university hospitals in Tripoli (Al khadra, Salahdin and Algala children hospital) and Gharrian teaching hospital where she has continued her research. Also she joined royal hospital for sick children (Glasgow) and Alexandria University Children hospital during her post graduate study. Presently she is working at Tripoli University, Medical College, and pediatric department as assistant professor and helping Gharrian medical college in the teaching program once per week.
Globally, acute gastroenteritis is an ailment that is very common among children during their first 3 years of life at which they will most likely experience about 1 to 3 acute diarrheal illnesses that can generate complication such as dehydration and disseminated intravascular coagulation. The diagnosis itself and its accompanying complications can be easily identified though proper clinical and laboratory evaluation. The purpose of this study was to identify evidences of disseminated intravascular coagulation (DIC) and correlate with other clinical or laboratory tests related to other complications of acute gastroenteritis (AGE) such as dehydration and some metabolic imbalances. Almost all of pediatrics patient who are severely dehydrated, suffering from hypernatremia and with hyperammonemia are with evidences of DIC. Moreover, some of the variables found to be significantly associated with positive and strong relationship while some are not.
1.June II Atombio Kiblasan Badridden F.A. Abufayed Aisha A. Sehari Kaltoom Mhana Analyzing the learning style and study habit of students in the faculty of nursing of Al Jabal Al Gharbi University, Gharyan, Libya DOI: 10.5430/cns.v4n2p48