Scientific Program

Day 1
Day 2

Keynote Session:

09:15-10:00

Wong Boh Boi

Wong Boh Boi Pvt Ltd, Singapore

Title: To review TCM and the current practices for lower back pain management for a lasting effect.

Biography:

Wong Boh Boi has graduated with a Bachelor of Health Science (Nursing) from the University of Sydney with distinction. She later went on to obtain a Master of Education (Early Childhood Education) and received her PhD from the National University of Singapore.

Abstract:

Objective: To introduce pain management and relief for lower back using the methods of Traditional Chinese Medicine (TCM) and its approach.

Setting: Chien Chi Yow, a Traditional Chinese Medicine company and specialist with over 50 years of experience and expertise. Medical Case studies of 2 patients; Patients Profile and Medical History: Sedentary lifestyle and occupational requirement, Senior & Sportsperson. History of lower back pain and/or have received medicallyinvasive lower back surgery Mothers in their Pre- and Post-Partum

Methods: Uses (but not limited to) a combination of
Meridian point massage (Tui Na), Cupping, Acupuncture, Spinal Lumbar Reconstruction and Encourage Stretching Exercise.

Results: Participants experience significant pain relief after the TCM treatment compared to before treatment was done.

Conclusion: While TCM is proven to be able to significantly manage and relieve the lower back pain with TCM approach, good advisory and counseling are as important to reinforce the importance of a healthy lifestyle for an enhanced quality of life.

10:00-10:30

James Stoxen

Team Doctors Treatment Center, USA

Title: The integrated Spring-Mass model approach to treating Thoracic Outlet Syndrome

Biography:

James Stoxen, DC, FSSEMM (hon) FWSSEM, is the president of Team Doctors, Chicago, Illinois, one of the most recognized treatment centers in the world. He has been invited to give scientific presentations at over 60 medical conferences in over 20 countries. In 2015 he was awarded an honorary fellowship by a member of the royal family, the Sultan of Pahang, at the World Congress of Sports and Exercise Medicine for his distinguished research and contributions to the advancement of sports and exercise medicine on an International level.

Abstract:

The use of hand held devices (HHD) such as mobile
phones, game controls, tablets, portable media players
and personal digital assistants have increased dramatically in past decade. This drastic change has led to new batch of difficult to treat, musculoskeletal Disorders of the Upper Extremities such as myofascial pain syndrome of neck and upper back and thoracic outlet syndrome. The thoracic outlet anatomy and how the bundle passes through the passageway is complex for even musculoskeletal experts. So for doctors trained in other specialties there can be an inadequate understanding about nature and cause of thoracic outlet syndrome. A syndrome rather than a disease, the Mayo Clinic, Cleveland Clinic and the National Institute of Neurological Disorders And Stroke, plus top 10
ranked hospitals for neurology and neurosurgery agree
persistent compression of nerves, arteries and veins
traveling through the thoracic outlet is what leads to
thoracic outlet syndrome. I will discuss the three models of human movement, the inverted pendulum model, the spring-mass model and the integrated spring-mass model (ISMM). The (ISMM), which integrates the spring suspension systems of the foot and shoulder region as well as the torsion spring of the spine and the mass, the head. I will discuss my clinical findings show compressive disorders like TOS and herniated discs are merely an over control of tension on the human spring mechanism leading to these syndromes. I will give brief review of the symptoms and their patterns, the common orthopedic tests, and diagnostic tests, the 16 different common conservative therapies and the 10 reasons for when surgery is medically necessary. I will discuss an alternative treatment for this disorder based on the integrated spring mass model.

10:30-11:00

Huang Wei Ling

Huang Wei Ling, Medical Acupuncture and Pain Management Clinic, Brazil

Title: Why patients with knee pain still have symptoms despite the use of anti-inflammatory medications?

Biography:

Huang Wei Ling has graduated in medicine in Brazil, specialist in infectious and parasitic diseases, a General Practitioner and Parenteral and Enteral Medical Nutrition Therapist. Once in charge of the Hospital Infection Control Service of the City of Franca’s General Hospital, she was responsible for the control of all prescribed antimicrobial medication and received an award for the best paper presented at the Brazilian Hospital Infection Control Congress in 1998. Since 1997, she works with the approach and treatment of all diseases of all systems of the human body in a holistic way, with treatment guided through the teachings of Traditional Chinese Medicine and Hippocrates.

Abstract:

Statement of the Problem: According to Western Medicine, chronic knee pain can have different causes. The problem is usually associated with sprained ligaments, meniscus tears, tendinitis, and runner's knee. The usual treatment is done with ice, stretching exercises and antiinflammatory medications. According to Traditional Chinese Medicine (TCM), the knee pain is associated with invasion of External Wind, Cold, Damp and Heat, deficiency of Liver and Kidney, or deficiency of Qi and Blood. Purpose: Demonstrate that by using anti-inflammatory for the treatment of knee pain, we will be causing a greater injury in Kidney and Liver energy, according to TCM, which are responsible for the integrity of the knee. Therefore, the use of these medications will worsen the energy imbalance, maintaining the pain condition. Methods: The description of two case reports of 65 and 70-year-old patients with chronic knee pain, who were using anti-inflammatory drugs for long periods without any significant improvement, only side effects such as epigastric pain and drug intolerance. They sought acupuncture in an attempt to control their pain without having to use such medications. Results: There was a significant improvement in pain symptoms when using acupuncture, dietary counseling and general guidelines on external pathogenic factors such as Wind, Cold, Humidity, and so on. We noticed that when the patient underwent treatment to restore the energy of the chakras corresponding in TCM to the Five Elements, the pain that the patient presented disappeared completely. Conclusion: In order to adequately treat patients with knee pain, we should understand more deeply the significance of this symptom at the energy level by treating the organs that command the knee such as Liver and Kidney according to TCM. The treatment of energy replacement of the internal organs through crystals-based drugs has proved to be very important for the consolidation of the treatment.

11:20-11:50

P Venkataraman

SRM Institute of Science and Technology, India

Title: Expression levels of obesity - related genes in high fat diet (HFD) induced experimental animals: Impact of combination therapy of anti-obesity drugs

Biography:

P Venkataraman has completed his MPhil degree from department of Endocrinology, University of Madras, Chennai, India and awarded PhD degree at the age of 32 years from the same department. At present he is working as an Assistant Professor in Department of Medical Research, SRM Medical College Hospital and Research Centre, SRM University, Chennai, INDIA. He has an extraordinary ability in the field of Molecular, Environmental and Neuroendocrinology. He has published his research works in 41 international peer reviewed journals especially Journal of Nutritional biochemistry, Endocrine research, Neurotoxicology, International Journal of Developmental Neuroscience, Neuroscience Research, BBA Clinical, Obesity medicine, Biomedicine and Pharmacotherapy. He is the reviewer in reputed journals especially Biomedicine and Pharmacotherapy, Comparative Clinical Pathology and Reproductive Sciences. He is also the editorial board member in Journal of Experimental and Integrative Medicine and Journal of clinical and Molecular endocrinology. He has participated and presented many research papers in International and National conferences in the field of Reproductive and comparative endocrinology and environmental toxicology. He served as a resource person in two national workshops (DST, DBT, ICMR and CSIR sponsored) entitled, “Techniques in molecular and cellular endocrinology”, organized by Department of Endocrinology, University of Madras on 2010 & 2013. He is supervising 8 PhD students and among them two students got PhD degree.

Abstract:

Obesity is a global health problem and also a strong risk factor for type 2 diabetes mellitus, cardiovascular diseases and obesity genes play a major role in the central regulation of energy balance. Orlistat (Xenical, Alli) is a synthetic anti obesity drug approved by European Medicines Association (EMA) and Food and drug administration (FDA). But studies shown, orlistat supplementation causes severe liver and kidney injury. Melatonin, an indolamine, produced by the pineal gland plays a major role in circadian rhythm and one of the powerful antioxidant. Literatures shown, it also exerts control over metabolic functions that determine fat accumulation and obesity and it also protects environmental toxicants induced liver and kidney injury. Garlic (Allium sativum L.), has been used as medicinal and alimentary medicine from ancient period and these has been used extensively worldwide especially in countries like India. Studies reported garlic and its constituents have shown the various biological activities especially against cardiovascular disease due to its blood lipid-lowering, antithrombosis, antioxidant effects and inflammatory response. Diallyl trisulphide (DATS), a natural product from garlic have gained attention in many biological activities. Based on literatures and to compensate the orlistat induced side effects, we propose to study the expression levels of obesityrelated genes in high fat diet (HFD) induced experimental animals and also to see the impact of melatonin alone and in combination with DATS supplementation compared to orlistat alone therapy. We studied mRNA and protein expression of KSR2, IRX3, FTO and Neuropeptide Y by real time PCR and western blot method in liver, adipose tissue and brain of experimental animals along with antioxidant and liver function parameters. Histological observations of liver and adipose tissue were also studied. Based on results we found that both the melatonin and DATS alone and its combination with orlistat therapy is efficacy and safety when compared to orlistat alone therapy. This study determined the clinical usefulness of melatonin and DATS as supplemental therapeutic agents in obesity induced liver and kidney dysfunction as well as in orlistat therapy and it may help in providing the therapeutic options to tackle the obesity without causing side effects.

Huang Wei Ling

Medical Acupuncture and Pain Management Clinic, Brazil

Title: Can metallic surgical implants influence the bodyâ€™s health?

Biography:

Abstract:

Statement of the problem: The necessity of surgical

implants use is a consequence of the increase of life expectancy. Therefore, there is a range of studies regarding the implant materials and their interactions. However, those studies are carried out analyzing the factory and interaction of materials, and often, they do not consider the effects of those materials in the normal functioning of the human body. Purpose: Demonstrate that the placement of metal implants can influence body’s health, leading to a decrease in vital energy. Methods: Two clinical cases, the first, of a 30-year-old male patient, who suffered an accident and broke the right elbow and right leg, requiring surgery with surgical implant of titanium rod in both limbs. Two months after surgery the patient presented a very severe depression, that would not improve with the use of antidepressants. The second case is from 60-years old female patient, who implanted a titanium dental prosthesis. Three months after the implant, the patient started feeling weakness, indisposition for the daily activities, in contrast to her normal behavior, in addition to precocious aging with the wrath of her hair. The chakras energies of both patients were measured through a crystal pendulum. All chakras were energy depleted. Results: In the first case, the patient was instructed to try to remove the implant. Two hours after the removal, the patient presented extreme improvement of the symptoms. The second patient did not remove the implant yet, and continued to present symptoms of low vital energy. Conclusion: The implantation of metallic material inside the human body, can lead to reduction of vital energy, inducing different symptoms, like depression, according to these two case reports.

Keynote Session:

Huang Wei Ling

Medical Acupuncture and Pain Management Clinic, Brazil

Title: Why orthopedic patients still catch hospital infections despite the practice of infection prevention and control programs & can hospital Osteomyelitis be treated without the use of antibiotics?

Biography:

Huang Wei Ling has graduated in medicine in Brazil, specialist in infectious and parasitic diseases. She is a General Practitioner and Parenteral and Enteral Medical Nutrition Therapist. Once in charge of the Hospital Infection Control Service of the City of Franca’s General Hospital, she was responsible for the control of all prescribed antimicrobial medication and received an award for the best paper presented at the Brazilian Hospital Infection Control Congress in 1998. Since 1997, she works with the approach and treatment of all diseases of all systems of the human body in a holistic way, with treatment guided through the teachings of Traditional Chinese Medicine and Hippocrates.

Abstract:

Statement of the problem: Very few publications provide sound scientific data used to determine which components are essential for Infection Prevention and Control (IPC) programs in terms of effectiveness in reducing the risk of infection. As surgical procedures are common in the orthopedics specialty, the difficulty in preventing infections influences the orthopedic treatment outcome. The purpose of this study was to show why patients still catch hospital infections despite IPC programs. A better understanding of a variety of theories could explain the physiopathology of diverse diseases described in the medical past history, as in Traditional Chinese Medicine. A broader view seems to show the necessity of seeing the patient completely; not only focusing on the disease in the prevention of these hospital infections. The methodology used was a review of these theories such as those presented by Hippocrates (“Natural forces within us are the true healers of disease.”), as well as others from oriental medicine, which explain that diseases originate from three factors: external (exposure to cold, heat, humidity, wind and dryness), internal (emotional) and dietary.

Findings: Having a broader view of the patient as a whole (Yin, Yang, Qi, Blood energy and Heat retention), we can understand better the formation of hospital infection which is a systemic energy reaction of the body undergoing normal hospital treatment.

Conclusion: To understand better why patients are still

catching hospital infections, despite IPC programs, we need to broaden our view observing all emotional, environmental and dietary factors, as well as studying the energy imbalance at the moment of admittance, or prior to the orthopedic surgery. Every patient is unique and to achieve a more successful treatment, it is important to individualize them. Therefore, it is possible to identify those who have more risk

of hospital infection, studying them in their energy levels.

10:00-10:30

Sheetal Kalra

Medical Acupuncture and Pain Management Clinic, Brazil

Title: Integrated role of yoga and physiotherapy in sports injuries prevention

Biography:

Sheetal Kalra born and brought up in Gurgaon, Haryana, she did my graduation from DAV College of Physiotherapy and Rehabilitation Yamunanagar and post-graduation in Sports Rehabilitation from S.B.S.P.G.I Dehradoon. She is also pursuing PhD in Physiotherapy from SGT University Gurugram. She have worked with reputed organizations like

Indraprastha University, Manav Rachna International University and Guru Jhambeshwear University. Presently she is working as Professor and Associate Dean ,Faculty of Physiotherapy,

SGT University, Gurugram.

Abstract:

According to a recent estimate approximately 30 % of the population worldwide is engaged in one or other kind of sports and approximately 60 % of them suffer from various kinds of sports injuries and a large percentage of sports men are rendered unfit for further sports life due to the nature of injuries they suffer from. Poor fitness in the form of inadequate flexibility needed for the type of sports, core strength, balance, agility and the psychological factors like anxieties, stress associated with the game not only hamper

the performance of the players but also make them prone to injuries. Physiotherapy has its origin in Yoga. Integrated role of Physiotherapy and Yoga can be useful components of comprehensive preventive and treatment programs in athletic injuries. The aim of Yoga is to bring balance into the body physically, mentally and emotionally. The mindbody connection in yoga is essential to helping athletes develop mental acuity and concentration. In addition, yoga helps to relax not just tight muscles, but also anxious and

overstressed minds. Various health benefits associated with Yoga and Physiotherapy are improved flexibility, strength endurance, neuromuscular coordination, enhanced control over body movements and hence prevent injuries by conditioning of the athlete. The integration of physiotherapy with yoga offers an evidence based approach not only to enhance the fitness and performance of the sports men but also prevent injuries on field as well as off field.

10:30-11:00

Abdulrahim Aljayar

Aljala Teaching Trauma Hospital, Libya

Title: A modified Sayreâ€™s technique, for correction of congenital Radial Club Hand Deformity

Biography:

Abdulrahim Aljayar is a consultant Orthopedic surgeon in Aljala Hospital, Libya. He was a former consultant hand surgeon in Benghazi Hospital. He received many awards and rewards in several National and International Conferences

Abstract:

Congenital radial club hand is a spectrum of complex

pre-axial upper limb defect, Characterized by radial

deviation and flexion of the hand, hypoplasia, or aplasia of the radius and thumb, shortened forearm and generalized underdevelopment of the involved extremity. Since first described by (Petit) in 1733, however a huge diversity of techniques ranging conservative stretching, to the complex microsurgical interventions, have been suggested, for treatment, the centralization remains the core idea, despite the recognized relapse rates. Such diversity would reflect

the great challenge of management. Here is a prospective assessment of our local exposure, and satisfying results of correction in13 hands with congenital radial club hand deficiency, in 10 patients, using a newly modified technique (Sayre). Where we achieved a mean total hand-forearm angulation correction of 71.5 degrees, left with only 8.4 degrees mean residual angulation after an average 3.8 years follow up.

Oral Session 1:

Chair

James Stoxen

Team Doctors Treatment Center, USA

Co-Chair

Abdulrahim Aljayar

Aljala Teaching Trauma Hospital, Libya

11:20-11:40

Arathy Mary John

Manipal Academy of Higher Education, India

Title: Anatomical variants of the circle of willis: A computed tomography angiography based study

Biography:

Abstract:

Knowledge of the presence of normal variants of Circle

of Willis (COW) plays a crucial role in the diagnosis and management of cerebro vascular disorders1. Based on

radiological and anatomical studies, no more than 50% of the

general population have a complete Circle of Willis (COW) 2.

It is proven that Lack of knowledge of the anatomical variants

of COW is the cause of approximately 10% of medical errors3.

Sensitivity (81%–90%) and specificity (93%) of multi-detector

CT angiography (CTA) are reported to be high in identifying the

anatomical variants in Circle of Willis (COW)4. Aim of this study

is to identify the frequency of anatomical variants in Circle of

Willis by using Computed Tomography Angiography (CTA)

and to determine the gender association of COW anatomical

variants. In this retrospective study COW CTA images of 400

patients are reading by a radiologist to identify the variants by

using Multi Planar Reconstruction (MPR) mages, Maximum

Intensity projection (MIP) images and Volume Rendering (VR)

images.. Variants present in anterior circulation (A1 segment,

Anterior Communicating artery (AComA) and A2 segment),

posterior circulation (P1 segment, Posterior Communicating

artery (PComA) and P2 segment), Middle cerebral artery

(MCA), Basilar and vertebral artery, internal carotid artery

(ICA), and others will be studied. Data will be analyzed by

using SPSS and frequency of variants will be identified. Chi-

Square test will be used to find out the association of variants

among gender.

11:40-12:00

Keerthana Wilson

Yenepoya Medical College, India

Title: Assessment of RV function in ASD by using tissue doppler imaging and strain rate imaging

Biography:

Keerthana Wilson is an Assistant Professor and Echocardiographer in Yenepoya Medical College has completed her Masters in Echocardiography and Bachler in CardioVascular Technology from an excellent development team of a progressive hospital where knowledge and skills of an individual are counted, shared and encouraged. She is an expertise in echoardiographic evaluation and has passion in improving the health and wellbeing of the patients. She is having experience in, evaluation and teaching both in hospital and education institutions. She intends to build a career in a challenging environment by adding value to the organization with her subject matter expertise, quick grasp of new facts, patience and skills, and work to be a model with a perfect blend of professionalism and human values.

Abstract:

Assessment of Right ventricular function plays a major role

in the Evaluation of Atrial Septal Defect. The introduction

of Doppler measurement of myocardial wall velocities (tissue

Doppler imaging; TDI) and the recent development of strain

rate imaging (SRI) technique have made a more adequate

assessment of global and regional systolic and diastolic RV

function possible. This study was conducted to evaluate the

RV function by using newer echocardiographic indices such as

Tissue Doppler Imaging & Strain Rate Imaging. A prospective

study was conducted among 64 adult patients admitted for

ASD device closure in the department of cardiology at Narayana Institute of Cardiac Sciences (NICS) Bangalore. A basic apical 4chamber (A4CH) view was taken during echocardiography in which the tissue motion velocity is superimposed for real time colour display. TDI annular velocities during systole, early relaxation (Ea), and atrial systole (Aa) were possessed from RV free wall (FW) and inter ventricular septum at basal site in the A4CH view. Deceleration time (DT), isovolumic relaxation time (IVRT), isovolumic contraction time (IVCT) and ejection time (ET) were measured. For the analysis of global RV function, Doppler parameters are used to derive the Tei index i.e. (IVCT+IVRT)/ET. The stain and strain rate was estimated from the RV focused AP4CH view from tissue Doppler data, by calculating the velocity gradient. All these measurements were taken pre and post ASD closure. Data was analyzed by descriptive statistics and Wilcoxon sign rank test was used to find out pre and post procedural comparison. The study showed significant decrease in tissue Doppler parameters including annular velocity, strain and strain rate during immediate post device closure and increase after 1 month of closure. The RV function improved significantly post 1 month of closure compared with post 24 hours.

12:00-12:20

Suha Hashim Abduljawad

Taibah University, Saudi Arabia

Title: The effect of flaxseed powder & oil on reduction of hyperglycemia and associated parameters in Streptozotocin-induced diabetic rats

Biography:

Suha Hashim Abduljawad has completed her PhD at the age of 32 years from king Saud University and Postdoctoral Studies from food and nutrition collage, King Saud University, Saudi Arabia. She has published more than 15 papers in reputed journals and has been serving as an editorial board member of repute.

Abstract:

Introduction: The global prevalence of obesity has reached an alarming rate. In addition to obesity and chronic diseases, high prevalence of micronutrient deficiencies especially iron deficiency anemia (ADA) was observed in many countries.. Among the different potential causes of iron deficiency, the sequestration of iron through an inflammatory mediated was identified as the most probable cause of iron deficiency in obesity. Adipose tissue is recognized as an endocrine organ that contribute to the inflammatory process by secreting proinflammatory cytokines, and The role of hepcidin in the regulation of iron metabolism has been emphasized in recent years. Hepcidin represents the main regulator of intestinal iron absorption and macrophage iron release and, thus, ultimately of the iron available for erythropoiesis.

Objectives: To examine the relationship between fat distribution (WC, total body fat %, and trunk fat %), iron status biomarkers and hepcidin in obese Qatari adults

Methods: Diabetes mellitus was induced in Sprague-

Dawley rats using a single injection of multiple low-dose

streptozotocin (20, 40 and 60 mg/kg/day, i.p). The rats were

divided into six groups consisting of 5 rats in each group. CD,

diabetes control; CFP, normal rats feed on diet contain 10%

flaxseed powder; CFO, normal rats feed on diet contains

4% flaxseed oil; DFP, diabetic rats feed on diet contain 10%

flaxseed powder; DFO, diabetic rats fed on a diet containing

4% flaxseed oil. The measurable parameters were; body

weight gain (BWG), food intake (FI), feed efficiency ratio (FER), Total glutathione (GSH), Superoxide dismutase (SOD), Catalase (CAT), blood glucose, total cholesterol (TC), Triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C).

Results: There was a significant decrease in BWG (P<0.05)

in DFP and DFO groups when compared with C groups. The

highest significant increase (p< 0.01) of GSH levels and SOD

and CAT activity were seen in group CFP when compared to CD group. Supplementation with flaxseed powder in the diet was more effective than flaxseed oil in the reduction of blood glucose level of diabetic rats. DFP group showed the lowest significant (P<0.05) decreasing in TC, TG and LDL-C, and the highest significant (P<0.05) increasing in HDL-C as compared to diabetic CD group. Conclusion: Diabetic rats in a group which were treated with 10% flaxseed powder were able to partly recover from STZ -induced diabetes within eight weeks when compared to DC group.

O Fadili

University Hassan, Morocco

Title: Robotic equipment in upper limb amputations

Biography:

O Fadili, is a Doctor, inventor and young researcher in University Hassan 2 of Casablanca, Morocco. He published several papers in medical and robotic field. He received many

awards and rewards at his young age. He was nominated as the Young Researcher of 2018 by winning the award of The International Conference of Orthopedics and Advanced Cares in Dubai at the Young Researcher Forum 2018. He did several internship and externship and established a remarkable bench mark on prosthetic field by designing and modeling bionic hands and prosthetic arms. His field of interest includes medical research, orthopedics and rehabilitation.

Abstract:

Human hand is a very important member in our daily life, it is necessary in any activity. However, the loss of all or part of the arm, as a result of trauma, accident or other cause is a catastrophic event for a patient and a significant challenge to rehabilitation professionals and prosthetic engineers. Upper limb amputation have a detrimental effect on the individual's personal, social, psychological and economic life. The amputated patient is deprived of his hand, and as a result deprived of a large part of his life. We designed and created a robotic device, which served to the patients, who lost upper limb, to have a bionic hand under the vocal or myo-electrical command, and which can reproduce the movements elementals of a biological hand. During the design and manufacture of the equipment, we tried to respect the biomechanical rules of the physiological principle. First, we designed the equipment in a 3D modeling software, and used 3D printing convert all virtual file into a real object. All the printed parts are brought together to form all the equipment. Also, we installed servo-motors and connect them to a programmable chipset to ensure the movement of wrist and fingers. The device can be connected to the patient and he use vocal or myoelectrical command to move all the elements of this bionic hand. We are also developing a neurological component so the patient can use his brain to command the hand. Patients with upper limb amputation can recovers their basics hand's functions with this equipment and this after rehabilitation. It is reasonable, however, to state that in the majority of cases the provision of a prosthesis can make a valued addition to the life of the patient and should at least be attempted. Evidence exists that attempting prosthetic rehabilitation immediately after amputation increases the chances of long-term success, whereas a ‘wait and try later’ approach makes successful rehabilitation less likely. Amputation is a big problem; this bionic hand is an ultimate solution for amputated patients and allow them to recover their hand’s functions.

Rakesh Goyal

Lok Nayak Hospital and Maulana Azad Medical College, India

Title: Ganglion cyst of Hoffaâ€™s fat pad of knee-a rare cause of anterior knee pain and swelling

Biography:

Rakesh Goyal has completed his Master of surgery in field of orthopedics from Gujarat University, India. Previously he has worked as Senior Resident in Sir GangaRam Hospital, New Delhi. He is currently working as Senior Resident in department of orthopedics in Lok Nayak Hospital and Maulana Azad Medical College, New Delhi, India.

Abstract:

Ganglion cysts around knee joint are uncommon and that from Hoffa’s fat pad are even rarer. We present a case of 30 year old male patient with complaint of pain and swelling in left knee joint. Radiograph did not show any bony abnormality. MRI showed large tubulocystic lesion within Hoffa’s fat pad which showed low signal intensity on T1-weighted images and high signal intensity on T2-STIR images. Open excision of the lesion was done. Histopathology of the specimen confirmed the diagnosis of the ganglion cyst. In follow-up, patient had asymptomatic left knee with full range of motion and did not show any sign of recurrence. Ganglion cysts from fat pad though very rare but should be considered in differential diagnosis to have an early diagnosis and management. Symptomatic ganglion cyst should be excised by open procedure or arthroscopically depending upon the size and extent of the lesion.

Rakesh Goyal

Lok Nayak Hospital and Maulana Azad Medical College, India

Title: A rare case of traumatic posterior dislocation of hip in a 7 year old child following trivial trauma

Biography:

Abstract:

Traumatic hip dislocation is relatively rare in children .It

accounts for 5 % of total hip dislocations in all age groups.

We reported a case of hip dislocation in 7 year old child following trivial trauma. Diagnosis was confirmed clinically and radiologically. Reduction was done after four hours of injury under general anesthesia and fluoroscopic guidance. Post reduction radiograph and Computed tomographic scans showed joint congruency. Post reduction abduction bar was given and child kept non weight bearing initially and allowed weight bearing gradually as tolerated. At 10 weeks post reduction, patient has full range of motion at right hip joint and able to walk with full weight bearing. Reduction should be done as soon as possible to avoid complications like avascular necrosis.

Hiren Sarma

Solace Hospital and Research Centre, India

Title: Management of Medial Patellofemoral ligament injury- A case report

Biography:

Hiren Sarma is known among his peers and colleagues for his yearning keenness into matters of concern at hand. He has his prowess and passion into systemic investigation of burning issues of health and wellbeing. The conceptual framework of the current paper, i.e. anatomical double bundle reconstruction technique for MPFL, has been derived from the works of Dr. M. Kalra et al. He has completed his postgraduate studies from Southern Railway HQ hospital under National Board of Examinations, India. He is the Head of the department, Department of orthopaedics, Solace Hospital and Research Centre, Assam, India, a premier organization in the field of healthcare.

Abstract:

The medial patellofemoral ligament (MPFL) is the primary stabilizer of the patellofemoral joint; its reconstruction has been recommended in adults over the past decade after recurrent patellar instability. However, there has been no standardized technique for reconstruction, therefore, ideal graft and technique for reconstruction are as yet undetermined. We performed this procedure in a patient with chronic pain and patellar instability following trauma. MPFL reconstruction was done with hamstring tendons detached distally and secured to patellar periosteum after being passed through a bony tunnel in the patella without an implant and using the medial collateral ligament as a pulley. The MPFL reconstruction was isolated and was not associated with any other realignment procedures. No recurrent episodes of dislocation or subluxation were reported at 6 weeks follow up. The initial treatment of patellar instability is always conservative mainly Quadriceps progressive strengthening exercises (focusing on vastus medialis obliqus) and braces. Surgical treatment is indicated only when patient remains symptomatic after a fair conservative trial.Medial patellofemoral ligament (MPFL) is the most important static stabilizer of the patella, contributing 50-60% (average 53%) of the restraint during initial 30 degees of knee flexion. 94% patients of patellar dislocation have been found to have involvement of MPFL, 70% at the patellar insertion and the rest at the femoral origin. In all, however, there is also interstitial damage. Patellar tracking is significantly affected by a lateral force in the absence of the MPFL, but returns to normal following reconstruction. The Anatomic Double Bundle MPFL Reconstruction technique replicates the native shape of the MPFL and provides the best possible stability in both flexion and extension. The Double Bundle technique also effectively limits rotation throughout the ROM minimizing postoperative instability. So MPFL reconstruction surgeries are increasingly being used for recurrent patellar dislocations. The technique, if accomplished anatomically, may also provide for more aggressive rehabilitation protocols and earlier return to activity.

Rakesh Goyal

Lok Nayak Hospital and Maulana Azad Medical College, India

Title: A rare case of giant cell tumor of tendon sheath of Hoffaâ€™s fat pad of knee misdiagnosed as ganglion cyst

Biography:

Abstract:

A giant cell tumor of tendon sheath (GCTTS) is a benign

lesion whose presence in Hoffa’s pad has been rarely reported. In this case report we have demonstrated a case of GCTTS in a 37 year old female in Hoffa’s fat pad of knee. The patient had presented with the symptoms of pain and swelling in her left knee and provisionally diagnosed as ganglion cyst. The radiographic findings were inconclusive. The diagnosis was confirmed with excisional biopsy after the tumor was completely removed. This is a unique case report which shows

the presence of a large tumor (5×3×2 cm) in Hoffa’s fat pad

which was diagnosed as GCTTS and managed with openresection due to its size. Oxford knee score has improved

from 34 from the time of presentation to 58, six months post

surgery. The patient was pain free, had full range of motion

and had returned to previous level of activities and there was

no sign of any recurrence. Giant Cell Tumor should be kept

as a differential of non-traumatic chronic knee pain in young

individuals.

Rasheed Abid

Uttara University, Bangladesh

Title: A two-pointer filtering method on breast ultrasound images (BUS) to improve segmentation with traditional algorithms

Biography:

Rasheed Abid is a graduate in Electrical and Electronic Engineering from Islamic University of Technology. Being a programming enthusiast, he completed his major in Biomedical

imaging. Currently he is working on a filtering method that will develop the edge image of Breast Ultrasound Images.

Abstract:

Segmentation is a challenge when applied on ultrasound images. Noise, speckle and artifacts make it relatively harder for any segmentation algorithm to successfully segment the region of interest (ROI) with high accuracy. As a first step towards segmentation, most algorithms take the edge-map of the image to get an approximate idea about the gradient change. For ultrasound breast image, the edge image provides almost no clear information at all. The purpose of this study is to filter the edge image so that the traditional segmentation algorithm improves.

Methodology: We propose a semi-automatic technique that improves the edge-map around the lesion area of a BUS image. Improving the edge images require manually initializing two points on the original image, which will cover a major region of the ROI and from there the method will initialize a simple shape automatically. This shape is used to determine estimated pixel information of the ROI and then two separating pointers are used on its histogram to filter the main image. This filtered image, which we call intermediate image, has a better edge-map with respect to the original edge-map. Findings: General segmentation has yielded better results on these filtered images. Dice Similarity Co-efficient values proved that the segmentation on the filtered images increase by a few percentages depending on the type of algorithms used.

Conclusion & Significance: Further investigation into the algorithm can improve the efficiency for general BUS images. Improving the edge-map will give a better result for CAD systems that will find cancer cells and their segmentation.

Abdelhamid Kerkadi

Qatar University, Qatar

Title: Relationship between fat distribution, iron status biomarkers and hepcidin in obese Qatari adults

Biography:

Abdelhamid kerkadi obtained his PhD in Human Nutrition from Department of Nutrition, College of Medicine, University of Montreal, Canada in 1999. He joined Qatar University in 2006 and he was Program Coordinator from 2009-2012. He is currently an Associate Professor in Human Nutrition Program, Department of Health Sciences, College of Arts and Sciences, Qatar University. His research is manly oriented to community nutrition and nutrition intervention especially obesity prevention. He recently received a grant (NPRP-Exceptional) from Qatar national Research Fund. He has published peer-reviewed articles in many journals. He serves as the Editorial Board member of Current Research in Nutrition and Food Science , Journal of Food , Agriculture and Environment and Interenational Journal of Nutrition.

Abstract:

Introduction: The global prevalence of obesity has reached

an alarming rate. In addition to obesity and chronic diseases,

high prevalence of micronutrient deficiencies especially iron

deficiency anemia (ADA) was observed in many countries..

Among the different potential causes of iron deficiency, the

sequestration of iron through an inflammatory mediated was identified as the most probable cause of iron deficiency in obesity. Adipose tissue is recognized as an endocrine organ that contribute to the inflammatory process by secreting proinflammatory cytokines, and The role of hepcidin in the

regulation of iron metabolism has been emphasized in recent

years. Hepcidin represents the main regulator of intestinal iron

absorption and macrophage iron release and, thus, ultimately

of the iron available for erythropoiesis.

Objectives: To examine the relationship between fat distribution (WC, total body fat %, and trunk fat %), iron status

biomarkers and hepcidin in obese Qatari adults

Methods: Secondary data was obtained from Qatar BioBank. The sample size consisted of 100 Qatari obese (male and female) aged 21-50 years free of chronic diseases. Subjects were randomly selected from data base. Collected data included anthropometric measurements (Wt, Ht, BMI, WC, % total fat and % trunk fat), iron status biomarkers (iron, ferritin, transferrin saturation, Hb, RBC), hepcidin and transferrin receptors. IDA was defined as Hb <12g/100ml for female and Hgb <13 g/100ml for male.

Results: A high statistically significant association (P<0.05) was observed between IDA and the increase in trunk and total

fat. We noted a decrease in ferritin, Hemoglobin, serum iron

and RBC with an increase in % fat. There was a statistically

significant correlation between the trunk fat% and iron status indicators: ferritin (r = -0.48), Hb (r= -0.64), serum iron (r= -0.29) and RBC (r= -0.51). Results indicated a significant

decrease in hepcidin with an increase in total and trunk fat. A

strong negative correlation between hepcidin, total body fat

and trunk fat.

Conclusion: The results of this study reported a high prevalence of IDA among obese. Abdominal obesity determined (WC, body and trunk fat) was correlated with iron biomarkers.