Day 1 :
Keynote Forum
Dr. Rabbia Khalid Latif
MBBS, M.Phil, Rawalpindi Medical University, Rawalpindi
Keynote: Spectrum of bone marrow changes in patients of advanced chronic kidney disease
Biography:
Dr. Rabbia has her expertise in evaluation and passion in improving the health and wellbeing. She completed her M.Phil in Hematology from Army Medical College, Rawalpindi in 2016 and currently working as lecturer at Rawalpindi Medical University, Rawalpindi. Her open and contextual evaluation model based on responsive constructivists creates new pathways for improving health care. She has built this model after years of experience in research, evaluation, teaching and administration both in hospital and education institutions. She is capable of accepting responsibility towards patient’s health and well-being and has thorough knowledge of medical laws and ethical standards of medical care
Abstract:
Statement of the Problem: Chronic kidney disease (CKD) is a health problem present worldwide1. CKD is a collective term covering a number of primary disease processes resulting in structural or functional kidney abnormalities, or both, persisting for at least 3 months2. It is related with premature mortality and decreased quality of life. Untreated cases can end up in end stage renal disease (ESRD) finally necessitating dialysis. In Pakistan more than 21 million people are affected by this disease3. Almost every patient of advanced CKD suffers from some degree of hematological abnormalities. Aims & Objectives: The purpose of this study is to analyze various hematological manifestations of advanced stage CKD in peripheral blood & bone marrow (BM) of the patients, referred to us from the nephrology unit of our tertiary care medical set up. Material & Methods: Patients of both genders & all age groups with CKD stage III, IV & V were included in this study. Patient’s histories were recorded. Complete blood counts, bone marrow aspiration & trephine biopsies were done and evaluated microscopically. Mean blood counts of the patients in three groups of CKD were compared. Frequencies of various bone marrow findings in CKD patients were calculated. Results: Out of 57 patients, 41 (71.9%) were males while 16 (28%) were females. Mean age was 60 years. There was no statistically significant difference between the mean hemoglobin, mean white cell count & mean platelet count of the patients in three groups of CKD. Reactive changes due to underlying CKD and inflammation were the most frequent finding in the BM of the patients. Conclusion & Significance: Anaemia of mild to moderate severity and reactive changes in the BM are the most frequent hematological findings encountered in patients suffering from advanced stage CKD. Since CKD is predominantly a disease of the elderly so it is not rare to find the co-morbidities including plasmacytosis, malignancies & their effects on the BM in the patients of CKD. Recommendations: We should focus our attention on primary prevention of anaemia by strictly adhering to the treatment guidelines, adapting healthy life styles & dietary modifications as early recognition can slow the progression of the disease to ESRD. Public awareness is very essential to halt the advancement of disease
- Surgical Pathology
Location: San Francisco | United States
Session Introduction
Dr. Aditi Parihar
Lokmanya Tilak Municipal General Hospital and Medical College, Mumbai, India
Title: A rare case of Wolfram Syndrome diagnosed at autopsy
Biography:
Dr. Aditi Parihar has completed her MBBS in 2015 from Goa medical College, Goa, India and is currently pursuing her M. D. pathology (Junior Resident - third year) in one of the prime government hospitals of Mumbai in Lokamnya Tilak Municipal Medical College and Municipal Hospital, India. She has completed her thesis in Autopsy pathology and has a couple of publications in National journals. She is also involved in other research studies in cytopathology and histopathology. She intends to pursue other research projects in the same field.
Abstract:
Objectives: To present a rare case of Wolfram syndrome diagnosed at autopsy.
Case report: A complete autopsy case of a 19 yrs. old male, admitted in our hospital with breathlessness, oliguria, pedal edema.
He was diagnosed of hypocontractile bladder and congenital bilateral megaureter with vesico-ureteric reflux and DJ stent removal 2years back.
He was diabetic since 7 years of age and was on testosterone and anti hypertensives.
Past history of stroke with left sided weakness and tonic- clonic movements.
His younger brother died of similar complaints and one first male cousin also have similar symptoms, however all females were asymptomatic.
Investigations revealed elevated BUN-57mg% and Se. Creatinine – 6.8mg/dl with low testosterone-0.09mg/dl. At autopsy, externally bilateral kidneys showed coarse granularity with deep cortical scars. Pelvicalaceal system was dilated. Bilteral ureters were dilated with diameter of 1.2cm. A right sided undescended intrabdominal testes was identified showing atrophy on histology. CT scan of the brain showed a chronic infarct on right fronto parietal region, which on section showed gliosis.
Sections from the kidney showed features of diabetic nephropathy. Pancreas had normal acini but decreased number of islet cells.
Conclusion:
Wolfram Syndrome(DIDMOAD) was diagnosed based on clinical picture, investigations and autopsy findings.
- Veterinary Pathology
Location: San Francisco | United States
Session Introduction
Yasmine Fathy El-Esawy
Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
Title: HER-2 Immunohistochemical Expression in Bone Sarcomas: A New Hope for Osteosarcoma Patients
Biography:
Yasmine Fathy El-Esawy has completed her MD in Pathology at the age of 34 years from Faculty of Medicine, Cairo University. She is a lecturer, Consultant Histopathologist and a member in Cytopathology Unit in Faculty of Medicine, Cairo University. She had about five papers. She is involved in different scientific activities. She was a speaker in Annual Conference of Obstetrics & Gynecology Department, Colposcopy Workshop, Cervical Smear, and in the Clinical Day Of Thyroid Dysfunction Cases (Diabetes, Endocrinology, Metabolism and Clinical Nutrition Unit). She achieved the ISN-ANIO Clinical Nephropathology Certificate Program. She participated in undergraduate and postgraduate education with fullfilment of Basic Medical Education Course
Abstract:
Osteosarcoma and chondrosarcoma, remain the most common primary bone tumours. Questions have been raised about the prognostic influence of HER-2 in bone sarcomas, but so far the results have been debatable. We investigated the extent of HER-2 expression in bone sarcomas, and attempted to correlate it with pertinent variables. Fifty-two cases of bone sarcomas (32 osteosarcoma cases and 20 chondrosarcoma ones) were studied for HER-2 immunohistochemical expression. Most of the osteosarcoma cases exhibited membranous staining (78.1%). Strong staining was observed (score 3+) in 34.4%; while 21.9% showed moderate staining (score 2+); and 21.9% displayed weak staining (score 1+), on the other hand, no staining was detected in 7 out of 32 cases (21.9%) (score 0). As regards chondrosarcoma, the absence of staining in all examined cases was noted. Immunohistochemical HER-2 overexpression correlated significantly with osteosarcoma site, with variation relating HER-2 intensity score to the site of osteosarcoma. A statistically significant negative correlation was detected between HER-2 expression and the presence of metastasis at time of diagnosis, A significant correlation was also found regarding HER-2 score and presence of metastasis as more than half of cases with no metastasis at diagnosis (17/28 cases, 60.7%) showed positive intensity score. A statistically significant correlation was detected between HER-2 expression and patients’ age. Also, HER-2 expression significantly correlated to histopathological detection of fibrous tissue. Higher scores of HER-2 expression were associated with a significantly better differentiation since detection of wide areas of osteoid were associated with higher HER-2 scores.
- Molecular Pathology
Location: San Francisco | United States
Session Introduction
Amber Valentine
Baptist Health Lexington
Title: Pre and Post Evaluation and Treatment of Dysphagia in Head and Neck Cancer
Biography:
Amber Valentine is a Speech-Language Pathologist who graduated from the University of Kentucky with her MS in Communication Disorders. She is a Board Certified Specialist in Swallowing and Swallowing Disorders and an International Board Certified Lactation Consultant. She recently received her credentials to become a Certified Neonatal Therapist (CNT). She worked for Baptist Health Systems, Inc for 8 years before moving to Florida where she worked for Wolfsons Children�s Hospital and Mayo Florida. She is now back in Kentucky working for Baptist Health Lexington. She has experience in adults and pediatrics with feeding and swallowing difficulties including: bedside swallow evaluations, Modified Barium Swallow studies, FEES, and pediatric feeding evaluations including NICU. She has experience with head and neck cancer patient including evaluation and treatment of swallowing difficulties, PMV use, and voice after total laryngectomy including TEP. She has provided guest lectures for the University of Kentucky and the University of Louisville on feeding and swallowing
Abstract:
Patients with head and neck cancer often times develop signs and symptoms of dysphagia in their course of diagnosis and treatment. As speech pathologists, beginning the process of evaluation and treatment prior to beginning of radiation treatment provides the best outcomes for patients to maintain most efficient swallowing function. During this presentation, it will be discussed methods of evaluation options for dysphagia prior to and during course of treatment. We will also discuss treatment options and other dysphagia management techniques for this patient population.
Learner Outcomes:
1. Learner will identify evaluation methods for diagnosis of dysphagia.
2. Learner will compare treatment options for patients with head and neck cancer who develop dysphagia.
3. Learner will determine options for follow up care/treatment for this patient population.
4. None
Day(s) and or time(s) you cannot present: Attending ALL days/times