Day 1 :
WHO consultant Dhaka, Bangladesh
Time : 10:00-10:30
King Abdulaziz University, Saudi Arabia
Fatimah Mohammed Ali Yousef is an Associated Professor in Nutritional Science with major fields of research interest in dietary, behavioral and lifestyle changes to improve health outcomes, physical performance and long-term maintenance. She has extensive background in nutritional sciences education, counseling and research, dietary assessment and analysis, public speaking, customer service. She has specialized expertise in laboratory work, human research and in body composition methodology and public health and dietary supplements/fortification
Abnormal excess of fat accumulation in adipose tissue is considered as overweight with Body Mass Index (BMI) from 25 to 29.9 Kg/m2, which cues adversely affect. Overweight is a risk factor for many diseases such as some cancers including (endometria, breast, liver and colon), type II diabetes mellitus, hypertension, cardiovascular diseases, fatty liver disease, sleep apnea, and osteoarthritis. Overweight is considering a global world problem as estimated by world health organization (WHO). According WHO, in 2016 more than 1.9 billion of adults (40% of women and 39% of men) were overweight. In Arabian Gulf such as Qatar, Kuwait and Saudi Arabia there were high rates of overweight and obesity among adult (75-88% women, 70-85% men). Additionally, Saudi Arabia has one of the highest overweight prevalence rates among them. A clinical-based study in AL Khobar showed prevalence overweight and obesity among female aged 18-74 years was 65.4%. Similar result has been reported from Jeddah and Riyadh. Study conducted in south-western of Saudi Arabia at female university students, showed that the overweight and obesity among students was 23.8%. However, other study done in Jeddah and Qassim University in Saudi Arabia the prevalence of overweight was 29.8% and 21.8% in male students, respectively. Because of increasing the prevalence of overweight among adults in Saudi Arabia, there is an urgent need to work on reducing weight. So, our study aimed to investigate the effect of green coffee extract supplementation on body weight, lipid profile and adipocytokines among healthy overweight adults in Saudi Arabia for 22 weeks.
- Clinical Nutrition
Location: Cassia 1+2
Children’s Treatment Center, Ukraine
Gold Coast University Hospital, Australia
Purpose and Aim:There has been an increasing trend towards utilising ultra-wide field, non-contact fundus photography systems like the Optos P200DTx, especially in paediatric patients. As a challenging opulation, this requires the use of techniques such as modification of the equipment, development of specific holds and positioning of the child. We describe the specific techniques utilised to take fundus photos on the Optos P200DTx for paediatric patient roups, 0-1 years, 1-3 years and and above 3 years old.
Methods: A systematic literature review of techniques used to image paediatric a patient on the Optos P200DTx was conducted, case reports studied, and expert opinions consulted. For primary data collection, parents were consented for clinical digital images and video recordings to be taken of their child undergoing Optos imaging in a tertiary hospital Ophthalmology clinic. The subsequent media was analysed and compared with the current literature, to develop specific techniques for each age group, 0-1 years, 1-3 years and & above 3 years old.
Results: Photos displaying the specific techniques were illustrated, accompanied by step-by-step descriptions of the methodology. The ‘Flying Baby’ position, ‘Back-to-face’ position and kneeling/seated position were employed for each respective age group.
Conclusion: These results support the use of the Optos P200DTx for fundus photography in paediatric patients of all ages, provided, tailored techniques are utilised.
Aier Eye Hospital, China
Jiang Lin is a Chief physician. He is a member of the standing committee of visual health care branch of Sichuan preventive medical association; A senior member of IAOA; Deputy director of Aier eye hospital in Sichuan province. He has over thirty years of clinical experience. He is an expert in strabismus surgery, treatment of refraction, especially for children and Orthokeratology.
Purpose: To investigate the diagnoses and surgical outcomes of acute acquired comitant esotropia (ACCE) with similar symptoms who were associated with myopia.
Methods: The data of the 84 cases, who received treatments for esotropia in the Aier eye hospital between February 2014 and February 2019, were collected. The age of them was 12ï½ž18 years, and 44 patients were male. Preoperatively, patients complained diplopia. All they were homonymous diplopia and no difference in different diagnostic eye positions; Eye movements were normal; Prism test was +15ï½ž+45 prism diopters(PD); The angle of deviation at distance was more than 10PD greater than that at near; Cycloplegic refraction was -1.00ï½ž-5.00D. No one had neurological diseases. After six months of follow-up, we did the medial rectus (MR) weaken procedure with lateral rectus (LR) strengthen procedure.
Results: Diplopia disappeared, and eye positions turned to normal postoperatively. Meanwhile no regressions appeared during six-month reviews.
Conclusion: These patients had similar symptoms (e.g. normal eye movements, diplopia especially at distant, etc.). According to these they were diagnosed as ACCE . Besides, they had other same features like low to moderate myopia and wearing glasses all the time. Therefore, ACCE associated with myopia could be a better diagnosis. The onset of this disease related to near-work directly leads to convergence excess and divergence insufficiency. Apparently, visual training is not a preferred treatment of divergence insufficiency, and surgery for this kind of esotropia would be better. Compared with other doctors, we rarely use the MR weaken procedure only. Our surgeries mainly strengthen LR with slight weakening MR. We just strengthen LR with people less than 15PD at near. By this way, patients with Preoperative diplopia, normal binocular visual function, get pretty surgical outcomes.
All India Institute of Medical Sciences, India
Vinita Gupta is working as an additional Professor in Department of Ophthalmology at All India Institute of Medical Sciences, Rishikesh, India. She also have published many article in reputed journals.
Although dramatic advances have occurred in the field of paediatric cataract surgery over the last decade, calculating and selecting an optimum intraocular lens for the small eye of a growing child is a unique challenge. The need to implant a fixed power lens into the eye that is still growing makes it difficult to choose an optimum IOL power that best suits the child’s eye. The younger the child, the more difficult it is.
What are the issues we encounter? Just as a child’s body grows after birth through adolescence, so does the child’s eye from infancy till adult life. Moreover, as regards the amount of myopic shift, just as some children grow faster than others, some eyes grow faster than others. And there are no factors that clearly indicate which eye will grow faster than others. So there is large variability in myopic shift and difficulty in predicting future (target) refraction for any given child.
Then comes the issue of measuring axial length and keratometry measurement in children, can be as difficult as unattainable in the office setting – most children need an EUA. Then the question – which IOL formula is to be used for children? Since these are short eyes, all the formulas are slightly inaccurate.
Then comes the influence of genetic behaviour of the refractive error in the parents, which can again not be predicted with accuracy. It has been noted that if both parents are myopic, 30-40% of children become myopic whereas if only one of the parents is myopic, 20-25% of children will become myopic. If none of the parents is myopic, then 10% of children become myopic, so it depends upon genetic influence, and it is therefore unpredictable.
The undercorrection guidelines and power calculation methods therefore vary according to the age of the child and there has been changing trends towards implanting IOL in even infants. Also methods for piggyback IOLs and secondary IOLs implantation have evolved, but with their own merits and demerits.
In summary, choosing an IOL for paediatric patients is not a child’s play, and the surgeon has several considerations to keep in mind in order to give optimal vision children with pediatric cataracts.
Hatem A Saeed is working as a professor of ophthalmology at faculty of medicine in Cairo University, Egypt
Aim of work: To evaluate the intra-operative technical advantages and difficulties of secondary implantation of posterior chamber intraocular lens following pars-plicata lensectomy versus limbal irrigation aspiration as well as postoperative results in aphakic children.
Subjects and Methods: Twenty eyes of 17 children were enrolled in this study .The age at the initial cataract surgery ranged from 4 months to 3 years. The age at the second surgery ranged from 4 -8 years (mean of 6 ±1.414). Twenty aphakic eyes divided into 2 groups: Group 1 included 10 eyes who underwent secondary implantation of PCIOL in the ciliary sulcus following pars-plicata lensectomy. Group 2 included 10 eyes who underwent secondary implantation of PCIOL in the ciliary sulcus following limbal irrigation aspiration. During preoperative ophthalmic examination; particular attention was given to the presence of: posterior synechiae to the posterior capsular rim, pupillary irregularity, extent of pupillary dilatation and the presence of any trapped cortical matter inside the capsular adhesions. Intra-operatively ; certain parameters were evaluated including :the need to dissect posterior synechiae to the posterior capsular rim threatening the enlargement of posterior capsular opening with vitreous prolapse, the need to dissect capsular adhesions to remove trapped cortical matter, the need to perform sulcus dissection and reformation, the ease of lens implantation and the final lens centration .Postoperatively; the degree of postoperative reaction, centration of the implant and the pupil regularity were reported.
Results: Previous pars-plicata lensectomy offered several intra-operative technical advantages to secondary implantation compared to previous limbal irrigation aspiration regarding: Less posterior synechiae, less pupillary irregularity, better pupillary dilatation, absence of the need to perform capsular or sulcus dissection, less need to perform cortical clean up, easier IOL implantation and better final lens centration .Postoperatively; less reaction, better lens centration and less pupillary irregularity were reported in group 1.
Conclusion: Secondary implantation of PCIOL following pars-plicata lensectomy was easier with more intra-operative technical advantages and less difficulties and with better postoperative results compared to secondary implantation of PCIOL following limbal irrigation aspiration in aphakic children
The 2nd Xiangya Hospital of Central South University, China
Li Yun has her expertise in evaluation and passion in improving the pediatric ophthalmology clinical and translational research
Case presentation: A male infant (gestational age 30 weeks, birth weight 1410g) presented for the screening of retinopathy of prematurity (ROP). On examination at age PMA 34 weeks (initial visit) a port wine stain was noted on his left eyelids and maxillary area, following the V1 and V2 distributions of the trigeminal nerve. From post menstrual age (PMA) 37 weeks, he was found to have progressive ROP (Zone 2 stage 3) in his left eye and received intravitreal ranibizumab at PMA 39 weeks to treat type 1 ROP. The ridge and neovascularization (NV) regressed satisfactorily, but diffuse choroidal hemangioma became evident at 40 weeks, with typical “tomato catsup fundus”. These clinical findings characterized Sturge-Weber Syndrome. At PMA 44 weeks, the baby was then noted to have increased bulbar conjunctival vascularization and retinal vascular tortuosity. Multiple vein-to-vein anastomoses in the peripheral retina and increased retinal vascular tortuosity are spotted on fundus photography and fluorescein angiography (FFA). The baby has a normal IOP thus far and is under close observation for further ocular changes. No leptomeningeal angiomatosis was noted from the MRI.
Discussion and conclusions: We describe a premature infant as a youngest SWS patient whose progressive multiple ocular vessel malformations was documented. The patient was also diagnosed with type1 ROP in his left eye at PMA 37. a lesson we should think and learn from this case is how we can differentiate the vascular abnormality in SWS and ROP. .morphology of the abnormal vessels, progression pattern and FFA under anesthesia is helpful in such situation
Chai Fang is working in Shaanxi Ophthalmic Medical Center, Xi’an No. 4 Hospital, Affiliated Guangren Hospital, School of Medicine, Xi'an Jiaotong University, Xi’an, China
Purpose: To report a case of coats-like ocular toxocariasis clinical feature and treatment.
Methods: We present a case of ocular toxocariasis that occurred in a 22-year- old man misdiagnosed with coats disease. The patient underwent a full ophthalmic examination, a complete blood count; blood chemistry tests for Toxocara immunoglobulin (Ig)G, Toxoplasma IgM, and Toxoplasma IgG; an assessment of total IgE levels; chest X-rays; measurements of angiotensin converting enzyme, antinuclear antibody, hepatitis B surface antigen antibody, and anti-hepatitis C virus antibody levels; and a questionnaire about eating habits and whether the patient had pets.
Results: The patients had a pets feeding history. The patient's left eye had a visual acuity of 0.3 and an intraocular pressure of 10 mmHg. Fundus examination showed a large amount of yellow-white submucosal exudation and exudative retinal detachment, epiretinal membrane traction macular edema, optic disc anterior membrane were all exsisted. Vitrectomy was performed. During the vitreous surgery, the vitreous body showed a thin gauze-like change, and the yellow-white granuloma was seen in the posterior pole. Through the intraoperative pressure, multiple granulation lesions were found in the peripheral retina. One week after vitrectomy, the retina was flat, the macular edema was reduced, and the visual acuity was increased to 0.5.
Conclusion: The history of pet feeding, gauze-like changes in the vitreous, and typical yellow-white granuloma are strong evidence for the diagnosis of ocular ascariasis. Detailed medical history inquiry, careful fundus examination, blood and intraocular fluid antibody monitoring, UBM examination can more accurately help our diagnosis, to avoid missed diagnosis and misdiagnosis.
Xi'an Jiaotong University, China
Zhao Xiquan is working as Shaanxi Ophthalmic Medical Center, Xi’an No. 4 Hospital, Affiliated Guangren Hospital, School of Medicine, Xi'an Jiaotong University, Xi’an, China
Purpose: To report a treatment of rhegmatogenous retinal detachments in adult with retinopathy of prematurity.
Methods: We present a case of rhegmatogenous retinal detachments in a 21-year-old female with retinopathy of prematurity. The patient had history of premature birth and treatment of ROP. After a full ophthalmic examination, scleral buckling was taken to treat the rhegmatogenous retinal detachments.
Results: The fundus examination showed retinal folds in both eyes, and the retinal vessels were pulled straight, the retina of the left eye was removed from 1 to 8 o'clock, and the peripheral hole was at 5 o’clock. The silicone tape was pressed from the 4 to 6 o'clock pad at the anterior equatorial hole. Intraoperative combined retinal drainage. Postoperative follow-up observation of subretinal fluid absorption, and the retinal are flat.
Conclusion: In patients with a history of premature birth, features of fundus examinations do not correlate with the occurrence of a retinal detachment. Repair of detachment in such a patient is more likely to require multiple procedures. Physicians should consider widespread relief of vitreoretinal traction for detachment in any patient with a history of premature birth
Nicolaus Copernicus University, Poland
Joanna SÅ‚omko has completed his PhD at the age of 28 years from Nicolaus Copernicus University in Bydgoszcz. She is adjunct, university teacher; she conducting and coordinating research projects in the areas: clinical and applied physiology, exercise physiology and neurophysiology. She is vice-chairman of Polish Society of CFS/ME Research. She has published more than 70 papers in reputed journals and has been serving as an editorial board member of repute.
The aim of our work was to examine the level of minerals among patients with chronic fatigue syndrome (CFS). Our study included 9 patients (3 men and 6 women) diagnosed using the Fukuda criteria. The mean age of the patients was 33.33 ± 6.48 years and the mean disease duration was 3.94 ± 3.11 years. Hair samples 3-4 cm long, counting from the scalp skin, were taken. from which external impurities were then removed based on recommendations of the International Atomic Energy Agency and pressure mineralization using microwave energy. Samples were then analysed for minerals using Atomic Absorption Spectrometer (AAS). We evaluated the levels of calcium, magnesium, zinc, copper, iron, sodium and potassium in the study and control group. The bioelectrical impedance method (BIA) was used to analyze body composition. We observed statistically significant differences in the levels of some minerals Ca (P = 0.0151), Mg (P = 0.0050), Zn (P = 0.0002), K (P = 0.0372), Na (P = 0.0321) compared to the control group composed from healthy volunteers. Moreover, a positive correlation was observed only between Fe level and length of history (R= - 0.71, p<0.05). Differences in mineral levels may be related to many different symptoms in the course of chronic fatigue syndrome. Appropriate regulation of mineral levels may lead to the relief of symptoms, but further research is needed.
Lions Eye Institute, Australia
Jiwen Yang got a master's degree of Strabismus and Pediatric ophthalmology in 2005, then obtained PhD of Optometry from China Medical University in 2008. She engages in clinical work and scientific research, especially in diagnosis and treatment of strabismus, amblyopia and refractive error. She has completed tens of thousands strabismus correction surgery, including horizontal, vertical and rotating strabismus correction, and has fitted with Ortho-K lense and RGP for tens of thousands patients with myopia or astigmatism. She is the master tutor of Central South University, had completed mang provincial projects, received two items of Shenyang new technology awards, two projects sponsored by Health Development Planning Commission of Hunan province participated in formulating professional criteria of diagnosis and treatment criteria of strabismus of national third-level hospital, making many times of presentation in domestic and foreign academic conferences doing academic communication to the United States, Japan and so on.
Purpose: To review and analyze surgical outcomes of patients with Bielschowsky type acute acquired concomitant esotropia (AACE).
Methods: Retrospective study. We enrolled 9 esotropia and diplopia patients with myopia who performed strabismus surgery in Shenyang Aier Eye Hospital between June 2018 and March 2019, including 4 males, 5 females. The mean age of the patients was 22.67±5.41 (range, 16-30) years. They underwent monocular Medial Rectus Recession and Lateral Rectus Resection (6 cases), monocular Lateral Rectus Resection (3 cases).
Results: 1.The mean time of esotropia and diplopia onset: 22±15.59 (range, 6-48) months. 2. Incentives and treatment history: Excessive near working (2 cases), acupuncture treatment (3 cases), others with no treatment.3.The mean refractive errors in the right and left eyes were -4.05±1.34 (range,-2.25~-6.50) and -3.52±0.98 (range,-2.00~-5.25) diopters (D), respectively. 4. The mean AC/A value: 2.04±1.10 (range,0.67~4).5.Esodeviations: Average preoperative esodeviations at near and distance were 22.67±12.41(range,14~48) and 29.11±9.27(range,18~46) PD, average postoperative esodeviations at near and distance were 0 and 0.44±1.33(range,0~4)PD. There were significant statistically difference between preoperative and postoperative esodeviations both at near (T=5.48ï¼ŒPï¼œ0.01) and distance (T=8.65ï¼ŒPï¼œ0.0 1), respectively.6.The mean Medial Rectus Recession 2.44±1.94 (range,0-5) mm, 3 cases had dominant diplopia at distance, so they underwent monocular Lateral Rectus Resection, the mean Lateral Rectus Resection 4. 89±0.78 (range,4-6) mm.7.Diplopia: 9 patients all had diplopia preoperatively, all disappeared postoperatively. 8. Stereopsis: 5 patients had no stereopsis before surgery, 3 cases regained stereopsis after surgery.
Conclusions: In case of patients with Bielschowsky type AACE, surgery is the main treatment, patients achieved successful surgical alignment and the diplopia vanished as well. For patients with myopia, they should control the near work moderately
IPB University, Indonesia
Dr Syartiwidya has expertise in the evaluation of health conditions in the community, especially for non-communicable diseases namely diabetes. He believes that diabetes can be controlled or prevented from becoming a complication of other diseases by regulating eating patterns, especially food that is at risk of causing the disease. She is very concentrated in the development of liocal food in his area, namely sago. This is evidenced by the results of his research related to sago and its impact on health.
The objective of this study was to analyze food habits and carbohydrate contribution intake from sago consumption in Kepulauan Meranti regency Riau Province. The study design was cross sectional study through interviews and filling out FFQ and food recall questionnaires, also measurement of body mass index from 181 subjects with inclusion criteria are sago consumption, aged 35-80 years, and undiagnosed with diabetes. The results showed that there were 71,16% participant have been consumed sago more than 10 years and consumed sago 1-6 times a week, about 173,7±88,3 g/day. Subjects with normal body mass index (BMI) were more than 50%. There were significant correlation between energy and carbohydrate intake with BMI. Frequency of sago consumption have significant correlation with carbohydrate and fat intake, nor with sago consumption. The significant correlation between the carbohydrates contribution from sago to amount of sago consumption (g / day), frequency of sago consumption / month, the frequency of sago consumption in the last month, amount of total energy intake, carbohydrate intake and protein intake, with a value of p = 0.000 at the level of α = 0.01. In conclusion, sago consumption minimal 1-6 times a week could be contribution to keep the BMI in normal range if consumed at the amount of 173,7±88,3 g/day.
Professor Randa Reda Mabrouk is an Immunologist and Clinical Pathologist professor at Ain Shams University. She was assigned as a member of the National Committee for the Professors promotion in the whole country from the year 2013 till 2019. Currently she is the head of the Clinical Nutrition Master Board at the Faculty of Medicine and is the constructor of the first Clinical Nutrition Master for Physicians in Egypt and the Middle East at the Faculty of Medicine , Ain Shams University, Cairo, Egypt. She is also the head and constructed the Clinical Nutrition Diploma for the health Care Professionals and Physicians at the American University in Cairo. She is a passionate instructor in the field of nutrition in both programs and has many publications in the nutrition and immunology field. Her passion of medical education extends to the community awareness.
Statement of the Problem: Cancer patients and their families are always in need to know the nutritional care process to complement the management of the morbidity. Unfortunately not all of them are aware of the different nutritional modalities at different stages. Most health materials are written at higher levels than most adults can understand. Limited literacy impacts health behaviors, decisions, and outcomes. Research suggests patient knowledge and comprehension can be increased by incorporating visual images and words using video technology. Development and implementation of appropriate videos can help the patients and their family members to reach an optimum knowledge of the different nutritional modalities. The implementation of a cost-effective and literacy-sensitive video-education program for this group delivers an easy access to the knowledge and information that is needed in this aspect. Methodology & Theoretical Orientation: The study was conducted at Clinical Oncology Department, Ain Shams University. The needs assessment was determined through conducting a focus group including clinical nutritionists who were responsible for the nutrition care process at the oncology department at Ain Shams University Hospitals, oncologists, and a clinical nutritionist nurse. Based on the focus group analysis, five video scripts were written in Arabic according to the decided needs with a timing of not more than four minutes each. One pilot video was displayed to the patients, their relatives, clinical nutritionists, and the nurse using both visual and audio effects. Check list for the quality and content of the pilot video was delivered to the whole group and results were satisfactory for all fields. Four additional videos were prepared. Conclusion & Significance: Cancer patients and their families lack the basic information about the importance of nutrition as a part of the treatment plan. Incorporating visual images and words using video technology is feasible and can enhance patient knowledge and comprehension,
Agricultural Research System, Government of Pakistan
Mr. Muhammad Usman, Former Director General of Agricultural Research System, Government of Pakistan who retired from service after a spotless career of about 32 years with senior level experience on research and development of integrated agricultural production, industries, Agriculture & Horticulture and bioenergy on a sustainable way.
Mr. Usman is consider as the senior most scientist in the world, always participated in the international conferences as a plenary speaker, keynote speaker, renowned speaker, organizing committee member as well as moderator of the conferences around the world. Mr. Usman established “Prominent Agro Based Industries, Agro Based Industries and Consultancy SDN BHD” in Malaysia and “Foundation for Rural Development in Pakistan”, with primarily aims to work on integrated agricultural project for Rural Development through improvement in agriculture and consultancy services to the formers at Malaysia.
The aim of presentation consist of clinical nutrition, food nutrients, health, industry, employment, income, economy, crises, poverty and hunger were studied and reported that Clinical Nutrition is the major industry for the development of health, basic need of daily life, create employment, generate income, stronger economy, reducing financial crises, global Poverty and hunger in the developing countries of the world particularly in south Asia. The study reported that Clinical nutrition involves studying what nutrients are necessary for your body to function and how what you eat affects your health. Keep reading to find out more about the field of clinical nutrition, including education programs, professional requirements and career information. Schools offering Fitness & Nutrition degrees can also be found in these popular choices. The study further reported that Clinical nutrition is the practice of analyzing if a person is consuming an adequate amount of nutrients for good health. A clinical nutritionist is concerned with how nutrients in food are processed, stored and discarded by your body, along with how what you eat affects your overall well-being. Professionals in this field assess your nutritional needs based on your family and medical history, lifestyle and laboratory tests in order to make recommendations on your diet and individual nutritional needs. A clinical nutritionist may provide advice on changes to your diet that may help prevent disease. Similarly the difference between the clinical nutrition and dietetics showed that the primary role of a clinical dietician is to design nutrition programs to improve or maintain the health of patients. Clinical dieticians most often work in hospitals, clinics, or public and community health settings. Dietitians and nutritionists are both food and nutrition experts. They've studied how diet and dietary supplements affect your health. Both are considered to be healthcare professionals, but the two titles shouldn't be used interchangeably. Food scientists and technologists apply scientific disciplines including chemistry, engineering, microbiology and nutrition to the study of food to improve the safety, nutrition, wholesomeness and availability of food. Food carbohydrates include sugar, starches and fibers, lipids include fats, oil, waxes and cholesterol. Protein is very important component of food and necessary for the life of human being. The study reported that the total countries available in the world are 225, consist of (Developed countries = 49, developing countries = 150, observer state = 4, state without partial recognition = 8, unrecognized state = 14). Similarly, South Asia comprises the countries of Pakistan, Bangladesh, India, Bhutan, Maldives, Nepal and Sri Lanka. In the light of above study, it is proposed that Nutritional Science and Food Chemistry should be commercialized for the development of health, basic need of daily life, create employment, generate income, stronger economy, reducing financial crises, global Poverty and hunger in the developing countries of the world particularly in south Asia.
Aier Eye Hospital Group, China
Aisling McGlacken-Byrne is currently a Senior House Officer in her first year as an Ophthalmology Surgical Trainee in Sligo University Hospital. She has special interests thats include rural and remote medicine and health inequity. Her previous employment was a resident with the Lions Outback Vision Van, part of the Lions Eye Institute. The Lions Outback Vision Van is a mobile eye health clinic launched in 2016 which travels around Western Australia providing specialist eye health services to remote communities.
Gliomas are the most common paediatric tumours of the central nervous system, exhibiting a broad range of clinical behaviours depending on origin, size and pathological subgroup. Knowledge of current and evolving advances in molecular characterization of this tumour is needed to ensure effective management. A 2-year-old boy presented with nystagmus since 10 months of age. Parents described initially left eye moving horizontally then right eye moving horizontally, then both with a vertical component. Poor vision was reported, with running into objects and difficulty recognizing people far away. He was otherwise well, normal term vaginal delivery and reaching developmental milestones. On examination the boy had high frequency, small amplitude see-saw nystagmus. It had no null point and no change with convergence or fixation. He had no anomalous head position and a normal red reflex with clear corneas. Dilated exam under general anaesthetic revealed left subtle nerve pallor and atrophy. Magnetic resonance imaging revealed a large optic nerve glioma originating from the optic nerve chiasm, spreading anteriorly and posteriorly. Our case documents see-saw nystagmus in a patient with likely bi-temporal hemianopia due to a large tumour but without mesencephalic compression or CSF dissemination. Because preschool children rarely complain about poor vision, by the time symptoms manifests, the disorders of vision have already progressed. Early diagnosis is paramount in diagnosing these often silently enlarging optic pathway gliomas.
Prefectural Cardiovascular Center, Japan
Hitoshi Adachi has completed his MD at Gunma University and worked as an Exchange Researcher at Harbor-UCLA Medical Center. He is the Director of Cardiac Rehabilitation Division of the Gunma Prefectural Cardiovascular Center. He has published more than 25 papers in the field of cardiac rehabilitation and has been serving as one of the Directors of Japanese Association of Cardiac Rehabilitation.
Statement of the Problem: Free fatty acid production from triglyceride is well known to induce insulin resistance, which is reported to be one of the causes of cardiac dysfunction in patients with dyslipidemia. Nocturnal monosaccharide over taking causes hyper triglyceridemia and with holding it is supposed to reduce fasting triglyceride levels. And as a result, there is a possibility that cardiac dysfunction would improve. Hereby, we investigated the effect of restriction of night-time ice cream intake on insulin resistance and cardiac function.
Method: Thirteen patients with cardiac dysfunction who routinely take ice-cream at night were enrolled. We instructed them not to eat ice cream after 21 o’clock for 3 months, and compared the HOMA-IR, blood triglyceride level, exercise tolerance (peak VO2 and anaerobic threshold) and diastolic cardiac functions before and after the examination.
Findings: Triglyceride level and HOMA-IR significantly improved from 217.2+-63.1 to 150.2+-37.7 mg/dL (p<0.01), and 4.5+2.0 to 2.4+-2.3(p<0.05) respectively. Although, E/A failed to improve, E/E’ and DcT improved significantly from 10.1+-3.0 to 8.1+-2.3(p<0.01) and 241+-65 to 231+-50(p<0.05), respectively. Peak oxygen uptake and anaerobic threshold improved significantly.
Conclusion & Significance: It is concluded that restriction of nocturnal ice-cream improves cardiac function by ameliorates insulin resistance.
Kazan State Medical University, Russia
Elina Borkhanova is a PhD student from Kazan State Medical University. She is medical doctor and dietician. Elina is interested in clinical nutrition, her research work is about effects of low-protein diet and normal-protein diet for nutritional status in older patients with chronic kidney disease 3B-5 stage.
Statement of the Problem: The number of geriatric patients with predialysis stages of chronic kidney disease (CKD) has increased significantly. Malnutrition and protein energy wasting (PEW) are prevalent in older patients with advanced CKD and are associated with mortality.
Aim: The purpose of this study is to assess prevalence of nutritional disorders in geriatric patients with predialysis stages of CKD.
Methods: The study included 106 geriatric patients with CKD 3 b-5 stages: 42 males and 64 females; age range of 60 to 90 years; mean age 76.5±9.2years; patients with CKD3b stage-67.9% of patients, CKD4-24.5 % and CKD5-7.5%. The patients were assessed by Mini Nutritional Assessment Scale (MNA), Subjective Global Assessment, anthropometry and biochemical indicators of nutritional status.
Results: According to the MNA 72, 1% of patients with CKD 3b stage have normal nutritional status, 18.6% patients are at risk of malnutrition 9.3% are malnourished. 41.7% of patients with CKD 4 stage have normal nutritional status, 33.3% patients are at risk of malnutrition 25% malnourished. In patients with CKD 5 42.9% are at risk of malnutrition, 57.1% patients are malnourished. There are results of accessing by SGA scale on Figure 1. The level of total cholesterol in the blood serum in the elderly patients with CKD stage3b-5 decreases with increasing risk of PEW in MNA(r=0.46). The level of total protein in the blood serum is correlated with nutritional disorders on the SGA scale(r=-0.52) in geriatric patients with predialysis stages of CKD.
Summary: The prevalence of nutritional disorders of mild and moderate severity is observed in 33-43% of elderly patients with stage 3B-4 CKD and until 75% with stage 5CKD. Severe symptoms of PEW occur in 8-25% of older patients with CKD stage 3b-4and 25-50% with CKD stage.
Faculdade de CiÃªncias da NutriÃ§Ã£o e AlimentaÃ§Ã£o da Universidade do Porto, Porto, Portugal
Beatriz GT has completed her Undergraduate Degree at the age of 22 from the Faculty of Nutrition and Food Science of the University of Porto, Portugal. She has enrolled on the Clinical Nutrition Master Degree at the same university in 2018. She is collaborating with the Basic and Clinic Immunology department of the St. John's Hospital Center, Porto, Portugal, in order to produce the present investigation. She has done 2 nutrition internships at the St. John's Hospital Center, Porto, Portugal, at the gastrointestinal surgery department.
Introduction: Obesity is one of the most prevalent chronic diseases in childhood, being an important public health issue. Excess weight has been associated with autonomic dysfunction but the evidence in children is scarce. Therefore, this study aimed to assess the effect of overweight and obesity on the autonomic nervous system activity in children.
Methods: Data were collected from a cross sectional study including 916 children (7 to 12 years), from 20 primary schools in Porto, Portugal. Anthropometric measurements and bioelectrical impedance analysis were performed to assess body mass index (BMI) and characterize body composition - body fat percentage, body fat mass and total body water. BMI was classified according to age- and sex-specific percentiles defined by the World Health Organization, the US Centers for Disease Control and Prevention and the International Obesity Task Force. Pupillometry was performed to evaluate autonomic activity. Mann-Whitney, the chi-square, and Kruskall-Wallis tests were used as appropriate.
Results: Final analysis included 858 children, 50.6% boys, with a prevalence of obesity ranging between 7.5% and 16.2% according to the International Obesity Task Force and percentage of body fat criteria, respectively. The average dilation velocity was significantly higher among children with obesity, regardless of BMI criteria.
Conclusions: Our results suggest that obesity in children is associated with a dysautonomia in autonomic nervous system, namely with changes in sympathetic activity. Moreover, this findings provide support for the role of the autonomic nervous system in the interaction between lifestyle, diet and the BMI in children.
Dept. of Medical Nutrition, Kyung Hee University, Korea
Yoo Kyoung Park has her expertise in evaluation in improving the health and wellbeing in view of nutrition. She has been conducting numerous clinical studies on the effects on health and antioxidant indices. In addition, research is being conducted on sleep, aging, brain health and nutrition. Her interest is in evaluating the health benefits of vegetarian diet, DASH diet, ketone diet, and Mediterranean diet and recently MIND diet which is a well proven diet for the prevention of Alzheimer’s disease.
Statement of the Problem: Muscle mass declines with age, starting in the 40s and picking up speed after about age 50. Protein supplementation (PS) is a positive strategy to prevent sarcopenia. Although early prevention is important, most studies have focused on people over 65. Therefore, this study investigated the effect of PS including leucine on muscle condition in both middle-aged and older adults.
Methodology & Theoretical Orientation: A 12-week randomized, double-blinded, placebo-controlled clinical trial was done on the subjects of 120 community-dwelling healthy adults in their 50s -80s. They were assigned to either an intervention group (n = 60) or control group (n = 60). Protein supplement [Leucine(3g) enriched protein mixture (whey 40%+casein 50%+soy 10%) 20g, VitD 800IU, Ca 300mg, carbohydrate 2.5g] and isocaloric supplement [protein 0g, carbohydrate 25g] were offered to intervention group and control group respectively, twice a day. Physical Activities were assessed but subjects were advised to maintain their usual activity. Appendicular skeletal muscle mass index (ASMI) and lean body mass were measured by dual-energy X-ray absorptiometry.
Findings: Thirty-three men and 87 women started and 111 subjects finished the study with a drop-out rate of 9.2%. From the Per Protocol analysis the lean body mass normalized by body weight (LBM/Wt) was significantly increased (p<0.001 only in the intervention group (0wk: 633.9±8.5 vs. 12wk 636.9±8.4 in the intervention group, 0wk: 638.6±8.3 vs. 12wk 632.9±8.1 in the control group) after Mixed Effect Model Repeat Measurement (MMRM) Analysis. No significant changes were observed in the ASMI values.
Conclusion & Significance: Nutrition is an essential piece of the puzzle in supporting adequate nutritional needs at different stages of life. From this study, we conclude that PS may exert beneficial effects to prevent muscle loss not only in the elderly, but also in the pre-elderly subjects