21^st World Congress on Neurology and Therapeutics March 15-17, 2018 London, UK

Biography:

Hardeep Sahota is a NHS Doctor in the UK currently working at Chelsea and Westminster NHS Foundation Trust. His long-term ambition is to follow a path in neurosurgery. He is also a fully qualified Pharmacist in Great Britain. He completed his medical degree at Bristol Medical School.

Peggy Fooks is a NHS Doctor in the UK currently working at Chelsea and Westminster NHS Foundation Trust. She graduated from Oxford Medical School. She has passion for singing and has travelled the world with her choral music. She also enjoys long distance running.

Abstract:

A 19-year-old year university student was brought to the Emergency Department by his mother. He had been non-specifically unwell for about nine days, but his peers had called his parents when he began to become confused, disoriented and drowsy. On admission, he was complaining of headache and photophobia; his family had noticed right eyelid drooping. He had Glasgow Coma Scale/Score (GCS) 13 to 14 and generally weak, but no focal neurology on examination. He was febrile-spiking 38.8℃. An urgent CT head scan was performed, followed up with an MRI, which together showed marked oedema in the right temporal lobe and, to a lesser degree, in the medial right frontal lobe. Significantly, 7 mm of midline shift and effacement of the ventricles was noted. He was commenced immediately on IV aciclovir treating for likely HSV encephalitis with empirical ceftriaxone cover. Although the diagnosis was uncertain, a lumbar puncture was not performed as his imaging showed raised intracranial pressure. His case was discussed with Neurosurgical Registrar at our tertiary referral center, and the local Neurology Consultant. Neither of them felt that an immediate transfer to a neurosurgical unit was necessary given his GCS was relatively stable and he had been commenced on treatment for the most likely diagnosis. He was reviewed by ITU on site who did not find an indication to admit him to HDU while he remained stable. After 48 hours of antimicrobials and supportive therapy, his GCS deteriorated fluctuating between 8 and 13. There was still no focal neurology observed. A repeat CT showed new hypodense regions in the left hemisphere and increased midline shift at 12 mm. the condition was discussed with neurosurgeon who recommended urgent decompression surgery. They asked that the patient be intubated immediately and transferred as urgently as possible to the theatre for decompressive craniotomy. Audiences will gain knowledge on the following topics after the presentation: herpes simplex encephalitis is associated with 70% mortality if untreated; delay in treatment leads to higher morbidity and mortality; clinicians should aim for MRI to correlate images with the clinical presentation; aciclovir must be started immediately and only stopped once lumbar puncture definitely rules out diagnosis which can take up to ten days from having the initial investigation; and a combination gold standard for diagnosis are MRI, CSF, PCR for viral DNA.

Biography:

Caroline Attwell graduated with a Master’s in Physiotherapy in 2004 from de University of Buenos Aires, Argentina. She started her career in a high-performance athletic training facility then left for the United States and Europe where she worked and did research for a polo organization. Since 2008, she has been in the acute neurorehabilitation team at the CHUV (University Hospital of Lausanne) as Physiotherapist and Researcher. She occasionally lectures for the HESAV (University of Applied Sciences and Arts, Western Switzerland). Her domains of preference are the new developments in neurorehabilitation, acute neurorehabilitation, new technologies and respiratory care for acute neurological patients

Abstract:

Introduction: The use of natural environments to promote health and prevent illness is widely recognized. However, in the case of individuals experiencing disorders of consciousness (DOC), little is understood about the use of contact with nature in treatment and rehabilitation. The aim of this study is to investigate the effects of outdoor therapy in relation to the awareness and wakefulness levels of this population.

Patients & Methods: This study is a non-randomized cross-over pilot trial. It is set within the Acute Neuro-Rehabilitation Unit (University Hospital, Lausanne). Twenty adults diagnosed with DOC were included in the study. They participated in an indoor-outdoor neurosensory interdisciplinary therapy program. As the primary outcome awareness and wakefulness were measured by an adapted behavioral grid. Functioning and disability were recorded as secondary outcomes.

Results: The difference in scores between indoor and outdoor therapy was computed. Preliminary results show a solid positive trend in favor of the outdoor therapy. We can clearly detect the improvement of several points such as, visual fixation, exploration, intentional movements and communication. It is noteworthy that these clinical items are involved in in the determination of DOC diagnosis.

Conclusion: Outdoor therapy may provide a beneficial complementary treatment option for DOC. The promising preliminary results of the study show the need to develop further interdisciplinary research in this field.

Biography:

Tania Alexandra Couto is a Portuguese neuroscience researcher currently based in Macau, SAR, China. Her work is developed in the neuroimaging department in Faculty of Health Sciences at the University of Macau. The research aims are focused on neuroimaging fusion projects, integrating NIRS-ERP simultaneous measurements, applied to neuropsychiatric disorders. She has participated in different conferences, symposiums and Congress as speaker on a subject of Neurofeedback; haemodynamic approach with NIRS tool; NIRS-ERP studies: multimodal approach applied to neuropsychiatric disorders. She combines clinic experience in neurofeedback -EEG, cognitive rehabilitation and clinic psychology in several hospitals and Portuguese clinics between 2009-2016 and also, a valuable internship in Stroke Unit in King´s Hospital College (London), where she had the opportunity to develop her clinical practice with stroke acute patients, her major area of interest in cognitive rehabilitation. In parallel, the neurofeedback /EEG-Q clinic experience allowed to develop a deep interest in neuro creativity applied to the neuropsychiatric and healthy population.  As PhD student, she has been worked on the neurofeedback application in a multimodal approach (NIRS-ERP studies), focused on working memory and visual creativity.

Abstract:

The present study investigated the neural correlates of prefrontal dysfunction in food addiction disorder activated by a n-back task in undergraduate and graduate students. We used a neuro-vascular coupling measure captured by near-infrared spectroscopy recordings with n-back paradigm in 2-back and 3-back conditions. We found that middle frontal gyrus (dorsolateral PFC – BA46) and frontopolar (orbitofrontal cortex BA 10) areas were activated, highlighting significant differences in three channels. Furthermore, to support the main hypothesis, in the behavioral performance students with low results in food addiction scale (less than three symptoms) were related with health conditions activated by n-back task, specifically the 2-back health condition. These results suggest that undergraduate and graduate students are sensitive to highly palatable food and the activation of BA 46 and BA 10 may correlate with unhealthy food pattern, which highlight the possibility of biomarker for food addiction disorder related to the dysfunction of working memory in PFC captured by nirs recordings. Even that the record of junk items has been presented higher activations during a 3-back task, junk conditions are not always related with inefficient emotional regulation underlying the binge eating events referred to in the YSAS and traditionally expected by the literature. This evidence could reflect that other patterns of eating behaviour and strategies of emotional regulation related should be more explored and redefined among students populations exposed to risky eating behaviors

Biography:

Abstract:

Electro diagnostic (EDX) studies play an essential role in the evaluation and disorders localization of the peripheral nervous system such as disorders of the primary motor neurons (anterior horn cells), primary sensory neurons (dorsal root ganglia), nerve roots, brachial and lumbosacral plexuses, peripheral nerves, neuromuscular junctions, and muscles. These studies include variety of tests such as nerve conduction studies (NCSs), repetitive nerve stimulation, late responses, blink reflexes, and needle electromyography (EMG). It is an extension of the clinical history and examination. Therefore, a directed history and examination prior to the study is important and it helps to formulate a study based on the differential diagnosis. Nerve conduction studies are tests of the peripheral sensory and motor nerves assess pre and post ganglionic lesions, identify lesions of the plexus or the relevant peripheral nerves. EMG helps further to localize the lesion by assessing the presence of active denervation in the muscles supplied by the affected nerve, the presence of re-enervating potentials, it also analyzes whether the underlying process is neuropathic or myopathic in origin as well as helps in predicting the prognosis. Patients with suspected neuromuscular junction disorders undergo repetitive nerve stimulation to assess for abnormalities in neuromuscular transmission and identify the presence of pre or post synaptic defect. A specific test for the single muscle fiber (single fiber EMG) assesses the presence of jitter. The use of the various EDX studies summarized

Biography:

Abstract:

Biography:

Vahe Poghosyan received his MSc in Mathematics (1997) from Yerevan State University and PhD in Neurophysiology (2000) from National Academy of Sciences of Armenia. He held positions of Research Scientist in RIKEN Brain Science Institute in Japan (2000-2007), and Senior Scientist (2007-2016) and Director of Research Training Program (2011-2016) at AAI Scientific Cultural Services Ltd. in Cyprus. Currently, he is the Head of MEG Laboratory and Consultant of Neuronavigation at King Fahad Medical City in Riyadh, KSA. He has published more than 20 research papers in the high-impact journals in the field of Neuroscience

Abstract:

Magnetoencephalography (MEG) is a state-of-the-art functional neuroimaging and neurophysiology technique, whose primary clinical application is in the diagnostic evaluation of patients with epilepsy. MEG’s value in epilepsy and in functional neuroimaging in general, stems from its high spatiotemporal accuracy and resolution: MEG is the only currently available non-invasive technique to offer both, high spatial (of the order of few millimeters) and excellent temporal (sub-milliseconds) resolution. Numerous studies have shown the clinical usefulness and added value of MEG in epilepsy. In a prospective blinded study (considered class 1 evidence by American Academy of Neurology), MEG yielded non-redundant information in 33% of patients, where it suggested to cover additional areas in 13% of patients and modifications of the surgical decision in 20% of patients. This information would not have been available from other techniques, although patients underwent video/EEG, imaging, and PET and SPECT when indicated. In general, recent incorporation of MEG in the clinical practice has been a valuable advancement in the field. MEG’s role in the pre-surgical evaluation of patients with epilepsy is threefold. First, it is used to localize the epileptic foci, estimating the epileptogenic zone. Second, MEG is used to determine the language-dominant hemisphere. Third, it is used to map the eloquent cortex of language, motor and sensory (visual, auditory and somatosensory) functions

Biography:

Elamir H Elsherif is a Neurophysiologist Physician. He has completed his Medical degree in 2002 at Ain Shams University in Cairo. He had his training in Neurophysiology in Kings County and Downstate Hospitals in Brooklyn New York. In 2008, he completed the American Board of Neurophysiologic Monitoring in Chicago. Currently, he is working as a Consultant of Intra-operative Neuromonitoring and the Director of Neurosonology Lab at King Fahd Medical City. He is interested in Cortical Mapping, Neuromodulation and Brain Computer Interfaces.

Abstract:

Electrocorticography (ECoG) is the direct recording of electrical potentials associated with brain activity from the cerebral cortex, ECoG is comprehensive to reading electrical activity whether its spontaneous similar to Electroencephalogram (EEG) or evoked as in case of central sulcus mapping technique. The grid electrodes used for recording can be used as stimulators as well; this invasive stimulation and recording from the human brain can provide unique opportunities to study fundamental processes at fine temporal and spatial resolution. ECoG vs. EEG; while ECoG is useful in temporal and spatial localization, EEG is useful to look for diffusion of the seizure, either in the same or the contralateral hemisphere. The circumstances during which ECoG is employed vary among hospitals, at some institutions, recordings are made during all epilepsy surgeries, and the intraoperative findings are used to tailor the surgical resection to each patient. At other centers, ECoG is used selectively (e.g. only in extratemporal procedures). On the other hand, it may be performed universally for research purposes but the findings then are not used in determining the volume of brain tissue to be resected. EEG and ECoG recordings are important during the entire duration of the procedure because they allow monitoring for the occurrence of after-discharges, electrical seizures, and even clinical seizures. The occurrence of after-discharges is quite common during these procedures, and the main objective of monitoring is to recognize those that occur in response to stimulation. Technical limitations of recording and keeping the electrode in place during the surgery should be considered. Controversy also exists concerning the use of ECoG to guide the extent of resection of adjacent or distant seizure foci associated with brain tumors.

Biography:

Abstract:

Introduction: Recent decades have shown substantial progresses in the development of adjunctive tools in epilepsy surgery, specifically, image-based neuronavigation and electrophysiological neuromonitoring. For many patients, surgery for intractable epilepsy provides freedom or significant relief from seizures, offering functional improvement that ameliorates their quality of life. The aim of this paper is to show how neuronavigation helps to improve the precision and safety of epilepsy surgery.

Methods: Despite the availability of noninvasive structural and functional neuroimaging techniques, invasive monitoring with depth electrodes, strips and grids is still often indicated in the management of intractable epilepsy. Neuronavigation is used as a common platform to merge complementary information obtained from the correlation of anatomic and structural details with functional information. During surgery, neuronavigation is a valuable tool in planning the best trajectory for inserting recording electrodes in the brain. Also, it will enhance the precision and accuracy of the surgery during the removal of the epileptogenic area without damaging any vital structures. Precise identification of the epileptogenic area in medically refractory epilepsy is of vital importance. The main benefits of neuronavigation in epilepsy surgery is the effective precision of targeting even in small and deeply seated lesions, safe manipulation in critical brain areas, accurate placement of electrodes, and correlation of electro-clinical information modalities with underlying structures. Furthermore, navigation provides individual tailoring of the craniotomy and reaches the target in the planned trajectory. Additionally, minimally invasive procedures are performed rather than traditional surgeries, which require more invasive craniotomies. The whole procedure is achieved, through a small incision, to remove the seizure-producing regions deep within the brain.

Conclusion: The neuronavigation concept proved its value in epilepsy surgery by linking anatomic and functional data of a specific patient. Enhanced by the integration of multimodal information, neuronavigation significantly improved the available treatment options. Neuronavigational imaging data combined with functional investigations can greatly help discussion within the multidisciplinary epilepsy surgery team helping in the shared decision making process. Finally, during surgery, an intraoperative acquisition can be acquired to refresh the navigation data. These intraoperative acquisitions allow the assessment of surgical results within the operating room while the patient still on the surgical table and before closing the craniotomy.

Biography:

Abstract:

Biography:

Hardeep Sahota is a FY1 Doctor at Chelsea and Westminister Hospital NHS Foundation Trust, he is currently on a stroke rehabiliation ward caring for patients who have been transferred from hyper acute stroke units. His long term long goal is to become a Neurosurgeon

Abstract:

We present a very tragic case of a women in her early 60’s who had a confirmed diagnosis of right sided non-small cell lung adenocarcinoma. Interestingly, she had complained of unilateral right sided hand weakness and altered sensenations. She went on to have a CT and MRI scan with the thought that her cancer had metastasied to her brain. However, MRI went on to reveal that she had gone onto have cerebral infarct, infact the strokes were multiple and resulting in profound dense weakness. A literature search revealed that marantic endocarditits whilst a rare cause of stroke in the general population is not so uncommon cause of stroke in the presence of underlying cancer diagnosis. Hence we would like to highlight the uncommon causes for cardioembolic stroke. 

Biography:

Chaonan Yang has completed his Master's degree from Graduate Institute of Integrated Medicine, China Medical University, Taiwan. He is now the attending Physician of Neurology in China Medical University Hospital, Taipei branch

Abstract:

A case of 53-year-old female patient with insidiously feet numbness initially, with the progressive ascending numbness and mild to moderate weakness of lower limbs reaching the maximum impairment for two months. Initial examination found decreased DTR on bilateral ankle reflex without weakness. It takes about two months to the nadir, very slow progressive ascending weakness and paresthesia. She took rehabilitation for two months and has received PRF (Pulsed Radio Frequency) therapy one month later symptom onset under the impression of mild L4/L5 HIVD and radiculopathy by neurosurgery doctor. With 42°C electrode stimulation in bilateral L5 DRG (dorsal root ganglion) she has developed sudden electric shock-like sensation in the whole back area with radiation to 4 limbs soon after PRF stimulation, and the symptoms lasted for 3-4 weeks when moving back or neck. And slowly relieved, DTR was increased two months later when she came to our neurologic clinic and she walked with the help of a stick. The spinal cord MRI revealed a long extended spinal cord lesion from T9-T11. The VEP (visual evoked potential) showed prolonged latencies bilaterally without any eye symptom. Further brain MRI showed lesion at right middle cerebellar peduncular. Lab data was not remarkable. CSF study showed no active inflammation or infection. IgG index: 0.54, blood test for AQP4 Ab showed positive. Lhermitte’s sign (LS) is one of the sensory symptoms of the spinal cord that is frequently seen in NMOSD. But it was rare under pulsed radiofrequency situation. Physician should be aware of the disease course and should always put spinal cord lesion into consideration before invasive procedure.

Biography:

Jameelah Saeedi is a certified Saudi Neurologist who specializes in Multiple Sclerosis and Neuroimmunological Diseases. She received her Medical qualification from King Abdulaziz University in Saudi Arabia in 2001 followed by two-boards in Neurology from Saudi Commission for Health Specialties and the Jordanian Medical Council in 2007. She is a alumni of University of British Columbia where she pursued her fellowship and training in Neuroimmunology and Multiple Sclerosis with Professor Peter Rieckman in 2009. In 2010, she received two more fellowships in Electromyography and Boutlinum Toxin Injection treatment from the University of Toronto. She is one of few leading pioneers who holds vast knowledge, experience, sub-specializes and practices Multiple Sclerosis and Neuroimmunological Diseases in Saudi Arabia. She has been working at King Fahad Medical City as a Subspecialty Consultant and KFMC Comprehensive Neuroimmunology Program Director. She is currently working at King Abdullah Bin Abdulaziz University Hospital in Saudi Arabia.

Abstract:

Neuromyeltis optica (NMO) also known as Devic's disease is an immune-mediated inflammatory disease of the central nervous system (CNS). Immune cells and auto-antibodies primarily attack optic nerves and spinal cord. NMO and multiple sclerosis (MS) are distinct diseases with some similar clinical and radiological features. In 2004, anti-AQP4 antibodies (NMO-IgG) was first reported to be associated with the disease, Since this discovery, the disease spectrum has significantly widened. Patients without the typical spinal cord and optic nerve manifestations have also been diagnosed with NMO. In 2015, new diagnostic criteria were published defining anti-AQP4 positive and negative disease with a new unified term, NMO spectrum disorder (NMOSD) to describe the disease. Although majority of NMO patients are positive for serum AQP-4 antibodies, some can exhibit negative results despite using the most sensitive available technique. The others might have antibodies targeting myelin oligodendrocyte glycoprotein (MOG). In my presentation, I will discuss the new diagnostic criteria for NMO, the differences between anti-MOG NMO and anti–AQP-4 NMO, the radiological features of the disease, as well as some practical points in the diagnosis and management of the disease. I will also present real cases that I have encountered during my clinical practice

Biography:

Vakhtang Fedotov completed his 1^st year of Medicine in Kharkiv National Medical University during September 2016-June 2017. During 2005-2016, he studied in private school “Ochag Gymnasium” and has finished it with excellent marks and a gold medal. He is a winner of regional chemical competition. Since 2015, he is a member of the minor Academy of Sciences. He took part in Biology and Anatomy conferences previously.

Abstract:

Introduction: Gait is a kind of visiting card of any person which says a lot about the individual. It can testify both health status and possible pathology. The gait of a person is the harmonious interaction of muscles, bones, eyes and the inner ear under the control of the central nervous system. Despite clinical significance and widespread prevalence, gait disturbances have not been the subject of special studies until recently. This has determined the subject of our preliminary communication.

Purpose: The purpose is to study some mechanisms of human gait.

Materials & Methods: The studies were performed in 4 patients with Parkinson's disease, 5 patients suffering from ischemic stroke, 4 patients with peroneal nerve neuropathy, and 2 patients with myopathy. The comparison group involved 7 healthy volunteers. All patients and the study group underwent clinical examination, electromyography and biomechanical studies.

Results: We have seen obvious differences in patients during electromyography: high-frequency, high-amplitude curves during muscle contraction in healthy volunteers were recorded; the amplitude of the potentials increased and subsequently decreased in patients with Parkinson, spindle shapes were also recorded and; patients with peroneal nerve neuropathy showed singular irregular potentials in amplitude and frequency. The nature of the EMG changes indicated the different anatomical level of injury of the particular anatomical structure involved in the act of walking. So, EMG studies allowed us to objectivize changes in the process of neuromuscular transmission in various diseases. Within the biomechanical parameters, we measured PI (inclination of the pelvis) - the angle between the line joining the middle of the upper surface of the sacrum with the center of the femoral head and perpendicular to the upper surface of the sacrum, restored at the point 0. This measure also varied in patients with different pathologies. PI (50.1°) - patients with peroneal nerve neuropathy and volunteers; PI (less than 35°) - patients with stroke and; PI (between 35° and 50.1°) patients with myopathy and Parkinson's disease. In the vertical position, the spino-pelvic balance is regulated by the neuromuscular system. Therefore, it is logical to assume that alterations in neuromuscular transmission also change the parameters of the spino-pelvic balance.

Conclusions: The person’s gait being individual and absolutely unique testifies both to a healthy status and even reflects the presence of a possible pathology. The type of pathological gait depends on which of the links of the locomotor chain has suffered: corticospinal tract, extrapyramidal system, musculoskeletal system, etc. In setting the correct diagnosis in the presence of a pathological gait, the clinical examination is of utmost importance along with electromyography and biomechanical examinations. We will be presenting our overall study details and results with case examples.

Biography:

Neil Senior is a Board certified Child Adolescent and Adult Psychiatrist in Vermont. He received his medical degree from The University of Queensland Medical School, Australia and has been in practice for more than 20 years. He did his Internship in Christchurch New Zealand, Child psychiatry Internship in University of Vermont Medical School and Adult Psychiatry Internship in Dartmouth Medical School New Hampshire. He is a staff Psychiatrist and Medical Director Brattleboro Retreat and Out Patient Child, Adolescent and Adult Psychiatrist at Otter Creek Associates Brattleboro, Vermont.

Abstract:

DSM-5 child psychiatry diagnoses have low inter-rater reliability, often overlap with each other and tend to be limiting in their descriptions. By focussing on a patient's target symptoms one can both simplify treatment interventions and hence hopefully improve outcomes

Biography:

Mohammad Shamsul Ola is an Associate Professor in the Department of Biochemistry at King Saud University, Riyadh, Saudi Arabia. He completed his Postdoctoral Training at Medical College of Georgia and Pennsylvania State University, USA and subsequently joined as a Faculty Member at King Saud University in 2008. He is an established Scientist working in the research area of cellular and molecular mechanism of diabetic retinopathy. He has made fundamental discoveries that have greatly added to our understanding of vision impairment caused by diabetes. His research on altered metabolism in diabetes has contributed a thorough understanding of the molecular causes of impairment in the early stages of diabetic retinopathy. His major area of research interest includes molecular mechanism of neurodegeneration, and oxidative stress and neuroprotection in diabetic retinopathy. 

Abstract:

Excess extracellular glutamate is known to cause excitotoxicity and neurodegeneration in the brain and retina under various pathological conditions. Diabetes-induced altered level of glutamate is believed to be a major factor to cause neurodegeneration in diabetic retina, leading to diabetic retinopathy. The purpose of this study was to understand the regulation of glutamate metabolism in non-diabetic and diabetic rat retinas. We performed glutamate metabolic studies in the rat retinas and in cultured Muller cells. We analyzed both rate of anaplerosis (de novo synthesis of glutamate and glutamine) and cataplerosis (catabolism of glutamate) in the control and diabetic rat retinas. We measured metabolites in those rat retinas using spectrophotometric, high performance liquid chromatography and radioisotopic techniques. In addition, we also analyzed glutamate uptake in the cultured retinal Muller cells under glutamate depletion conditions. Results of anaplerosis indicated that the level of glutamate and glutamine synthesis significantly decreased in diabetic retina compared to control (p<0.05). Cataplerosis experiments showed that glutamate oxidized to CO₂ and lactate, and their levels were significantly decreased in diabetic retina compared to control. Glutamate uptake experiments in Muller cells suggested that the rate of glutamate transport increased when cells were depleted of glutamate. Thus, glutamate metabolism experiments suggest that the rate of anaplerosis of glutamate did not increase in the diabetic rat retina, however cataplerosis decreased, which gives the basis of an increased intracellular level of glutamate within Muller cells. Glutamate uptake experiments in cultured Muller cells suggest that either high or low intracellular levels of glutamate may hinder the rate of glutamate uptake. Thus, these results suggest the basis of glutamate excitotoxicity and neurodegeneration due to increased intracellular level of glutamate in the diabetic retina

Biography:

Tansel Comoglu was graduated from Ankara University Faculty of Pharmacy in 1991. She received her MSc degree on Pharmaceutical Technology. She obtained her PhD degree in 2002 and she worked as an Assistant Professor in 2010 and received her Associate Professor title in 2011. She was awarded Post-Doctoral Research support by the Scientific and Technological Council of Turkey (TUBITAK) and continued her work in Tromso University, Institute of Pharmacy, Department of Pharmaceutics and Biopharmaceutics, Norway on “physics of tabletting” in 2005. In 2017, she was appointed as Full Professor of Pharmaceutical Technology at the Ankara University, Faculty of Pharmacy. She has been serving as an Editorial Board Member of “Pharmaceutical Development and Technology” since 2012 and “AAPS Pharmaceutical Sciences and Technology Journal” since 2015 and is the Writer of more than 30 scientific articles, and 3 international book chapters.

Abstract:

Parkinson's is a major neurodegenerative disorder that occurs due to loss of dopaminergic neurons in basal ganglia. Conventional therapy includes surgery that involves a lot of risk and administration of levodopa which is accompanied by poor bioavailability, short half-life, and side effects. In this present study, poly(lactic-co-glycolic acid) (PLGA) nanoparticles-based drug delivery system to improve the bioavailability of the drug was evaluated. Nanoparticles were prepared by double emulsion solvent evaporation technique (w/o/w). The process of encapsulation of drugs by double emulsion/evaporation in a matrix of PLGA can be divided into three successive steps: first, an aqueous solution of the active compound is emulsified into an organic solution of the hydrophobic coating polymer; second, this primary water-in-oil emulsion (w/o) is dispersed in water with formation of a double water-oil-water emulsion (w/o/w); third, the organic solvent is removed with formation of solid particles. In our study, the effect of inner phase, evaporation time and polymers’ moleculer weight on entrapment efficiency were evaluated. In the experiment, 5% poly vinyl alcohol is used as outer phase and 2 mL dichloromethane is used as the oil phase. The drug encapsulation efficiency were measured by high performance liquid chromatography (HPLC). 10 μl of supernatant was injected into an Agilent 1100 liquid chromatograph to determine the actual amounts of Levodopa non-incorporated within the nanoparticles. Separation was achieved using a C18 column (250 mm × 4.6 mm, 5 μm) at a flow rate of 1.0 ml/min and a detection of 280 nm. All the analysis was performed at 25°C. An increase in the encapsulation efficiency was observed in the nanoparticles prepared with PLGA with the lower molecular weight, showing that PLGA with the lower molecular weight effectively trapped Levodopa. When 1% Tween 80 solution was used in the inner phase with a 20 mM HCl solution a shortened evaporation time and an increased drug encapsulation were observed. 

Biography:

Umur Kayabasi is a Graduate of Istanbul Medical Faculty. After working as a Resident in Ophthalmology, he completed his Clinical Fellowship Program of Neuro-Ophthalmology and Electrophysiology at Michigan State University in 1995. After working as a Consultant Neuro-Ophthalmologist in Istanbul, he worked at Wills Eye Hospital for three months as an Observer. He has been working at World Eye Hospital since 2000. He has chapters in different Neuro-Ophthalmology books, arranged international symposiums and attended TV programs to advertise the Neuro-Ophthalmology subspecialty. He has also given lectures at local and international meetings, published many papers in Neuro-Ophthalmology. He became an Assistant Professor at Uskudar University, Istanbul in 2016.

Abstract:

Introduction: Tau protein plays a crucial role in many neurodegenerative diseases including Alzheimer's disease (AD). Tau inclusions and amyloid beta (AB) depositions have been described in the post-mortem retina exams of AD patients. Cryo- electron microscopy (Cryo- EM) was recently used to detect the detailed structure of Tau filaments.

Methods & Results: We examined the retinas of PET-proven live AD patients by spectral domain optical scanning tomography (SD- OCT) and fundus auto fluoresce in (FAF). The hyper or hypo-fluorescent lesions in the retina were scanned by OCT and images that completely corresponded with the histopathological and Cryo-EM shapes of tau filaments were observed.

Conclusion: Retinal tau is a very promising target to detect early changes in AD and retinal imaging may be an exciting and trustable technique to predict and monitor the disease.

Biography:

Gehan Abdel-Raouf Ahmed has completed her PhD in Molecular Biophysics from Cairo University. She had initiated the Biophysics and Regenerative Medicine Research Group in Spectroscopy Department, Physics Division at National Research Centre, Egypt. She is working on Alzheimer’s disease from November 2016. She established the Medical Biophysics Laboratory in King Fahd Medical Research Centre, King Abdulaziz University, Jeddah, Saudi Arabia during September 2008 - April 2015. She is a Principle Investigator and Co-Investigator in many projects dealing with early diagnosis and prognosis of cancer.

Abstract:

In this work we have investigated the alterations in membrane physical properties and peroxidation mediated by AlCl₃ in isolated synaptosomes of rat cortical brain tissue after 21, 42 and 65 days. The potential therapeutic role of Lepedium sativum (LS) as a natural anti-inflammatory, antioxidant and as acetylcholinesterase inhibitor in treating AD was also assessed in a curative group. We adopted ATR-IR spectroscopy, electron paramagnetic resonance (EPR) spin labeling and trapping (NADPH oxidase (NOX) activity), MRI, histopathological study, and animal behavior test. The ATR-IR and EPR spectroscopy results revealed that synaptosomal membrane lipids undergo free radical attacks mainly at early stage of AD (21D ) and late 65D, due to Al toxicity. Al alters significantly the phospholipids membrane order, packing, membrane fluidity and polarity. These changes are time dependent. At late AD (42, 65D), the detected increase in synaptic membrane polarity renders the membrane hyperpolarized, that may obstacle the release of synaptic vesicles content into the synaptic cleft. Moreover, AD rats gave the lowest significant (P≤0.05) poking frequency compared to the control while curative group showed a great improvement with no significant changes between control and curative rats. MRI showed lateral ventricles dilation and brain atrophy only in the AD group. Gradual degenerative change was observed in AD cortical neurons with time; neurofibrillary tangles were appeared as magenta colored and looking like flames in the cytoplasm. In curative group, neurons looked more/or less similar to those of control. In conclusion, LS greatly restore membrane integrity and showed a promising curative effect. 

Biography:

Muaz Abd Alrahman Ibrahim is a medical student at University of Bahri and interested in research conducting now 3 researches and a member of Daoud research group under supervision of senior neurologist and will see 200 patients of neurology per week in our charity clinic.

Abstract:

The aim of the study is to investigate the relation between serum levels of anticonvulsants and their side effects. This is a prospective cross sectional hospital based study conducted at Al Shaab Teaching Hospital. 120 patients were included in the study. The AEDs used were phenytoin, phenobarbitone, carbamazibine, and sodium valproate. The results showed that the side effects among the studied group were not uncommon. There was no relationship between serum levels of AEDs and their side effects.

Biography:

Abstract:

The aim of this study was to describe the prevalence of epilepsy among Sudanese AIDS patients and to study the underlying causes and types of epilepsy. About 700 AIDS patients were included in the cross sectional hospital based study. Almost 5.71% of the patients had epilepsy and 50% of them had generalized convulsion. Encephalitis was found to be the commonest cause of epilepsy followed by meningitis, brain abscess, CNS lymphoma and toxoplasmosis. The EEGs showed abnormal discharge in 28 patients (70%). AIDS is a great mimicker. It can be present in almost any neurological manifestation. Epilepsy is not an uncommon neurological manifestation associated with AIDS. 

Biography:

Mawadda Karrar Ibrahim is a Medical Student at University of Bahri, Sudan. She is interested in research field particularly in Neurology and Infectious Diseases, member of Daoud Research Group , it is intended to give more chances for health care professionals in research field, attending neurologic clinic every week, She will see approximately 100 patients per week with professor of neurology Abbashar Hussein, also every month she travel to other states in my country for mobile charity clinic to see neurologic cases with professor of neurology Abbashar Hussein, and participating now in one research, and one other research under the process of publication.

Abstract:

Background: Stroke is a condition that involves loss of brain functions caused by loss of blood supply to part of the brain. It is the third most common cause of death in the developed countries and in 40% of young patients no cause can be identified.

Methodology: A case control study involving 100 patients with thrombotic CVA and 300 age and gender matched healthy control (2002-2004).

Results: In this study, the hematological profiles for patients were within normal range. With normal ranges of APTT (activated partial thromboplastin time) and thrombin clotting time, LA and dysfibrinogenemias can be excluded. Natural anticoagulants (PC, PS, and AT-III) were at the lower range of normal in all patients (p=0.04), and were significantly lower from those of the age (p=0.04), and gender matched controls (p=0.02). In addition, most of the female patients were on oral contraceptive pills at the time of the stroke. Female patients had even lower AT-III levels compared to female controls.

Conclusion: Relative PC, PS, AT-111 deficiencies could be a possible cause of increase thromboembolic CVAs in Sudan.

Biography:

Monzer Hassan Balla Mustafa is a Medical Student interested in Neurology and Neuroscience, member in Daoud Research Group in which they tend to see 200 patients/week with neurological disorders under supervision of Professor Abbashar Hussein (Senior Neurologist). Now he is participating in three researches and one more research is under the process of publication.

Abstract:

Background: Cosmetic effects of AEDs are of particular concern to the female population as they impair body image and self-esteem.

Methodology: This is across sectional analytical non-intervention clinical based study (2011 -2012.

Results: 45 patients received phenytoin, 42 received Phenobarbitone, 35 received carbamazepine and 38 patients received sodium valproate. Eighty patients (66.6%) took one drug, while 40 (33.4%) received more than one drug. Regarding Idiosyncratic side effects, out of 45 patients on phenytoin, five had acne, four had skin rash, four had coarse facial appearance, one had blood dyscrasias, one had Steven-Johnsons syndrome and one patient had duptuytrens contracture. Dose related side effects of phenytoin (four had gum hypertrophy), four received carbamazepine had skin rash. Out of 42 patients who received Phenobarbitone; four had skin rash. Out of 35 patients who received sodium valproate; four had weight gain, three had tremor, while two patients experienced hair loss. It appeared that most of the patients (60%) who showed some evidence of side effects due to the AEDs had normal serum levels of the AEDs.

Conclusion: Hair loss and weight gain are the most common side effects

Biography:

Abstract:

Objective: This study aimed to determine the clinical presentations of epilepsy and its correlation with stigma of epilepsy and occurrence of psychogenic non epileptic seizures.

Materials & Methods: This is a prospective cross-sectional health facility based study that was conducted on 66 patients with epilepsy aged from 18-71 years attending Banat Charity Clinic in Omdurman city. Verbal consent was obtained from participants and a predesigned structured questionnaire was used to interview them. Statistical analysis was performed using SPSS version 23.

Results: Out of 66 patients 39 (60%) were males and 26 (40%) were females. Generalized seizure types constituted 50 (75.7%), while focal seizure types constituted 14 (21.2%). Generalized tonic clonic was the commonest seizure type 45 (68.2), followed by focal motor seizure with impaired awareness 10 (15.1%), focal to bilateral 4 (6%), myoclonic and atypical absence 2 (3%) each and clonic seizure 1 (1.5%), two data were missing. Regarding stigma, 22.7% had felt stigma, 7.6% had courtesy stigma, 27.3% had coaching stigma, and 16.7% had coping stigma. Psychogenic non epileptic seizures (PNES) co-existed with epilepsy in 21.2%. PNES, type of epilepsy and educational level were statistically associated with stigma of epilepsy.

Conclusion: The clinical presentation of epilepsy, co-existence of psychogenic non epileptic seizures and epilepsy, and stigma were different from what was mentioned in the literature

Biography:

Chandrika Dasgupta is studying MBBS (5^th year) at Shaheed Ziaur Rahman Medical College, Bangladesh. She is very much interested in research and wants to devote herself to invent new era in Medical Science

Abstract:

Objectives: Antibiotic resistance is an important obstacle for treatment of UTI specially in low cost health setup of developing countries. The aim of this study is to investigate the resistance pattern of the common pathogens responsible for UTI in Bogra, Bangladesh. Specific factors associated with antibiotic resistance and prescription pattern were also explored to render data for appropriate empiric evidence-based antibiotic guidelines for this area.

Methods: This retrospective analysis was done among the patients presented with clinical suspicions of UTI for a period of 1 year from October 2016 to September 2017. A total 1256 patients were included in the study. A single clean catch midstream urine sample was collected per patient and samples with more than 105 CFU/mL bacteria were considered positive. 552 samples met the inclusion criteria and in these samples, the bacteria were identified by standard microbiological techniques and the profile of antibiotic susceptibility was obtained using Kibry- Bauer method following Clinical and Laboratory Standards Institute (CLSI) guidelines. Patients’ characteristics, self-reported previous antibiotic consumption history within last 1 year, presenting symptoms, empirical antibiotic prescription given at presentation are also recorded and statistical analysis was done using Stata 15 to investigate the possible factors associated with resistance.

Results: UTI was more common in women (61.5%) and its incidence varied with age, affecting more the elderly patients (29.6%). E. coli was the predominant isolate (61.05%, n=337), followed by Klebsiella (22.28%, n=123). E. coli showed very high frequency of resistance ranging from 54.30% to 77.15% to cefixime, ciprofloxacin, cotrimoxazole and nalidixic acid, moderately high resistance (47.18% to 48.96%) to cefipime, ceftazidime, ceftriaxone and azithromycin and low resistance (1.19% to 16.62%) to imipenem, amikacin, nitrofurantoin and netilimycin. Previous antibiotic consumption history revealed macrolides, cephalosporins and quinolones are mostly consumed antibiotic and 36.34% was based on self-medication and 25.78% was recommended by quacks and drug sellers. 78.29% registered physicians used empirical antibiotic at presentation. Mismatching differences of antibiotic prescription and resistance were slightly evident.

Conclusion: High percentage of resistance to most of first line low cost antibiotics made the choice of empirical therapy critical. Continued surveillance, educational interventions and antibiotic stewardship programs for clinicians are necessary to fight the rising problem of antimicrobial resistance. Further exploration of physician prescribing behavior with development of evidence based empirical therapy for infectious diseases is recommendeda