Global Summit on Neurology and Neurosurgery January 16-17, 2020 Lisbon, Portugal

Biography:

Mr Nath is a neurosurgery consultant at James Cook University Hospital in Middlesbrough, with a special interest in acoustic neuroma, skull base and vascular sugery, trigeminal neuralgia and cervical disc replacement. Summary of training:

Mb ChB Liverpool 1974

FRCS Edinburgh 180

Ghorka Dakshin Bahu (King of Nepal’s Birthday Honours list 2002)

FRCS England adeundem 2008

Royal College of Surgeons:

Interview Representative

Regional Adviser in Neurosurrgery

Abstract:

Objective: The aim of this study is to share our experience of an effective dural repair technique, which we have utilised to minimise the incidence of postoperative CSF leakage in patients undergoing microvascular decompression (MVD) for Trigeminal Neuralgia and Hemifacial Spasm.

Methods:  Between 1987 and 2018, 134 patients had microvascular decompression, mainly for Trigeminal Neuralgia and Hemifacial Spasm  in our unit. All our patients having posterior fossa MVD using the technique described by Janetta, had an apparently watertight repair of the dura at the end of the operation.   We describe our technique using Duraguard ® and Histacryl® glue. The post-operative outcome of the duraplasty was assessed retrospectively by case note review. 

Results:   Of 134 patients, 129 (96.2%) had no post-operative CSF leakage. Only 5 (3.7%) of the patients experienced  post-operative CSF  leakage.(3 from the wound,  2 from the nose)

Conclusion: We conclude that dural repair using the described technique  utilising  a dural substitute (Duraguard) and Histacryl glue  is safe and effective in preventing post operative CSF leak following MVD.

Keyword: CSF leak, Duraplasty, Microvascular Decompression(MVD).

Biography:

Sandra Sungailaite completed her medical degree at the Lithuanian University of Health Sciences, Lithuania. Currently, she works as a specialty doctor in Neurosurgery Department, James Cook University Hospital, Middlesbrough, United Kingdom. Sandra has an interest in teaching and is pursuing a degree in medical education, along with her work in neurosurgery and a degree in Surgical Sciences. Mr Anil Varma is a senior neurosurgery consultant at James Cook University Hospital in Middlesbrough,  with a special interest in neuro-oncology and endoscopic pituitary surgery.  He is an author and co-author of many publications and research in his area of interest.

Abstract:

Objective: The main objective of this study is to review the outcome of chronic subdural hematomas (CSDH) and patients’ characteristics in a cohort referred to a major tertiary trauma centre. 

Design: Retrospective audit.

Subjects: Patients with CSDH referred to the trauma centre of North East in the UK between April 2019 and January 2020.

Methods: A retrospective analysis of 88 patients presented over a nine-month period of 2019 to a tertiary centre in the UK with CSDH. We reviewed the referral database collecting data on patients’ age, GCS, presenting symptoms, anticoagulation status and the management outcome.  We analyse the radiological findings and clinical outcome of the patients in the different treatment groups.

Results: The results indicated that 88 patients with CSDH were identified during the study period. Twenty (20%) underwent surgery immediately. Forty-eight (55%) were managed conservatively, and 20 (20%) were managed medically with dexamethasone. Subsequently, one of the patients managed conservatively, and one with dexamethasone underwent surgery. Forty-four (54%) out of 88 patients were on various forms of anticoagulation. 

Conclusions: This study confirms that operative management was deemed suitable for a small portion of patients referred with CSDH. Medical management with dexamethasone is an option for the patients for whom surgery is not warranted or when a patient is unfit for surgery with good outcome.

Biography:

Jin Eun has completed MD at the age of 25 years from Eunji medical University. She trained neurosurgery at the Catholic University of Korea. She is the clinical instructor of the department of neurosurgery, Eunpyeong St.Mary’s hospital

Abstract:

In patients with hyperacute infarctions, there are situations in which initial diffusion-weighted magnetic resonance imaging (DW MRI) fails to explain the patient's neurological status. In the present case, the patient visited the emergency room about 15 minutes after the onset of symptoms and his initial neurological status was not explained by DW MRI. We injected intravenous tissue plasminogen activator on the basis of non-enhanced brain computed tomography. However, the degree of neurological improvement was insignificant and follow up DW MRI showed multiple acute infarctions in the pons, midbrain, and bilateral thalamus. A rare case of acute bilateral thalamic infarction, this article summarizes initial management and clinical outcome.

Biography:

Sheng Yuan is a final year undergraduate medical student from the University of Edinburgh. He is previously an events coordinator and currently the treasurer for the Edinburgh University Neurological Society. He is interested in neurology/neurosurgery/neuroscience research and very keen to discuss ideas with other like-minded people.

Abstract:

Systematic Review of Clinicopathological Correlations in Logopenic Progressive Aphasia: Logopenic aphasia (lvPPA) is characterised by impaired word-retrieval and sentence repetition. It is usually associated with AD pathology, but other pathologies have been reported. The objectives of this study was to estimate the prevalence of different neuropathology in autopsied lvPPA cases and evaluate the performance of new criteria in predicting Alzheimer’s Disease (AD) pathology in lvPPA patients. In this systematic review, we developed search strategies to identify studies which reported clinical cases of lvPPA and neuropathology investigation results. The included studies were analysed for reporting quality, demographics, clinical criteria and pathological diagnosis. Out of 2459 articles screened, 35 studies reported 200 lvPPA patients in total. Reporting quality were good for clinical criteria (100%) and neuropathology (91.4%), moderate for gender, age at onset and duration (60%) and poor for ethnicity (5.7%). The neuropathology findings in lvPPA are 74% AD, 20% Frontotemporal Lobar Degeneration (FTLD-TDP=14%, FTLD-Tau=6%), 2% Dementia with Lewy Bodies (DLB), 2% Creutzfeldt-Jakob disease (CJD) and 2% others. The positive predictive value of new criteria is 9% higher, but not statistically significant (p>0.05). This study confirmed the prevalence of different neuropathologies among lvPPA patients, with AD pathology being the most prevalent. We also showed that more studies are published using the new criteria and suggested the importance of multimodal diagnostic approach due to the low positive predictive value (77%) of the consensus clinical criteria.

Biography:

Dr. Luke Hale is a doctor and multi-disciplinary designer working in London, UK. He is currently working as an emergency medicine doctor in East London and is a visiting researcher at the UCL Institute of Surgical and Interventional Science and the Royal National Orthopaedic Hospital

Abstract:

3D printing is becoming a widespread and useful technology in medicine with applications in simulation, teaching, surgical planning and patient-specific prostheses. Typically, in order to 3D print neuroimaging data, anatomical areas of interest must first be identified on individual 2D slices, then isolated (either manually or via thresholding), and then converted to a 3D mesh. This time-consuming ‘segmentation’ typically requires commercial software and, in forming this 3D mesh, the rest of the scan data is lost and reduced to a binary representation i.e. either outside or inside the anatomical area of interest. Furthermore, the size of structures may be over or underestimated. Voxels (volume pixels) represent a value on a 3-dimensional regular grid, with 3D printing outputting these values to a 3D printed model. Voxel printing can obviate the need for segmentation and 3D mesh generation, with effectively lossless printing of whole neuroimaging datasets. Here, 7T MRI brain images were converted to bitmap images and printed on a Stratasys 760M printer at the printer's native resolution. SimpleITK, an open source library for imaging analysis, was used to interpolate between imaging slices to achieve the required 800dpi slice resolution; a Floyd-Steinberg dithering algorithm was used to convert images to two pixel values representing clear and opaque resin. The resulting printed model has preservation of the delicate cerebral vasculature and differentiation between grey / white matter (see images below). Voxel printing of neuroimaging therefore offers exciting possibilities with more accurate visualisation of complex neurological structures.

Biography:

King Abdullah International Medical Research Center, Saudi Arabia

Abstract:

Background:

Stroke mimics (SM) can be difficult to distinguish from real stroke. Misdiagnosis of stroke leads to unnecessary tests, harmful intervention, and increased cost. We aimed to study the prevalence and nature of SMs among Saudi patients who came to the emergency department with sudden neurological deficit and suspected stroke.

Methods:

We retrospectively reviewed records of all patients with suspected stroke admitted to the stroke unit at King Abdulaziz Medical City, Riyadh, Saudi Arabia from February 2016 to July 2018. We compared SM to real strokes. Logistic regression analysis was conducted to identify the potential predictors of SMs. This study was approved by local institutional review board.

Results:

Of the 1,063 patients, 131 (12.3%) had SM. The most common causes were peripheral vestibular disorder (27.4%) followed by psychogenic causes (24.4%). Stroke mimics were more common among younger individuals and women, and individuals with SM were less likely to have arterial hypertension, diabetes, and to be smokers. At discharge, individuals with SM were more likely to be independent at discharge, had milder deficits, and shorter hospital stays. Predictors of SM were young age, female gender, mild deficit at presentation, and good functional status prior to stroke.

Conclusion:

Stroke mimics are common among suspected strokes. Practicing physicians should consider potential diagnostic errors, particularly in the hyperacute phase of stroke.

Biography:

Sandra Sungailaite, The James Cook University Hospital, UK

Abstract:

Objective

The objective of the study is to look for the effectiveness of percutaneous  balloon kyphoplasty in the restoration of Vertebral body  height  and correction or improvement of kyphosis .

Design

Retrospective study.

Subjects

Patients  with Vertebral column wedge  compression fracture.

Methods

A retrospective  analysis of  112 patients presented  over 4  years and 4 months with 200  symptomatic  wedge vertebral compression fractures treated by Percutaneous  balloon Kyphoplasty. To assess  degree of kyphosis  and height restoration of  fractured  vertebral  body , we reviewed  digital radiographs  and measured  pre  and post cobb and wedge angle for  kyphosis ; Ratios of the height of the anterior border, centre, and posterior borders of the collapsed vertebra to the height at the posterior border of an adjacent normal vertebral body were measured in  immediate post-operative period  and next follow up   and also  calculated  gain of  height in anterior , middles and posterior  part of  Vertebral body, percentage of lost height restoration.

Results

The height of vertebral body height increases after  kyphoplasty. The anterior body height  improved  10%  in first post-operative and subsequently 14% in next follow up . Middle and posterior heights also revealed  13%, 17% and 9% , 11% improvement  respectively.  The restoration percentage for the  lost vertebral height were 34 % for anterior  border in the first  Post operative  period , 49%  in the next  out patient follow up; 46%  and 60% for middle border, and  62%, 76% for posterior  border of vertebral  height. The  mean reduction  in kyphotic angle  was 3.1 degree, and  2.4 degree in wedge angle, restoration percentages for the kyphosis angle and wedge angle were 11.3%  and 18.7%, respectively.

Conclusions: 

Kyphoplasty result in  improvement of height of vertebral body and angular deformity .

Biography:

Dr. Rahul Hajare has been a hard worker all his academic life. After his Ph.D in Pharmacy from VMRF Salem which he completed with flying colours, he is fortunate to work NARI primer HIV research Institute to complete Post Docunder the of World Renowned Scientist Respected Dr. R.S.Paranjape., Retired Director & Scientist ‘G’ National AIDS Research Institute Pune. Dr. Rahul Hajare has Associate Professor of Pharmaceutical Medical Chemistry to Pune University (until 2020), he has serviced three times AssociateProfessor in Pharmaceutical Science and Analytical Science. Graduated from Amravati University in 2003, after an assignment he worked as an M.Pharm Scholar in the Institute of Pharmaceutical Education and Research passed with distinction, he has Post Graduate Teacher for Master of Pharmacy, he has more than 30 scientific and methodological works, 3 patents of scientific research.

Abstract:

Colleagues finish a task at work can be draining, even leading to poor performance. Helping your co-workers too often may lead to mental and emotional exhaustion and hurt your job performance; a new study has come out form less sunlight pharmacy Institutions in reputed Amravati university. The effects has especially strong for employees with high "pro-social motivation" or those who care deeply about the welfare of others, researchers from Amravati University seen.While a previous study on helping has focused largely on the effects of the beneficiaries, this has one of the first studies to focus on the helpers, they said."Helping co-workers can be draining for the helpers, especially for employees who help a lot. Somewhat ironically, the draining effects of helping are worse for employees who have high pro-social motivation. When these folks are asked for help, they feel a strong obligation to provide help, which can be especially taxing.

Biography:

Cairo University Hospitals, Egypt

Abstract:

Childhood meningiomas are uncommon and their characteristics differ from those commonly found in adults. Over the 7-years period from 1992 to 1998 five cases of histopathologically proven meningiomas are discussed as regards clinical presentation, age and sex, site, size, presence of cysts, histological nature and operative management. There were three males and two females, ages ranging from 7 months to 12 years. All cases presented within seven months of clinical symptomatology. The most common presentation being raised intracranial pressure followed by seizures. Three were located supratentorially and two in the posterior fossa. They all showed bright tumour enhancement and were large (>5 cms in diameter). There were no postradiation or intraventricular tumors in our series. One of our cases revealed the importance of CT scanning in conjunction with MRI in cases where meningioma is suspected and presented valuable preoperative information. It showed a hyerostosing reaction, which MRI failed to demonstrate. There was one case each of meningothelial, transitional, round cell, atypical and vascular meningioma. Where the tumor could not be totally removed along with basal dural attachment recurrence occurred in less than 8 months. One case died due to postoperative pulmonary complications. Two cases received postoperative irradiation

Biography:

OGUEJI, Ifeanyichukwu Anthony. "Clinical Psychology in Nigeria: An Assessment of Perceptions of the Growing Subfield Among Non-Mental Health Professionals And Recommendations For Growth Acceleration.

Abstract:

Background: One area of substance abuse among adolescents that has not been fully understood in the Nigerian context is the attitude of adolescents towards cough syrup abuse, as most related studies were either focused on attitude towards general substance abuse or substances other than cough syrup.

Objective: The main objective of this research explored the attitudes of adolescents towards cough syrup abuse in Southwest Nigeria.

Methods: By a stratified sampling method, 302 participants (152 males, 150 females; mean age=13.61 years, SD=2.09) were selected from secondary schools in Oyo state and Lagos state, Nigeria, and data were collected using standardized questionnaires. Guided by literature review, four hypotheses were stated and tested using t-test and correlation statistics.

Results: Findings indicated that male and female adolescents did not significantly differ in their attitude towards cough syrup abuse (t=-16.68; DF=300; P>.05). Further results showed that, there was a significant positive relationship between adolescents’ age and their attitude towards cough syrup abuse (r=.21; DF=300; P<.01). Another result showed that, adolescents from polygamous family reported significantly higher positive attitude towards cough syrup abuse than their counterparts from monogamous family (t=-18.98; DF=300; P<.05). The last finding showed that adolescents in Oyo state and Lagos state did not significantly differ in their attitude towards cough syrup abuse (t=.03; DF=300; P>.05).

Conclusion: Adolescents’ age and family marital structure are the variables found in this research that significantly accounts for their attitude towards cough syrup abuse, thus, it is imperative enough that as adolescents are growing older, they are rightly guided against giving into substance abuse. Also, parents/caregivers of adolescents need to be actively involved in educating adolescents on the hazards associated with substance abuse.

Biography:

Leslie A McCallum has completed her PhD at the Factor-Inwentash Faculty of Social Work in 2019. She also holds a Master of Social Work from the University of Toronto and a Bachelor of Commers (honours) from Queen’s University. She is a Director of Research and Program Evaluation at Cedar Centre (part-time), a mental health agency that treats individuals with childhood interpersonal trauma, and a Research Associate at the University of Toronto. Prior to entering the PhD program, she was as a Senior Executive in Communications and Marketing, working for a wide range of clients, including several mental health organizations.

Abstract:

Anorexia nervosa (AN) is a complex, life-threatening mental illness with high comorbidity rates. This disorder has one of the worst prognoses of all mental illnesses, with a mortality rate of 10.5%. It affects people of varying socioeconomic statuses, cultures, sexes, genders, and ages. There is no universally effective treatment for adults living with AN. Despite the high percentage of individuals who continue to live with AN for decades, there is limited understanding of what it means to be in midlife living with a disorder that is more commonly noted to occur among adolescents and young adults. This was a qualitative study using constructivist grounded theory methodology. This research was conducted in accordance with the ethics protocol approved by the Health Sciences Research Ethics Board of the University of Toronto. Nineteen individuals in midlife (40 to 65 years of age) living with AN participated in individual, in-depth interviews. Four main findings emerged from this study. First, important differences exist between livings with AN in midlife versus when one is younger. Second, based on this sample and their retrospective accounts, complex trauma is common among individuals in midlife living with AN. Third, midlife can act as a barrier to seeking treatment and/or facilitate disengaging from treatment. Fourth, shifts occur in midlife that can act as catalysts to fully engaging in recovery. Honoring the added challenges that come with midlife, as well as harnessing qualities developed in midlife will help this older age group move forward with their recovery journey, moving from feeling hopeless to feeling hopeful.

Biography:

Seyed Raheleh Ahmadian currently works at the Cellular and Molecular Biology Research Center, Babol University of Medical Sciences. Seyed Raheleh does research in Molecular Biology, Cell Biology and Neuroscience. Their most recent project is ' Effect of ZnO nanoparticles on expression of inflammatory  genes, learning function and spatial memory

I have completed my MSc at the age of 27 years from Babol University of Medical Sciences. Now I am flow cytometer Operator in cellular and molecular biology research center, Health Research Institute, Babol University of Medical Sciences. He has published 6 papers in reputed journals and 9 impress articles.

Abstract:

Introduction: Epilepsy is one of the most common chronic neurological disorders, which provoke progressive neuronal degeneration and memory impairment. In recent years, application of herbal compounds with anti-inflammatory properties, such as ursin has been introduced as useful agent in reducing of the epilepsy symptoms. In this study, the effect of ursin application on spatial memory improvement, neuronal density and astrocyte activation were evaluated in pentylenetetrazol (PTZ)-induced kindling model.

Method and material: Male NMRI mice have received the daily injection of ursin at dose of 25 and 50 mg/kg. All interventions were injected intraperitoneally (i.p.), 10 days before PTZ administration and the injections were continued until 1 h before each PTZ injection. Spatial learning and memory was evaluated using Morris water maze test after the 11th PTZ injection. Animals have received 13 injections of PTZ and then, brain tissues were removed. Immunostaining against NeuN and GFAP respectively as mature neuronal and astrocyte markers were performed on brain sections. High performance liquid chromatography (HPLC) was performed to measure the ursin content in hippocampus.

Result: Our results showed that ursin administration reduced the seizures behavior and prevented cognitive impairment in fully kindled animals. The results of HPLC analysis showed that high amount of ursin can be detected in hippocampus of ursin+PTZ receiving animals. Immunostaining data demonstrated that the level of neuronal loss and astrocyte activation were reduced in animals under treatment of ursin.

Conclusion: Overall, the results of this study suggest that ursin administration effectively ameliorates memory impairment and alleviates the level of neuronal death and astrocyte activation in PTZ-induced kindling model.

Biography:

Jessica Barnes graduated from Worcester Polytechnic Institute with a B.S. in Biotechnology, and earned her PhD in Molecular Neuroscience from the University of Illinois at Urbana-Champaign. She was a fellow in the department of pediatric neuro-oncology at the Dana-Farber Cancer Institute and Children’s Hospital Boston under the mentorship of Dr. Judah Folkman. Her roles have including CEO/Co-founder of the 20Lighter Program, Director of New Ventures at Access BridgeGap Ventures, Senior Science Officer at Summer Street Research Partners, and Vice President in MEDACorp at Leerink Swann. Additionally, she provides Business & Corporate Development consulting services to biotech & med device companies.

Abstract:

Treatment of advanced Parkinson’s disease (PD) remains challenging, with fluctuations in motor status often resulting in patients becoming severely handicapped¹. The short-acting dopamine D1/D2 receptor agonist, Apomorphine (Apo), was the first dopamine receptor agonist used to treat PD². The magnitude and pattern of the motor response to single dose of subcutaneously administered Apo is qualitatively comparable to that of oral levodopa, however side effects (nausea, vomiting, etc.) can be problematic³. Close to a dozen clinical studies have shown subcutaneous Apo infusions are successful in aborting ‘off’ periods, reducing dyskinesias and improving PD motor scores with the added benefit of a substantial levodopa-sparing effect². However, bulky infusion pumps requiring delivery of relatively large volumes remain a barrier to development of therapeutic products that are patient (and caregiver) friendly. We investigated the pharmacokinetics (PK) of Apo delivered over a single 24-hour period using the wearable h-Patch™ subcutaneous infusion device in dogs. Apo (10mg) was delivered with PK evaluated at time points to 48h from the start of infusion. Apo levels were detectable in blood detected within two hours of the beginning of infusion and gradually dropped off after completion of h-Patch™ infusion (24h). With additional work on a concentrated Apo solution and modest expansion of the h-Patch reservoir, the wearable

h-Patch represents a patient friendly subcutaneous delivery mechanism for Apo providing the benefits of a full 24h infusion of low dose Apo to eliminate ‘off’ periods and improve motor status without tolerability issues seen with subcutaneous injections.

Biography:

Published many papers in Cardiosource, American College of Cardiology Foundation, Case Reports in Clinical Medicine (SCIRP) and Journal of Saudi Heart Association. Special research on Rheumatic fever and Endomyocardial fibrosis in tropical belts, Myxomas, Infective endocarditis, apical hypertrophic cardiomyopathy, Ebstein’s anomaly, Rheumatic Taussig-Bing Heart, Costello syndrome and Tetralogy of Fallot.

Abstract:

Brain abscess is an intraparenchymal infection of brain parenchyma and begins with a localized area of inflammatory change referred to as ‘cerebritis’, progress to immature capsule stage and then to abscess, containing pus encapsulated by a vascularized membrane. The capsule serves to prevent the infective process from becoming generalized and it also create within it an inflammatory “soup” that may impede resolution of the infection. The incidence of brain abscess is about 8% of intracranial masses in developing countries and in cyanotic heart disease, its incidence varies from 5 to 18.7%. In patients with right-to-left shunts, absence of pulmonary phagocytic clearance of pathogens can occur and the ischemic injury from hypoxaemia and polycyathaemia, produce low perfusion areas in the brain which may act as a nidus for infection and anaerobic streptococci are the most common agents isolated in cyanotic heart disease with brain abscess. All abscesses > 1 cm produce positive scans and CT brain appears to be adequate in most cases of brain abscess. Third generation cephalosporins (cefotaxime or ceftriaxone) combined with metronidazole for 2 weeks followed by 4 weeks of oral therapy is the medical treatment of choice for cyanotic brain abscess. Surgical techniques such as drainage via burr-hole, complete excision after craniotomy, migration technique and neuroendoscopic technique with freehand stereotaxy  have also been practiced in the treatment of brain abscess.