19^th International Conference on Gastroenterology and Hepatology November 18-19, 2019 Hawthorn Suites By Wyndham Abu Dhabi City Center, Abu Dhabi, UAE

Biography:

Dr. Ahmad Almaiman is an MBBS graduate from the University of Sharjah College of Medicine in the UAE. He conducted his internship in King Khalid University Hospital in Riyadh, Saudi Arabia, after which he became a licensed General Practitioner under the Saudi Commission for Health Specialties as well as a listing in the Dubai Medical Registry in the UAE. His field of interest is Pediatrics and sub specialties of interest and previous publishing include Neonatology and Gastroenterology.

Abstract:

Pancreatitis is defined as the inflammation of the pancreas. Alongside providing the regulatory hormones of insulin and glucagon, this organ aids in the digestion process by producing activated enzymes that exist near the duodenum. However, during an inflammation the enzymes self-digest the pancreas as a result of the acinar cell damage due to particular triggers. The incidence of acute pancreatitis has been increasing over the past twenty years; though the approach of managing it is similar to that of adult pancreatitis there still remains a need to convey official guidelines for pediatric management. It is convenient to understand the minor distinctions that relate to the cause and overall observation of pancreatitis as well as also being aware of any onward possible complications. Both gallstones and alcohol represent the two most common causes of pancreatitis in adult groups; while the former alongside hereditary pancreatitis and trauma are the lead causes of childhood pancreatitis. Viruses were at a previous time the mainstay in cases of acute pancreatitis but now they are intermediate. In spite of providing the same treatment used on adults there still exists a significant association with morbidity. Currently pediatric guidelines are being discussed, while adult guidelines remain in adequate service in the modern clinical setting of acute pancreatitis.

Biography:

Dr. Ahmad Almaiman is an MBBS graduate from the University of Sharjah College of Medicine in the UAE. He conducted his internship in King Khalid University Hospital in Riyadh, Saudi Arabia, after which he became a licensed General Practitioner under the Saudi Commission for Health Specialties as well as a listing in the Dubai Medical Registry in the UAE. His field of interest is Pediatrics and sub specialties of interest and previous publishing include Neonatology and Gastroenterology.

Abstract:

Pancreatitis is defined as the inflammation of the pancreas. Alongside providing the regulatory hormones of insulin and glucagon, this organ aids in the digestion process by producing activated enzymes that exist near the duodenum. However, during an inflammation the enzymes self-digest the pancreas as a result of the acinar cell damage due to particular triggers. The incidence of acute pancreatitis has been increasing over the past twenty years; though the approach of managing it is similar to that of adult pancreatitis there still remains a need to convey official guidelines for pediatric management. It is convenient to understand the minor distinctions that relate to the cause and overall observation of pancreatitis as well as also being aware of any onward possible complications. Both gallstones and alcohol represent the two most common causes of pancreatitis in adult groups; while the former alongside hereditary pancreatitis and trauma are the lead causes of childhood pancreatitis. Viruses were at a previous time the mainstay in cases of acute pancreatitis but now they are intermediate. In spite of providing the same treatment used on adults there still exists a significant association with morbidity. Currently pediatric guidelines are being discussed, while adult guidelines remain in adequate service in the modern clinical setting of acute pancreatitis.

Biography:

Dr. Ahmad Almaiman is an MBBS graduate from the University of Sharjah College of Medicine in the UAE. He conducted his internship in King Khalid University Hospital in Riyadh, Saudi Arabia, after which he became a licensed General Practitioner under the Saudi Commission for Health Specialties as well as a listing in the Dubai Medical Registry in the UAE. His field of interest is Pediatrics and sub specialties of interest and previous publishing include Neonatology and Gastroenterology.

Abstract:

Intussusception  is    a  clinical  disorder  characterized  by  the  telescoping  of  a    proximal part  of  the  bowel  into  its  distal  part.  The  point  that  invaginates  into  its  adjacent  part  is known  as  the  "Intussusceptum"  (also  referred  to  as  the  lead  point),  while  the  distal segment  that  receives  the  folding  is  known  as  the  ''Intussuscipien''.  This  is  one  of  the most  important  causes  of  acute  abdomen  in  children,  particularly  infants  and  toddlers (3  months  -  3  years),  however  it  is  a  rare  condition  in  adults  and  brings  about  a  variety of   symptoms  and  patterns;  be  it  acute,  intermittent,  or  chronic.  This  disorder particularly  triggers  worrisome  matters  that  are  deemed  target  worthy  in  the  clinical setting.  One  of  these  matters  is  managing  the  possible  shock  that  comes  about  with the  excessive  compromise  of  the  mesenteric  blood  supply,  which  ends  up  thickening the   intestinal   wall   leading  to  fatal  complications  of  ischemia  and  perforation. Intussusception's  diagnostic  approach  also  happens  to  be  its  therapeutic  approach, which  is  non-operative  reduction  (be  it  air  or  barium  enema).  The  recurrence  risk  of Intussusception  is  one  that  demands  a  cautious  observation  in  an  in-patient  setting,  as the  reduction  management  helps  in  limiting  said  risk  allowing  the  recurrence  to  alter between  24  and  48  hours  onwards.  In  recent  years,  there  has  been  a  presentation  of this  disorder  in  children  who  were  provided  with  the  Rotavirus  vaccine  bringing  about different  post-marketing  surveillances  to  understand  the  possible  risks  of  developing Intussesception.  Along  with  the  general  overview  on  the  topic  of  Intussusception  the following  highlights  will  be  included:  an  emphasis  on  the  potential  complications  of Intussesception,  its  distinguishing  presentation  between  children  and  adults,  favoring air  over  liquid  enema  in  reduction  management,  and  Intussesception's  increasing  risk if/when  the  Rotavirus  vaccine  is  given.

Biography:

Romualdas Maskelis is currently working in National Cancer Institute, Lithuania.

Abstract:

Surgical treatment has been the mainstay for the management of GI leakage from perforations, fistulae, or anastomotic dehiscence. Moreover, in the era of minimal invasive surgery, the need for endoscopic management is increasing. The use of new endoscopic closure devices such as the endoscopic suturing system and over-the-scope clip allows endoscopicts to expand the indications of endoscopic treatment.  Gastrointestinal (GI) leakage, fistulae and perforations can be seriously and life threatening. There has been a paradigm shift in the management approach of these conditions, from surgical to conservative, including endoscopic management. The systematic review of the literature form 1966 to 2013 for studies that have been published on endoscopic closure of perforations is found more than 700 studies but only included 24 cohort studies (21 retrospective , 3 prospective) in the analysis. In the past years, covered self-expanding metal stents were the mainstay of endoscopic therapy. However, two new techniques are now available that enlarge the possibilities of defect closure.  In the past decades, endoscopic clip application has repeatedly been used as a minimally invasive treatment option for small leakages and fistulas of the upper GI tract.  We applicate OTSC clips (OVESCO) more than for 30 patients during the last six year. Till now we don’t have randomized trials on OTSC application, and most authors provide retrospective case series with heterogeneous indications and applications. Most studies included less than 20 patients with gastrointestinal perforations. The OTSC obviously is a very effective treatment option of GI tract perforations, and in our opinion it is clearly superior to the placement of covered stents. Furthermore, in case of failure, the OTSC procedure does not impair further treatment, such as surgery. Further studies are needed to compare the novel techniques to other treatment modalities, and to define their exact place in treatment algorithms of upper GI perforations. Successful endoscopic closure of acute iatrogenic perfora­tions in the GI tract can reduce medical costs and hospital stays and prevent the need for surgical intervention for the patient.

Biography:

Mohammed Shafiqul Islam Bhuiyan has completed his MD in Gastroenterology from Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. He is currently working as an Associate Professor and Head of the Department of Gastroenterology, US-Bangla Medical College, Narayanganj, Bangladesh.

Abstract:

Tuberculosis is common in Bangladesh. It rarely involves the liver and spleen and when it does so, it is usually associated with disseminated disease. This is case report of a patient with isolated tuberculosis of the liver and spleen. A 55 years old female presented with fever with chill and rigor and upper abdominal pain. USG revealed multiple hypoechoic lesions with central echogenicity in liver and spleen. CT scan showed multiple mixed density lesions in the liver and spleen. AFP, CEA and CA-19-9 were normal. As temperature was not subsided with antibiotics, pus from liver and spleen was aspirated and sent for gram and AFB stain, C/S, malignant cell and Gene Xpert. All but Gene Xpert reports were negative. A detailed workup failed to identify other focus of tuberculosis. CAT-1 Anti tubercular started and the fever subsided. The patient gained weight on the subsequent follow up. Tuberculosis should also be considered in the differential diagnosis for multiple nodules in the liver and spleen along with other diagnosis, though it is rare. Gene Xpert is a good diagnostic tool.

Biography:

Abstract:

Introduction & Objective: Despite the high prevalence of NAFLD non-invasive markers of disease activity and severity remain limited. Different modalities are available for predicting severity of NAFLD with different sensitivity and specificity. A single, cheap, widely available marker with high sensitivity and specificity is yet to be identified. The current study intends to find out the utility of serum complement C3 and FIB4 Index to predict stages of fibrosis of liver in NAFLD patients.

Method: This observational cross-sectional study was done at department of GHPD, BIRDEM General Hospital, Dhaka, during the period of January 2016 to October 2017. A total of 105 sonographically diagnosed NAFLD subjects attending at OPD and admitted in that Hospital were included in the study. Statistical analysis was done with SPSS version 16.

Result: Out of 105 subjects, 70 (66.7%) were female and 35 (33.3%) male. Serum complement C3 (mg/dl) 142.30±21.02 (mean±SD). USG of W/A or HBS showed 61 (58.10%) had grade I, 33 (31.43%) grade II, 11 (10.48%) grade III fatty liver disease. Fibroscan showed no fibrosis in 31 (29.52%), F1 stage of fibrosis in 22 (20.95%) and F2 in 22 (20.95%). FIB4 Index was 1.22±0.76 (mean±SD). Pearson correlation test showed stages of fibrosis by fibroscan had significant positive correlation with FIB4 index, weak positive correlation with BMI (kg/m2), weak negative correlation with serum complement C3 and almost no correlation with grading of fatty liver on USG (Spearman’s correlation).

Conclusion: The positive correlation of stages of fibrosis by fibroscan with FIB4 index was significant whereas negative correlation with serum complement C3 was not so significant statistically. Sensitivity and specificity of serum complement C3 and FIB 4 index as fibrosis marker was not so significant. Serum complement C3 and FIB4 index may not be used as a marker of severity of fibrosis.

Biography:

Romualdas Maskelis is currently working in National Cancer Institute.

Abstract:

Today, there is a growing tendency for second or even Primary Early Gastric Cancer (PEGC) after Endoscopic Submucosal Disorder (ESD) or Mucosal Resection (EMR). The PEGC is earlier, until there is no visible or unnoticed violation in the clinical period, but as it really was, there is no possibility or at least it would be difficult to retrospectively evaluate it. It is clear that today's endoscopic diagnostic of PEGC has improved significantly, and today we can already see cancer when it is in the mucous membrane or in the submucosal layer, only long term and indefinitely endoscopic observation is required. Several retrospective studies have shown excellent long-term results in patients with PEGC, who had endoscopic intervention on stomach cancer. It is reported in the literature that the incidence of PEGC after ESD/EMR is higher than in patients undergoing gastrectomy. Longer life expectancy and PEGC-it is the risk factors independent of one another. Most of the lesions were found at an early half-yearly or annual follow-up and were successfully treated endoscopically, with excellent long-term results. The H. pylori eradication particularly reduces the risk of PEGC. Prolonged life expectancy and polymorphic (metachromic) PEGC are independent of each other, and most of the lesions were found at an early half-yearly or annual follow-up and were successfully treated endoscopically with excellent long-term results, and eradication of H. pylori particularly reduces the risk of PASV. Today, we have an agreement based on previous observations-if stomach cancer becomes occurred within one year after ESD is considered to be missed syndrome of stomach cancer. Four patients with PEGC who were treated endoscopically in Lithuanian NCI since 2016- for two was perform ESD and two were undergo to surgery. Unequivocally, endoscopic operations are now well advanced and doctors performing ESD/EMR are certified (expert status) and institutions are ranked by the number of such interventions per year. In the West, where both morbidity and mortality are higher than in Japan, where early mucosal cancer with high dysplasia is recognized as a cancer. Now any from us thinking about implementing a gastric cancer screening program, as was made in S. Korea where more 40 % patients were treated endoscopically. Today, we already have a risk assessment strategy for PASVs, but are needed for endoscopic monitoring regimes and in the near future the national gastric cancer screening program.