Day :
- Adavance Telemedicine
Session Introduction
Hoda Dahroug
Egypt ICT Trust Fund, Egypt
Title: A Case Study of Using Telemedicine Solution to Bridge the Health Gap in Remote Areas in Egypt
Biography:
Hoda Dahroug holds the position of Regional Projects Director at Egypt ICT Trust Fund; a division jointly established between the Ministry of Communications and Information Technology (MCIT) in Egypt and the UNDP, she acts as the Head of the Community Development Division at MCIT, and a member of specialized boards for the development of border areas. She has a vast experience in major project management and implementation, as well as in ICT4D programs, especially when working in collaboration with local and international companies or institutions. Moreover, stemming from her solid belief in public private partnerships, she secured foreign investment, created distinguished partnerships, and enlarged the support of the public sector in areas such as education, health, women empowerment, youth employment, entrepreneurship, people with disabilities. She participated as a speaker in various regional and international conferences, covering various topics mostly notably South – South Cooperation.
Abstract:
While many forward strides had been made over recent years in the Egyptian health ecosystem, in terms of overall mortality rates, vaccination and immunization efforts, and expansion and improvement of medical infrastructure, some challenges remained unresolved. One major challenge is unequal distribution of resources between cities and rural governorates as the specialized medical services are located in the country’s major cities. To receive medical services a patient usually must travel to either the capital of the governorate he/she is in, or travel to the capital city of the country, incurring high costs of transportation, and rendering it quite a difficult journey for severely ill patients. Women are more severely affected than men because traditional customs prevent them from travelling unaccompanied. The purpose of this paper is to describe the process of successful implementation of each telemedicine session, and highlights the possible policy implications for future expansion of a workable model. Methodology & Theoretical Orientation: As the project aimed at improving medical services to rural population in general, the following methods were used to field needs assessment studies, surveys, and focus groups discussions. Findings: offering remote telemedicine diagnostic services would be a major asset to such communities. Furthermore, women benefitted from the project due to the fact that women in these areas usually face cultural and traditional barriers preventing them from travelling freely if unaccompanied by a male guardian, rendering it very difficult for them to receive medical services from distant cities Conclusion & Significance: the future vision of the project shall expand the model into all of Egypt’s marginalized regions, through the creation of strategic partnerships with major health consultation institutions.
- Telehealth and Medicine Today
Session Introduction
Shobhit Swarup
Khoo Teck Puat Hospital, Singapore
Title: Telemedicine- Current practice and further scope
Biography:
Dr Shobhit Swarup is Emergency Medicine consultant at Khoo Teck Puat Hospital, Singapore. He has studied Medicine in India and done speciality training in Emergency Medicine in Singapore. He is attached with National University of Singapore as Senior Lecturer and faculty of Emergency Ultrasound under Alexandra Academy for clinical and emergency sonography. He is currently the lead for Emergency Medicine Observation unit and has widened scope with multidiscipline involvement. His area of interest includes identification and prevention of diagnostic dilemma in Emergency Medicine. He is actively involved in improvement of health care in with use of telemedicine in emergency department and providing acute and home care at community.
Abstract:
Telemedicine gained popularity and is going through constant innovation in providing medical care in Medical emergencies and chronic conditions. It has emerged as important modality in time sensitive conditions including Stroke and Heart attack, were it can help emergency physicians to directly interact and discuss with specialist and proceed with early intervention. In major trauma, the timely and systematic guided approach online by emergency physicians within early golden hours has been found to have significant impact in saving life threatening emergencies. Studies have shown improved outcome on cardiac emergencies, arrhythmias, sepsis management via online consultation. In oncology patients as well, telemedicine is an important bridge in providing optimal palliative care with pain control in terminal illnesses.
With the aging population, frail elderly patient which can be managed best at home, reducing readmissions and healthcare burden integrated community based multidisciplinary approach under supervision of Geriatrician can be achieved. In big and developing countries with large rural population and geographical area there are limited health resources and doctors. With easy availability of internet and mobile phone, various satellite clinics have been established in rural setup linking specialist service to primary care. There is still wider scope both in Emergency and Community care. The concept of “hospital at home” with doctor-online and nurse-onsite is the need of time. This is not only cost efficient but also keep patient at home preventing hospital acquired disease and de-conditioning. Minor injuries, stable acute medical conditions and chronic diseases can be managed at community-level, with expertise of trained nurses and online consultation with doctors. This includes examination using various digital equipment, investigations and treatment with e-prescription based on doctor recommendation. There is huge potential for further improvement in telemedicine aiming towards saving time, resources and life.
Nisha Nangrani
James Cook University, Australia
Title: Outcomes of Telehealth in the Management of Type 2 Diabetes: a systematic review and meta-analysis of randomized controlled trials.
Biography:
Nisha Nangrani is a final year medical student at James Cook University in Townsville, QLD, Australia. As part of her Bachelor of Medicine/Bachelor of Surgery (MBBS) Honours Research project, she has joined the team at Translational Research in Endocrinology and Diabetes (TREAD) at James Cook University. TREAD has recently commenced the Telehealth for Diabetes Project which aims at making healthcare more accessible to patients suffering from diabetes in rural and remote North Queensland. She is guided and supervised by Dr Usman Malabu, Consultant Endocrinologist at the Townsville Hospital and Dr Venkat Vangaveti, Senior Research Officer at James Cook University.
Abstract:
The outcomes of telehealth in the management of Type 2 diabetes (T2DM) have not been evaluated since the publication of recent clinical trials. The objective of this study is to conduct a systematic review and meta-analysis of recently published randomized controlled trials (RCTs) to assess the biochemical, clinical and psychosocial outcomes of telehealth in subjects with T2DM. Electronic databases, MEDLINE, CINAHL, INFORMIT, SCOPUS and the Cochrane Central Register of Controlled Trials and reference lists of existing systematic reviews were searched until August 2017 to identify relevant studies. Study search and selection were performed by two independent reviewers. 4791 articles were retrieved of which 11 RCTs (n=3772) were included. A meta-analysis with random effects model was applied to estimate the pooled results.
Muhammad Tariq Pervaz
Virtual University 54 Lawrence, Pakistan
Title: Hepatitis B Virus Genotype D Sub Genotype D1 Circulating in Pakistan, China and India: An In-Silico Analysis.
Biography:
M.T.Perverz’s work focuses on analysis and developing computational methods for high throughput sequencing data. He is a highly skilled professional in analyzing high-throughput sequence data including WGS/WES, RNA-seq and the integration of data. His technical expertise includes but not limited to: a) methods/ algorithms and software tools/ pipeline development for complex biological data analysis, b) custom database design and development, and c) web applications development for data exploration and visualization.
Abstract:
HBV genotype D sub genotype D1 predominates in Pakistan and India. It is more than 80% among all genotypes of HBV in these two regions. However, it is less dominant in China where genotype B and C predominates. In this study, we present a computational analysis of HBV genotype D sub genotype D1 in Pakistan, India and China. For this purpose, 25 complete genome sequences of HBV genotype D sub genotype D1 were collected. Four complete genome sequences were obtained from Pakistan 8 from China and 13 from India. Sequence alignment showed less than 4% divergence in reported sequences from Pakistan, India and China. C and X genes showed divergence of less than 3%. While comparison over the S gene showed similarity ratio of 97–98% of genotype D sub genotype D1. Phylogenetic analysis highlighted that Pakistan HBV complete genome isolate have the closest evolutionary relationship with the HBV complete genome isolate prevailing in its neighbor countries China and India. Gene structure analysis showed that exons of ‘P’ gene was the longest; about 75% of the gene size while gene ‘S’ had 2nd longest coding regions with two exons and one intron with size ratio of 40% and 60% respectively.
- Medical Informatics Research and Services
Session Introduction
Kiyomi Sakata
Iwate Med University, Japan
Title: Prevalence of obesity in survivors living in temporary housing in the tsunami-stricken area during the recovery phase following the Great East Japan Earthquake and Tsunami
Biography:
Kiyomi Sakata has his expertise in epidemiology of chronic disease such as CVD, cancer, and osteoporosis and passion in preventing infectious disease such as influenza. He had studied epidemiology at the Epidemiology Research Center, School of Public Health, The University of Texas Houston Health Science Center. Awarded the degree of Master of Public Health in epidemiology for a thesis entitled “Changes in cardiovascular disease risk factors in three Japanese National Surveys 1971-1990.”Work supervised by Professor Labarthe. Now he is a professor at the Department of Hygiene and Preventive Medicine, Iwate Medical University School of Medicine in Japan.
Abstract:
A total of 10,198 participants aged 18 years or older who provided written informed consent in 2011 comprised the original cohort. In this study, we analyzed the data of 6,157 participants (Yamada Town 1,935 participants, Otsuchi Town 1,186 participants, Rikuzentakata City 2,894 participants, Kamaishi City 142 participants) who received the health check-up in 2016. We classified living conditions into three groups, which are same housing as before the earthquake group, temporary housing group, and others group. Anthropometrical examinations (body weight (kg) and height (cm)) were performed (body weight: AD-6400, A&D Co., Ltd, Tokyo, Japan; BWB-200, TANITA Corporation, Tokyo, Japan; height: AD-6121A, A&D Co. Ltd, Tokyo, Japan; YG200D, YAGAMI INC, Nagoya, Japan). Body weight was measured with an accuracy of +/- 0.1 kg using a standard scale while dressed in very light closing without shoes. Body mass index (BMI; kg/m2) was calculated as body weight (kg) divided by height (m)2. Obesity was defined as 25kg/m2 or over.
- Recent Development in Digital Health Care Services
Session Introduction
Jacob Bore
Ampath Oncology& Hematology,Eldoret Kenya
Title: The delivery of oncology health services to resource limited LMIC through Telemedicine.
Biography:
Jacob Bore is a passionate Electronics Technologist, ambitious in giving the best of my professional ability, skills, and techniques to enhance my knowledge and growth in information technology, telecommunication and healthcare industry. Jacob is well-versed in medical records systems, point-of-care (POC) applications, mobile health technology, radio frequency, satellite and mobile communication, biometric security control, packet data telecommunication, computer hardware and software repair and maintenance, electrical and electronic snstallations, web development, and Microsoft Dynamics Navision (Installation, Configuration, Financials, Development and ability to offer systems support) and Mobile Programming
Abstract:
We have been using telemedicine to increase access to specialized cancer care to remote areas with poor accessibility and lacking basic health care facility to deal with cancer care. This has been achieved through partnership with eight county governments in Kenya in terms of reducing patient travel costs through teleconsultation and virtual tumor board which have enabled health care providers in these remote areas to consult with specialist in the regional referral hospitals and health care professional training, extended specialty to all clinics and improved patient referral system with prompt treatment.
Through our telemedicine center, we have been able to hold over twenty tumor boards where we interconnect with other five major hospitals to discuss patient cases. We have also established three remote telemedicine clinics where cancer patients and care providers can consult with oncologist virtually. There many challenges that are inhibiting our advancement of access to cancer care through telemedicine and it’s not limited only to cost of funding it but also includes lack of funding to establish a reliable ICT infrastructure, lack of adequate qualified health care personnel i.e. Oncology clinical officers, nurses, pharmacists, lab technologist in remote clinics.
Anatoly Petrenko
Igor Sikorsky Kyiv Polytechnic Institute, Ukraine
Title: Personal healthcare platform for chronic diseases with mobile self-management support.
Biography:
Prof. A.I. Petrenko has gotten a Diploma of Engineering from Kiev Polytechnic Institute (1957), a Diploma of Imperial College from Imperial College of London University(1960), a Candidate of Science- Degree (Ph.D) from Moscow Power Institute (1963), Doctor of Science Degree from Moscow Power Institute (1969). He was invited as a Visiting Professor to 14-th universities including California University (Berkeley),USA, 1976; Michigan State University, USA, 1991; New Jersey Institute of Technology, USA, 1995; Hong Kong University,1997; Pohang University of Science and Technology, Korea, 2000; Illnenay technical University, Germany,2005, etc. The scope of Prof. Petrenko A. scientific activities are cloud and grid technologies, SOA and SOC, mobile medicine, web-based Design, large-scale systems, numerical algorithms, etc. His leadership in Computer Science is through publications and educational activities (25 books, 424 scientific articles, 40 patents). His one book "Algorithmic Analysis of Electronic Circuits" was translated and published in USA by Western Periodicals, San-Francisco, 1975, 618 p. and another book “ALLTED-a Computer-Aided Engineering System for Electronic Circuit Design” was published in Australia by UICEE(UNESCO), Melbourne,1997,204 p.
Abstract:
Cloud SaaS for supporting individual healthcare for asthma patients by providing the interaction of the doctor and the patient in the treatment process. It will be built as microservice system which includes:
- microservices for physical data traction (breath monitoring, heart rate);
- microservice for air pollution monitoring;
- microservice for warning user before critical state coming;
- microservice for encrypting and storing data in publicly accessible blockchain;
- containers for integration executing microservices and integration them with local PHR services.
The SaaS will consist of wearable device for air monitoring (air contents+dust sensors with Bluetooth connection module) connected to user’s smartphone which will upload collected data also from body wearable devices (wheezometer, peakflow meter, etc.) and transfer them to SaaS. Smartphone is also capable for tracking user’s breath and local detection of exacerbation of asthma and delivering recommendations based on data analysis. With advancements in technology, home telemonitoring has become an effective and reliable approach that is well accepted by patients and supports patient care at home. Mobile asthma management tools target those who suffer from asthma attacks, especially children; in order to help them avoid attack inducing allergen areas and help them better control and treat their asthma symptoms. They can help to reduce asthma attacks, which could prevent unnecessary hospital readmissions and decrease the number of hospital admissions due to preventable asthma complications. Depending on particular requirements the m-application can be scaled from the corporate (national) scale of patients care with asthma to the scale of supporting profile patients in a particular region. In addition there are possibilities to rearrange the system for supporting people with other diseases due to the system microservice architecture. Previous developments were monolithic applications, designed for a fixed HW infrastructure. The whole application has to be developed and deployed in one piece and the entire tier has to be retested and redeployed when something is changed.
We were the first who start to investigate advantages of service-oriented architecture in mobile medicine.
Manuela Cesaretti
Hospital Beaujon, France
Title: Liver-donor steatosis assessment from smartphone images acquired in the operatory room.
Biography:
Manuela Cesaretti is a surgeon works in the department of HPB Surgery and Liver Transplantation of Beaujon Hospital in Clichy (France) and in the department of Nanophysics of the Italian Institute of Technology in Genova (Italy). She has an expertise in liver transplantation and passion in improving methods for liver graft quality assessment.
Abstract:
Fast and accurate graft hepatic steatosis (HS) assessment is of primary importance for lowering liver dysfunction risks after transplantation. Despite diagnosis being recognized as challenging in the clinical literature, few efforts have been invested to develop computer-assisted solutions for HS assessment. The objective of this study is to investigate the automatic learning-based analysis of liver texture from RGB images acquired in the operating room (OR), with the goal of classifying liver grafts rejected due to high HS level. Forty RGB images of forty different donors were analyzed. Twenty images refer to accepted livers and twenty to livers that were discarded due to high HS value. The ground-truth HS diagnosis associated to each image was obtained with histopathological analysis. The images were captured with an RGB (12-megapixel) smartphone camera in the OR. Intensity-based features ( S tat 1), histogram of local binary pattern ( HLBP) and features extracted from blood tests ( B l o) were investigated. Semi-supervised multiple instance learning was exploited to perform image classification (Fig 2). With the best performing feature (HLBP + S tat 1 + B l o), the overall classification accuracy was 0.88. The achieved recall in classifying discarded grafts was 0.95. The results suggest that the proposed method is a promising strategy to develop a fully automatic solution to assist surgeons in HS assessment inside the OR.
Biography:
Monika Rogozinska, MPharm, PMP® is a Boston-based biopharmaceutical R&D executive. During her career, she has been developing and bringing new medicines and medical devices to market. Monika has gained interdisciplinary, global expertise in various therapeutic areas, leading R&D strategy and operation in smaller and larger biopharma. She is focused on the improvement of patients’ health and quality of their lives. She is Harvard Business School alumnus, a blogger, nature lover, and photographer. Currently, Monika provides consulting services to VC and hedge funds, assessing various pharmaceutical assets regarding development risks and scenarios, to ensure only deals of highest priority are being advanced and executed by her clients.
Abstract:
Pharmaceutical companies have been forever challenged with both rising development costs and the need to find novel ways to differentiate the candidate drugs. Recent advances in digital health (DH) technology, including wearables, in-home clinical devices, and sensors, have enabled a growing array of available data endpoints, making these devices an invaluable tool in clinical programs. The broad scope of DH includes categories such as mobile health (mHealth), health information technology (IT), wearable devices and sensors, telehealth, telemedicine, and personalized medicine. Wearable devices can measure many physiological parameters and functions, including sleep, heart rate, gait, velocity, step count, blood pressure, body temperature, oxygen saturation, electrocardiogram (ECG), glucose, or even drug adherence. They are used mostly in chronic illnesses such as congestive heart failure, hypertension, diabetes, and chronic obstructive pulmonary disease (Figure 1). As a consequence, to this progress, surging drug development costs, and the need for speed, quality, and efficiency in drug development, pharmaceutical companies prompted the search for innovative technology and solutions. Advances in digital health devices and data could allow drug developers to carry out more detailed and real-time analysis of data from clinical trials. Real-time data in clinical trials brought the potential to increase the speed at which drugs progress through clinical trials, as well as accelerating go/no-go decision-making. Although digital health remains new, there is significant optimism over how a digital revolution could transform drug development, also among the regulators who actively guide and support the industry. On the other side, the discussion about the reliability of digital devices in clinical trials continues. Standardization of measurement and validation of wearable devices need a lot of work. Most software used in wearable devices has not been validated per the FDA’s standards, and doing such will add to the cost and time for developing such devices for use in specific medical settings, such as clinical trials. Device-to-device variability could lead to challenges with data analysis. Independently, we can expect to see the adoption of these digital technologies to increase as pharmaceutical companies begin to see their significant benefits.
- Health Care Technologies
Session Introduction
MIkahilu Abdullahi
Mbchb student, Uganda
Title: HEALTHCARE SYSTEM IN DEVELOPING COUNTRIES, EDUCATION AND HEALTH, NOSOCOMEPHOBIA
Biography:
Abstract:
Health service in developing countries, according to WHO over 400million people lack one of seven essential health service ranging from pregnancy care and people mostly women and children, and such people are at a greater risk of developing other complications. [The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief economic or social condition. Which the WHO will focus on this year. But also education matters to health, there is a saying people with more education live longer, healthier lives than those with less or no education, I have lived almost half my life in western Africa and for almost three years in east Africa and I must say education has it say in health, organizations always focuses on providing the necessary health equipment but a big percentage of people don’t go to the healthcare centers because of lack of proper knowledge that why a great number of people in the villages prefer to deliver from their homes rather than going to a proper hospital, which show they don’t go for their regular antenatal checkup also
- Emerging Technology on Health System Informatics
Session Introduction
Mohammed Jamal al-Mansor
Iraq University College, Iraq
Title: Steganography and Cryptography of Medical Images for Content Authentication
Biography:
Mohammed Jamal has expertise in evaluation and passion in improving the health and wellbeing. Her open and contextual evaluation model based on responsive constructivists creates new pathways for improving healthcare. He has built this model after years of experience in research, evaluation, teaching and administration both in hospital and education institutions.
Abstract:
Medical images are often transmitted over insecure channel. Telemedicine enables medical diagnosis and Patient care using modern medical equipment’s. These equipment’s generate huge volume of data every day. Hence protection of medical image is very crucial. Many approaches like encryption, digital signature, watermarking etc. are spotted in the literature. Watermarking in medical images is commonly used for content authentication, effective data distribution and management, storage, security, safe archiving, controlled access retrieval and captioning. Medical image is usually comprised of region of interest (ROI) and non region of interest (NROI). ROI is the region that contains the important information from diagnosis point of view so it must be stored without any distortion. This paper develops an optimized embedding of payload in medical images by using genetic optimization. The goal is to preserve the region of interest from being distorted because of the watermark. By using this system there is no need to manually define the region of interest by experts as the system will apply the genetic optimization to select the parts of image that can carry the watermark guaranteeing less distortion . The experimental results assure that genetic based optimization is useful for performing steganography with less mean square error percentage.
- Pediatric Otolaryngology | Laryngology | Nasal Disorders | Head, Neck and Oral Oncology
Session Introduction
Lauren Styan
Ipswich Hospital, Australia
Title: Laryngeal myxedema resulting in acute upper airway obstruction: A case report and review of the literature
Time : 14:00-14:30
Biography:
Lauren Styan is an Ear Nose and Throat Principle House Officer currently working at Ipswich Hospital, Australia.
Abstract:
Introduction: The differential diagnosis of upper airway obstruction in adults is broad, including infection, foreign body aspiration, trauma, allergic reaction, malignancy and systemic disease. Upper airway obstruction secondary to laryngeal myxedema is a rare complication of severe hypothyroidism. There is limited literature to guide diagnosis and management, with only a small number of case reports available. We report the case of a patient with acute upper airway obstruction secondary to laryngeal myxedema, resulting in supraglottic oedema and bilateral vocal cord palsy. A review of the literature regarding the presentation, diagnosis and management of this rare, but life threatening condition is presented.
Case Presentation: A 54-year-old male presented to the emergency department with a 2 weeks history of progressive shortness of breath, productive cough and dysphonia. His past medical history was significant for hypertension, hypothyroidism and severe obstructive sleep apnea. He had self-ceased his antihypertensive and thyroxin two weeks prior. On initial evaluation the patient was in respiratory distress with significant stridor. Flexible nasendoscopy demonstrated diffuse edema of the supraglottis, with bilateral vocal cord palsy. His acute upper airway obstruction was managed with urgent fiber-optic intubation and subsequent tracheostomy. Laboratory studies revealed profound hypothyroidism and hyponatremia. The patient was admitted to the intensive care unit and commenced on thyroid replacement therapy and glucocorticoids. His bilateral vocal cord palsy and laryngeal edema resolved and he was successfully decannulated 4 weeks later.
Conclusion: Laryngeal myxedema is uncommon, but should be considered in patients presenting with upper airway obstruction and hypothyroidism. To our knowledge this is the only case reported in the literature in which laryngeal myxedema has resulted in bilateral vocal cord palsy. This case report and review of the literature suggests that, with appropriate airway management and treatment of underlying hypothyroidism, laryngeal myxedema is reversible and resolves over the course of two to four weeks.
Amarendra Singh
Mahatma Gandhi Mission Medical College, India
Title: Olfactory neuroblastoma: A case report
Time : 14:30-15:00
Biography:
Amarendra Singh has completed his Master’s degree in ENT from Mahatma Gandhi Mission Medical College, Mumbai, India. He has completed his Fellowship in the Skull Base Surgery from Grouppo Otologico Piacenza, Italy in 2016. He has worked for 30 months as the Senior Resident in the Department of ENT at Heritage Institute of Medical Science, Varanasi. He has set up his own ENT center, Kashi ENT Center, Varanasi.
Abstract:
Olfactory neuroblastoma is an uncommon malignant nasal tumor originating from the olfactory neurosurgical cells of nasal cavity. OAN represents less than 5% of all sinonasal malignancies. The incidence of this tumor has a nominal distribution with peak at 20 and 50 year of age, respectively. OAN is also as anesthesia neuroblastoma or neuroendocrine carcinoma. A 50 year old male presented with mass in nasal cavity with intermittent epistaxis, which was treated by combined surgical excision and RT.
Lucy Huang
Flinders Medical Center, Australia
Title: Upper airway surgery with tubeless anesthesia and apnoiec Oxygenation-A "game changer" in ENT surgery?
Time : 15:00-15:30
Biography:
Lucy Huang is a Surgical Resident Medical Officer at Flinders Medical Center with a particular interest in Otorhinolaryngology Head and Neck Surgery. She has completed her Internship at Lyell McEwin Hospital and is completing two years of Surgical Residency at Flinders Medical Centre. She is actively involved in clinical audits and multiple research projects with the Department of Otolaryngology Head and Neck Surgery.
Abstract:
Background: Trans nasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE) is an anesthetic technique that allows for prolonged apnoeic oxygenation without intubation. THRIVE is often conducted in patients with normal BMI and mild systemic disease. However, it is unclear if patients with an increased BMI or significant comorbidities are able to safely undergo upper airway ENT procedure with THRIVE.
Method: A case note review of all ENT upper airway surgery conducted at Flinders Medical Centre and Flinders Private Hospital with the use of THRIVE and optiflow was conducted. Factors extracted from the case notes were: age, BMI, ASA, smoking status, reflux disease, presence of respiratory and cardiac disease. Analysis utilized non-parametric tests and odds ratios.
Result: THRIVE was used with the following upper airway procedures (n=56): micro laryngoscopy with biopsy and/or injection laryngoplasty (n=20), micro laryngoscopy with KTP laser use (n=12), panendoscopy with biopsy (n=11), esophageal dilatation (n=2), subglottic stenosis dilatation (n=10) and stapling of pharyngeal pouch (n=1). Rescue ventilation was required in 21.4% of cases (n=12). THRIVE related complications were reported in 1.8% of cases (1/56). Weight and BMI were associated with rescue ventilation (Mann Whitney U Tests; weight p=0.022, BMI p=0.045). A weight >100 kg or BMI >30 were 5.7 times more likely to require rescue ventilation (Fisher Exact Test p=0.028 and p=0.021). Gender was also associated with rescue ventilation (Pearson Chi-Square r=-0.319, p=0.017), with 75% being male. No other factors reported an association with rescue ventilation.
Conclusion: This case series demonstrates that THRIVE can be safely used for a variety of ENT upper airway procedures. However, there is a higher likelihood of rescue ventilation if patient is >100 kg or has BMI >30. Continued investigation with a larger dataset is recommended.
Lauren Styan
Ipswich Hospital, Australia
Title: Coblation tonsillectomy: An alternative to bipolar tonsillectomy in children with sleep disordered breathing
Time : 16:00-16:30
Biography:
Lauren Styan is an Ear Nose and Throat Principle House Officer currently working at Ipswich Hospital, Australia.
Abstract:
Introduction & Aim: Tonsillectomy is one of the most commonly performed procedures in children, typically for the management of sleep disordered breathing and/or recurrent tonsillitis. Intracapsular coblation tonsillectomy is an emerging technique that has become popular due to its reported reductions in postoperative pain when compared to other methods. We aimed to investigate the outcomes of children undergoing intracapsular coblation tonsillectomy for management of sleep disordered breathing in our department.
Method: 44 pediatric patients undergoing intracapsular coblation tonsillectomy (with or without adenoidectomy) for the management of sleep disordered breathing were recruited. Post-operative pain levels, diet, analgesia requirement, return to normal activity and complication rates were collected. Validated self-reported T-14 pediatric throat disorders outcome tools were completed by parent’s pre and post-operatively to assess for resolution of sleep disordered breathing symptoms. The outcomes were compared to a cohort of pediatric patients undergoing bipolar tonsillectomy.
Result: Coblation tonsillectomy was associated with significantly less postoperative pain (P<0.0001), earlier return to normal diet (P=0.008) and activity (P=0.013) and reduced analgesia requirement (P=0.001). There was no statistically significant difference in the rates of post-tonsillectomy hemorrhage between the two groups (P=0.109). Sleep disordered breathing outcomes have been excellent, with significant improvements in parent reported symptoms at three week postoperative follow-up (mean total T-14 score (/70) 23.9 preoperative, 2.4 three weeks postoperative, P<0.0001). Only a portion of the cohort has reached 12-month follow-up, however at this early stage there have been no reported recurrence of symptoms and no requirement for revision tonsil surgery.
Conclusion: Children with sleep disordered breathing undergoing intracapsular coblation tonsillectomy have less postoperative pain and faster recovery, when compared to bipolar tonsillectomy. Effective reduction of sleep disordered breathing symptoms is also demonstrated. Further studies are required to determine the long-term outcomes and also investigate the utility of this method for the management of recurrent tonsillitis
Mikyung Ye
Catholic University of Daegu School of Medicine, Republic of Korea
Title: Taste and Smell Disturbances in Patients with Gastroesophageal Reflux Disease
Time : 16:30-17:00
Biography:
Mikyung Ye has completed her PhD at the age of 36years from Kyungpook National University and postdoctoral studies from University of Tennessee Health Science Center. She is the director of Public Relations of Korean Society of Otorhinolaryngology Head and Neck Sugery. She has published more than 100 papers in reputed journals and has been serving as an editorial board member of repute.
Abstract:
Gastroesophageal reflux disease (GERD) is related to lifestyles including eating habits. Patients with GERD often report decreased taste sensitivity when eating. Some patients remark that food does not smell or taste the same. We aimed to investigate the effect of GERD on smell and taste functions. Four hundred eighty seven patients with taste disturbance who visited smell and taste clinic from 2010 to 2016 were evaluated. A questionnaire, which included questions regarding demographic information, taste and smell symptoms, taste preferences, and gastrointestinal symptoms was conducted. Diagnosis of GERD was based on the Korean version of GER questionnaires and/or esophagogastroduodenoscopy (EGD), 24hours PH monitoring. Olfactory testing was performed using the Korean version of sniffin’ sticks test. Whole mouth taste test was performed with successive solutions of sucrose, sodium chloride, citric acid, and quinine hydrochloride. The electrical taste thresholds were measured using an electrogustometer for four different sites in the oral cavity. One hundred ninety patients were diagnosed with GERD. Taste threshold and gastrointestinal symptom severity were significantly correlated. However, olfactory function test score was not significantly correlated with gastrointestinal symptom severity and with EGD findings. The patients with GERD showed higher taste preferences to salty, sour, and spicy food than without GERD group. Abnormalities in taste function were correlated with gastrointestinal symptom severity. Awareness of this high prevalence of GERD among patients with taste disturbance may help to better manage the taste disorder.
- Exhibition
Chair
Emmanuel Lee
Illingworth Research Group, UK
Session Introduction
Tina Thorpe
Illingworth Research Group, UK
Title: Patient centricity in action-The use of mobile research nurses in clinical trials
Biography:
Abstract:
- Exhibitor
Session Introduction
Emmanuel Lee
Illingworth Research Group, UK
Title: Patient centricity in action-The use of mobile research nurses in clinical trials
Biography:
Abstract:
Tina Thorpe
Illingworth Research Group, UK