Biography:

Kamal Kumar Chaudhary has completed his Orientation Course conducted from the Department of Drug Administration for entrepreneurs of Modern Drug sale and distribution in Nepal at the age of 25. He is the chief executive officer of Princess Pharma Pvt. Ltd, a drug sale and distribution company. He has researched in fields such as the approach of alternative treatment of patients, introduce and implement new technological treatment methods. He is keen on importing new technological measures to treat the patients and involves himself in different seminars aaaand conferences to stay updated on present medical technological advancement.

Abstract:

The chronic metabolic disorder diabetes mellitus is a fast growing global problem with huge social,health and economic consequences. It is estimated that in 2010 there were globally 285 million people (approximately 6.4% of the adult population) suffering from this disease. This number is estimated to increase to 430 million in the absence of better control or cure. An ageing population and obesity are two main reasons for the increase. Furthermore it has been shown that almost 50% of the putative diabetes are not diagnosed until 10 years after onset of the disease, hence the real prevalence of global diabetes must be astronomically high. Diabetes is an important cause of prolonged ill health and premature mortality, and claims more lives per year than HIV AIDS with nearly 1 death every 10 seconds.

This chapter introduces the types of diabetes and diabetic complications such as impairment of immune system periodontal disease, retinopathy nephropathy, somatic and autonomic neuropathy, cardiovascular diseases and diabetic foot. Also included are the current management and treatments, and emerging therapies.  

Biography:

Mohamed Eddouks is Professor at Moulay Ismail University, Faculty of Sciences and Techniques Errachidia, Morocco. He is a researcher in Physiology and Pharmacology with a Master Degree in Metabolic and Molecular Endocrinology from University of Paris vi, a specialized certificate in Endocrine Pharmacology from University of Paris vii and PhD degrees in Physiology and Pharmacology from University of Liege, Belgium and Sidi Mohammed Ben Abdellah University, Fez, Morocco. After his post-doctoral fellowship at Department of Physiology, Faculty of Medicine of Montreal, Canada, he is working for the last 16 years on medicinal plants. His work on antidiabetic and antihypertensive plants is well recognized globally. His research focuses on ethnobiological as well as pharmacological issues in the use of Moroccan medicinal plants for the treatment of diabetes mellitus, obesity and hypertension.  His contribution to this field includes four international books and more than 80 peer-reviewed articles and book chapters of international repute. He is Guest Editor of American Journal of Pharmacology and Toxicology, Lead Guest Editor of an annual special issue published by Evidence-Based and Complementary Alternative Medicine, Regional Editor of the Following journals: American Journal of Food Technology, Journal of Applied Sciences, Trends in Applied Sciences Research and Singapore Journal of Scientific research, Member of Editorial Board of several international journals. He has been honored with the first Prize of Scientific Research in 2008 by the Moroccan Association of Research and Development and the first Prize of the Federation of Arab Scientific Councils in 2016. He has been the Dean of Polydisciplinary Faculty of Errachidia from 2008 to 2012.

Abstract:

The purpose of this study was to investigate the effect of a single dose and daily oral administration for seven days of the aerial part aqueous extract (A.P.A.E) of Tamarix articulata Vahl. (T. articulata) at a dose of 5 mg/kg body weight on blood glucose levels in both normal and streptozotocin-induced diabetic rats (STZ). Single oral administration of T. articulata A.P.A.E reduced blood glucose levels 6 h after administration in normal rats and STZ diabetic rats (p<0.0001). Furthermore, blood glucose levels were decreased in both normal and STZ diabetic rats after seven days of treatment (p<0.0001). Moreover, no significant changes in body weight in normal and STZ rats were shown. According to the oral glucose tolerance test, the aqueous extract of T. articulata (20 mg/kg) was shown to improve significantly the increase on blood glucose levels in normal treated rats (p<0.001) 90 min after glucose administration as compared to the control groups. Finally, histopathological analysis revealed the beneficial effect of T. articulata on pancreas and liver. In conclusion, this study demonstrates antihyperglycemic and hypoglycemic affects of T. articulata in severe diabetic state thus warrants further investigation on its major compounds with in depth mechanistic studies

Biography:

Heidi Dowse is currently employed by The Salvation Army Aged Care Plus, Australia, as the Clinic, Quality and Compliance Manager.  Heidi has worked in Aged Care for almost 30 years, holding a variety of positions, including Dementia Specialist and Learning and Development Manager. She currently has a Master’s Degree in Nursing where she has researched culture change in aged care.Heidi is passionate about education and believes the key to change lies in moving the heart of staff before being able to move their thoughts to change.  She is able to do this by sharing the stories of the people she has had the honour to care for, in particular at the end of their life. Heidi believes in always looking for the shiny in life.  So often we spend our lives looking for mud.  If that is all you look for, you will miss the shining moments in life.

Abstract:

This presentation explores the premise of assisted suicide and the impacts on symptom management with a consumer directed palliative approach. There is significant debate around assisted suicide and the premise of good palliative care. Legislation in many countries indicates assisted suicide is only available for ‘insufferable pain’, when this is considered from a symptom management perspective; no one should experience insufferable pain through the implementation of appropriate interventions to meet a person's pain experience. The debate from a social, spiritual and ethical position is diverse and complex, however, regardless of one's position in the debate, there is no substitute for best practice palliative care. Clinicians need to have an awareness and understanding of the issues, as well as keys to manage personal bias on this matter in order to ensure effective symptom management is achieved for the consumer.

Evaluation

As a not for profit Christian organisation, there are significant moral and ethical considerations associated with Assisted Suicide, however from a consumer directed focus, there is a requirement to ensure that individual needs are met and this means viewpoints which are plastic. The Salvation Army Aged Care Plus operates in an environment of dichotomies and to meet individual needs, there first needs to be an understanding of the issues; we have achieved this through education. Our education resources include –

•           Assisted Suicide

•           The Sanctity of Life

•           Spirituality

•           Palliative Care Interventions to ensure appropriate Symptom Management

Implications for practice

The resource was prompted by a realisation that all people experience the end of life differently and have specific views on euthanasia and assisted suicide. It is imperative our staff have a good understanding of the issues and ensure that best practice palliative care is not taken into consideration as a sil approach. There is always a need for appropriate symptom management regardless of the circumstance. Our aim is to ensure symptom management is not confused as something it is not by either clouding this by religious ideals or social ideations based on decisions which are made in regards to one’s own life choices.

Biography:

Megan Vierhout is a fourth year Honors Life Science undergraduate student at McMaster University and a research student at Toronto Western Hospital, working under Dr. Mark Bernstein. She has been a volunteer in various palliative care settings, including Hamilton Health Sciences St. Peter's Hospital and St. Peter's Residence at Chedoke, since 2013. She is currently interested in qualitative research, and her past research focuses have included palliative care for brain cancer patients and the immunological gut-brain axis.

Abstract:

Palliative care is a specialty aimed at providing optimal care to patients with life-threatening conditions and has been shown to improve length of survival and quality of life, especially when introduced early. It can be administered in a hospital, a hospice (i.e. palliative care unit), or in a home-based setting. In this study the perceptions and attitudes regarding palliative care of patients with brain cancer were explored using qualitative research methodology. Convenience sampling was used to accrue patients at the Brain Tumor Clinic at Princess Margaret Cancer Center, University Health Network and 35 semi-structured interviews were conducted over a four-month period. Interviews were audiotaped and transcribed, and the data were subjected to thematic analysis. Seven overarching themes emerged from the data: 1) Patients prefer to be educated about palliative care as an option early in their illness, even if they are fearful of it; 2) there is a pre-conceived idea that palliative care is directly linked to active dying, and this generates fear in some patients; 3) patients are open to palliative care if they believe it will not diminish optimism; 4) patients would prefer to receive palliative care in the home; 5) increased time with caregivers and family are the main appeals of home care; 6) patients believe palliative care can contribute to their emotional well-being; 7) patients express dissatisfaction with brief and superficial interactions with health care providers. Overall, when educated on the true meaning of palliative care, most patients express interest in accessing palliative care services.

Biography:

Jaydeep Sengupta is pursuing his PhD at Indian Institute of Technology Kharagpur, West Bengal, India. He is formally trained in Anthropology and Development Studies. His area of interest is in issues related to palliative & EoLC, Death & Dying and Public Health.

Abstract:

ICU deaths are common in India. Many of the patients, admitted in ICUs, are medically futile. This compels attention to palliative and end-of-life (EoLC) care within ICUs. Since early 2005, till 2015, the Indian Society of Critical Care Medicine and the Indian Association of Palliative Care published total 6 Policy Papers and Guidelines, focusing on palliative and EoLC within ICUs. However, these documents, written solely from a medical perspective, failed to elicit wider public responses. This paper therefore takes non-medical stand for critically exam these 6 documents to find: discrepancies between the medical rhetoric and the contextual realities; and the extent to which the policies are able to clarify various clinical and ethical issues of palliative and EoLC within ICUs. The review comments are substantiated with field information, collected from a 550 bedded private hospital during 2015. It was found that although barrier-free doctor-patient communication, upholding patient’s autonomy, shared decision-making and compassionate Caregiving were strongly recommended by these guidelines, they were grossly missing in clinical practice. By and large, the physicians avoided taking the risk of shifting ICU patients from rescue to palliative care mode primarily due to inadequate infrastructure, poor human skill, medico-legal hassles and public rage associated with such shift of care. The policy documents failed to guide physicians in tackling these deficiencies. In addition, their over-simplistic model of palliative and EoLC in ICUs did not take into account several clinical and ethical complexities. The paper concludes by highlighting the need to contextualize the policies in Indian situations.

Biography:

Ehab Mudher Mikhael was born in Baghdad, Iraq, in 1984. He received the BSc. degree in pharmacy from Baghdad University, Baghdad, Iraq, in 2006, and the MSc. degree in clinical pharmacy from Baghdad University also in 2013.

In 2008, he joined the Department of Clinical Pharmacy, College of Pharmacy, Baghdad University, as instructor, and in 2013 became an assistant lecturer. He has more than 27 pharmaceutical and medical researches. His current research interests include pharmacotherapy of autoimmune diseases, pharmacotherapy of diabetes mellitus, and ethical issues in pharmacy practice diabetes mellitus.

He is and editorial board member in 3 pharmaceutical journals

Abstract:

Diabetes mellitus (DM) is a common metabolic disorder that associated with many complications. These complications can be prevented or delayed by ensuring good glycemic control. This control can be achieved only if appropriate pharmacological treatment is prescribed to a patient who is totally adherent to such treatment.To assess patient diabetic knowledge and the effect of such knowledge on medication ‎adherence and glycemic control among patients with type 2 DMA cross-sectional, multicenter study, for a convenient sample of 53 adult patients with type 2 DM ‎ was done during November 2015. A direct interview with each patient was done to assess their medication adherence and diabetic knowledge using already developed questionnaires. HbA1c for each patient was also obtained from the laboratory sheet at the day of the interviewIn this study a significantly higher percent (77%, 62%, 51%) of ‎patients had poor diabetes knowledge, medication adherence and glycemic control ‎respectively. ‎Diabetic patient knowledge is positively correlated with medication ‎adherence and with better glycemic control; furthermore diabetic patient knowledge is positively influenced by patient ‎educational level.‎

Biography:

Dr Syeda Sadia Fatima is a Senior Instructor at the Aga Khan University Hospital. She holds a MBBS degree and is currently pursuing her PhD in Molecular Physiology. Her research focuses on genetic and adipocytokine factors, unique to Pakistani population in respect to metabolic syndrome. She has offered courses, workshops and public awareness sessions on these non-communicable diseases and has more than 30 publications in reputed journals and has also contributed a book chapter in this thematic area. In addition she has been serving as an editorial board member and reviewer of repute.

Abstract:

Chemerin is a multi-functional peptide involved in lipid and glucose metabolism. Elevated levels of this peptide have been associated with insulin resistance and systemic inflammation. We aimed to explore whether chemerin can discriminate subjects at risk of developing diabetes in non-pregnant population (n=286) as well as in pregnant females (n=483). All study participants were classified according to the American diabetic association criteria as normo-glycemic controls or diabetic cases. ELISA assays were performed for chemerin, leptin, interleukin-18, tumor necrosis factor and insulin, while body mass index and insulin resistance were calculated. Ultrasound scans were conducted on pregnant females to record the fetal growth parameters.Levels of chemerin, interluekin-18 and leptin were seven, four and five folds higher in newly diagnosed diabetic non-pregnant cases as well as those who developed gestational diabetes (p<0.01). Chemerin showed strong positive correlation with fasting blood glucose, insulin resistance, fetal weight, and TNF (p<0.01) even after adjusting for age and BMI. Based on these findings we propose that the cut off of 13.7 ng/ml of Chemerin can discriminate 73% of subjects with impaired glucose level with 91% sensitivity and 96% specificity respectively. Furthermore a cut off of 15.49 ng/ml can identify 96% GDM cases with 96% sensitivity and 72% specificity. Chemerin along with other inflammatory biomarkers suggest an ongoing inflammatory process in high risk individuals suggesting a role in development of insulin resistance and subsequent diabetes in the long run. Therefore, it can be used as a potential screening biomarker to identify individuals at risk of developing diabetes.

Biography:

Leyla Fallahi is a PhD student in health psychology at Islamic Azad University. She is a psychologist in the cancer section in Shohadaye Tajrish hospital. She has held more than    40 workshops about psycho-oncology, and palliative care. She is a board member of the clinical psychology community in Tehran. Also she is a member of specialized psycho-oncology committee in Iran. She has written and translated a number of books in the field of psycho-oncology and health psychology. She has actively been engaged in teaching, and researching of spirituality.

Abstract:

Spiritual beliefs and faith are important in the lives of many terminally cancer patients, spiritual beliefs and faith can help patients cope with the emotional experiences of end of life and face death and also influence life expectancy in terminally cancer patients. The spiritual and faith dimensions fuse the essential estimations of terminally cancer patients, their considerations on what gives life meaning and religious or non-religious perspective. It additionally incorporates convictions about what happens after death. The purpose of this literature review was to describe the role of spirituality and faith in life expectancy and end of life experience in terminally Cancer patients. The reviewers searched electronic databases, and performed a manual search for studies published. The inclusion criteria covered spirituality and faith for terminally cancer patients in relation to life expectancy and end of life experience. The studies were, originally, randomized controlled trials or quasi-experimental designs. Studies were selected using the inclusion criteria. The results indicate that spirituality and faith produce positive effects on patients’ end of life experience and psychological conditions and an increase their life expectancy. Spirituality and faith improve the adjustment and coping strategies with cancer. Further research into the cost effectiveness of spirituality, faith and its long-term effectiveness for cancer suffering is needed.