Day 1 :
- Heart Disease & Failure | Cardiac Nursing and Healthcare | Cardiovascular Toxicology and Pharmacology
King’s College, London
Having attained a PhD in biochemistry at the University of East Anglia, Andrew Cobb is currently a research associate at King’s College London. He is investigating the biochemical pathways underlying vascular calcification and working on elucidating the link between the osteogenic transcription factor Runx2 and DNA damage.
Cardiovascular disease is a leading cause of mortality in developed nations. As ageing has established itself as one of the biggest causative factors of heart disease, we were interested in understanding what age-associated molecular changes were underlying these diseases. Hardening of the vascular network by ectopic calcification commonly occurs as we get older and this can lead to eventual heart failure and death. Accumulation of DNA damage and increased genomic instability are the primary drivers of ageing so we wanted to assess the impact of this upon calcification of vascular smooth muscle cells (VSMCs). Our data has shown induction of calcification with high calcium and phosphate in vitro causes increased levels of DNA damage in cells. Interestingly, addition of H2O2 to Ca+P media accelerated VSMC calcification and this was highly dependent on the presence of the osteogenic transcription factor Runx2 as its depletion attenuated this increase. Further analysis of Runx2 showed it localised to sites of DNA damage and its levels were significantly increased following DNA damage induction. We were able to determine a novel role for Runx2 in the regulation of H2AX phosphorylation on Ser139 via mediation of phosphorylation of an adjacent Tyrosine residue that is instrumental in determining cell fate following genotoxic stress. A side-effect of elevated Runx2 levels following DNA damage induction was subsequent enhanced binding of Runx2 to promoter regions of its target genes that are implicated in osteogenic differentiation, thereby explaining how DNA damage accelerates calcification of VSMCs. Importantly, we observed that inhibition of DNA damage response signalling was able to attenuate these effects and slow calcification.
National AIDS Research Institute, India
Dr.Rahul Hajare is a post doctoral student of Renowned Scientist Respected Dr. R S. Paranjape Retired Director and Scientist ‘G’ National AIDS Research Institute India. He achieved his training at the National AIDS Research Institute, the reputed and primer HIV research institute in India. Dr. Hajare is board certified by Director-in-Charge, National AIDS Research Institute, the Secretory Board of Management KLE Society Belagavi and Registrar Vinayaka Mission’s Research Foundation. Dr Hajare won World Academic Championship-2017 in Pharmacy (Antiretroviral Therapy) and certified as Fellow, Directorate of Pharmacy, IASR (Lifetime Membership).
Statement of the Problem: A medicine is knowledge in process. Researchers have reported that non-teaching men staffs with these experiences are more difficult to treat; many do not access treatment and those who do, frequently do not stay because of difficulty maintaining helping relationships. However, these men’s perspective has not been previously studied, particularly. The purpose of this study is to describe the experience of seeking help for alcohol dependency by men with and a history of chain alcohol dependency with other men the context in which it occurs. Methodology & Theoretical Orientation: An inter subjective in-house study using hermeneutic dialogue was utilized during participant observation, in- depth and focus groups. Classically, as we define reactions to antigens, either environmental or foods, we have broken the immune reaction down and divided them based on specific activity. This definition allows us to describe the difference between. Type I IgE Medicated Hypersensitivity and Type II IgG mediated activity, and Type III driven by complement activation as well as Type IV Cell-Mediated Hypersensitivity. While these descriptions are not wrong, they are not the whole picture. While it is true IgE and IgG maintain distinct activity, it is also true that IgG, particularly type 1-3 will increase the activity of IgE. Patterns of immune response can be seen for other reasons as well. For example, someone who is in general, more up regulated in terms of IgE reactions, may be low in sIgA. A decrease in sIgA creates a deficiency in a first line of defense, the 85% of the immune system that lines the mucosa. Because of this low level of defense or sIgA, the immune system works to compensate. One ways the immune system will compensate is by up regulating IgE activity, relying on a higher level of response in that pathway to overcome short comings created by low sIgA. When we look at various immunoglobulin’s responses together, rather than in isolation, we will get a deeper understanding into what is truly happening with immune function.
Apollo Hospitals Dhaka, Bangladesh
Dr. Mahmood Hasan Khan has his expertise in evaluation and passion in improving the health and wellbeing. His open and contextual evaluation model based on responsive constructivists creates new pathways for improving healthcare. He has years of experience in research, evaluation, teaching and administration both in hospital and education institutions.
Coronary heart disease is the most common category of the heart disease. cTnI is 100% tissue-specific for the myocardium and a very sensitive and specific marker for acute myocardial infarction. Ventricular function provides information on systolic function as well as diagnosis and prognosis. The study aimed at investigating the impact of LVEF on elevated Troponin-I level in patients with first attack of NSTEMI. This cross-sectional analytical study was conducted in the department of cardiology in Mymensingh Medical College Hospital from December, 2015 to November, 2016. Total 130 first attack of NSTEMI patients were included considering inclusion and exclusion criteria. The sample population was divided into two groups: Group–I: Patients with first attack of NSTEMI with good LV function (LVEF: ≥55%). Group–II: Patients with first attack of NSTEMI with LV systolic dysfunction (LVEF: <55%). In this study mean Troponin-I of were 5.53±7.43 and 16.46±15.79 ng/ml respectively. It was also statistically significant (p<0.05). The mean LV ejection fraction value were 65.31±10.30% and 40.17±4.62% respectively. It was statistically significant (p < 0.05). The Echocardiography showed that patients with high Troponin-I level had low LVEF and patients with low Troponin-I level had preserved LVEF. Analysis showed that patients with highest level of Troponin-I had severe left ventricular systolic dysfunction (LVEF <35%) and the patients with the lowest levels of Troponin-I had preserved systolic function (LVEF ≥ 55%). In our study, it also showed that the levels of Troponin-I had negative correlation with LV ejection fraction levels with medium strength of association (r= -0.5394, p=0.001). Our study also discovered that Troponin-I level ≥6.6 ng/ml is a very sensitive and specific marker for LV systolic dysfunction.
Bhagwan Mahavir Medical Research Centre, India
Prashanth.Chiliveri has a good experience in molecular analysis, protein characterization and chromatographic analysis by emerging techniques and his area of research is in Human Toxicology, Heart Diseases, Raw and finished products and biosimilar characterization. He started his career at Central Institute for Cotton Research, Maharashtra, India and had gained good experience in characterization of proteins and development of Bio-pesticide. He also worked as a Scientist at Vimta Labs Ltd, Hyderabad on Biosimilar characterization. Currently he is a Research Associate at Bhagwan Mahavir Medical Research Centre, Hyderabad and carrying research in Human Toxicology and Heart Diseases. He published about 29 bacterial sequences in NCBI and 7 Research Articles in National and International Journals. He also involved in conducting many conferences and workshops at national level.
Cytokines are the important mediators of inflammatory and immune responses to RF and RHD. The study aimed to investigate the association of TGF Beta -1 (-509) and TNF-Alpha (-308) gene polymorphisms with susceptibility to RHD. The study was carried out on 56 RHD and 45 ethnically matched healthy subjects for comparison (controls). Demographic data was collected and 2D echocardiography was carried out for confirmation of the disease. Blood samples were drawn from each subject, genomic DNA was isolated from each and subjected to PCR-RFLP to identify the polymorphisms of cytokine genes. Our results showed that GG genotype of TNF-Alpha (-308) was significantly associated with increased risk of RHD (P < 0.05, OR 3.1, CI 1.17-8.4) and G allele was found to be highly significant (P < 0.001, OR 2.81, CI 1.57 to 4.97). AG genotype showed 1.8 folds risk (P>0.05, 1.8, CI 0.65-5.1) and AG+GG combination showed 1.3 fold risk for RHD (P> 0.05 OR 1.3 CI 0.6-2.8). However, none of the genotypes of TGF-β- 1 showed an increase in the RHD patients compared to control subjects thus indicating that TGF-Beta-1 gene was not associated with susceptibility for RHD. Our findings suggest that TNF-Alpha (-308) gene polymorphism plays an important role in predisposition to RHD in Telangana population. However, our results showed that the TGF Beta- 1 (-509) was not associated with increased risk for RHD in this population.
Debre Tabor university, Ethiopia
Working as a professor in department of biomedical sciences, Debre Tabor university, Ethiopia
Introduction: Prenatal development of Humans might not always end up by producing full term healthy neonate. There are times where infants could be born with different birth defects due to numerous factors. Congenital Heart Defects (CHD) among the commonest type birth defects causing mortality, morbidity and long term disabilities in children especially in middle and low-income countries.
Objectives: The purpose of this study is to assess the magnitude and associated factors of Congenital Heart Defects among under-five children with birth defect in Debre Tabor and Gondar university hospitals.
Methodology: Institutional based retrospective cross-sectional study design was employed. All under-five children with birth defects from September 12, 2015 up to September 08, 2017 were included in the study.
Result: A total of 503 children were found to have birth defect. Among theses CHD accounts 19.3%, where VSD is the predominant of all types of CHD, (38.8%). Among the socio demographic characteristics none of them were significantly associated with the occurrence of CHD. But, maternal alcohol intake during pregnancy and gestational age were found to be associated significantly with AOR 0.48(95% CI, 0.29, 0.79) and AOR 0.448 (95% CI, 0.20, 0.98), respectively. While folic acid supplementation, and ANC follow up remains not significant.
Conclusion: prevalence of congenital heart defects is higher in North and south Gonder. According to this study maternal alcohol intake and pre term delivery were identified risk factors for CHD.
Recommendation: Based on the result of this study, we strongly recommend to strengthen the activities of ANC follow up insuring maternal risk factors for CHD
Cyberjaya University College of Medical Science, Malaysia
Dr. Syeda Humayra,a remarkably young and talented personality who believes in the advancement of scientific/medical knowledge for the welfare of mankind and society. This true Bengal beauty served as an Honorary Doctor at Ashiyan Medical College Hospital, Dhaka. Born leader, grew up in United Arab Emirates, pursued her higher education in Ukraine and currently doing her Post-Graduation on ‘Cardiovascular Sciences’ at Cyberjaya University College of Medical Science Malaysia; has got tremendous exposure and expertise of being in a multilingual and multi-cultural diversity. This defines her unique bonding with people and having active role in several humanitarian organisations to support children education, women empowerment and other fund raising charity events. As a researcher her primary area of interest revolves around cardiac investigations, latest discoveries involving cardiomyopathies, heart failure, cardiovascular diseases, etc. Her motto in life is: “Gaining Knowledge is the first step towards Wisdom and sharing it with others is the key to Humanity”
Takotsubo syndrome- The acquired cardiomyopathy that has recently gained popularity as ‘broken heart syndrome’ can be described as an acute left ventricular dysfunction presented mostly in postmenopausal women followed by intense stressful event, but its exact pathophysiology remains unclear. The term first came into existence in early 1990’s in Japan as reported by Hikaru Sato et. al. Initially originated from Japanese ‘octopus trap’ because of its distinctive resemblance in shape with the left ventricle in systole. TTC being an unconventionally rare, under recognized syndrome has emerged out as a momentous form of acute cardiac failure over the last decade. Several researches have been revolving around it to quantify its extensive damage on the heart. Clinical diagnosis of takotsubo is largely misguiding due to its inevitable similarity with ACS, but in the absence of evident coronary obstruction in angiographic presentation. Although, there is substantial elevation of cardiac biomarkers like troponin and natriuretric peptide (pro-BNP and NT- pro-BNP) which are major diagnostic keys in differentiating TS from MI.
Methodology: The aim of this retrospective observational study is to investigate and establish the epidemiological events of takotsubo during mass population stress (taking into account the tragic cases of Malaysia Airlines Flight 370 and MH17; and the recent fall of UMNO in 2018 election period ); to contribute sufficient statistical data on the International Takotsubo Registry to fill in the gaps lacking geographic variation and demographic profile due to limited literature on TTC from Asian countries.
Suggestive Findings: It’s rationally conceptualized that TS cases reported under stressful scenario would be higher in comparison to control, which would help determine cardiovascular complications, misdiagnosed cases, recurrent TTC and mortality rates.
Conclusion: Recent studies suggest that TTC isn’t rare anymore, but awareness is required to facilitate better management mostly in emergency department. As it presents with catecholamine toxicity and enhanced nitric oxide signalling; providing incorrect treatment would eventually harm the patient. Therefore, acknowledging the overall effect it has on patient’s heart is certainly important.