Day 2 :
Keynote Forum
Apurva Vyas
Radiance Hospital, India
Keynote: SILS for sleeve gastrectomy
Time : 10:00-11:00
Biography:
Apurva Vyas has extensive experience in obesity surgeries and has a record of performing the highest number of laparoscopic surgeries in Gujarat, India. He has performed more single port surgeries (SILS – Single Incision Laparoscopic Surgery) than any other doctor in India. His laparoscopic surgical video papers were awarded the best surgical videos in a conference in Singapore in the year 2010-2011.
Abstract:
This study consists of single incision laparoscopy surgery for bariatric patients. It includes 120 patients with BMI ( 40+-5 kg/m2) . All the patients included were operated for sleeve gastrectomy . It includes single incision over umbilicus through which multiple trocars were used for gastrectomy. During first year, duration of surgery was around 120 minutes . But with experience and synchronisation of both surgeon and asistant gradually duration was around 40 minutes. Postop recovery is comparable with great cosmetic benefit and no postoperative incisional hernia noted in any patients tracked 5 years postoperatively. On the basis of this study SILS is advised for any patient to undergo sleeve gastrectomy and specially in young female patients.
Keynote Forum
Mohamad Miqdady,
Sheikh Khalifa Medical City, UAE
Keynote: Chubby child ≠Cute child!
Time : 11:30-12:30
Biography:
Mohamad Miqdady is the Chief of Ped. GI, Hepatology & Nutrition Division at Sheikh Khalifa Medical City in UAE and an Adjunct Staff at Cleveland Clinic, Ohio USA. He is American Board certified in Pediatric Gastroenterology, Hepatology and Nutrition. He completed his Fellowship in Pediatric Gastroenterology at Baylor College of Medicine and Texas Children’s Hospital in Houston, TX, USA. He held the position of Assistant Professor at Jordan University of Science and Technology in Jordan for six years prior to joining SKMC. Main research interests include feeding difficulties, functional GI disorders, probiotics, picky eating, obesity, procedural sedation, allergic GI disorders and celiac disease. He has authored several publications and book chapters including www.uptodate.com. On the Editorial Board of few journals including Gastroenterology & Hepatology.
Abstract:
Obesity epidemic is a very serious concern for the medical professionals as well as the community. It is estimated that 30-35% of children in US are overweight or obese and probably higher percentages apply in our community. Local data will be presented. Overweight is defined as a BMI of >85% and obesity if BMI>95%. BMI correlates very well with comorbidities. Obesity occurs when there is imbalance between energy intake and energy output. There is a universal trend towards decreasing physical activity and increasing dietary intake among adults and children. Unlike the animal model, most obese humans are leptin resistant rather than deficient. Childhood obesity is clearly associated with adulthood obesity, with the strongest association if obesity occurs at later childhood. Obese children are usually taller with advanced bone age and enter puberty earlier. Comorbidities are many and involve almost all body systems such as (1) CVS- Hypertension, coronary artery disease, pulmonary hypertension corpulmonale, cardiomyopathy and atherosclerosis. (2) Pulmonary- Obstructive sleep apnea and pickwickian syndrome. (3) Gastrointestinal- Gallbladder diseases, nonalcoholic steatohepatitis and reflux. (4) CNS- Stroke and increased intracranial pressure. (5) Orthopedic- Osteoarthritis, slipped capital femoral epiphyses, low back pain and Legg-Calvé-Perthes disease. (6) Psychological- Social stigmatization, depression and lack of self esteem. (7) Endocrine- Early puberty, hyperandrogenism, anovulation, infertility, polycystic ovaries and hypogonadotrophic hypogonadism (8) Malignancy- Increased risk of malignancy- endometrial cancer, prostate cancer, gall bladder cancer, breast cancer, colon cancer (9) Metabolic- Insulin resistance, type II DM, dyslipidemia (cholesterol, TG, LDL, HDL). Although genetic and hormonal causes are rare causes of obesity; they should always be kept in mind. Managing obese individuals is challenging and with limited success. Management should include exercise, diet and behavioral modification. Exercise should be 30-60 minutes 5-7 days a week. Normal or low calorie diets with the appropriate use of the food pyramid are to be used in most individuals. Medications and surgery can be included in certain indications in conjunction with diet and exercise.
- Chronic Diseases| Obesity and Pregnancy | Obesity: Childhood, Teens and Adolescents | Cholesterol Metabolism and Diabetes | Epidemiology of Diabetes | Metabolic Syndrome | Gestational Diabetes | Hypercholesterolemia and Hyperlipidaemia
Chair
Apurva Vyas
Radiance Hospital, India
Session Introduction
Mayssa Adnan Traboulsi
Lebanese University, Lebanon
Title: The impact of high body mass index and gestational weight gain on obstetric complications and fetal outcome in north lebanon population
Time : 12:30-13:00
Biography:
Mayssa Adnan Traboulsi had completed her Masters in Nutrition and Public Health in 2013 from the University of Holy Spirit kaslik, Lebanon. Currently, she is pursuing PhD in Caddy Ayyad University, Morocco. She is an instructor in Lebanese international university since 2013 and has her own private diet clinic.
Abstract:
Increased rates of obesity among pregnant women are a public health concern. Several studies have reported an association between maternal overweight and obesity and adverse pregnancy outcomes. This study aims to assess the maternal complications in correlation to early pregnancy high body mass index (BMI) and weight gain during pregnancy in North Lebanon. A retrospective cohort study was conducted in North Lebanon in five hospitals and health care centers. Data was collected from 2016-2018. Anthropometric, maternal and fetal health data were obtained from the medical records of 1308 women and their fetuses. Anthropometric data at the beginning of pregnancy and gestational age were collected through two private clinics and one primary health care center. Socio-demographic and lifestyle data were gathered by a questionnaire through a telephone call to each woman individually. Maternal and fetal outcomes were compared by univariate, bivariate and logistics analysis through SPSS 13.0. This study states that in a nearly pregnancy high BMI and weight gain during pregnancy are associated with high risks of pre-eclampsia (p-value<0.0001), eclampsia (p-value<0.024), c section, gestational diabetes, induction of labor, hemorrhage and severe hemorrhage (p-value<0.0001), women aged 25-34 years old, smokers and women with sedentary lifestyle were more likely to undergo complications (p-value<0.0001). Women living in the village had more complications than those who live in cities (p-value<0.0001). Low social level was significantly associated with maternal complications (p-value<0.0001). Concerning fetal adverse outcomes, a significant association was found between high maternal BMI, weight gain during pregnancy and marcrosomia (p-value<0.0001).
Nabil Al-Kayssi
University of Alberta, Canada
Title: Diabetic Foot infections, A practical approach for assessment and management
Time : 14:00-15:00
Biography:
Nabil Al-Kayssi has done his graduation form medical college in Baghdad/ Iraq and granted M.B.Ch.B. in 1984, then he finished a master degree in Human anatomy, embryology and neuroscience in 1994 from Iraq. He was a lecturer and assistance professor of Human Anatomy in Iraq for 12 years. In 1999 Dr. Al-Kayssi immigrated to Canada and obtained a full licence of medical council of Canada in 2005 and then Canadian board in Family medicine in 2009. Dr. Al-Kayssi worked as family and emergency physician and as a Hospitalist at different Canadian hospitals from 2001. Now Dr. Al-Kayssi works as a Hospitalist and intravenous Clinic staff physician, infectious diseases at Sturgeon Hospital, Site Lead, East Edmonton Health Centre and Clinical lecturer at University of Alberta, Faculty of Medicine in Alberta, Canada.
Abstract:
It is well known that one of major complications of diabetes is foot infection, which is defined as ‘soft tissue or bone infection below the malleoli’. It is the most common complication of diabetes mellitus leading to hospitalization and the most frequent cause of non-â€traumatic lower extremity amputation. Diabetic foot infections are diagnosed clinically based on the presence of at least two classic findings of inflammation or purulence. Infections are classified as mild, moderate, or severe. Most diabetic foot infections are polymicrobial. This type of infections are serious as most of the patients ignores them until get more serious as the patient usually does not feel any pain or feel minimal pain due to peripheral neuropathy and vasculopathy. In this presentation I will shed a light on this very important and serious diabetic complication and practical methods for management. The presentation will discuss the following points: (1) Clinical assessment of infected foot in diabetic patients and whether it is cellulitis, infected ulcer, septic arthritis and/or osteomyelitis. (2) Investigations, including blood and diagnostic imaging help in reaching the diagnosis. (3) The most common pathogens causes foot infections and appropriate selection and use of antibiotics. (4) Appropriate selection and use of the type of dressing suitable for each wound and infection. (5) When to seek orthopaedic consultation to consider amputation.
Gerald C Hsu
EclaireMD Foundation, USA
Title: From weight management via diabetes control to cardiovascular risk reduction
Time : 15:00-15:30
Biography:
Gerald C Hsu has completed his PhD in Mathematics and has been majored in Engineering at MIT. He has attended different universities over 17 years and studied seven academic disciplines. He has spent 20,000 hours in T2D research. First, he studied six metabolic diseases and food nutrition during 2010-2013, then conducted research during 2014-2018. His approach is math-physics and quantitative medicine based on mathematics, physics, engineering modeling; signal processing, computer science, big data analytics, statistics, machine learning and AI. His main focus is on preventive medicine using prediction tools. He believes that the better the prediction, the more control you have.
Abstract:
Introduction: Since 1997, the author has been diagnosed with obesity, type 2 diabetes (T2D), hypertension, hyperlipidemia, and suffered five cardiac episodes. He spent 20,000 hours since 2010 to study and research his chronic diseases in order to save his own life.
Methods: He created a math-physical medicine approach, instead of using the traditional biochemical approach, to conduct his research. Initially, he defined inter-relationships among 11 categories and 500 elements of a human metabolism system. He collected and processed 1.5 million data of his lifestyle details and medical conditions. Furthermore, utilizing physics, mathematics, engineering modelling, and artificial intelligence (AI), he developed four prediction models with 99% accuracy, including weight, fasting plasma glucose, post prandial glucose, and haemoglobin A1C. Finally, he developed a risk probability model of having heart attack or stroke.
Results: From the period of 2013-2018, he has reduced his weight from 220 lbs. to 167 lbs., waistline from 44” to 32”, and BMI from 33.1 (obese) to 24.7 (normal). Based on his acquired knowledge, he developed AI-based prediction tools to reduce his average glucose value from 279 mg/dL to 116 mg/dL, A1C from 10% to 6.5%. Since 2016, his hypertension and hyperlipidemia are no longer health concerns along with dropping his cardiovascular risk from 74% to 31%.
Conclusion: Over eight years, the author was finally able to control his weight and T2D along with greatly reducing his cardiovascular risk. In addition to his willpower and persistence, his diligence in acquiring medical knowledge from reading hundreds of textbooks and medical papers has assisted him. More importantly, his knowledge from other disciplines in mathematics, physics, engineering, statistics, computer science, and technology have provided him with necessary and useful tools.
Oudi Abouchacra
Parker University, Texas
Title: Gastro Intelligence as a driver for weight loss and reconnection with self
Time : 15:30-16:00
Biography:
The founder and chief inspirational officer, dr. Oudi Abouchacra, is an international speaker, author, coach, certified demartini method® facilitator, master nlp certificate awarded by the national federation for neuro-linguistic-psychology, former vp of the emirates chiropractic association and executive director for bni abu dhabi. Dr.Oudi thrives on educating, empowering and enlightening professionals worldwide. From downtown Toronto to Uptown Johannesburg, Australia, Africa, Lebanon, and throughout the UAE – Dr.Oudi has empowered thousands of professionals from around the globe to maximize their health potential.
Abstract:
Obesity has thus become a global epidemic and individuals continue to struggle with this diet and that in efforts to lose weight, prevent further weight gain and get healthy. Despite the myriad of available diets, little success has been achieved as these mainstream diets are restrictive, too regimented and cannot be sustained in the long term. People therefore need to be empowered to find their own way of eating that is effective, sustainable and enjoyable. Humanity’s potbelly is not the only issue though. Human beings are severely dis-c-on-n-e-c-t-and with themselves the question is; it is reverible? Despite the fact that this journey of reconnection revolves around food, it has the potential to affect not only ones’ body but one’s journey of self-mastery in general. This presentation cuts through the complex web of nutritional info to deliver to you a simple eating methodology. With each meal you will uncover and piece together the only sustainable diet out there, your OWN unique diet. By doing so you will be on your way to getting to your ideal weight, staying there for life while avoiding a myriad of common digestive issues. There are factors just as, if not more important than, what you should and shouldn’t eat. In this presentation, there will be a focus on when human beings should eat and how many times per day. Intermittent fasting will be discussed, along with the research supporting it. However intermittent fasting will be faced off against a powerful philosophy, simple psychology and solid logic in efforts to discover the superior way of looking at meal timing, meal number, and fasting. Participants will leave with not only a handful of new terms but considerable food for thought surrounding the question of WHEN to eat.