Scientific Program

Conference Series Ltd invites all the participants across the globe to attend 25th International Conference on Neurology: Neurochemistry, Neuropharmacology and Neurosciences Dubai, UAE.

Day :

  • Spine and Spinal Disorders|Spine Surgery | Neuropharmacology
Location: Dubai
Speaker

Chair

Hischam Bassiouni

Klinikum St. Marien Amberg, Germany

Speaker

Co-Chair

Sebouh Kassis

Al Zahra Hospital, UAE

Session Introduction

Basem Awad

Mansoura University Hospital, Egypt

Title: Lateral extracavitary approach to spinal tumors

Time : 11:50-12:20

Speaker
Biography:

Basem I. Awad is an Assistant Professor of Neurosurgery from Egypt, currently working at Mansoura University School of Medicine, in Mansoura, Egypt. He is the Educational Neuro officer at the AOSpine Egypt Council Board. He has completed his Master Degree of Surgery at Mansoura University, Egypt and Doctorate Degree at Joint between Case Western Reserve University, Cleveland, OH and Mansoura University. He also received the Crockard International Spine Fellowship at Cleveland Clinic and the AOSpine International Fellowship at the Center for Spinal Disorders, CO, USA. Recently, he completed Bioinformatics PostDoc Fellowship at Luxembourg Center for Systems Biomedicine, University of Luxembourg. Dr. Awad is also member of many international socities e.g. American Association of Neurosurgery (AANS), Congress of Neurosurgery (CNS), AOSpine, and North Americam Spine Society (NASS). He was selected to be on of the EDITORIAL BOARD for the Global Spine journal and World NEUROSURGERY Journal. His neurosurgical and scientific subspecializations includes spinal disorders and surgery, spinal trauma, spinal cord injury, neuro-oncology.

Abstract:

The surgical management of pathology involving the ventral aspect of the thoracic and upper lumbar spine is typically challenging. Thoracotomy provides direct ventral exposure of the spine and spinalcord. However the approach related morbidities could be markedly significant while a separate dorsal approach may be required for instrumentation. The Lateral Extracavitary Approach (LECA) is a dorsolateral approach that provides lateral and ventral access to thoracic and upper lumbar spine without entrance into the pleural cavity. By remaining extra pleural, the LECA avoids the complications noticed previously with thoracotomy. Neural decompression, tumor removal and fixation can all be accomplished via LECA, which makes it an invaluable tool in spinal surgery. This technical advantage has led to excellent neurological outcomes with nearly 75% of patients described in the literature revealing neurological improvement. In the present study, we reviewed 15 patients with spinal tumors treated with anterior and posterior resection and reconstruction from a single posterior approach. Pre- and post-operative neurological condition means blood loss, length of hospital stay after surgery and complications related directly to surgery were analyzed. Pre- and post-operative Computed Tomography (CT) scans and Magnetic Resonance Imaging (MRI) scans were evaluated. Our results showed neurological improvement in 69.2%, 29.2% experienced no change and 1.5% reported worse condition. Mean blood loss was 2,134 mL and hospital stay was 7.2 days. Total complication rate were 15.5%. In conclusion the adequate neural decompression combined with anterior and posterior column reconstruction is feasible through lateral extracavitary approach using a single posterior skin incision. Minimally Invasive (MIS) approaches are now being applied in all areas of the spine surgeries including LECA. MIS LECA approach is purported to have decreased operative time, reduced blood loss, less tissue dissection, less perioperative pain and earlier mobility.

Basem Awad

Mansoura University Hospital, Egypt

Title: Minimally invasive approach for intradural extra-medullary spinal tumors

Time : 12:20-12:50

Speaker
Biography:

Basem I. Awad is an Assistant Professor of Neurosurgery from Egypt, currently working at Mansoura University School of Medicine, in Mansoura, Egypt. He is the Educational Neuro officer at the AOSpine Egypt Council Board. He has completed his Master Degree of Surgery at Mansoura University, Egypt and Doctorate Degree at Joint between Case Western Reserve University, Cleveland, OH and Mansoura University. He also received the Crockard International Spine Fellowship at Cleveland Clinic and the AOSpine International Fellowship at the Center for Spinal Disorders, CO, USA. Recently, he completed Bioinformatics PostDoc Fellowship at Luxembourg Center for Systems Biomedicine, University of Luxembourg. Dr. Awad is also member of many international socities e.g. American Association of Neurosurgery (AANS), Congress of Neurosurgery (CNS), AOSpine, and North Americam Spine Society (NASS). He was selected to be on of the EDITORIAL BOARD for the Global Spine journal and World NEUROSURGERY Journal. His neurosurgical and scientific sub specializations includes spinal disorders and surgery, spinal trauma, spinal cord injury, neuro-oncology. 

Abstract:

Complete resection of intradural extra medullary spinal tumor is the gold-standard treatment, particularly for tumors with less aggressive potential, such as meningiomas, neuromas or ependymoma. Accordingly, sufficient exposure for visibility and maneuvering space are crucial to this type of surgery. Therefore, extensive approaches were preferred in the past, with full laminectomies of 2 or more segments. These approaches led to problems in terms of large wounds with high infection rates and blood loss and may pre-disposed patients to spinal instability and deformities, like the swan neck that was observed especially in young patients who underwent multilevel laminectomy. This led to an increase the use of additional spinal instrumentation to solve this expected long-term complication. With technology advancing, several reports have elucidated that possibility to achieve a comparable quality of resection with minimally invasive approaches, thus dropping exposure-related comorbidities to a minimum. Our work objective is to share our experience with intradural extra medullary spinal tumor resection and show the feasibility and safety of tumor excision using a Minimally Invasive (MIS) approach. Our results showed that one and two level intradural extra medullary spinal tumors could be resected through a minimally invasive surgical corridor without an increased risk for adverse neurologic complications. The use of the tubular retractor system allows for adequate visualization while minimizing local tissue damage. MIS approach resulted in less post-operative pain, intra-operative blood loss, surgical time and length of hospital stay. In conclusion, MIS can be an appropriate alternative to an open approach for one or two level intradural extra medullary lesions. Although our initial experience is promising, these results will require validation through methodologically sound randomized, prospective trials before routine recommendation of MIS approaches for spinal tumor resection.
 

Arman Rahimmi

Kurdistan University of Medical Sciences, Iran

Title: Are anti-oxidants & anti-inflammatory compounds good choices for curing Parkinson’s disease?

Time : 14:00-14:30

Speaker
Biography:

Arman Rahimmi is a PhD student of Molecular Medicine in Kurdistan University Medical Sciences, Sanandaj, Iran. His research works has been focused on molecular nature of neurodegenerative disease especially Parkinson’s disease. His studies include the role of oxidative stress and inflammation in those diseases and evaluate potentials of antioxidants and anti-inflammatory compounds for treating them.

Abstract:

Parkinson’s Disease (PD) is a progressive neurodegenerative disorder, which is considered as one of the most prevalent diseases of Central Nervous System (CNS). Its clinical signs include both motor (resting tremor, rigidity and bradykinesia) and mental disorders (cognitive problems, behavioral impairments and dementia). These clinical symptoms are mainly the consequents of progressive loss of dopaminergic (DAergic) neurons in brain, especially those of Substantia Nigra (SN) and Striatum (ST). Accordingly, current PD therapies focus on maintaining dopamine levels of brain at normal range. However, this approach is fairly useful to control and manage Parkinson’s disease, it has some disadvantages. Firstly, patients need higher doses of drugs over time which it implies some serious side effects such as psychosis, motor fluctuations, and dyskinesias. Additionally, PD patients under this type of treatment develop a series of dopa-resistant motor symptoms (speech impairment, abnormal posture, and gait and balance problems) and dopa-resistant non-motor signs (anosmia, sleep disorders, autonomic dysfunction, mood impairment and pain) after a while. In this regard, previous studies indicate that Levodopa and other dopaminergic medications accelerate neuronal degeneration in some parkinsonian brains via production of free radicals and Reactive Oxygen Species (ROS). This is in addition to the main oxidative and inflammatory processes of PD. Literature strongly confirm the role of oxidative stress and inflammation in development and progression of Parkinson’s disease. So that, during the recent years, interest in administration of neuroprotective factors such as brain repairing antioxidants and anti-inflammatory drugs for management of PD is being popular, increasingly. On the other hand, since PD is a chronic and long-lasting disease, it is important to improve life quality and life expectancy of PD patients by appropriate medications. According to the above literature, it is important to understand the mechanism of action of these neuro-protectant factors and investigate the new and more effective ones. Therefore, the objective of this article is to do a comprehensive review on oxidative and inflammatory mechanisms playing role in pathogenesis of PD. We also highlight the studies concerning antioxidant and anti-inflammation therapies for PD and their molecular mechanisms of action. 

Stefan Reguli

University Hospital Ostrava Poruba, Czech Republic

Title: Long non-coding RNA analysis in glioblastoma

Time : 14:30-15:00

Speaker
Biography:

Stefan Reguli is a Neurosurgeon working in the University Hospital Ostrava Poruba, Czech Republic. His main field is Neuro-oncology, especially treating patients with gliomas. He is Coordinator of Ostrava Neuro-Oncology Center and has participated in several studies focused on basic brain tumor research.

Abstract:

Glioblastoma Multiforme (GBM) is the most frequent primary brain tumor of astrocytic origin. The prognosis of GBM patients is very poor with median of overall survival ranging between 12 and 15 months from diagnosis despite conventional therapeutic protocol consisting of maximal surgical resection followed by concomitant chemo-radiotherapy with Temozolomide and adjuvant Temozolomide in monotherapy. Therefore, a lot of financial resources and a great deal of effort are spent in the research of new therapeutic approaches that could prolong the survival of GBM patients. Long non-coding RNAs (lncRNAs) are a relatively new class of noncoding gene regulators playing critical roles in tumor biology, including GBM. From this perspective, lncRNAs seem to be promising therapeutic targets in GBM patients. We performed NGS analysis of fresh-frozen histopathologically confirmed GBM tissues and non-tumor brain tissues obtained from non-dominant anterior temporal cortexes resected during surgery for intractable epilepsy with no signs of dysplastic changes. Informed consent approved by the local Ethical Commission was obtained from each patient before the treatment. rRNA depletion and cDNA library preparation were performed with GeneRead rRNA depletion kit (Qiagen) and NEXTflex rapid directional qRNA-Seq Kit (Bioo Scientific), respectively. Sequencing was done using NextSeq 500 high output kit and NextSeq 500 instrument (both Illumina). Statistical analysis evaluated protein-coding and non-coding RNAs and their sequential variants with non-zero RPKM (reads per kilobase of transcript per million mapped reads) at least in one sample. We used CLC genomic workbench for the alignment and target counts. Targeted regulation of ZFAS1 level has been carried out by the transient transfection of specific siRNA in GBM stable cell lines (A172, U87MG and T98G). The success of transfection and viability were analyzed in vitro using qRT-PCR and MTT assay, respectively. We have demonstrated a dysregulation of many lncRNAs and protein-coding RNAs in GBM tissue in comparison with non-tumor brain tissue. However, the forced down regulation of ZFAS1, one of the most up-regulated lncRNAs in GBM tissue, was not found to have an impact on the viability of GBM cell lines in vitro.

Speaker
Biography:

Olaitan J. Jeremiah completed her B.Pharm. degree from the Faculty of Pharmacy of Obafemi Awolowo University (OAU), Ile-Ife, Nigeria with a distinction in 2010. She also completed a masters degree in pharmacology from the same university between 2012 and 2014 and was appointed a lecturer in the department of pharmacology, OAU, during the course of her M.Sc programme.  Ms. O. J. Jeremiah is presently undertaking her PhD in neuropharmacology at the School of Pharmacy of RCSI, Dublin 2, under the supervision of Dr. Benedict K. Ryan (BSc(Pharm), MPharm, PhD, MPSI).

Abstract:

Depression affects approximately 4.4% of the world’s population (over 300 million people) and is the leading cause of disability worldwide. Being a heterogenous disease, its pathophysiology has been linked with a number of distinct factors including metabolic factors. For instance, research has shown an association between depression and insulin resistance (IR). Its comorbidity with IR is known to increase disease severity, while also predisposing to antidepressant ineffectiveness. Some insulin sensitivity-enhancing lifestyle and dietary-related adjuncts have been found to improve antidepressant effectiveness. These include exercise, vitamin D supplementation, zinc supplementation and hygienic-dietary recommendations. The aim of this systematic review was to synthesize available clinical evidence from the literature (by searching CENTRAL, MEDLINE PubMed, Embase, PsychINFO, ClinicalTrials.gov and EU clinical trials register), with a view to establishing a link between the insulin sensitivity- enhancing potential of these adjuncts and their antidepressant treatment response-improving potential. Sixteen randomized controlled trials with 827 depressed patients were included in this meta-analysis. Adjunctive therapy with any of the above stated lifestyle/dietary adjuncts was compared with conventional antidepressant treatment with or without placebo. Random-effects meta-analysis was used to separately combine the effects estimates of studies that reported binary outcomes (% remission) and those that reported continuous outcomes- mean change in standard depression rating scale (HAM-D, BDI and MADRS) scores, from baseline to follow-up. The results of this analysis will be discussed during this presentation as this will add to the body of evidence on the utility of insulin sensitivity-enhancing non-pharmacological therapies in enhancing conventional antidepressant treatment response.
 

  • Special Session
  • Neurology | Neurosurgery |Brain Tumor & Cancer | Neurooncology
Location: Dubai
Speaker

Chair

Ernesto Miguel Delgado Cidranes

Complutense University Madrid, Spain

Speaker
Biography:

Nibras Alsumaidaee is a Neurosurgeon. He has completed his training in Neurosurgery from Baghdad Medical Complex (Martyr Gazi Al-hariry for specialized surgical hospital). His interest is mainly towards neuro-oncology, functional neurosurgery. 

Abstract:

Statement of the Problem: GBM is the most common intra-axial primary brain tumor. It is a highly malignant, rapidly progressive astrocytoma which is characterized by its wide range of clinical, pathological and morphological appearance. (In US) Over 13,000 deaths are attributed to gliomas annually and approximately 18,000 new cases are diagnosed each year. Increasing age correlates to incidence. Although there are many treatments available for GBM including surgical resection, chemotherapy and radiation, prognosis remains bleak. The average survival time is only 14 months. Furthermore, the five-year survival rate of GBM is also only 10%. Assessing possible risk factors remains a major focus of disease prevention. Method: The patients histologically confirmed as glioblastoma were included in the study,  clinical approaches together with lab and radiological investigation was done, then surgery planning done and complications predicted and survival were collected and statistically collected and classified using (SPSS) system to demonstrate the statistically significant variables . My study main objectives were comparative of clinical features and demographical prevalence in Iraqi patients, mobile usage effect on developing of glioblastoma multiforme and finally we predict the patients outcome after surgical management. Findings: Most of patients died after 9 months of diagnosis and few others cases died during final preparation of this study, the age, geographical area, history of mobile usage, KPS, radiotherapy, type and the extent of the surgery were main prognostic factors affecting the survival rate. Conclusion & Recommendations: The overall survival rate of the patients was very short (not exceeding 9 months). Age, KPS, type and the extent of the surgery, radiotherapy all affect the survival rate. Early surgical intervention to avoid further neurological deterioration, complete surgical resection whenever possible, improving and updating neurosurgical operative techniques, reduction in mobile usage duration, improve the standardization and quality control for mobile phone which not meet the international standards (like FCC), further future study for Iraqi area with high incidence rate.
 

Speaker
Biography:

Abderrahman Omer is a neurosurgeon at Omdurman Military Hospital, to look after and manage neurosurgical problems as part of the neurosurgical department there, which serves both military and civilian patients. Before starting his career as a neurosurgeon, He joined the ministry of health as a general practitioner and an intern immediately after completing the medical school in the University of Gezira. After having the degree of clinical MD in neurosurgery in 2013,He  joined the army hospital and started to work as a neurosurgeon  dealing with trauma cases as part of trauma team and nontrauma cases in pediatrics, neuro-oncology  and spine cases for simple non complicated cases and later , for the first time in the hospital, to operate on posterior fossa and more complex cases and just few weeks before they did the first transsphenoidal case with ENT team. His ambition is to start more subspecialised surgeries in his hospital and the whole country.

Abstract:

Introduction: Despite the profound progress in and achievements in medical services in Sudan, still in neurosurgery there are some frustrations markedly affecting the patients'` management. These difficulties include the number of neurosurgeons, the training centers, the equipment and the inadequate health care planning. These factors lead neurosurgeons not to work at home or return home after trained outside. It is obvious that the future development of neurosurgery in Sudan will depend largely on efforts to improve the quality of training program by adding new subspecialties in training and by improving the local condition to enable neurosurgeons to practice properly. 
 
Objectives: To describe the rise and progress of neurosurgery in Sudan.
 
Methods: Data collections regarding neurosurgical practice in Sudan including difficulties, timeline of progress and dominant pathologies.
 
Results: Despite the progress in medical service in Sudan, neurosurgery is lagging behind in terms of service. 
 
Discussion: Future progress in neurosurgery in Sudan depends mainly on improving the local training program, adding new subspecialties, improving the local conditions, start exchange programs of training outside the country and invite visiting trainers to conduct domestic training programs, bring recent technologies through local budgets or charity donations and lastly participate in international events in neurosurgery to exchange experience.
 
Conclusion: Despite the difficult day's neurosurgery in Sudan is facing now, but the future of both practice and specialty is quite promising.

 

Pankaj R Nepal

B & C Teaching Hospital and Research Center Pvt. Ltd., Nepal

Title: Morphological variation of the confluences of sinuses in head
Speaker
Biography:

Pankaj Raj Nepal is currently the Head of Department of Neurosurgery at BNC Medical College and Teaching Hospital in Birtamode, Nepal. He completed his Residency (FCPS Neurosurgery) under the supervision of Professor Upendra P Devkota.
 

Abstract:

Aim: The aim of the study is to analyze the morphological variation of the confluences of sinuses and propose a classification system.

Method: The study was based on the cross sectional analytical study. Data collection and analysis was done from all the cases of CT Venogram were evaluated in the CT console using the inbuilt software. This Venogram was evaluated using the VRT view of the sinuses and the part of the arterial phage of the angiogram were punched out. Evaluation of the sinuses was done by carefully rotating the venous sinus in all the direction. Evaluation of typical form of the confluence of sinus was identified and variations of the sinuses were evaluated for the rest atypical type.

Result: Total 70 cases were enrolled in the study. Overall the confluence of sinus of Torcula was identified as typical and atypical type. The typical types were further seen as solid or a fenestrated type. The atypical confluences of sinus were seen as (1) Aplastic/hypoplastic transverse sinus, (2) Transverse sinus connecting only with superior sagittal sinus, straight sinus or occipital sinus and (3) Various patterns of occipital sinus either unilateral branching, bilateral branching or no branching. The typical form of the confluences were present in only few cases, however rest were the atypical type. The aplastic or hypoplastic trasverse sinuses were more common in the left side. The presence of occipital sinus in the typical morphology gave the confluence a diamond shaped, however the shape were angled to one side when one of the draining sinus was not connected at Torcula.

Conclusion: Keeping the classification of confluence of sinus in mind could aid in the surgical planning and prevent an advertent injury to the anomalous sinus type. 

Speaker
Biography:

Ritesh Nawkhare is a Neurosurgeon, recently completed his Post-doctorate training in Neurosurgery. His areas of core interest lies in cranial oncology and craniovertebral junction. Currently he works as a Senior Resident at one of the biggest neurosciences institute of eastern India, Institute of Post-Graduate Medical Education and Research (IPGMER) and Seth Sukhlal Karnani Memorial Hospital (SSKM) Hospital.
 

Abstract:

Plasma cell granuloma of the Central Nervous System (CNS) is a rare entity. Primary intracranial lymphoma was first reported by West et al. in 1980 with around 60 cases reported till date. Previously reported locations include meninges, cerebral hemispheres, ventricles, hypothalamus, sellar region and cerebellum. Intracranial plasma cell granuloma is characterized radiologically by its extra axial, dural based location and homogeneous enhancement with contrast. Owing to it, meningioma, tuberculoma, sarcoidosis and wegners granulomatosis comprise important differential diagnosis. Plasma cell granuloma is generally a benign, non-recurring lesion. Treatment options for plasma cell granuloma include total/subtotal excision, steroids and radiotherapy. Technically inaccessible sites have been treated with biopsy followed by steroid therapy. In majority of cases a single plasma cell granuloma has been reported in the brain or spinal cord. Only two cases of plasma cell granuloma simultaneously involving the brain and spinal cord have been reported. We believe this is the first case showing a single lesion contiguously involving the brain and spinal cord in its extent and was managed surgically and discuss its clinical, radiological and pathological findings along with review of literature.