Annual Congress and Medicare Expo on Trauma & Critical Care March 07-09, 2016 Madrid, Spain

Dr Tabinda Hasan is MBBS, MD, PGDHE(higher education) and PhD( Anatomy), is Ast Professor in College of medicine, Riyadh,Saudi Arabia. She has 12 years teaching experience in anatomy and is proficient in Cadaveric Dissection and prosection, Video based case construction in Problem based learning, Research methodology, Research Ethics and Atomic force microscopy. She was awarded by Boston university school of medicine, USA(advancing ethical research award), Stem cell unit, King Saud University ,KSA(scientific vocalizations); OSDOW 2011 nominee, Elsevier, Trieste-Italy(women in science for developing world), Faculty of medicine &Health sciences, Jazan, KSA(appreciation certificate for excellence in Teaching during 1428-29 H & 1431-32 H). She has headed the scientific committee for 3 consecutive years for Medical Research Day international conference organized by MOHE , KSA from 2010 to 2012. She is a renowned author, with 37 Journal publications and 72 citations, 34 conference presentations including USA, California, Germany, Venice-Italy, Bulgaria, Malaysia, Korea, Greece, Abu-Dhabi, Qatar, India ,Saudi Arabia, Pakistan. She is a keen researcher and has served as principal investigator in 7 research projects including 2011 grant funded research project of MOHE, KSA. Her current research area is angiographic analysis of retinal vasculature. She is a Member American Association of Anatomists and board member of several international medical journals.

Background : India contributes to 1/6th of the world’s population, 55% of them being minors(<18yrs). Urbanization, industrialization, sprawling road infrastructure and increased vehicle-purchasing- power are now part of a revolutionized, yet over-populated India. This has its own consequences; the gravest being 1 RTA(road traffic accident )fatality/4 minutes(Mondal report, India,2011). rnThis study was conducted at MLN Health institute, a major tertiary care facility of North India, to provide baseline data on commonly observed ‘trends’ in RTA fatalities among minors, so as to identify ‘preventable areas’and facilitate intervention. rnMethodology : Hospital/Forensic records (5600 deaths in 15 years: 2000-2015) were used to collect epidemiological data on socio-demographic parameters-Age, Sex, Place, Time, Cause of death, Vehicular occupancy etc. rnData was analyzed through SPSS-16(Chi-square p<0.05 significant). rnResults : Maximum victims belonged to Uttar Pradesh(40%) and Bihar(36%) states. Rural population observed greater deaths (62%). Males were significantly more affected than Females(68% M vs 32% F). Head injury was a major cause(79%), followed by multiple chest/abdomen injuries(22%). A whopping 42% deaths occurred in the 16–18 year age group. rnTwo-wheel-riders predominated(45%), followed by Pedestrians (38%). Most fatalities occurred between 10am–5pm (38%) and during September- December. rnDiscussion: Exploding population, superfluous vehicles, poor road conditions and usual disregard for traffic regulations increases fatalities among young Indians. Head-neck trauma is the main cause of death because our brain is a delicate, yet most important organ, containing vital cardiac and respiratory centers. Traditional culture, particularly among rurals promotes males ‘going out’ more frequently than females, leading to their RTA susceptibility. While increased crime rates deter people from venturing out late nights, most work being done during the day accounts for higher diurnal RTA’s. Public-Holidays involve more outdoors, increasing vulnerability. rnConclusion: Minors represent promising human resource for any nation. Such overwhelming magnitude of RTA causalities needs traffic rules to be ‘actually’ implemented and road safety policies improved. This requires an attitude change among key stake holders. There is an urgent need for practicable measures like Mandatory Helmets, Vehicular-Laning, additional Red-light &Zebra-crossings, Road side Cameras and Pot hole fillers;existing not merely on municipal records but ‘physically’ on roads. rn

Dr. Kravchenko-Ph.D., Associate Professor of department of surgery №3 Odessa National Medical University, 18 years’ experience. Publications: 3 patents of Ukraine, more than 30 articles in medical journals.

Patient S., female, age 76 admitted to emergency surgical department with complaints of constant dull pain in the epigastria, left upper quadrant, single vomiting, lack of appetite, general weakness expressed by 12 hours from the occurrence of complaints (June 2014). After the examination: ultrasound of the abdomen, gastroscopy, CT of the abdomen and pelvic organs (with intravenous and per os contrast) diagnosed: strangulated hiatal hernia with perforation esophageal-gastric junction, obstructive mass of the bowel (splenic angle). The volume of surgical intervention was laparotomy, Hartmann surgery, drainage esophageal-gastric junction area and drainage of the abdominal cavity. The Closure of the perforation was not performed due to severe general condition, hemodynamic instability (intraoperative blood pressure 60 / 40mm, clinical death during preoperative preparation) and presence of the cartilaginous mass of the left lobe of the liver from the abdominal portion of the esophagus and the small curvature of the stomach.\r\nHistological conclusion: moderately differentiated adenocarcinoma, germinating the entire thickness of the wall of the colon, resection margin - no tumor growth, greater omentum - vascular congestion, and no mts data.\r\nOn the third day after surgery developed outer gastric fistula (along the drainage channel), which is confirmed by dynamic computed tomography of the abdominal cavity. On the 25 th day of the fistula was closed independently under the conservative treatment. The patient was discharged in good condition on the 36th day.\r\nIn January 2015, there was the reconstruction surgery of the large intestine with the small bowel \"end-to-side.\"\r\nOverall, if we analyze the clinical observation we can suggests that acute large bowel obstruction has provoked an increase an intra-abdominal pressure and strangulation of the hiatal hernia. Dynamic monitoring of the patient confirmed the adequacy of the chosen tactic of the treatment, allowing to save your life, and afterwards to perform reconstructive surgery on the colon.\r\n

Luis del Carpio Orantes is a Medical Specialist in Internal Medicine, Internist in Mexican Social Security Institute and assigned to ICU internist, D\'Maria Hospital. He is an expert columnist for the Iberoamerican Society of Scientific Information, with the theme of emerging viruses. He has published articles related to intensive care (anaphylactic shock, negative pressure pulmonary edema and disseminated intravascular coagulation in the ICU), and epidemiology, regarding leptospira, dengue and influenza. He is an expert on emerging viruses in America (dengue, chikungunya and zika). He has references in PubMed and other index. He is an independent researcher, projects a research on the treatment of dengue.\r\n\r\n

Background: Disseminated intravascular coagulation is an entity characterized by activation of the coagulation cascade and endogenous fibrinolysis, which can cause death. \r\n\r\nObjective: Our objectives were to identify the incidence of disseminated intravascular coagulation, its etiologic agents and the correlation between the Apache II score and the one proposed by the International Society on Thrombosis and Haemostasis for the diagnosis of this entity. Assess whether there is a relationship with patients with trauma or polytrauma.\r\n\r\nMethods: Retrospective, descriptive, observational study of patients treated in an intensive care unit over a 17-month period. Etiology, age, sex, platelet count, coagulation tests, serum fibrinogen levels and D-dimer quantification were analyzed. The score on the scale proposed by the International Society on Thrombosis and Haemostasis and the Apache II score were calculated.\r\n\r\nResults: 11 patients (7.18 % of the total number treated subjects at the intensive care unit) had a diagnosis of disseminated intravascular coagulation; 6 were females. Sepsis was the main etiologic agent (four cases), followed by trauma/polytrauma and cardiovascular causes. The most affected age group was the 51-60 years group (4 cases). The prognosis was bad in 7 subjects. Patients with 5 points or more in the DIC system, but with a low Apache II score had a good prognosis.\r\n\r\nConclusions: The combination of the DIC and the Apache II scores serves for predicting the outcome of patients with severe organ injuries. The incidence of DIC is elevated in patients with trauma, so it should take into account all traumatized patient who develops thrombocytopenia and/or coagulopathy and discard DIC to improve prognosis.\r\n