Day 2 :
Keynote Forum
Yousef Shahin
United Nations Relief and Works Agency, Jordan
Keynote: Diabetes care in refugee camps: The experience of UNRWA
Time : 09:30-10:10
Biography:
Yousef Shahin joined Jordan University of Science and Technology after graduating in Medicine from Zaporozhe Medical University where he obtained his Master degree in Public Health in 1995. Since 2005 he is at senior position in United Nations and Relief Agency for Palestine refuges (UNRWA), Manager of communicable and non-communicable diseases program. He joined World Health Organization from July-December 2011 as Technical Officer on Non communicable Diseases. He joined Aetna, Qatar as Director of disease Management from August 2015 to April 2016. He has 12 publications in medical journals including the Lancet on health topics targeting communicable and non-communicable diseases.
Abstract:
United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) was established in 1949 and has delivered health care services for around 67 years. The epidemiological transition in disease burden is changing the context in which UNRWA’s health program operates and poses new challenges that require new ways of providing health services. Hypertension and diabetes are two major health problems for Palestine refugees. Among NCDs, hypertension and diabetes are two major health problems for Palestine refugees. UNRWA has been providing diabetes and hypertension care since 1992 in its primary health care centers. Around 11.0% and 16.2% of people ≥40 years attending UNRWA health facilities in 2015 had diabetes and hypertension respectively, with almost 250,000 people with diabetes and/or hypertension being cared for at UNRWA clinics in the region. The number of people with diabetes has been steadily increasing by 5% each year. The UNRWA NCD strategy is primarily directed at reducing risk factors and providing services for common conditions such as hypertension and diabetes. The current strategy has three main elements namely, healthy life style promotion, early detection of diabetes and hypertension - achieved by active screening of at risk individuals and implementation of treatment protocols and effective case management. Through a structured process of care delivery the UNRWA health system is making significant strides in addressing diabetes and hypertension and consequently the nine voluntary global targets as envisaged in the WHO Global Action Plan for the Prevention and Control of NCDs 2013-2020
Keynote Forum
David Naor
The Hebrew University-Hadassah Medical School, Israel
Keynote: Cell surface CD44 of β cell, a mediator of β cell destruction in autoimmune diabetes
Time : 10:10-10:50
Biography:
Professor David Naor is a professor of immunology in the Hebrew University, faculty of Medicine and was the head of Milton Winograd Chair of Cancer Studies. He received his Ph.D from the Hebrew University. He served as visiting professor in leading universities (e.g., UCLA, Harvard). He published 152 articles, including in leading journals like Nature, PNAS , J Clin Invest, J immunol , J Exp Med etc. His current research. has been focused on the role of CD44 and other hyaluronan-binding molecules (e.g., RHAMM) in autoimmune and cancer diseases. This CD44 research yielded 34 articles, which were cited thousands of times. He was invited to speak on CD44 at 8 plenary sessions of international conferences. He has been a member in editorial boards of several international scientific journals and he is on the scientific board of International Congress on Autoimmunity. He received awards from Johnson & Johnson "In recognition of outstanding research towards the advances of science and technology in health care” and from the Hebrew University for his “outstanding achievements in research and teaching
Abstract:
CD44 is a multi-functional receptor with multiple of isoforms engaged in modulation of cell trafficking and transmission of apoptotic signals. We have previously shown that injection of anti-CD44 antibody into NOD mice induced resistance to type 1 diabetes (T1D). In this communication we describe the mechanism underlying this effect. We found that CD44-deficient NOD mice develop stronger resistance to T1D than wild-type littermates. This effect is not explained by the involvement of CD44 in cell migration, because CD44-deficient inflammatory cells surprisingly had greater invasive potential than the corresponding wild type cells, probably owing to molecular redundancy. We describe here a mechanism underlying the T1D enhancement that has not yet been previously reported. CD44 expression and hyaluronic acid (HA, the principal ligand for CD44) accumulation were detected in pancreatic islets of diabetic NOD mice, but not of non-diabetic DBA/1 mice. Expression of CD44 on insulin-secreting β cells renders them susceptible to autoimmune attack, leading to β cell apoptotic destruction as indicated by TUNEL assay as well as by functional assays exhibiting increased nitric oxide release, reduced insulin secretion after glucose stimulation and decreased insulin content in β cells. All these parameters could not be detected in CD44-deficient islets. We further suggest that HA-binding to CD44-expressing β cells is implicated in β-cell demise. Altogether, these data demonstrate that CD44 is a receptor capable of modulating cell fate. This finding is important for other pathologies (e.g., cancer, neurodegenerative diseases) in which CD44 and HA appear to be implicated.
Keynote Forum
Muhammad Abul Hasanat
Bangabandhu Sheikh Mujib Medical University, Bangladesh
Keynote: Gestational diabetes mellitus- experience in BSMMU, Bangladesh
Time : 11:10-11:50
Biography:
M A Hasanat has completed his MPhil on 1990 and MD (Endocrinology and Metabolism) in 1997 from Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh. He is the Chairman of Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. He has published more than 45 papers in reputed journals at international and national level. He is very keen to teaching and academic research all thorough.
Abstract:
South-East Asia has the highest prevalence of hyperglycemia in pregnancy (24.2%). Screening for gestational diabetes mellitus (GDM) is important owing to adverse fetal and maternal outcomes and risk of developing diabetes in future. Different methods of screening has hindered the development of a universal diagnostic criterion for GDM. An alarming frequency of GDM in Bangladeshi population following World Health Organization (WHO) 1999 and WHO 2013 diagnostic criteria respectively (36.6% and 40.9%) was observed. Comparison of WHO 1999, modified O’Sullivan and WHO 2013 criteria for GDM revealed discrepancy among these criteria despite good agreement. We observed higher frequency of risk allele, TCF7L2 rs7903146 in Bangladeshi GDM mothers under pilot study. Association was stronger in women having lower age and body mass index (BMI). Postpartum persistence of abnormal glucose tolerance (AGT) in GDM was also higher (50%); AGT in early gestation, use of insulin during pregnancy, higher maternal age and BMI were predictors for it. Adverse events were relatively higher in mothers with AGT than those with normal glucose tolerance (NGT) despite treatment (not significant). Implementation of 03-sample OGTT in resource poor setting is difficult. We are comparing diagnostic efficiency of simpler Diabetes in Pregnancy Study Group India (DIPSI) criterion with intention to implement for screening of GDM in community level. The extent of thyroid dysfunction in mothers with GDM is also being evaluated by our group. Multinational broad-based comparative studies are needed to explore the genetic predisposition and risk factors for GDM among the ethnic groups of different countries in Asia.