Day 2 :
Keynote Forum
Mary Ann G Sanders
University of Louisville, USA
Keynote: Decline in frozen section diagnosis of sentinel lymph nodes for breast cancer as a result of the ACOSOG Z0011 trial
Time : 10:00-10:30
Biography:
Mary Ann G Sanders has received her Bachelor's degree from the University of Wisconsin-Madison. After she obtained her MD and PhD degrees from Washington University in St. Louis, she completed an Anatomic Pathology and Clinical Pathology Residency at the University of Louisville followed by a Breast Pathology Fellowship at the Brigham and Women’s Hospital, Harvard Medical School. She joined the Department of Pathology Faculty at the University of Louisville in 2011 as an Assistant Professor and Breast Pathologist for James Graham Brown Cancer Center, and is an Associate Program Director for the University of Louisville Pathology Residency Program.
Abstract:
Results of the multicenter American College of Surgeons Oncology Group (ACOSOG) Z0011 trial published in 2011 showed that patients with early-stage breast cancer and limited sentinel lymph node (SLN) metastasis treated with breast conserving surgery and systemic therapy did not benefit from axillary lymph node dissection (ALND). The Z0011 trial was practice changing for the surgical management of breast cancer, and in turn, has proven to be equally impactful on the pathologic diagnosis of SLNBs. The purpose of this study is to demonstrate the impact of the Z0011 trial on intraoperative frozen section diagnosis of SLNBs.
Keynote Forum
Raja Alyusuf
Ministry of Health, Bahrain
Keynote: The immunoexpression of glucocorticoid receptors in breast carcinomas, lactational change and normal breast epithelium and its possible role in mammary carcinogenesis
Time : 11:50-12:20
Biography:
Dr. Raja Alyusuf is a Fellow of the Royal College of Pathologists since 1998. She is a Consultant histopathologist with special interest in the area of breast treatment. She chaired the Department of Pathology at the Salmaniya Medical Complex for 10 years after which she became the Deputy Chief of Medical Staff for Diagnostic Affairs at the Salmaniya Medical Complex. In addition, she is a part-time Associate Professor of Pathology in the Royal College of Surgeons of Ireland-Bahrain branch. She has over 20 publications is reputable journals and is a member of a number of international and national professional associations.
Abstract:
Glucocorticoids (GC) are known to play a role in mammary development and differentiation, thus it is of interest to attempt to delineate it’s immunoexpression across a spectrum of mammary epithelia. This study aims to delineate the distribution pattern of GRs in malignant versus non-malignant epithelium with particular emphasis on lactational change epithelium as its cells are considered the most terminally differentiated mammary cells. Immunohistochemistry (IHC) for glucocorticoid receptors (GR) was performed on archival formalin fixed paraffin embedded tissue blocks of 97 cases comprising 53 invasive carcinomas, 21 cases with lactational change and 23 cases showing normal mammary tissue histology. The results reveal an over-expression of GR receptors in mammary malignant epithelium compared to both the normal and lactational group individually and combined together as a non-malignant group. This is the first study to compare GR expression in human lactating epithelium versus malignant and benign epithelium. GR overexpression was also established in Her-2 negative cancers as compared to Her-2 positive ones, while GR immunoexpression in tumors categorized according to grade, estrogen (ER), progesterone receptor (PR) or axillary lymph node (ALN) status showed no statistical difference. It seems that GR expression in mammary epithelium promotes the development of her-2 negative breast cancer, thus such receptors may become targets for the development of therapeutic interventions. Further studies are required to determine the level of caution that is needed if any in the use of steroid therapy in such category of patients.
- Clinical Applications of Molecular Biology | Cytogenetics | Clinical Coagulation | Molecular Pathology | Blood transfusion | Laboratory Management | Clinical Microbiology | Urinalysis & Diagnosis | Medical Microscopy | Laboratory Toxicology
Chair
Petr Starostik
University of Florida, USA
Co-Chair
Sarah Adelaide Crawford
Southern Connecticut State University, USA
Session Introduction
Parviz Parvizi
Pasteur Institute of Iran
Title: Evaluating and Setting up a qPCR by High Resolution Melting method for definitely discrimination of Leishmania species by targeting amino acid permease 3 gene
Biography:
Parviz Parvizi has completed his PhD from the London School of Hygiene and Tropical Medicine (London University) and Natural History Museum (London) in 2004. He has been a Full Professor from 2015 and has been appointed as the Head of Parasitology department and also as the Director of Parasitology, Immunology and Mycology Research Group at Pasteur Institute of Iran. He has published more than 60 papers in reputed journals.
Abstract:
Leishmania as protozoan parasites causes major diseases of leishmaniasis in humans in tropical and subtropical regions. In different hosts including humans, clinical samples, rodents and/or other mammals as reservoir hosts and sand flies as vectors, mixed infections, co-infections and different hybrids of Leishmania parasite with different aneuploidy in chromosomes are observed. Differentiate common Old World parasite species and discriminate co-infection with different species. The genetic variation analysis and SNP prediction identify using high resolution melting analysis as a powerful method. For each species, one standard sample was amplified and a recognized region was cloned. Three sets of primer were designed for nuclear gene of amino acid permeases (AAP3) gene and EvaGreen dye mechanism was used and the different temperature of HRM species was optimized. Temperature variation in HRM separated L. major and L. tropica co-infections and their sub-strains. The specific and common primers were separate species and strains by melting temperature analysis. To compare with variety of mitochondrial and nuclear genes, AAP3 gene is more sensitive and specific than other genes for identification of Leishmania parasites. The setup HRM could separate common species of Leishmania parasite and useful in separations intra-stains. Efficiency and regression coefficient reactions for genus and species Leishmania were also validated.
Jyotsna Agarwal
King George’s Medical University
Title: Comparative gene expression of urine and fecal E. coli isolated from women with acute cystitis
Biography:
Jyotsna Agarwal has joined at the King George’s Medical University, Lucknow as a Faculty in 2002 and is currently working as a Professor of Microbiology, In-charge Bacteriology Laboratory. She received her MBBS degree from CMC, Vellore and MD in Microbiology from BHU, Varanasi. She is Nodal Officer In-charge for Regional Centre of WHO sponsored Diphtheria Surveillance Project and Regional RTI/STI Centre for state of Uttar Pradesh. Her research interests include antimicrobial resistance, molecular diagnostics; focus areas are infections of children including pneumonia, septicemia and meningitis; sexually transmitted/reproductive tract infection along with pathogenesis of urinary tract infections in women. She has nearly 50 publications in reputed journals and a book chapter to her credit.
Abstract:
Temporal and spatial regulation of gene expression induced by bladder environment may be accountable for difference in the pathogenicity of urinary and fecal E. coli isolates. In order to better understand the pathogenesis of urinary tract infection (UTI), genetic and functional (expression) profiles of cystitis and fecal E. coli isolates were analyzed in present study. Fifty sets of concurrent urinary and dominant fecal E. coli from women with acute cystitis were correlated by analyzing their mRNA and phenotypic expression for five virulence genes (VGs) viz. fimH, papG alleles, hlyA, iutA and traT along with phylogenetic grouping. Predominance of phylogenetic group B2 (48% and 40%, respectively) and higher prevalence of VGs fimH (82% and 78%), followed by traT (66% and 46%), and iutA (44% and 40%) was observed in both urinary and fecal E. coli isolates, respectively; with traT being the only gene significantly associated with urinary isolates (p=0.04). Number of urinary E. coli expressing mRNA and corresponding phenotype of the respective gene tested was more in urinary isolates as compared to fecal isolates; though this difference was statistically significant only for traT (p=0.02). Differences between genetic and expression profiles of concurrent dominant fecal and cystitis E. coli were not prominent; indicating establishment of symptomatic infection might be more dependent on the host factors rather than on the virulence potential of uropathogens alone.
Moonira Mullah
Cape Peninsula University of Technology
Title: Global Perceptions of the Profession of Medical Laboratory Sciences
Biography:
Abstract:
Biomedical Laboratory Technologists or Scientists play a fundamental role in diagnosis and disease management of patients. “South Africa has the largest economy in Africa but is one of the most inequitable societies in the world, illustrated by the disparity between private and public sector healthcare funding. Eighty-four percent (84%) of South Africans cannot afford to contribute to private health care insurance and are thus reliant on the public health care systems which utilise the laboratory services provided by the National Health Laboratory Services (NHLS). The NHLS provides South Africans access to pathology services in both the private and state funded medical laboratories. The service provides a comprehensive range of laboratory tests across all Medical Laboratory Science disciplines. A mere 16% of the South African population belong to private medical aids which gives them greater benefits for utilisation of private pathology laboratory services after consultation with a clinician. These private pathology laboratories provide additional comprehensive specialised diagnostic analyses for patient treatment.
This was a qualitative study making use of semi-structured open ended questions. Over 480 surveys were sent out using an online programme called Survey Monkey. There was a response rate of 32.4%.
Majority of the respondents were Medical Technologist employed in private pathology laboratories. Approximately 98.59% of respondents were registered with the Health Professions Council of South Africa, however, only 54.23% were active members of the Society of Medical Laboratory Technologist of South Africa. The majority of respondents were female with job satisfaction of approximately 71.90%. More than 30% of respondents were employed for longer than 15 years with their current employer
Asma Shabbir Hussaini
Jinnah Sindh Medical University
Title: Evaluation of Human Epidermal Growth Factor Receptor (Her-2/neu) in Gastric Adenocarcinoma: A Study from South Asia region
Biography:
Dr. Asma Shabbir has done MBBS from B.J.M.C, Pune University, India. She has done her post-graduation from Dow International Medical College & University, Karachi, Pakistan. She is a gold medalist throughout her career. She has a passion towards research & concerned for better prognosis of the patient. She has presented her research work in many conferences. Recently she received "Young Researcher Award" in International Conference of Digestive Diseases held in Dubai 2016. She has also reviewed articles from International Journals. She is a member of different scientific & research associations. At present she is working as researcher & Assistant Professor in Department of Pathology, Jinnah Sindh Medical University, Karachi, Pakistan.
Abstract:
Background & Aim: Gastric cancer is the third leading cause of cancer mortality worldwide. Human epidermal growth factor (Her-2/neu) has shown strong therapeutic implication in breast cancer. Expression of Her-2/neu in gastric cancer has been reported from across the world, it is still unknown from South Asia region. The aim of this study is to evaluate Her-2/neu expression in gastric adenocarcinomas and to correlate with various clinico-pathological variables.
Patients & Method: A total of 95 consecutive patients undergoing endoscopic biopsy or gastrectomy were recruited in this study after institutional ethical approval. Clinico-pathological parameters of all patients were recorded and hematoxylin and eosin (H&E) staining was performed. Expression of Her-2/neu was investigated by immunohistochemistry using a-Her-2 antibody. Hofmann validation scoring system was used and its association was seen with various clinicopathological variables including age, gender, histopathological type, grade and stage of the tumor.
Results: Her-2/neu over expression was found in 21 (22.1%) cases from the total of 95 gastric adenocarcinomas. Her-2/neu was significantly expressed in low grade gastric cancer (p=0.030). Although there was no significant difference between Her-2/neu expression and other variables, Her-2/neu score 3+ was higher in females, age >60 years, Laurens intestinal type and IIIC stage.
Conclusion: Her-2/neu is expressed in a limited group of gastric cancer patients in Pakistani population. Our findings indicate a significant strong association of Her-2/neu expression with low grades of gastric cancer.
Eric S Donkor
University of Ghana
Title: A genomic infection control study for Staphylococcus aureus in two Ghanaian hospitals
Biography:
Eric S Donkor has done his Doctoral degrees in Infectious Diseases and Public Health from London School of Hygiene and Tropical Medicine, and University of Iceland, respectively. He holds Master degrees in Molecular Biology and Animal Microbiology from Birkbeck College, University of London and University of Ghana, respectively. He has received several researches funding and has published 50 peer reviewed articles in the areas of Infectious Diseases, Food Safety and Environmental Health. Currently, he is an Associate Professor of Public Health Microbiology at University of Ghana.
Abstract:
Staphylococcus aureus is a notorious hospital acquired pathogen and is implicated in several serious infections such as meningitis, bacteremia and pneumonia. Whole genome sequencing analysis (WGSA) provides the best resolution for typing of bacterial isolates and has the potential for identification of transmission pathways. We used WGSA to study isolates of S. aureus from the pediatric emergency ward of Korle-Bu Teaching Hospital (KBTH) in Ghana where a suspected outbreak had recently occurred. The dominant clone of S. aureus identified among the isolates was sequence (ST) 15. The genomics data indicated cross contamination of multiple surfaces in the emergency ward by multiple lineages of ST 15 with the door handle of the ward implicated as a potential transmission route. The data also suggests that ST 15 is widely disseminated at KBTH, as it was found in multiple infections in the hospital (during the period of the outbreak) that were unrelated to the transmission events in the pediatric emergency ward. This investigation highlights the need for proper disinfection of environmental surfaces at KBTH.
- Clinical Applications of Molecular Biology |Clinical Hematology | Clinical Microbiology | Antibiotics in Laboratory Medicine | Pediatric Laboratory Medicine | Transfusion medicine & Advances |Histocompatibility Complex (HLA)
Chair
Brian Bennett
Marquette University, USA
Co-Chair
Mary Ann G Sanders
University of Louisville, USA
Session Introduction
Asma Asif
Jinnah Sindh Medical University
Title: Iron deficiency and thalassemia trait in vitamin B12 deficient patients with normal or low mean corpuscular volume
Biography:
Asma Asif has completed my M.Phil in Hematology from Dow University of Health Sciences in 2016. She is currently working in Jinnah Sindh Medical University Karachi Pakistan.
Abstract:
Statement of the Problem: Vitamin B12 is one of the most important vitamins of the B-complex group. Its deficiency is not always accompanied by macrocytic picture refracted in the form of raised MCV. This rise in MCV can be blunted by concomitant iron deficiency or thalassemia trait. Due to these coexistent conditions, B12 deficiency can be missed on routine CBC leading to development of severe complications and few of them can be irreversible like neuropathy. The purpose of this research is to study the importance of normal or low MCV in vitamin B12 deficiency due to co-existence of iron deficiency or beta thalassemia trait masking a rise in mean corpuscular volume.
Methodology & Theoretical Orientation: Clinical records of 105 vitamin B12 deficient cases (vitamin B12 less than 200 ng/l) who had presented with normal or low mean corpuscular volume (MCV less than 95 fl) on complete blood count were determined from Dow diagnostic research and reference laboratory. Serum ferritin, red blood cell folate level and Hb electrophoresis for beta thalassemia trait were analyzed in these patients.
Findings: A total of 105 vitamin B12 deficient patients who fulfilled the inclusion criteria were enrolled in this study from which 39 (37.14%) were male and 66 (62.85%) were females. Amongst them 36.19% were microcytic with the mean age of 37±16.2 years and 63.8% were normocytic with the mean age of 41.58±15.65 years. In microcytic group, the percent value of iron deficient, beta thalassemia trait, combined deficiency of B12, iron and beta thalassemia trait and RBC folate deficient were 52.6%, 34.21%, 7.8% and 2.63%, respectively. In normocytic group, the percent value of iron deficient, beta thalassemia trait and RBC folate deficient were 13.4%, 00% and 11.9%, respectively.
Conclusion: It was concluded that frequency of iron deficiency and beta thalassemia trait are significant in vitaminB12 deficient cases with normal or low mean corpuscular volume. It is more common in females having age group of 20-40 years. Index of suspicion should be kept high and serum ferritin and Hb electrophoresis should be done in all such patients who present with B12 deficiency anemia with normal or low MCV.
Parviz Parvizi
Pasteur Institute of Iran
Title: Analyses of five nuclear and mitochondrial genes for the identification the old and new world Leishmania parasites
Biography:
Parviz Parvizi has completed his PhD from the London School of Hygiene and Tropical Medicine (London University) and Natural History Museum (London) in 2004. He has been a Full Professor since 2015 and honored as the Head of Parasitology department and as the Director of Parasitology, Immunology and Mycology Research Group at Pasteur Institute of Iran. He has published more than 60 papers in reputed journals.
Abstract:
Background: The polymorphism and genetic diversity of Leishmania genus have status under discussion depending on many items from clinical samples, reservoir hosts and vectors.
Objectives: The objectives are to compare genetic changes and the role of each two enzymatic and mitochondrial genes (COII and Cyt b) or housekeeping and nuclear genes (nagt, ITS-rDNA and HSP70) for accurate identification of Leishmania parasites.
Methods: After DNA extractions, PCR products were sequenced and evaluation of genetic proximity and phylogenetic analysis were performed using MEGA6 and DnaSP5 software.
Results: Of the 72 sequences, 54 new haplotypes from five Leishmania species were submitted to GenBank. The number of polymorphic sites was significantly lower as compared to the monomorphic sites.
Conclusions: The highest and lowest levels of haplotype diversity were observed in L. tropica (81.35%) and L. major (28.38%). Tajima’s D index analyses showed that Cyt b gene in L. tropica species was significantly negative, while COII and nagt genes were produced through evolutionary processes for both L. tropica and L. major.
Biography:
Eric S Donkor has done his Doctoral degrees in Infectious Diseases and Public Health from London School of Hygiene and Tropical Medicine, and University of Iceland, respectively. He holds Master degrees in Molecular Biology and Animal Microbiology from Birkbeck College, University of London and University of Ghana, respectively. He has received several researches funding and has published 50 peer reviewed articles in the areas of Infectious Diseases, Food Safety and Environmental Health. Currently, he is an Associate Professor of Public Health Microbiology at University of Ghana.
Abstract:
Background: In Africa, little is known about urinary tract infection (UTI) in relation to stroke patients. The aim of the study was to investigate the epidemiology of UTI among stroke patients at the Korle-Bu Teaching Hospital (KBTH) in Ghana.
Methods: This was a longitudinal study involving 55 outpatients and 16 inpatients of stroke from the physiotherapy clinic and stroke admission ward of KBTH, respectively. Urine cultures for inpatient subjects were done each day until the patient was discharged. With outpatients, urine specimens were analyzed every week or two for 6 months. Information on demographics and clinical history of the study participants were extracted from their clinical records.
Results: Prevalence of UTI among stroke outpatients and inpatients were 10.9% (6/55) and 18.8% (3/16), respectively (p=0.411). Incidence of UTI among stroke outpatients and inpatients were 1.8% (1/55) and 6.3% (1/16), respectively (p=0.125). Overall, 11% (1/9) of the UTI cases among the stroke patients were symptomatic. Severe stroke (OR=17.7, p=0.008) and pyuria (OR=38.7, p=0.002) were identified as predictors of UTI. Escherichia coli was the most common organism implicated in UTI and was susceptible to amikacin, but resistant to augmentin, ampicillin, cefuroxime, co-trimoxazole, meropenem, norfloxacin and tetracycline.
Conclusion: UTI is a common complication among both stroke inpatients and outpatients, though it appears to be more common among the former. Stroke severity appears to be the main stroke related determinant of UTI among stroke patients. UTI among stroke patients is mainly asymptomatic and E. coli is the most important aetiological agent.