Day 1 :
Nanavati Hospital, India
Time : 09:30-10:15
Dr. R K Sinha is a renowned senior Laparoscopic and Bariatric surgeon attached to Nanavati Hospital and Criticare Hospital (Mumbai, India), with a special interest in Advanced Laparoscopic Surgery including Bariatric and Hernia repair. He has received his MS degree (General Surgery) from Grant Medical College Mumbai in the year 2000. He has received training in Advanced Laparoscopic Surgery and Bariatric Surgery from Stanford Medical School (US, 2009) and Special Single Port Laparoscopic Surgery at The Royal Surrey County Hospital (UK, 2010). He is also trained in Robotic Surgery from Intuitive Surgicals, California. He is a fellow of International college of surgeons(FICS) and Indian association of Gastrointestinal Endo-surgeons(FIAGES). He is also a faculty at Obesity & Metabolic Surgeons Society of India (OSSI) and member of International Federation for Surgery of Obesity and Metabolic diseases (IFSO).
Bariatric surgery is emerging as a powerful weapon against severe obesity and Type 2 Diabetes mellitus. Diabetes Mellitus is a chronic disorder that can alter carbohydrate, protein and fat metabolism. It is caused by absence of insulin secretion due to either the progressive or marked inability of the b-Langerhans cells of Pancreas to produce insulin, or due to defects in insulin uptake in the peripheral tissue. DM is broadly classified under two categories which includes Type1 and Type 2 diabetes. The etiology of Type1 diabetes can be explained by damage to the pancreatic cells due to environmental or infectious agents. On the other hand, Type 2 diabetes etiology can be described as a combination of low amount of insulin production from pancreatic b cells and peripheral insulin resistance. Insulin resistance leads to elevated fatty acids in plasma causing decreased glucose transport into the muscle cells, as well as increased fat break down, subsequently leading to elevated hepatic glucose production. Anyone who is overweight and/or obese has some kind of insulin resistance, but diabetes only develops in those individuals who lack sufficient insulin secretion to match the degree of insulin resistance. Insulin in those people may be high yet it is not enough to normalise the level of glycaemia. Bariatric Surgery, before used for treating only obesity, is now being explored as a cure of Type 2 Diabetes not only in obese patient but also moderately overweight patients. Rapid improvement in blood sugars and reduction or elimination diabetic medication is often seen within the immediate post-operative period following Bariatric Surgery, even before significant weight loss. Potential mechanisms of diabetes remission following bariatric surgery can be due to decreased calorie intake and weight loss, changes in gut physiology, improved pancreatic beta cell functions, hepatic and peripheral insulin sensitivity, altered bile acid metabolism and changes in gut microbiota. Several Randomised controlled trials of Type 2 diabetes remission after bariatric surgery versus medical therapy have shown good control of diabetes mellitus following bariatric surgery.
District Hospital of Orthopedics and Trauma Surgery, Poland
Keynote: Primary traumatic anterior dislocation of the shoulder – epidemiology and risk factors of recurrences.
Time : 10:15-11:00
Szyluk K is currently working as the Deputy Head of the Department VI at the District Hospital of Orthopedics and Trauma Surgery, Poland. He has 30 scientific papers to his credit. He was a participant, organizer and speaker at many international scientific conferences and a Scientific Reviewer of papers in magazines.
Introduction: Shoulder joint is the most often dislocated joint in the human body. This is associated with unique structural and biomechanical features of the joint. The shoulder joint is a free ball-and-socket multiaxial joint with a large range of motion, thanks to: size ratio of 3:1 between the humeral head and the glenoid cavity, flexible and spacious joint capsule. Such anatomical configuration in not allowing for very stable shoulder congruence.
Purpose: To study the incidence of primary traumatic anterior shoulder dislocation, epidemiology and risk factors of recurrences in entire Polish population.
Methods: A retrospective study of Polish population from 1st of January 2010 to 1st of January 2015. This study analyzed incidence rate of primary traumatic anterior shoulder dislocation registered in Polish National Health System (NFZ) database. Data were collected in the electronic database accordingly with the applicable legal provisions regarding the protection of personal information in Poland. The basic demographic indices were obtained from Central Statistical Office of Poland. Main inclusion criteria were: diagnosis and code of primary traumatic anterior shoulder dislocation in a hospital emergency department during the study period. Study included only patients who were residents of Poland. To evaluate population (non-modifiable) risk factors in the study group, recurrent shoulder dislocations was coded during that period.
Results: Incidence rate of primary traumatic anterior dislocations of the shoulder join in Poland ranged from 24.75 dislocations/100 000 persons/year to 29.09 dislocations/100 000 persons/year, on average 26.69/100 000/year with peak among females 80 years old and above (Figure 1.). The highest risk of recurrences was in group of young males in the age group between 20 - 29 years old.
Conclusion: Overall incidence of primary anterior traumatic dislocation in Poland is 26.69/100 000/year with peak among females 80 years old and above. The most important risk factors for recurrences are: male sex and third decade of life.