Day 1 :
Doctor Xinhua Hospital-Shanghai Jiao Tong University School of Medicine, China
Keynote: Neurotrophic factor reduces inflammation and improve brain neuronal regeneration in inflammatory
Time : 16:10-16:40
Ling Li is Presently working as a Doctor in Xinhua Hospital-Shanghai Jiao Tong University School of Medicine, China. His international experience includes various programs, contributions and participation in different countries for diverse fields of study. His research interests reflect in his wide range of publications in various national and international journals.
The risk of suffering from serious permanent sequelae following a central nerve system (CNS) infection is high and varies in different studies from 30 to 60%, to some extent depending on the causative agent. Inflammation is emerging as a critical mechanism underlying neurological disorders of various etiologies, yet its role in altering brain function as a consequence of neuro infectious disease remains unclear. The main limitation to advance in prevention and treatment of the disease is incomplete knowledge of its pathogenesis and pathophysiology. There is now solid evidence that intense inflammatory host response causes important damage to the brain, thus inducing unfavorable outcomes of meningitis. Neuro trophic factor family(nerve growth factor, NGF, brain derived neuro trophic factor, BDNF, et al) plays an important role in the development, differentiation, and survival of neurons in the CNS. Dysfunction in the regulation of BDNF is associated with numerous disorders of CNS, including Alzheimer’s disease (AD), multiple sclerosis (MS), depression, and unacceptable outcomes of bacterial meningitis. Our previous study showed that increased expression of BDNF in the acute S. pneumonia meningitis was abviously alleviated after antibiotic treatment. Similarly, increased BDNF levels were also observed in the serum and cerebrospinal fluid (CSF) of pediatric patients with CNS infections on the day of admission. Furthermore, Barichello et al. reported that decreases in BDNF levels during the long-term phase of meningitis were correlated with behavioral deficits in adult animals submitted to meningitis during the neonatal period. Interestingly, our previous study reported that administration of exogenous BDNF increased neuron survival in both the cortex and hippocampus, and reversed brain damage, and it was recently reported that exogenous BDNF increases neurogenesis of neuron stem cells in the hippocampus after S pneumonia meningitis. These findings indicate that regulatory expression of BDNF may be a part of the host inflammatory response in S. pneumonia meningitis, and the innate immune response could be a double-edged blade possessing both protective and damaging properties, and there could be interaction between them. However, the underlying regulatory mechanism is still not clear. We investigated the effects of BDNF-related signaling on the inflammatory response and hippocampal apoptosis in experimental models of pneumococcal meningitis. Pretreatment with exogenous BDNF or the tropo myosin-receptor kinase B (TrkB) inhibitor k252a was performed to assess the activation or inhibition of the BDNF/TrkB-signaling axis prior to intracisternal infection with live S. pneumonia. The results showed Rats administered BDNF exhibited reduced clinical impairment, pathological severity, and hippocampal apoptosis.
All India Institutes of Medical Sciences, India
Keynote: A study to find out relapse of tobacco seeking behavior in tobacco users recovering from stroke and the related contributing factors
Time : 16:40-17:10
Neetu Kataria is a student at All India Institutes of Medical Sciences, India.
Email: [email protected]
Background: There are around one thousand stroke patients visiting the stroke clinic in the study setting annually. The outcome of treatment of stroke depends on removal of modifiable risk factors, such as stopping tobacco seeking behavior, which gets relapsed soon after a short period of abstinence post-stroke. Hence, there is need to plan strategies for tobacco cessation immediately after the attack of stroke for minimizing risk of relapse of stroke and other complications.
Methodology: A descriptive, cross sectional study on 164 tobacco user post-stroke patients seeking treatment from tertiary care hospital, New Delhi, India. A demographic data sheet, pattern of tobacco use semi-structured proforma, Modified Fagerström Tolerance Scale (MF-TS), Modified Fagerström-Smokeless Tobacco (MF-ST) version scale, checklist to assess factors contributing relapse of tobacco seeking behavior and National Institutes of Health Stroke Scale (NIHSS) were used for the study. All tools were tested for validity and reliability before use. Ethical clearance was obtained from institutional ethics committee.
Results: Mean age of post-stroke patients was 50.56±1.27 years. Most (75%) of the patients were above 45 years of age and were male (98.7%). Most of the subjects had an attack of stroke which had occurred more than 1.7 years back (35.9%, n=59) (before the time of data collection) and 15.8% (n=26) of the patients had attack of stroke 1 to 1.6 years back and most of them had ischemic attack of stroke (70%). Little over half 51.8% (n=85) of the patients had one to five score on NIH Stroke Scale at the time of admission and 3.1% (n=5) of the patients had score of 21 to 42 on NIH Stroke Scale. Slightly less than half (45%) of the patients relapsed to tobacco use post-stroke attack after initial abstinence whereas 54.87% (n=90) of the patients did not relapse to tobacco use. Most of the subjects reported that they were still not ready for enrolling in tobacco cessation treatment program (60.3%). A significant difference was found between relapse of tobacco seeking behavior with MF-ST (smokeless) scale (p<0.001) than MF-TS (smoking) scale (p<0.05). Most of the subjects gave some reasons of relapse like craving or uncontrollable desire. And patients reported symptoms such as irritability, sadness, poor concentration, constipation and non-availability of tobacco cessation treatment, which they reported led to their relapse of tobacco use.
Conclusion: The prevalence of tobacco users getting attack of stroke is four times higher than non-tobacco users. Even though patients are warned by doctor to stop smoking, they continue to use tobacco and same is the finding of the present study that 45.1% of the post-stroke patients relapsed to tobacco use and continue to be under risk of reoccurrence of stroke and other complications.
Implications: It is imperative for physicians treating post-stroke patient, to initiate tobacco cessation treatment at the earliest for patient within first month post-stroke to maintain abstinence from tobacco and thereafter follow-up.