Title: Socio-Demographic Determinants of Adult Pulmonary Tuberculosis Patients: A Hospital Based Study at Dhanmondi, Dhaka, Bangladesh

Abstract:

Background: Tuberculosis (TB) is a multi-system infectious disease with a major cause of morbidity and mortality all over the world but particularly in developing countries like Bangladesh. A normal healthy individual does not face the symptoms causing by tuberculosis due to their immune system that’s why infection among healthy individuals always remain silent. As it is highly infectious air borne disease that’s why treatment completion for TB is the cornerstone of its control and prevention. So to understand these factors efficiently this study was carried out about socio-demographic determinants of adult TB patients attending the tertiary care teaching hospital, Dhanmondi, Dhaka. Methodology: This was hospital based cross sectional observational study done at Bangladesh Medical College Hospital, Dhanmondi, Dhaka with the study period from January 2020 to December 2021.Total 410 patients of age group 18 years and above with persistent cough with sputum production for more than 2 weeks were enrolled for this study purpose. Results: Total prevalence of sputum positive adult pulmonary TB among the studied group was 69.02%. Majority 54% were male patients in the age group of 41-50 years (31.45%). Pulmonary TB was predominantly diagnosed among employed group 41.34%, those who have completed their high school level (34.28%) in mainly the rural (66.08%) locality. Joint family (61%) with 8-10 family members (43.46%) have been found mostly affected in our study. The cardinal features were cough with sputum production (80.21%) followed by fatigue (71.73%), fever (42.05%), sweating (46.99%), loss of appetite (32.86%) and weight loss (27.56%). Pulmonary TB was found mostly among smokers (57.23%) with normal BMI (44.88%).

Conclusion: To decrease the rate of infection with Tuberculosis, a ultifactorial approach can play the pivotal role by improving the living conditions, education level, economic status and adequate sanitation. Awareness can bring a new dimension in this regard.
Keywords: Socio-demographic determinants, tuberculosis.

Biography:

Sadia Saber, currently working as an Assistant Professor in the Department of Medicine, at Bangladesh Medical College, Dhanmondi, Dhaka, Bangladesh for the last 4 years. She completed her MBBS at the university of Dhaka in the year July 2010 with honors marks in Anatomy, Physiology, Biochemistry, and Pathology. She also secured 4th position in the merit list during her 2nd Professional MBBS Examination. Then she completed her 5 years of Post-graduation Clinical Training at Bangladesh Medical College Hospital From January 2012 – December 2016. She acquired her Fellowship (FCPS) in Internal Medicine from the Bangladesh College of Physicians and Surgeons (BCPS) in the session of January 2017. She obtained her MRCP (UK) & MRCP (Ireland) in the year of November 2017 & October 2019 respectively. She has passed MRCP SCE in Respiratory Medicine (UK) in the year of October 2021. She has also completed her Postgraduate Diploma in Respiratory Medicine, at the University of South Wales, Cardiff (UK) in the session of 2021-2022. She acquired European Diploma in Respiratory Medicine (Switzerland) in 2022. Currently, she is doing her Master’s Degree in Sleep Medicine at the European University of Madrid, Madrid, Spain. She is working as an active member of the Royal College of Physicians and Surgeons of Glasgow (UK), the Royal College of Physicians of Edinburgh (UK), the American College of Physicians (USA) & the American College of Chest Physicians (USA). She has got more than 35 publications in both national and international levels, among those she is the 1 st author for more than 25 publications.

Title: Effective secretolytic and bronchodilatativ Strategies by Prolonged Weaning by COPD GOLD D Patients on Respiratory Intensive Care Unit after quantitative based Lung Computertomographie and Lung Volume Reduction Surgery bei massive Emphysema

Abstract:

A meta-analysis of studies published in the 1990s calculated the incidence of VAP (ventilator-associated pneumonia), which is equivalent to 16.5 cases per 1,000 patient days. Attributable mortality due to VAP was estimated to be 20-40%, although the range in different studies was very broad. Healthcare costs related to VAP seem to be remarkable in particular with regard to multidrug-resistant pathogens. VAP is an infection frequently caused by Pseudomonas aeruginosa, Haemophilus spp., and Klebsiella spp. or by Staphylococcus aureus. Anaerobes are a rare cause of VAP. Patients with COPD GOLD D and massive Emphysema, who undergo a Lung Volume Reduction Surgery by prolonged Weaning and long-term treatment on intensive care units, after a quantitative-based Lung Computertomographie to prevent VIDD need an intensive and efficient secrtlytic additionally to bronchoscopy by presenting bronchospasms at the same time. On our Respiratory Intensive Care Unit, we use a Dymedso Frequenzer with sound wave (45 Hz) from the company inspiration medical four times daily in combination with six times deeply bronchodilatativ Aeronep Inhalation from the company Aerogen to reach a 17% lung disposition in compared to 3% by conventional nebulizer. We optimize this by an LALMA/LABA fix combination (Glycopyrroniumbromid/Formoterol) via tracheal cannula from the company AstraZeneca with AEROSPHERE Delivery Technology. Active ingredient particles are connected on aerodynamic Phospholipid particles, which are a natural carrier substance and a component of lung surfactant. Previous studies with health persons could show lung disposition of 38%. The safety and efficiency were demonstrated in phase 3 study PINNACLE 1 and 2 and long-term data of safety and effectiveness in PINNACLE 3.

Biography:

M Lavae-Mokhtari is a consultant in the Respiratory Intensive Care Unit in General Hospital Ibbenburen in Germany since 2013. He has seven publications, 17 national and international poster publications, one book publication, and three scientific international and one national oral presentation. He has 152 citations and a 17.48 RG Score by research gate. He is a member of the German Respiratory Society, Section Intensive-Care and Ventilation Medicine, European Respiratory Society, Section Intensive-Care and Ventilation Medicine, and Section Thorax oncology and German Interdisciplinary Society of Outpatient Ventilation.

Title: Co-pathogens causing respiratory infections in patients with SARS-CoV-2 in Bulgaria

Abstract:

Statement of the Problem: Coinfections with SARS Co-2 and bacterial, fungal, or viral pathogens can worsen the clinical condition and pose challenges to the disease's diagnosis, treatment, and prognosis. This study aims to determine the prevalence and clinical significance of co-infection with SARS-Co-2 and another respiratory pathogen in Bulgaria. Methodology & Theoretical Orientation: Nasopharyngeal swabs from patients with confirmed SARS-CoV-2 infection were prospectively collected from both inpatients and outpatients, with female patients being 55% and male patients being 45%, respectively, and patient ages varied from 45 days to 98 years. RT-PCR was used to detect SARS-Co-2, 8 common respiratory viruses - respiratory syncytial virus(RSV), human metapneumovirus(HMPV), parainfluenza viruses(PIV)1/2/3, rhinoviruses(RV), adenoviruses(AdV), bocaviruses(BoV) and 4 seasonal coronaviruses: OC43, NL63, 229E, and HKU-1. Capillary electrophoresis was used for the detection of three bacterial co-pathogens: Mycoplasma pneumonia(MP), Chlamydophila pneumonia(ChP), and Haemophilus influenza(HI).
Results: From August 2021 to early May 2022, clinical samples from 337 SARS-CoV-2 positive patients were tested for the presence of respiratory co-pathogens, with 42 co-infections detected. Those involving bacterial pathogens were n=23(54.8%) and those involving viral pathogens were n=14(33.3%). The order of evidence of co-pathogens was: HI(n=20; 47.6%), RSV(n=4, 9.5%), ChP(n=3,7.1%), AdV(n=3;7.1%), HI+RSV(n=3;7.1%), BoV(n=2,4;8%), HMPV(n=1;2.4%),PIV-3(n=1;2.4%), RV(n=1;2.4%), HKU-1(n=1;2.4%), NL63(n=1;2.4%), HI+AdV(n=1;2.4%) and HI+PIV2 (n=1;2.4%). Children aged 6-16 years and patients over 65 years had the highest rate of co-infections (37.5%/18.2%). Of the co-infected patients, 32(76%) were hospitalized and three(7.1%) had a fatal outcome. The deaths were in patients co-infected with a bacterial pathogen and SARS-CoV-2.
Conclusion & Significance: In patients positive for SARS-Co-2, the frequency of co-infections with a bacterial pathogen prevailed over that with a viral one. Due to the large proportion of antibiotic-treated patients(83%) with complications due to COVID-19 and the risk of the emergence of resistant strains, timely diagnostics aimed at identifying co-pathogens is of particular importance, which would help in the correct and timely treatment of patients.
Acknowledgments: This abstract is supported by: contracts KΠ-06-H 43/5/30.11.2020/ Molecular-genetic and clinical characteristics of human coronavirus. Study of the role of SARS-CoV-2 in co-infections with other respiratory viruses, NO KΠ-0 6-DK1/7/29.03.2021/ Viral load, cytokines and serum antibody levels depending on the clinical severity of COVID-19 infection and by the European Regional Development Fund through Operational Program Science and Education for Smart Growth 2014–2020, Grant BG05M2OP001-1.002-0001-C04 Fundamental Translational and Clinical Investigations on Infections and Immunity.
Recent Publications: Trifonova I, Christova I, Madzharova I, Angelova S, Voleva S, Yordanova R, Tcherveniakova T, Krumova S, Korsun N. Clinical significance and role of coinfections with respiratory pathogens among individuals with confirmed severe acute respiratory syndrome coronavirus-2 infection. Front Public Health. 2022 Sep 2;10:959319. doi: 10.3389/fpubh.2022.959319. PMID: 36117597; PMCID: PMC947944 IF2021 6.46
Alexiev I, Giovanetti M, Cella E, Ivanov I, Stoikov I, Donchev D, Grigorova L, Gancheva A, Dimitrova R, Korsun N, Trifonova I, Philipova I, Dobrinov V, Grigorova I, Kantardjiev T, Christova I, Ciccozzi M. Initial introduction and spread of the SARS-CoV-2 AY.4.2.1 Delta variant in Bulgaria, a genomic insight. J Med Virol. 2022 Jul 28:10.1002/jmv.28033. doi: 10.1002/jmv.28033. Epub ahead of print. PMID: 35902787; PMCID: PMC9353378. IF2021 20.6
Alexiev I, Ivanov I, Philipova I, Korsun N, Stoikov I, Dimitrova R, Grigorova L, Gancheva A, Trifonova I, Dobrinov V, Grigorova I, Savov A, Asenova B, Ciccozzi M, Kantardjiev T. Postvaccination SARS-CoV-2 Alpha (B.1.1.7) lineage infection among healthcare workers on the background of IgG antibodies. J Med Virol. 2022 Mar;94(3):836-839. doi: 10.1002/jmv.27394. Epub 2021 Oct 20. PMID: 34647629; PMCID: PMC8661687. IF2021 20.6
Korsun NS, Angelova SG, Trifonova IT, Voleva SE, Grigorova IG, Tzotcheva IS, Mileva SD, Perenovska PI. The Prevalence and Genetic Characterization of Human Metapneumovirus in Bulgaria, 2016-2019. Intervirology. 2021;64(4):194-202. doi: 10.1159/000516821. IF2020 1.763
Korsun N, Trifonova I, Voleva S, Grigorova I, Angelova S. Genetic characterization of the influenza viruses circulating in Bulgaria during the 2019-2020 winter season. Virus Genes. 2021 Oct;57(5):401-412. doi: 10.1007/s11262-021-01853-w. IF2020 2.332

Biography:

Iveta Madzharova is a biologist at the National Center for Infectious and Parasitic Diseases, National Laboratory "Influenza and SARS", Sofia, Bulgaria since the beginning of 2022. She has а bachelor’s degree in Biotechnology - Sofia University "St. Kliment Ohridski", Biological Faculty and started a master's degree in 2021 in the field of Microbiology and microbiological control - Sofia University "St. Kliment Ohridski", Biological Faculty. She is developing a master's thesis on the research topic. She participated in two projects related to the research topic. She published one article with impact factor in a reputable journal on the topic "Clinical significance and role of co-infections with respiratory pathogens among individuals with confirmed coronavirus-2 infection with severe acute respiratory syndrome". She participated in an international congress.

Title: SARS-CoV-2 Aerosols in Homes of COVID-19 Infected Adults: Presence and Control

Abstract:

Introduction. One key challenge is to reduce secondary attack rates among household contacts, which are estimated by the CDC to be as high as 50%. In addition to close interpersonal contact, emerging evidence suggests that airborne transmission is important for spreading SARS-CoV-2 infections in enclosed and/or poorly ventilated spaces, such as homes. Since one of the virus transmission routes is airborne, we hypothesized that its spread could be controlled using portable air cleaners (PACs). However, the existing data are sparse and based on scripted scenarios. Here, we report the first naturalistic intervention study to reduce SARS-CoV-2 airborne transmission using PACs with HEPA filters in the homes of COVID-19-infected individuals.

Methods. Subjects were recruited in the fall/winter of 2020-2021 through an email flyer delivered at the time of notification of test positivity. Saliva screening at the time of the first visit verified continued positivity for all reported subjects. 24-hr air samples of total aerosols were collected in the isolation room (the primary room used by the subject) and the common room (a secondary room) on PTFE filters using open-face filter holders (CH Technologies, Westwood, NJ, USA and SKC, Inc. Eighty-Four, PA, USA) or modified IMPACT filter samplers (SKC Inc.) and Leland Legacy pumps (SKC Inc.) operated at 10 L/min. The PAC was placed only in the primary room, away from any walls. In one 24-hr period, the PAC was operated with a HEPA filter and, during the other, without a filter ("sham" period). The filtration and treatment order was randomized. Samples were analyzed by RT-PCR for expression of three distinct SARS-CoV-2 genes: N, ORF1ab, and S. Samples were considered positive if any one gene and internal control (MS2 phage) were detected at Ct ≤ 40.

Results and Conclusions. Samples were collected in the homes of 17 individuals with newly diagnosed COVID-19 infection. Seven out of sixteen (44%) air samples in primary rooms were positive for at least one gene during the sham period. Seven out of fifteen (47%) air samples in secondary rooms were also positive during the sham period. The data also suggested a strong association between the amount of viral RNA in an infected person's saliva and the likelihood of airborne virus being detected in the primary room. During the filtration period, the proportion of positive aerosol samples decreased to four out of sixteen residences (25%) (p=0.223).

Biography:

Gediminas “Gedi” Mainelis is a Professor in the Department of Environmental Sciences at Rutgers, the State University of New Jersey, USA. He has a Bachelor’s degree in physics from Vilnius University, Lithuania, and a Ph.D. in Environmental Health from the University of Cincinnati, Ohio, USA. His research focuses on various aspects of bioaerosol science, including sampling and analysis methods, exposure assessment, and airborne microbiomes. Over the past years, his research expanded to investigate exposures to manufactured nanoparticles and explore indoor air issues. Several of his current projects focus on COVID-19 issues. His research efforts have resulted in more than 110 peer-reviewed publications, book chapters, and several patents. In addition, multiple papers from his group have been included in the most downloaded article lists of various peer-reviewed journals. Dr. Mainelis has served as Chair of the Bioaerosols and Health-Related Aerosol working groups of the American Association for Aerosol Research (AAAR). He is currently an editor (associate) of the Aerosol and Air Quality Research journal. Prof. Mainelis is a recipient of the Research Excellence Award from Rutgers University and the Lyman A. Ripperton Environmental Educator Award presented by the A&WMA.

Title: Challenges in the Epidemiological Evaluation of COVID Interventions

Abstract:

Why is it that we are having so much trouble answering the very basic question: What COVID interventions have proven to be most effective?  To answer this question, we need to study population and their behaviors; meaning we need epidemiology. As the COVID epidemic progressed we implemented what seemed be reasonable actions; i.e. social distancing, hand hygiene, wearing gloves, and later resorted to more complicated interventions such as closing businesses, closing schools, masking, double masking, and finally vaccination (followed by booster 1,2,3). But these rapid adoptions, changes and pivots, have produced a study population which is so confounded that deductions are challenging to say the least. While numerous COVID evaluations and investigations have been conducted, they tended to be singular actions within very small and specialized at risk populations; i.e. health care workers, bus drivers etc.. This session will present the historical progression of COVID interventions and review epidemiological study designs and applicable confounding variables. Suggestions for future public health surveillance programs will be presented and evaluated.

Biography:

Jack Caravanos, life in the field ranges from jumping onto a motorcycle and navigating the jungles of Madre de Dios in the Peruvian Amazon studying toxic substances to traveling to remotes areas in Zambia, Indonesia, and Bolivia studying lead and other toxic wastes. By cooperating with local governments, his work provides safe, healthy, and evidence-based solutions for pollution problems in low- and middle-income countries. In partnership with Pure Earth, an international non-profit organization, Caravanos is studying the impact of gold extraction with mercury in Peru and Indonesia. Since miners are in danger of mercury poisoning, his research team is planning interventions that teach safer techniques for gold extraction. In Kabwe, Zambia - a mining town with exposure to lead - his research will provide methods to institute safer mining practices and policy recommendations to improve environmental remediation laws. Caravanos teaches Environmental Health for graduate students and Environmental Health in a Global World for undergraduate students. He also provides opportunities for student researchers in his ongoing projects, including in Indonesia and Ghana.

Title: Health Care Providers are Now the Frontline for COVID-19 Response: Are We Ready?

Abstract:

The COVID-19 pandemic continues to evolve as the virus mutates to more contagious forms. With the new waves of new variants and continuing federal effort to address COVID-19, the pandemic response is shifting to state and local levels. We all need to recognize that health care providers are and will be playing an increasingly important role in COVID-19 control and treatment.  Measures to fight COVID-19 are widely available to healthcare providers, including tests, vaccines, monoclonal antibodies, and antiviral medications.  Our challenge is to help practitioners take advantage of the ample tools and guidance available to fight COVID-19.  Health care providers can prescribe anit-viral agents. Health care providers can offer protective monoclonal antibodies to immunocompromised patients. Health care providers can register as COVID-19 vaccine providers. It is recognized that the medical community has endured much during this pandemic. It is also recognized that we can continue to step up.

Biography:

Rivkees is a Professor of the Practice of Health Services, Policy, and Practice in the School of Public Health. He served as Florida's State Surgeon General and Secretary of Health from 2019 to 2021. Before moving to Florida, he served as a professor of pediatrics with tenure at Yale University. Dr. Rivkees has had more than 35 years of continuous research funding from the National Institutes of Health. He was responsible for the safety alert on liver toxicity caused by the antithyroid drug propylthiouracil. This led to major international treatment practice changes.

Title: The mistaken belief that fomites play a significant role in transmission of respiratory viruses

Title: Efficacy of Grignard Pure Against a Variety of Bioaerosols

Biography:

Grishma Desai is multifaceted Scientist and Quality Manager at Grignard Company LLC with experience in Biological Nutrient Removal (BNR), wastewater mineral removal and US EPA Pesticide Testing and Regulations. She has a Bachelor’s of Science in Biotechnology from Rutgers University, New Jersey, USA. During her eight years at Grignard Company, she has led multiple R&D efforts in new product development as well as regulatory compliance for products.  In the past two years, Ms. Desai’s work has focused on developing, testing and obtaining regulatory approvals for Grignard Pure® – an airborne antimicrobial effective against MS2 Bacteriophage, a surrogate for the SARS-CoV-2 as well as other bioaerosols. Ms. Desai worked closely with Dr Katherine Ratliff and her team at the US EPA Office of Research and Development to evaluate the efficacy of Grignard Pure® in reducing airborne virus concentrations using a large-scale test chamber and a standardized testing approach. Ms. Desai recently submitted a paper titled “The efficiency of Grignard Pure to inactivate airborne SARS-CoV-2 surrogate” to a peer reviewed journal detailing the testing conducted on Grignard Pure at independent testing labs.

Title: Mechanisms of lung endothelial barrier protection in acute lung injury: role of extracellular purines

Abstract:

The endothelial cells (EC) lining the vessels are in close contact with each other forming a tight barrier. Any breach in the EC barrier is a cardinal feature of acute lung injury (ALI) and its more severe form, Acute Respiratory Distress Syndrome (ARDS), and results in pulmonary edema, and impaired gas exchange and may cause respiratory failure. Despite the obvious importance of the EC barrier, a paucity of information exists concerning the mechanisms involved in the preservation of barrier integrity. We have demonstrated that extracellular purines, ATP (stable analog, ATPγS) and adenosine can preserve EC barrier integrity in vitro and reduce ALI in mice. However, while in both cases EC barrier-protective mechanisms involved cytoskeletal reorganization culminating in an increase in cortical F-actin, the upstream signaling events for extracellular purines differ significantly and include activation of P1 A2 receptors coupled to Gs for adenosine and P2Y receptors coupled to Gi for ATP. Further, we demonstrated that adenosine-induced EC barrier enhancement involves activations of cAMP-dependent protein kinase A (PKA) and myosin light chain (MLC) phosphatase (MLCP), followed by decrease in MLC phosphorylation, thus reducing EC contractility. In parallel, adenosine strengthens EC barrier through activation of small GTPase, Rac1. Unlike adenosine, ATP-mediated EC barrier-enhancement involves unconventional Gi-mediated cAMP-independent PKA, MLCP and Rac1 activations, which may be coordinated through the actions of adapter protein GAB1, Shp2 (a non-receptor Tyr phosphatase), and AKAP2 (PKA anchoring protein 2)-mediated signaling. AKAP2 was found in immune complexes with PKA and Gi and directly interacts with MLCP suggesting that the AKAP2/MLCP axis is a novel regulator of P2Y/Gi-mediated EC barrier enhancement. Further, our data demonstrate the involvement of a regulatory molecule ELMO1 (Engulfment and cell motility protein 1) in P2Y/Gi-mediated EC barrier strengthening, which together with the adapter protein Dock180 formed a bipartite GEF (Guanine nucleotide exchange factor) for Rac1, suggesting the involvement of ELMO1/Dock180 axis in Gi-mediated Rac1 activation. Collectively, our data suggested that while adenosine-induced EC barrier enhancement involves activation of Gs/cAMP-mediated signaling, ATPγS-induced P2Y-mediated EC barrier strengthening requires Gi-mediated, coordinated activation of GAB1/Shp2 and Dock180/ELMO1 leading to activation of PKA and Rac1 pathways, respectively.

Biography:

Verin completed his Ph.D. at the age of 29 years from Moscow State University, Moscow, USSR, and postdoctoral studies at the University of Indiana. During his scientific carrier, he was a faculty member at Johns Hopkins and the University of Chicago. Currently, he is a Professor at the Vascular Biology Center and Pulmonary Division, School of Medicine, Medical College of Georgia, at Augusta University, Augusta, GA.   He has published more than 170 papers in reputed journals primarily in the field of pulmonary vascular endothelial barrier regulation.  He served as an Editorial board member of the American Journal of Physiology (Lung) from 2006-2011 and Editor-in-chief of the academic journal, Vessel Plus, in 2016-2022. He is currently serving as an academic editor of the British Journal of Medicine and Medical Research and Cardiology and Angiology, and an editorial board member in several other journals in the field of pulmonary/cardiovascular research such as Biomolecules, Cardiovascular Pharmacology, Journal of Multidisciplinary Pathology, Tissue Barriers, World Journal of Respirology.

Title: London Hospital Almost Runs out of Oxygen for Covid-19 Patients

Abstract:

Standard delivery of oxygen (O2) to patients with respiratory failure is inadequate, both in pneumonia and in COPD patients.
In COVID-19 mortality rates from pneumonia in UK hospitals rose from 30% to 45%1. This was linked to early use of mechanical ventilation. Similar accounts were reported in USA.2
Currently home O2 is recommended for hypoxic patients at flow rates limited to 3-5L/min for COPD.3 In the USA O2 therapy costs $2.8 billion annually.4 COPD patients appear not to comply with its prescribed use.3 The National Institute Clinical and Care Excellence (NICE) recommends a maximum flow rate of O2 of 15 L/min for patients in acute respiratory failure when arterial O2 saturation (SpO2) falls below 94%.5
These recommended flow rates are below the inspiratory flow rates seen during mild exercise. The Minute Ventilation (MV) rises to 30L/min but requires the peak inspiratory flow rate to rise to 100L/min.6 The same MV occur in pulmonary disease at rest where there is reduction of gas exchange.7 Suggesting that these recommended O2 flow rates for pneumonia or hypoxic COPD patients are too low to match their peak inspiratory flow.
As standard O2 delivery uses open mask to the face/nose, that requires entrainment into the lungs by the inspiratory flow. If the inspiratory flow rate exceeds the flow of O2 then air is entrained so diluting the O2 reaching the lungs.8 The high COVID pneumonia mortality rates and the under use of home O2 can be explained by the use of recommended O2 at flow rates as low as 5L/min to 15L/min could explain.
We recommend instead, automatic matching the flow rate of O2 to the patients inspiratory flow and pulsing automatically selected volumes of O2 to ensure SpO2 remains between 94% - 100%, by using a robotic delivery device.

Biography:

Scientist and Clinician, NHS physician at the Royal Papworth Hospital Cambridge, discoverer of first effective therapies for Pulmonary Arterial Hypertension [PAH] (iv. Prostacyclin and Inhaled NO). Established the UK National Network of PAH centres. Professor, Medicine Sheffield University Medical School and Senior Principal Scientist AstraZeneca plc, Corporate Clinical Director Chiesi Farmaceutici (Italy), Architect of the first triple inhaler for asthma/COPD Trimbow®, Senior Partner TranScrip LLP, R&D Director Allergy Therapeutics plc, Vice President, and President Faculty of Pharmaceutical Medicine Royal Colleges of Medicine UK. CEO and founder of Camcon Robotics Ltd.

Title: The prevalence of Heart Failure in patients with Chronic Obstructive Pulmonary Disease: A systematic review and meta-analysis

Title: Socio-Demographic Determinants of Adult Pulmonary Tuberculosis Patients: A Hospital Based Study at Dhanmondi, Dhaka, Bangladesh

Title: The prevalence of Heart Failure in patients with Chronic Obstructive Pulmonary Disease: A systematic review and meta-analysis

Title: Workers exposure to respirable crystalline silica dust at selected coal fired power stations in Bethal, Mpumalanga province, South Africa

Biography:

Martha is a registered EHP with the Health Professions Council of South Africa. She is a holder of a Bachelor of Science Degree in Environmental Health. She also have an MBA in Environmental and Energy Management from Twente University. She completed an Honors in Leadership at the University of Johannesburg. She is currently registered for a PhD in Public Health at Witwatersrand University focusing on Occupational Health injuries. She was involved in the creation and content development on the online Master of Public Health at the University of Johannesburg. Currently she is an Online Facilitator on the Sample Abstract Template Master of Public Health at the University of Johannesburg. She has been an Adjunct lecturer at the Witwatersrand University and MANCOSA for more than three years. She has published papers on occupational and environmental health in internationally accredited journals. She has supervised more than 16 Masters Students to completion in her career. Her niche area of research is occupational and environmental health. She also involved with research that is focusing on how artificial intelligence is impacting occupational and environmental health. She was recently recognized as one of the top fifty influential women in Science, Technology, Engineering, and Mathematics (STEM) in South Africa for her contribution in the subject matter.

Title: Smartphone enabled home based self-management informatics platform for COPD in India