Background:
Non-Alcoholic Fatty Liver Disease (NAFLD) is the sign of noncommunicable disease; Type 2 Diabetes and other. In Thailand, they had the screening Program for Cholangiocarcinoma in Northeast area, 56% had the NAFLD, and associated with dietary. Oral health is the first part of digestive system. Disease of gum, Molar loss ≥ 3 pairs, and eating-fast behavior; may lead to NAFLD.

Methods:
Cross-sectional analytical study from the health screening project in municipality area. 365 participants were collected, exclude people age< 18-year-old and malignancy. The data were analyzed by odd ratio (OR) and p-value and 95% confident interval (95% CI) for test the relation between NAFLD and oral health; disease of gum, molar loss ≥ 3 pairs, and eating-fast behavior.

Results:
Two-hundred-fifty-four participants had NAFLD, 89% were female, average age (SD) was 58.32 (12.49) year-old, average BMI was 32.17 kg/m2, 53.7% had underlying disease; Diabetes, Hypertension, Dyslipidemia. However Diastolic blood pressure ≥90mmHg (OR=2.37, p-value=0.05, 95% CI 1.02-5.52), higher body weight or higher BMI or obesity (OR=4.28, p-value <0.001, 95% CI 2.62-7.01) associated with NAFLD. 49.6% had gum disease with NAFLD, and 19.7% hadn’t NAFLD (OR=1.34, p-value=0.22, 95% CI 0.84-2.16). 37.3% had Molar loss ≥ 3 pairs with NAFLD, and 12.9% hadn’t NAFLD (OR=1.57, p-value=0.05, 95% CI 1.01-2.46). 9.9% had Eating-fast behavior with NAFLD, 4.1.% hadn’t NAFLD (OR=1.06, p-value=0.87, 95% CI 0.55-2.02).

Conclusion:
Molar loss ≥ 3 pairs, associated with NAFLD. Disease of teeth should be evaluated in non-communicable prevention program and anticipatory planning for treatment patient with loss a few of molars. NAFLD hadn’t associated with disease of gum and eating-fast behavior, but associated with obesity and high diastolic blood pressure (≥90mmHg), weight and blood pressure control might be benefit for NAFLD.

1. Liver Ultrasonography might be benefit for NCD screening program
2. Molar (teeth) should be evaluated in NCD screening program
3. Higher Diastolic blood pressure associate with NAFLD

Background: In Heigun-island, Yanai City, Yamaguchi Prefecture, a doctor was stationed at the clinic until 2020. But it became a part-time system from 2021, and the opportunities for access to medical care for islanders have decreased.

Method: We aimed to improve access to medical care by starting telemedicine. It was conducted under the system of Doctor to Patient with Nurse (D to P with N). In 2021, it was limited to “stable condition”, “relatively ICT literate”, and “relatively young” people. From 2022, the target was expanded to include “elderly people with poor ICT literacy,” “patients with dementia or hearing loss,” and “patients with mild acute symptoms.” From 2022, in order to improve the quality of telemedicine and the medical care system, we have also verified medical treatment using high-definition mobile relay device under the environment without 5th generation mobile networks(5G), medical treatment using smartwatches, and drone delivery of medicine.

Result: With the D to P with N system, it was possible to conduct telemedicine smoothly for various subjects and situations. Even without a 5G, it is possible to share high-quality image and video data without delay, and the technology was useful for improving the quality of online medical care and consultation with specialists. We interviewed patients, their families, supporters such as social welfare commissioners, and doctors about how the information obtained from smartwatches contributed to improving the quality of telemedicine, and whether it gave them a sense of security. We demonstrated the flow of a series of telemedicine, prescription drug delivery by drone, and online medication guidance.

Conclusion: The use of ICT has the potential to improve the medical care system on remote areas, but there are many issues such as information provision and support systems for people with low ICT literacy, as well as related human resources and costs.

At the conclusion of my presentation attendees will take away
1. D to P with N is very useful in telemedicine.
2. Even without a 5G, it is possible to share high-quality image and video data without delay.
3. ICT can improve medical systems in remote areas, but there are many issues

Background
Non-Alcoholic Fatty Liver Disease (NAFLD) is the sign of noncommunicable disease; Type 2 Diabetes and other. In Thailand, they had the screening Program for Cholangiocarcinoma in Northeast area, 56% had the NAFLD, and associated with dietary. Oral health is the first part of digestive system. Disease of gum, Molar loss ≥ 3 pairs, and eating-fast behavior; may lead to NAFLD.
Methods
Cross-sectional analytical study from the health screening project in municipality area. 365 participants were collected, exclude people age< 18-year-old and malignancy. The data were analyzed by odd ratio (OR) and p-value and 95% confident interval (95% CI) for test the relation between NAFLD and oral health; disease of gum, molar loss ≥ 3 pairs, and eating-fast behavior.
Results
Two-hundred-fifty-four participants had NAFLD, 89% were female, average age (SD) was 58.32 (12.49) year-old, average BMI was 32.17 kg/m2, 53.7% had underlying disease; Diabetes, Hypertension, Dyslipidemia. However Diastolic blood pressure ≥90mmHg (OR=2.37, p-value=0.05, 95% CI 1.02-5.52), higher body weight or higher BMI or obesity (OR=4.28, p-value <0.001, 95% CI 2.62-7.01) associated with NAFLD. 49.6% had gum disease with NAFLD, and 19.7% hadn’t NAFLD (OR=1.34, p-value=0.22, 95% CI 0.84-2.16). 37.3% had Molar loss ≥ 3 pairs with NAFLD, and 12.9% hadn’t NAFLD (OR=1.57, p-value=0.05, 95% CI 1.01-2.46). 9.9% had Eating-fast behavior with NAFLD, 4.1.% hadn’t NAFLD (OR=1.06, p-value=0.87, 95% CI 0.55-2.02).
Conclusion
Molar loss ≥ 3 pairs, associated with NAFLD. Disease of teeth should be evaluated in non-communicable prevention program and anticipatory planning for treatment patient with loss a few of molars. NAFLD hadn’t associated with disease of gum and eating-fast behavior, but associated with obesity and high diastolic blood pressure (≥90mmHg), weight and blood pressure control might be benefit for NAFLD.

1. applicable of portable Ultasound for NCD screening
2. relation of Dental problem and NCDs
3. obesity and high Diastolic blood pressure in NAFLD.

Presentation of ECG scans, where every scan is shortly introduced as a real casuistry from the general practice. After some time for the attendees, to read the ecg, follows a slide with question and possible answers. There is a technical support needed to enable the voting of the learners for example by using their mobile phones with special application or another voting device. After the voting, there will be shown the correct answer and a slide with explanation of the ECG image.

At the conclusion of my presentation attendees will take away
1. key message : GP can be a confident evaluator of the ECG
2. key message : ECG is a must in the complex care of a patient with hypertension in general practice
3. key message: ECG is an excellent helper of a GP when a patient with chest pain appears