Biography:

Gilson Capilouto is an associate professor in the Department of Rehabilitation Sciences at the University of Kentucky. She has lectured and practiced extensively in the area of infant and pediatric feeding. Her current research focus includes development of an instrument to facilitate decisions regarding readiness to feed in fragile infants.

Abstract:

The lingual musculature contributes significantly to the coordinated suck, swallow and breathe required for independent infant feeding. However, clinical benchmarks of lingual function fundamental to feeding are unexplored. The aims of the current study were to compare: (1) tongue muscle force during nutritive and nonnutritive sucking for a cohort of healthy full term (FT) infants and healthy preterm (PT) infants; and, (2) mean values of posterior tongue thickness between the two cohorts. Our primary measures of interest were nonnutritive (NNS) and nutritive (NS) tongue force and posterior tongue thickness; secondary measures of interest were nonnutritive and nutritive sucking frequency. Muscle force data was collected using a custom fabricated pacifier and flow-through nipple. Muscle thickness was estimated from measures of posterior tongue thickness using ultrasonography. We found clinically significant differences in mean tongue force and frequency during NNS between the two groups; NNS tongue force and suck frequency was greater for FT infants compared to PT, after adjusting for weight and age at exam. A statistically significant difference in NS tongue force was also found; PT infants demonstrated significantly lower NS force as compared to FT infants. No significant difference in NS frequency between cohorts was found. Results also indicated clinically significant differences in mean posterior tongue thickness. PT infants were found to have smaller mean tongue thickness as compared to FT after adjusting for age and weight at exam. Post-hoc linear regression indicated that posterior tongue thickness may be a more significant predictor of NS force than postmenstrual age.

Biography:

Dr DiMario completed his M.D. at Tufts University and his M.A. in Adult Education from the University of Connecticut. His academic focus is in clinical teaching and conducting research in children with non-epileptic paroxysmal disorders and neurocutaneous diseases. He has authored over 100 peer-reviewed publications and the textbook, Non-Epileptic Childhood Paroxysmal Disorders, Oxford University Press. He has received multiple outstanding teacher awards, has served on the editorial boards of Pediatrics and J Child Neurology, the medical advisory boards for the National Tuberous Sclerosis Alliance, Epilepsy Foundation of America, and is a reviewer for numerous pediatric and neurological journals. He is an active member of the; CNS, AAP, AAN, ANA and SPR.

Abstract:

This is a review of some of the spells of childhood, which are often erroneously thought to be seizures. The initial segment of the presentation will provide the listener with a format and clinical approach toward best categorizing an entity being described by any forlorn parent. Specific case descriptions and video examples are provided for clarity and diagnostic assessment. This will be followed by a thoughtful discussion of the examples provided. The goal is to help clinicians better distinguish between non-epileptic and epileptic events by reviewing commonalities and differences between the two. These events are common in any pediatric practice and well worth knowing. This presentation can be augmented by use of the author’s accompanying textbook and related publications.

Biography:

Abstract:

Introduction The Acute Disseminated Encephalomyelitis (ADEM) is an auto-immune diffuse demyelinating disorder of the central nervous system after a viral infection or a vaccination. Observation Thomas, 12 years without preceding neurological abnormalities, consults to the emergency department for dysuria, pains and paresis of the lower limbs. A month ago, he had a mesenteric lymphadenitis. Two weeks ago, Thomas had an erythematous rash during 3 days. The physical examination reveals a bladder distention, constipation and a pyramidal syndrome to the lower limbs. The cerebral and spinal-cord MRI reveals encephalitis (left frontal lobe lesion) and a multifocal myelitis (median thoracic, low thoracic and conus medullaris). The viral serologic tests are negative; the cerebrospinal fluid is sterile with lymphocyte pleocytosis. The diagnosis of ADEM is established. After corticotherapy, the low thoracic lesion is the only one persisting on the 2-months MRI. Four months after the diagnosis, the neuro-motor evaluation is normal. Thomas complains of dysuria, urinary and fecal incontinence and erectile dysfunction. Discussion The ADEM is an uncommon disease which the initial differential diagnosis is multiple sclerosis. The acute treatment by high dose of corticoid is widely accepted. There is no data about an optimal treatment. The outcome is mostly with complete recovery. Four retrospective pediatric reviews report that only 2.5% (4/161) have a neurogenic bladder. None colon or erectile dysfunction are related. The few cases of neuro-sphincter troubles related show both the rarity of these symptoms and the lack of diagnosis. These must be consistently sought and followed-up behind the acute phase and the resolution of MRI lesions. The aim is to avoid renal damages and urinary and fecal incontinence. We detail the symptoms and the specific care modalities for the teenagers.

Biography:

Dr. Eyad Al-Midani has completed his MBBS at the age of 25 in King Saud University and taken the Residency Training Program in King Faisal Specialist Hospital and Fellowship Training in University of Toronto, Canada. Dr. Al-Midani has several administrative appointments namely: Section Head and Consultant of Neonatology, department of pediatrics, King Faisal Specialist Hospital and research center in Riyadh, Chairman, Pediatric Quality Management Team and Director, Neonatal Resuscitation Program. He is an Assistant Professor of Pediatrics, Alfaisal University; In addition, he is currently reviewer in more than one journal

Abstract:

Objective: To assess the compliance rate and overall quality of discharge summaries among KFSH & RC patients according JCIA standards, during three years. Methods: A multidisciplinary team formulated, including the Quality director in the department of pediatrics as a chair person, the chairman of the department of pediatrics, the chief resident, a representative from medical records, a representative from the quality management, a representative from the information technology department and a representative from the medical and clinical affairs. An analysis of the situation as well as an explanation of the project idea was discussed with all team members and the process was built up as following: (See appendix 1) Results: Between the first quarter of 2011 and the first quarter 2014, a significant drop in the number of delinquent records have been documented where it was 1131 at the end of the first quarter of 2011 and dropped down to 68 records at the end of the second quarter of 2014. as well as the compliance to the JCIA standards which represent the documentation quality that has been audited by the hospital quality management department using a random, retrospective audits for 20 charts selected from the ICIS and reported on quarterly basis It shows improvement from 70% in the first quarter of 2013 up to 79% in the first quarter of 2014, and 86% in the second quarter of 2014, making the department of pediatrics ranking the first position across the hospital in comparison to the other department in regard to the quality of the discharge summaries. Conclusions: It is been found that by implementing a systematic framework in building up a discharge summaries for the patients will lead to a better quality of documentation and will minimize unnecessary delay. Comprehensive and precise clinical documentation improves the quality of patient care as well as the health information that is critical for ideal management of the health care system.

Biography:

Omar Farouk Helal completed his PhD at the age of 35 years from Cairo University. He is an Assistant Professor in the Department of Physical Therapy, College of Applied Medical Sciences, Umm Al-Qura University and now is the director of Graduates and Academic Accreditation Committees. Omar has served on roughly thirty conference and workshop. He has published more than 10 papers in Cardiopulmonary and Geriatrics Rehabilitation and directs multiple research programs focused on the exercise intensity and geriatrics care. He has been serving as an editorial board member in Pediatric Physical Therapy Journal.

Abstract:

The purpose of this study is to examine effects of a rowing exercise regimen versus a chest physical therapy program on pulmonary function in children with Down syndrome. Methods: Twenty-nine participants of both sexes, between 8 to 12 years of age, participated in this study. They were assigned randomly into 2 study groups. The first group (A) received a chest physical therapy program, while the second group (B) received an aerobic exercise regimen using a rowing ergometer. Vital capacity, forced vital capacity, forced expiratory volume after 1 second, and peak expiratory flow rate were measured before and after 12 successive weeks of treatment. Results: Significant improvements in all measured variables were found post treatment in both study groups. No significant difference between the 2 groups was found post treatment. Conclusion: Rowing exercise could be effective in improving pulmonary functions in children with Down syndrome.

Biography:

Khaled T. Muhammad is a professor of pediatrics, Head of Tanta PICU, Tanta faculty of Medicine, Tanta University, Egypt. He has supervised more than 50 master and 10 doctoral degrees in PICU, published more than 30 articles in various national and international peer reviewed pediatric journals. He is active member of 5 pediatric societies in various fields of pediatric subspecialities.

Abstract:

Background: The risk factors of childhood obesity include; energy intake, positive family history and lifestyle. Obesity is associated with numerous co-morbidities such as cardiovascular diseases, type 2 diabetes, Objective: to study the effect of obesity on some myocardial functions and lipid profile. Design: 9-months prospective case controlled study. Setting: Pediatric Department Tanta University Hospital Patients and Methods: 30 patients were included 24 males and 6 females; aged 6-15 years with BMI ˃ age and sex specific cut off points. Exclusion criteria included organic causes of obesity, hormonal medications, corticosteroids, hypertension & diabetes mellitus. Twenty healthy children with matched age and sex set as a control group. All studied children were subjected to: Anthropometric measurements: weight, height & BMI. Echocardiographic evaluation; LVEF, LVFS, LVEDD, predicted LVEDD, %LVEDD, LVM, LVMI & LMPI. Lipid profile assessment included serum TCh, LDL, TCh / HDL ratio & TG. Results: there was highly significant increase in body weight, serum TCh, LVEDD, LVM & LVMI. There was significant increase in BMI, LDL, HDL, serum TG, TCh / HDL-cholesterol ratio, %LVEDD, predicted LVEDD & LMPI of obese as compared to controls. There was no significant difference between the two studied groups as regards height, LVEF & LVFS. There was significant decrease in HDL in obese as compared to control group. Conclusions: LMPI is an early echocardiographic detector of LV global dysfunction in obese children. This; in combination with lipid profile must be included in routine evaluation and identification of the high-risk obese children in addition to weight-control/reduction. It is recommended to clarify the effects of obesity on cardiac function and lipid profile in infants and young children

Biography:

Hsiu-Lin Chen has completed Master of medical science in 2007 from Kaohsiung Medical University, Graduate of Medicine. She is the attending physician in division of neonatology, the department of pediatrics, Kaohsiung Medical University Hospital and also the associate professor in department of respiratory therapy, school of medicine, Kaohsiung Medical University. She has published more than 30 papers focusing on neonatal intensive care and development of premature infants in reputed journals.

Abstract:

There is a high rate of antibiotics use in sick newborns in the neonatal intensive care unit (NICU). To reduce unnecessary use of and provide appropriate guidance for administration of antibiotics, we have developed a “Neonatal bacterial infections screening score” (NBISS) for each new patient admitted to the NICU of Kaohsiung Medical University Hospital. The NBISS was designed based on maternal risk factors, clinical presentations, and laboratory data. The total score for each new patient was calculated at the time of admission. The first period of study was an observational survey. Receiver-operating characteristic curve was used to determine the best cut-off value of NBISS for diagnosis of bacterial infection to guide antibiotics used in the second period of study. Of 250 neonates admitted to the NICU, 237 (94.8%) received antibiotics during the first period of study. The items including C-reaction protein, the presentation of a bulging fontanelle, pus from the ear canal, redness around the umbilicus, reduced movement, and not being able to feed were weighted to make significant difference between the bacterial infection and non-bacterial infection groups (p=0.015). Weighted scores higher than 8 points had best diagnostic accuracy for indicating bacterial infection for new neonatal patients needing NICU care. After the introduction of NBISS for predicting bacterial infection in new patients admitted to NICU, the rate of antibiotic use significantly decreased, from 94.8% to 60.3%, between the two periods. Through this simple screening strategy without increased cost for lab exam, we achieved a clinical reduction in unnecessary antibiotics use.

Biography:

Ashok Kapse is consulting Pediatrician practicing in the city of Surat in the Gujrat state of India, besides owning a private pediatric hospital he is also head of the pediatric department at a prestigious Mahavir super specialty hospital. He has special interest and skill in infectious diseases. Working along with CDC Atlanta he evolved simple clinical approach for diagnosis and management of Dengue illnesses particularly in resource limited situations. Recipient of many oration awards he is a popular and sought after speaker, he has delivered hundreds of lectures on Dengue, Malaria, Typhoid and antibiotic uses across the India. He has published more than 10 articles in reputed national & international journals also has contributed chapters in prestigious books.

Abstract:

Asthma is a considerable public health issue, with more than 300 million people affected by it worldwide. It remains the most common chronic disease of childhood in the world. A concomitant rise in allergic diseases is creating a major public health problem. The greatest burden of these diseases is during childhood, when the rapidly rising rates of disease are most evident. There is a possibility that some environmental factors are driving the allergy and asthma epidemic. Recently variations in vitamin D status and intake has been implicated in allergy development and considered as one of a number of explanations for epidemiological and immunological associations. The main role of the immune system is to protect us from infectious microorganisms, but it simultaneously has to distinguish these from harmless antigens such as self antigens and environmental antigens. The immunologic tolerance to self antigens and harmless air born antigens is primarily mediated through a group of lymphocytic cells termed as T regulatory (Treg cells). Depletion of Treg enhances immune responses to non-self antigens, to tumour cells and to commensal microbes. Consequently, a lack or a deficient function of regulatory ‘T’ cells breaks the tolerance to self antigens and environmental antigens such as allergens and leads to autoimmune diseases, allergic diseases, and asthma. Recent works suggest that a vitamin D has significant role in generation, maintenance, enhancement and restoration of Treg cell function in asthma. The role of vitamin D in induction and/or maintenance of essential Treg cell populations, coupled with the capability to promote antimicrobial pathways have led to the suggestion that vitamin D might promote homeostasis required for the unique pulmonary environment and is one of the most essential element for protecting airways and lungs from allergens and infections. Moreover Perinatal vitamin D deficiency could mechanistically drive both the proximal and distal airways to a myogenic phenotype, molecularly and structurally, predisposing the offspring to asthma. Modern lifestyle patterns and environments deprive adequate sun exposure (indoor occupation, “screen time” and active sun avoidance) this predispose to inadequate vitamin D synthesis and status which in turn has resulted in more asthma and allergy.

Biography:

Professor Rana is working as faculty in field of Clinical Biochemistry related to Gastroenterology since 1988.Throughout her career; she has worked on non-invasive malabsorption diagnostic tests for various gastrointestinal diseases. Her field of specialization is various aspects of gastrointestinal problems in different diseases like celiac, type 1 diabetes, IBS, IBD etc. She is actively involved in the research studies related to pathological, risk factors and preventive aspects of malabsorption syndromes.Her expertise is also in oxidative stress and antioxidants in different gastrointestinal diseases, hepatotoxicity and its prevention, She has published various research papers and review articles in National and International journals.

Abstract:

Celiac disease may be asymptomatic or symptomatic with severe malabsorption. Symptoms of malabsorption in celiac disease include chronic diarrhea, abdominal distention, failure to thrive and nutritional deficiencies. Celiac disease could lead to lactase deficiency. It can lead to lactose intolerance but it has not been reported in North Indians. Therefore, the study was planned to elucidate lactose intolerance in children with celiac disease. Lactose intolerance was estimated by using non-invasive lactose hydrogen breath test in 155 children suffering from celiac disease and 110 age & sex matched apparently healthy controls. 25g lactose dissolved in 250 ml water was given orally for lactose hydrogen breath test to all subjects after measuring fasting breath H2 and CH4 concentrations. End expiratory breath was collected every 30 minutes up to 4 hrs. H2 & CH4 concentrations were measured by using Microlyzer. Rise ≥ 20ppm over base line value in H2 and/or CH4 concentration in two consecutive readings was considered as lactose intolerance. Results: Out of 155 children, 90 (58.06%) were boys and 65 (41.94%) were girls. The age range of children was 3-13 years. The Mean SD of age was 7.5 2.9 years. Out of 110 healthy controls, 65 (59.09%) were boys and 45 (40.91 %) were girls. Lactose intolerance was significantly higher (p<0.0001) in celiac patients (106/155; 68.4%) as compared to controls (40/110; 36.4%) Conclusion: This study indicates that lactose intolerance is common among children with celiac disease which can be one of the causes for gastrointestinal symptoms.