Biography:

Daniela Prayer has completed her MD degreee at the University of Vienna/ Austria, and apent a year as a research fellow at the Departmetn of Radiology at USCF/ San Francisco. Since 2009 she is the director of the Division of Neuroradiology and Musculoskeletal Radiology at the Medical University of Vienna. One of her main scientific topics is fetal MRI.  She is the author of more than 280 scientific papers

Abstract:

One strategy to prevent or alleviate pediatric diseases is to get an early diagnosis of a pathology. From the radiological point of view, the means to get a most accurate diagnosis at the earliest time point lies in the use of MRI during fetal life. Regarding the brain, the main questions for fetal MRI comprise whether a pathology is compatible with survival, the long term prognosis for neuropsychological development, and the definition of a possible genetic background that would allow specific testing in a consecutive pregnancy. In addition to detailed morphology fetal MRI offers information about connectivity and function. Especially in malformations of cortical development, commissural agenesis, and posterior fossa pathologies these MR-applications allow most accurate answers to the questions above, from the middle second trimester onwards. In case of acquired conditions, such as cerebral haemorrhage, the underlying reason may be identified, and treatment (shunting of posthemorrhagic hydrocephalus) may be planned in a tailored scheme. With respect to spinal malformation the main challenge for prenatal MRI is to define the presence of an open or closed spinal defect. Open defects may be treated surgically already in intrauterine stages, while this option is not be indicated in closed defects. Prognostically, the spinal level of the expected palsy can also be estimated. The use of fetal MRI has increased worldwide during the last years, as early diagnosis , especially of CNS pathologies helps not only with the management of the pregnancies but also enables the development of new therapeutic strategies.

Biography:

Dong Yup Lee completed his Pediatric residency training at Severance Children’s Hospital, Yonsei University. And He earned Mast of Public Health at Graduate school of Public Health Yonsei University in 2014. He is currently working at Pyeongchang Health Center & County Hospital as a pediatric doctor.

Abstract:

Purpose: Recently, legal disputes resulting from medical accidents have been increasing annually. The purpose of this study is to determine the causes and characteristics of medical disputes brought as a result of neonatal accidents and to suggest measures to reduce the number of medical malpractice suits.

Methods: Twenty-eight medical malpractice lawsuits brought as a result of neonatal accidents between 2005 and 2009 were analyzed.

Results: The average time taken to resolve these lawsuits was approximately 4.4 years. The average gestational age and birth weight of the newborns in these cases were 35.3 ±4.2 weeks and 2,668±931 g, respectively. Twelve cases (42.9%) were concluded partially in favor of the plaintiffs, while in 10 (35.7%) cases the plaintiffs lost. In 11 of the 12 cases that were concluded partially in favor of the plaintiffs, the defendants were found guilty of violating their duty of care. Medical accidents resulted in death in 10 cases and physical disability in 18 cases, and cerebral palsy and blindness were the most common physical disabilities. The average compensation amount ordered as damages was KRW 161,389,291±12,636,454.

Conclusion: In medical litigation, the standard of judgment is whether appropriate medical practices were performed based on the patient’s symptoms. Thus, to comply with the medical treatment rules is paramount in securing patients’ safety and protecting doctors themselves. Individual effort is necessary, but not sufficient to prevent medical accidents; multilateral, systemic reform is also required if the number of neonatal medical accidents is to be reduced.

Biography:

Author is a Senior Consultant in the Department of Pediatrics at a Tertiary Care Children Hospital in South India.The author has around 40 publications in Indexed National & International Journals.Her areas of interest include Pediatric Infections,Hematology & Critical Care.

Abstract:

Skeletal tuberculosis in children can easily be missed due to their non specific presentations. The objective of our study is to review the varied presentation, pitfalls in the diagnosis of pediatric skeletal tuberculosis and treatment outcome . A retrospective review of children diagnosed with skeletal tuberculosis over a period of 3 years. A total of 19 cases were reviewed. Mean age was 5.6 years . Average duration of symptoms was 6 months with chronic pain being the most common . spine was the commonest site. Most of the cases were missed due to non specific presentation, hence delaying the diagnosis. Contact history was positive in 6 and ESR was elevated in majority of them. Diagnosis was confirmed radiologically, bacteriologically or histopathologically. All children were treated with anti tubercular drugs and surgical debridement with good prognosis. A high index of suspicion aided by confirmation using imaging or histopathology can help in early diagnosis. Treatment with anti tubercular drugs with surgical debridement has good prognosis

Biography:

Eun Joo Lee is a clinical professor at Kyungpook National University Children’s hospital in neonatology department. She has also experience as pediatric neurologist for 10 years. She completed her Pediatrics residency at Catholic University of Daegu hospital. She earned her PhD, Physiology at Kyungpook national University. She is interested in research involving neuroprotective mechanism in neonatal hypoxic-ischemic encephalopathy model.

Abstract:

Hypoxic-ischemic brain injuries influence the mechanisms of signal transduction, including mitogen-activated protein kinase (MAPK) that regulates gene expression through transcription factor activity. Several attempts have been made to use bee venom (BV) to treat neurological diseases. However, limited data are available for brain injuries such as neonatal hypoxic-ischemic encephalopathy (HIE) and neurodegenerative disorders. The purpose of this study was to investigate the neuroprotective effects by BV by determining the expression of activated MAPK pathways. We examined activation and cell viability in hypoxia (1% O₂, 5% CO₂, 94% N₂) in low glucose-treated (H+low G) neuronal cells and astrocytes in the presence and absence of BV. After they were subjected to hypoxic conditions and treated with low glucose, the cells were maintained for 0, 6, 15, and 24 hr under normoxic conditions. Extracellular-signal-regulated kinases 1/2 (ERK1/2), p38 MAPK, and stress activated protein kinase (SAPK)/Jun amino-terminal kinases(JNK) were activated in H+low G conditions. Particularly, phosphorylation of ERK1/2 was maximized 6 hr after exposure to H+low G condition. BV specifically inhibited the phosphorylation of ERK1/2. However, BV had no effect on p38 MAPK or SAPK/JNK. In addition, BV improved neuronal cell and astrocytes viability following exposure to H+low G. ERK inactivation is known to mediate protective effects in hypoxic brain injury. Taken together, these results suggest that treatment with BV may be helpful in reducing hypoxic injury in neonatal HIE through the ERK signaling pathway.

Biography:

Dr. Melnick earned his B.SC., Physics and Ph.D, Chemistry at McGill University and M.D. at Queen’s University. He completed his Pathology residency at Mount Sinai Medical Center, Miami Beach, FL and subsequently joined the Department of Pathology and Clinical Laboratories at Nicklaus Children’s Hospital where he serves as Department Chief. He directs research involving therapeutic development in cancer, immunology and metabolic disorders since 1999, published more than 85 papers in peer-reviewed journals and acquired intellectual property based on this research. He serves as an editorial board member of the Journal of Natural Products in Cancer Prevention and Therapy. 

Abstract:

Pediatric nutritional status assessment, typically reserved for children with overt clinical manifestation of nutrition-based disorders require comprehensive and time-consuming clinical and laboratory evaluation. However, many more children may be at risk for these disorders; long latency periods for clinical manifestation of primary and secondary (malabsorption, autoimmune, metabolic, genetic disorders and drug side-effects) nutritional deficiencies/insufficiencies and conditions related to over-nutrition, principally obesity and associated metabolic consequences. The latter form of malnutrition is complex and overlaps with conditions related to nutrient deficiency/insufficiency. Conventional nutritional evaluation is neither appropriate nor practical for the general pediatric population who are at risk for nutrition-based disorders. Given the scope of this societal health challenge, a more practical solution for recognizing children at risk for these disorders is beneficial. Such a screening tool must be evidence-based, easily administered and informative so that children with subtle manifestations of nutritional inadequacy or those at risk can be identified and directed to precise evaluation and nutritional/lifestyle interventions. This is the basis of the nutritional status screening panel known as the TOP™ (Test-Optimize-Perform) test. The panel addresses two principle categories of nutritional status; deficiency/insufficiency and nutrient metabolism. The analytes are; vitamin B_12, folate, vitamin D, iron, ferritin, total cholesterol, HDL-c, Non-HDL-c, HbA1c, homocysteine, transthyretin, hs-CRP, GGT and ALT. The panel is designed to directly or indirectly assess nutrient or micronutrient inadequacies and nutrition-acquired metabolic disorders as suggested by analytes that reflect lipid and carbohydrate metabolism, protein status, inflammation/oxidative stress, insulin resistance and mitochondrial dysfunction. Details of the rationale are presented.

Biography:

Dr. Naveed Durrani did his post-graduation in Pediatrics from Pakistan in 2004, and MRCP from Royal College of Physicians Ireland in 2009. Currently he is doing his fellowship in Neonatal-perinatal medicine at McMaster University, Canada. His interest is in neonatal sepsis and various quality improvement projects. He has more than 10 publications in an index medical journals.

Abstract:

Background and objective: In NICU blood culture is monitored at least 48 hours before stopping antibiotic treatment in rule out sepsis.

The objective of the study is to analyze the time to positive blood cultures for rule out sepsis to estimate minimum duration of antibiotics needed. 

Methods: Retrospective observational study performed in NICU at McMaster Children hospital (January 2004 to December 2013).  Positive blood cultures identified with BacT/Alert ®3D microbial detection system were analyzed for all admitted newborns. Outcome parameter were microorganisms, hours from inoculation to positive blood culture, age at the time of culture taken. Time to positivity was evaluated for clinically important gram positive and gram negative bacteria and yeast.

Results: In 9254 babies, 7480 blood cultures were performed. 845(11.3%) were positive for organisms. 815(96%) were considered as significant organism causing disease in newborn (yeast, definite, possible pathogens) while 30 (4%) had contaminants. 54 (6.4%) blood cultures were positive in EOS (Early onset sepsis in <72hours of age) while 791(94%) were in LOS (late onset sepsis>72hours of age).

613(72.5%), 802(95%) and 43(5%) blood cultures turned positive by 24hr, 48hr and >48hrs of incubation respectively.  All gram-negative organisms in EOS and LOS were identified within 24hours except one at 26hours.

Conclusion: Probability of gram negative microorganisms growing beyond 24hours is small. Initial antimicrobials treatment can be reduced after 24hours to target only gram positive organism beyond 24hours in LOS while they may be stopped in EOS unless clinically indicated.

Biography:

Graduated from San Francisco Xavier University in Chuquisaca, Bolivia. He did a Residency in Pediatrics at Santa Cruz Hospital, Bolivia. Studies in Pediatric Endocrinology at Hospital de Clinicas. University of Sao Paulo. Brazil. Member of the Bolivian Society of Pediatrics and the Latin American Society of Pediatric Endocrinology. He works as a Pediatric Endocrinologist and Professor of Pediatrics at Santa Cruz Hospital, Bolivia. Editor of the Journal of Cruceña Society of Pediatrics and Coeditor of the Journal of Bolivian Society of Pediatrics. Author of several articles in various national and international journals.

Abstract:

Nutritional marasmus is still prevalent in developing countries. Disorders of thyroid function have been reported in patients with marasmus.

The objective of the present study is to evaluate the levels of thyroid hormones in infants diagnosed with marasmus at the time of diagnosis and after reaching a normal weight for age and sex.

Material and methods: Prospective study of patients from one to 11 months of age, diagnosed with nutritional marasmus. Plasma levels of thyrotropin (TSH), thyroxine (T4) and triiodothyronine (T3) were determined at the time of diagnosis and after reaching normal weight for age and sex, when properly fed.

Results: We studied 47 patients with nutritional marasmus; 41 (87% of the total) had altered thyroid function at the time of diagnosis: In 29 (71% of those affected), there were low T3 values, with T4 levels being normal; 12 (29%) showed low values of T3 and T4. TSH levels were normal in this group of patients. Values of T3 and T4 were normalized when patients reached a weight adequate for age and sex.

Discussion: The alterations of the thyroid function observed in infants with nutritional marasmus (the decrease in T3 and T4 levels were evidenced), do not require replacement therapy with thyroid hormone, since once the patients reach the adequate weight for the age and sex, the thyroid profile normalizes.

Biography:

Saeyoon Kim has completed his PhD at the age of 35 years from Yeungnam University and postdoctoral studies from Kyungpook National University, School of Medicine. He is the director of Division of Pediatric Neurology of Yeungnam University Hospital.          

Abstract:

A limited number of studies have examined the link between F-wave abnormalities and clinical presentation in pediatric Guillain-Barre syndrome (GBS). Further randomized controlled studies are needed to confirm the clinical significance of these findings and efficacy of treatment. Therefore, this study examined the importance of F-wave abnormalities as a prognostic factor in pediatric GBS patient.

We retrospectively evaluated the records and electrodiagnostic studies (EDS) from 70 GBS patients. Subjects were divided into two groups according to the results of EDS, including F-wave examination. Group A (n=33) presented with F-wave abnormalities, and Group B (n=26) exhibited normal findings. We compared laboratory reports, clinical features, response to treatment, and prognosis between the two groups.

The most common symptom was motor weakness in both groups. The prevalence of abnormal deep tendon reflex (DTR) was significantly higher in Group A than B (p < 0.05). Patients diagnosed with GBS had received intravenous immunoglobulin treatment: 31/33 (94%) in Group A and 15/26 (58%) in Group B. With regard to the relationship to F-wave abnormalities, significantly greater numbers of children in Group A showed H-reflex abnormalities and poor prognosis compared with Group B (p < 0.05).

This study demonstrated that F-waves are clinically important as a prognostic factor in GBS patients. Significantly more cases exhibited an abnormal DTR, and had a poorer prognosis than the normal group. Limited studies have examined the correlations between F-wave abnormalities and clinical results. Therefore further randomized controlled studies are needed to confirm the clinical characteristics and efficacy of treatments.

Biography:

1993: Graduated Hamamatsu University School of Medicine, 1993: Residency in Okayama Medical Center, 1997- : Attending Physician in Okayama Medical Center

Abstract:

In this case report, two siblings with MPS VI started enzyme replacement therapy (ERT) with weekly infusions of recombinant human ASB (Galsulfase) at 1mg/kg. Sibling 1 started ERT 5.6 years of age and Sibling 2 was 6 weeks old. The disease status in these two siblings prior to and for no less than 120 months of ERT was followed up and compared. The treatment was well tolerated by both siblings. During 120 months of ERT, symptoms typical of MPS VI including short stature, progressive dysmorphic facial features, hepatosplenomegaly, hearing impairment, corneal clouding, and dysostosis multiplex were largely absent in the younger sibling. Her cardiac functions and joint mobility were well preserved. On the other hand, her affected brother had typical MPS VI phenotypic features described above before commencing ERT at the equivalent age, of 3 years. There was significant improvement in the shoulder range of motion and hearing loss after 120 months of treatment and cardiac function was largely preserved. His skeletal deformity and short stature remained unchanged, 　but he reached the age of puberty. The results showed that early ERT initiated at newborn is safe and effective in preventing or slowing down disease progression of MPS VI including bone deformities. These observations indicate that early diagnosis and treatment of MPS VI before development of an irreversible disease is critical for optimal clinical outcome

Biography:

Graduated from San Francisco Xavier University in Chuquisaca, Bolivia. He did a Residency in Pediatrics at Santa Cruz Hospital, Bolivia. Studies in Pediatric Endocrinology at Hospital de Clinicas. University of Sao Paulo. Brazil. Member of the Bolivian Society of Pediatrics and the Latin American Society of Pediatric Endocrinology. He works as a Pediatric Endocrinologist and Professor of Pediatrics at Santa Cruz Hospital, Bolivia. Editor of the Journal of Cruceña Society of Pediatrics and Coeditor of the Journal of Bolivian Society of Pediatrics. Author of several articles in various national and international journals.

Abstract:

Introduction:
Some patients receiving antituberculous drugs may develop thyroid disorders; hypothyroidism has been reported in patients receiving ethionamide and rifampicin.
The aim of the present study is to evaluate the levels of thyroid hormones in pediatric patients diagnosed with tuberculosis at the beginning and at the end of antituberculous therapy.
Material and methods:
Prospective study. Study of patients less than 15 years of age, diagnosed with pulmonary tuberculosis, who received antituberculous therapy: "Strictly Supervised Shortened Treatment" (DOTS), of two phases; the first of 52 doses of isoniazid, rifampicin and pyrazinamide; the second phase of 104 doses of isonacid and rifampicin. Plasma levels of thyrotropin (TSH), thyroxine (T4), free thyroxine (FT4), and triiodothyronine (T3) were determined at the beginning of treatment, three months after and at the end of antituberculous therapy.
Results:
We studied 19 patients who completed the DOTS. All of them were euthyroid at the beginning of antituberculous therapy. In 3 children (15.8% of the total) the non-thyroidal illness syndrome was diagnosed (T3 levels low with normal values of the other hormones), at 3 and 6 months of treatment; 4 patients (21.0%) presented subclinical hypothyroidism (TSH levels elevated with normal values of FT4, T4 and T3), at the end of therapy; in the remaining 12 patients (63.2%), hormone levels analyzed were normal.
Discussion:
It is important to analyze the thyroid profile in patients receiving antituberculous treatment, since they may develop non-thyroidal illness syndrome or hypothyroidism.

Biography:

Completed MD degree at the University of El Tecnologico de Monterrey (Class of 2015), in Monterrey, Mexico. Currently first year resident of pediatrics at Zambrano-Hellion TecSalud Hospital.

Abstract:

Background – breast-feeding has benefic effects in the mother and toddler, the absence of it has been implicated in numerous adverse effects.  Currently we see less patients nursing, the estimated prevalence in Mexico for 2012 was a 14.6% of exclusive breast-feeding in the first 6 months of life.

Problem – information has been documented in other countries about how socio economical status has a direct impact on the incidence of nursing. There has not such information reported in Mexico. Do differences in socio economical status have differences in the exclusivity and application of nursing in their babies?

Objective – the primarily objective of this study was to compare the duration of breast-feeding in Mexican infants younger than one year with low socio economical status versus those with medium and high socio economical status.

Methods – the design was a replicative, observational, retrospective, transversal and comparative study, without follow-up on the studied patients. The sample was a total of 1962 Mexican infants, younger than 1 year. The data was obtained at the public national health institute through the national health and nutrition survey 2012 (ENSANUT 2012) applied in 1719 houses (total of 55,008 homes surveyed), the study period was from may 2011 through may 2012, the level of significance (a) was of 95% for two tails, Z = 1.90, Z  = 1.96 with a potency of B 90% for the both. 

Results – the number of surveyed patients where 783 for low, 691 for medium and 488 for high socio economical status, representing 39.9%, 35.2% and 24.9% respectively of the total studied sample. We formed two groups of interest the low socio economical status versus the rest of the group (39.9% versus 60.1%). Studied subject medium age was 6.5 months with a Standard Deviation (SD)+- 3.5 months.  The highest number of patients nursing is during the firsts months of life, especially during the first month. The proportion of subjects that did not receive breastfeeding was higher among the group of medium and high socio economical status. The mean breastfeeding duration was 5.4 months (± 3.5 months) in the low socioeconomic status , versus 4.3 months (± 3.3 months) in the medium to high socioeconomic status. The level of significance for the test was found to have p>0.001.

Conclusion – There is a statistically significant difference in breastfeeding duration among Mexican infants younger than one year with low socioeconomic status, versus those with medium to high socioeconomic status.

Biography:

Sunil kumar Gonuguntla has completed his MD Pediatrics from Dr. NTRUHS, Vijayawada, India. He is currently working as Resident in SVRR GGH, Tirupati, India.

Abstract:

A 11 years boy is brought with complaints of abnormal movements, fever, passing mucous stools, vomitings and decreased vision in left eye of about 10 days. Boy was delivered at term vaginally. Child had blisters with erythematous base on his trunk and upper and lower limbs since the first few weeks of life. Later, hyperpigmentation developed. He received various treatments with topical medications, albeit without success. On clinical evaluation, the following clinical features of IP are observed²: CNS: Seizures (GTCS), Dental: White opaque lines seen on all labial surfaces of the teeth with retained deciduous teeth and pegged lateral incisor, partial anodontia, Eye: Cotton wool spots, Skin: Hyper pigmented hyperkeratotic plaques over lines of blaschko over thighs, both legs and axilla, lower trunk and buttocks.

Skin biopsy showed hyperkeratotic epidermis with mild acanthosis and basal cell degeneration, vacuolization and decreased pigment content. Melanophages extend into the epidermis and also into papillary dermis.

Biography:

ES Suh has completed hers PhD at the age of 32 years from Kyungbuk National University.  She is the director of department of Pediatrics, and Pediatric Neurology of Soonchunhynag University in Korea.  She has published more than 50 papers in reputed journals and has been serving as an editorial board member of Korean Journal of Pediatrics and Korean Journal of Child Neurology for more tha 10 years.

Abstract:

Isolated sphenoid sinusitis is a rare disease in children, and its symptoms are often nonspecific and confusing. Rarely, severe headache can be the first or only symptom of isolated sphenoid sinusitis. New daily persistent headache (NDPH) is a form of chronic daily headache that may have features of both migraines and tension-type headaches. NDPH is difficult to diagnose and requires a multifaceted approach. Here, we report on a 10-year-old boy and an 11-year-old girl who both presented with typical NDPH symptoms. These patients had no nasal symptoms or signs of infection. Neither non-steroidal anti-inflammatory drugs (NSAIDs) nor topiramate had any effect on the headaches. Their neurological and ophthalmological examinations were normal. The results of routine blood work, including thyroid function tests, inflammatory markers, complete blood count, tests for viral infection, and a metabolic panel, were normal. A brain magnetic resonance imaging (MRI) scan showed isolated sphenoid sinusitis. Both patients’ symptoms resolved completely after approximately 1 month of oral antibiotics for sinusitis.

Biography:

Dr.Sharayu Dighavkar has completed her undergraduate in Bachelor of Medicine and Bachelor of Surgery at the age of 21 years from D.Y Patil University School of medicne and is currently pursuing Post Graduation in Pathology from D.Y.Patil School of Medicine.   

Abstract:

Congenital pouch colon(CPC) is an anorectal malformation with highest number of reported cases in northern part of Indian Subcontinent. The cause of this unique geographical distribution has not yet been ascertained. In this anomaly an entire colon or a part of colon is repalced by a pouch like dialation, which communicates  distally with urogenital tract via a large fistula.

A 2yr old female patient had a history of anorectal malformation with passing of stools from introitus with absent anal opening since birth. Per abdominal examination fecaloma was palpable. In introitus two openings were noted urethra and vagina, and stools coming out of vagina with absent anal opening. Sigmoid stoma was done in February 2016, intraoperatively sigmoid colon was ectatic and the fecaloma was removed.

Faliure of the ectatic bowel to regress back to its normal morphology and structure even after 6 months post sigmoid stoma alerted the surgeon to the suspicion of Congenital Pouch Colon.  Sacro-abdominal pull through was performed and pouch was excised and sent for histopathological analysis.

Histopathology confirmed the diagnosis of Pouch colon. It showed chronic inflammation in the mucosa and submucosa, along with disruption of the outer longitudnal and inner circular muscle layers, hypertrophy of nerve bundle was noted and mature and few giant ganglion were noted between the ill-formed muscle layers(only 10% of all cases of CPC shows giant ganglion).

Biography:

Nada Alabdulkarim has graduated (2013) from King Saud University in Saudi Arabia with a bachelor degree of Medicine and surgery plus honor class. Nada completed two years of general pediatric training in Saudi Arabia. She has been interested in public health education and organized many events for that. Currently, she is working on research subjects including neonates of diabetic mothers and neonatal infections. In addition Nada is a member of the Saudi Pediatric society.

Abstract:

Background: The higher prevalence of diabetes mellitus during pregnancy causes perinatal and neonatal morbidities. There is a greater risk of morbidity among the infants born to diabetic mother. The study has aimed to investigate the perinatal and neonatal complications among the infants of diabetic mother. Methods: Quantitative research design was opted for the analysis of results. It has included the neonates born to diabetic mothers between July 1 2014-June 30 2015 in King Khalid University Hospital of King Saud University Medical City. A total of 279 mothers and 289 infants were enrolled in the study. The mothers were regularly checked during their gestation period and glucose levels of all the infants born to diabetic mother were monitored. Results: The potential complications causing neonatal morbidity and mortality have been highlighted in the study. The infants born to diabetic mothers were extensively observed to suffer metabolic abnormalities including hypoglycemia. Regarding the mode of delivery, majority of the diabetic mothers (61.5%) had spontaneous delivery; while others (38.5%) had induced delivery. The neonates born to diabetic mother were at risk of developing hypoglycemia (p= 0.008), hyperbilirubenemia (p= 0.014), respiratory distress syndrome (p= 0.035), admission in NICU (p= 0.005), and congenital anomalies (p= 0.024). Conclusion: The poor maternal diabetic control poses higher risk of neonatal morbidity and mortality. There is greater risk of adverse neonatal outcome among the mothers suffering gestational diabetes mellitus.

Biography:

Nada Alabdulkarim has graduated (2013) from King Saud University in Saudi Arabia with a bachelor degree of Medicine and surgery plus honor class. Nada completed two years of general pediatric training in Saudi Arabia. She has been interested in public health education and organized many events for that. Currently, she is working on research subjects including neonates of diabetic mothers and neonatal infections. In addition Nada is a member of the Saudi Pediatric society.

Abstract:

Introduction: Infection remains one of the leading causes of neonatal morbidity and mortality worldwide. Yearly 3·257 million child below 5 years old dies because of infections, 44% of them die in the neonatal period. Group B Streptococcus (GBS) is the most common pathogen particularly in infants under three months of age and it is unusual to present after that age. Neonatal GBS disease is divided into 3 categories according to the age of hospital admission; early-onset disease (EOD) (day 0–6), late-onset disease (LOD) (day 7–89), and ultra-late onset disease (ULOD) if more than 3 months (range 91–226 days). Significance of the study: To the best of our knowledge, only few cases were reported of invasive ULOD GBS outside of Saudi Arabia. In this report, we present and discuss a neonate who developed a rare invasive ULOD GBS. Patient description: Full term Afghani female was brought to the ER at 15 weeks (450 days) of age with 2 days history of fever, vomiting, poor appetite and lethargy. Blood and cerebrospinal fluid (CSF) cultures confirmed a heavy growth of streptococcus agalactiae. She developed multiple episodes of tonic-clonic convulsions of the right arm and left leg with lip smacking that lasted for few seconds. A right side facial palsy with generalized spasticity also noted, she was started on anticonvulsants. Electroencephalogram (EEG) demonstrated tendency for seizure and encephalopathy. Imaging showed bilateral extensive meningo-encephalitis and bilateral subdural fluid collection. Initial dexamethasone and empirical antibiotics were started. Her total antibiotics duration and hospital stay was ten weeks. Ptosis and spasticity improved to full recovery by her third week of admission.

Discussion: we present a rare GBS ULOD case with complicated course, including slow response to treatment, seizure and transient facial palsy. Although necessitating long hospital stay and despite of presence of persistent MRI changes, fortunately no functional deficit is noted till four months after hospital discharge at one year of age. More reports are needed for GBS ULOD patients for better understanding of pathophysiology and risk factors associated with it. Vaccination against specific strains of GBS is a promising preventive measure in the near future which possibly going to protects against both EOD and LOD.

Biography:

Judy Prehn completed her Physical Therapy degree from the Medical University of South Carolina. She completed her Doctoral degree in Rehabilitation Science from the University of Oklahoma Health Sciences Center. Her current research on infant transport was published in the Journal of Perinatalogy in 2015. She is a faculty member at William Carey University, where she teaches pediatric physical therapy and motor learning concepts, and continues research activities into developmentally supportive practices for infants born prematurely.

Abstract:

Premature infants with very low birth weight (VLBW) are at risk for germinal matrix (GMH) and intraventricular hemorrhage (IVH). Infants with VLBW are most vulnerable to hemorrhage during the first 24 to 72 hours following birth, which is the time they are likely to be transported from local hospitals to regional medical centers. In addition, preterm infants’ sensory systems are immature and unable to adapt or habituate to auditory and vestibular input. Premature infants respond negatively to intense sensory stimulation such as sudden, loud sound that can produce an increase in respiration and heart rates, increase in intracranial pressure and decrease in oxygenation. This study measured the effectiveness of modifications to reduce sound and vibration during ground transport of a model infant with VLBW (1368 grams) and prematurity (estimated gestational age 30 weeks). We modified the incubator mattress and found that the combination of a gel mattress over an air hambered mattress was effective in significantly decreasing vibration levels. Infant weight influenced the effectiveness of mattresses in decreasing vibration transmitted to the infant. Modifications that decreased vibration for infants weighing 2000 g were not effective for infants weighing 1368 g. Incubator cover modifications did not decrease sound levels inside the transport incubator, suggesting that sound was transmitted into the incubator as a low-frequency vibration through the incubator’s contact with the ambulance floor. Interprofessional collaboration is needed for transport redesign to protect infants born prematurely with VLBW from excessive physical strain during vulnerable periods of brain development.

Biography:

J L Mathew works at the Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India. He has contributed extensively to evidence-based policy-making for several vaccines in the Indian context, especially Hepatitis B, Hib, IPV, MMR, PCV, Influenza, Varicella, acellular pertussis, HPV, Rotavirus, and typhoid conjugate vaccines. He is one of the first to identify the rapid waning of maternal measles antibodies in infancy, creating a pool of susceptible infants/children. He has nearly 200 peer-reviewed publications to his credit and delivered numerous presentations related to Vaccinology in national and international meetings.

Abstract:

Background: In India and many other developing countries, a single dose of measles vaccine is administered to infants at 9 months of age. This is based on the assumption that maternal transplacentally transferred antibodies will protect infants until that age. However, our previous data showed that most infants lose maternal anti-measles antibodies before 6 months of age, making them susceptible to measles before vaccination at 9 months.

Objective: This prospective study was designed to compare susceptibility in pre-term vs. term infants, at different time points.

Material & Methods: Following Institutional Ethics Committee approval and a formal informed consent process, venous blood was drawn from a cohort of 45 consecutive term infants and 45 consecutive pre-term infants (both groups delivered by the vaginal route); at birth, 3 months, 6 months and 9 months (prior to measles vaccination). Serum was separated and anti-measles IgG antibody levels were measured by quantitative ELISA kits (with sensitivity and specificity >95%). Susceptibility to measles was defined as antibody titre <200 mIU/ml. The mean antibody levels were compared between the two groups at the four time points.

Results: The mean gestation of term babies was 38.5±1.2 weeks; and pre-term babies 34.7±2.8 weeks. The respective mean birth weights were 2655±215 g and 1985±175 g. Reliable maternal vaccination record was available in only 7 of the 90 mothers. Mean anti-measles IgG antibody (±SD) in terms babies was 3165±533 IU/ml at birth, 1074±272 IU/ml at 3 months, 314±153 IU/ml at 6 months, and 68±21 IU/ml at 9 months. The corresponding levels in pre-term babies were 2875±612 IU/ml, 948±377 IU/ml, 265±98 IU/ml, and 72±33 IU/ml at 9 months (p>0.05 for all inter-group comparisons). The proportion of susceptible term infants at birth, 3 months, 6 months and 9 months was 0%, 16%, 67% and 96%. The corresponding proportions in the pre-term infants were 0%, 29%, 82%, and 100% (p>0.05 for all inter-group comparisons).

Conclusion: Majority of infants are susceptible to measles before 9 months of age suggesting need to anticipate measles vaccination, but there was no statistically significant difference between the proportion of susceptible term and pre-term infants, at any of the four time points. A larger study is required to confirm these findings and compare sero-protection, if vaccination is anticipated to be administered between 6 and 9 months.

Biography:

Paula Francezca C. Padua, M.D has completed her MD at the age of  27 from St. Luke’s College of Medicine, Quezon City,  Philippines, last 2013.  She is currently in her 3rd year residency training at the Department of Otolaryngology, Head and Neck Surgery  at St. Luke’s Medical Center, Quezon City Philippines.

Abstract:

Objective:

(1) To present a case of venolymphatic malformation and OK-432 as its management

(2) To discuss the mechanism of action of OK-432 in the treatment of        venolymphatic malformations

(3) To discuss the known complications of OK-432 in the treatment of venolymphatic malformations

Design:  Case Report

Setting:  Tertiary Hospital in Metro Manila

Case Report: A 4 year old male, presenting with a right facial and cervicothoracic mass, consulted and given Picibanil (OK-432) as trial treatment for 2 doses.  A local inflammatory response was observed after the first dose.  However, the patient exhibited a systemic inflammatory response after the 2nd dose.

Conclusion: Venolymphatic malformation is one of the most common types of vascular malformations with an overall prevalence of up to 1% in the general population.  Although benign, these lesions have a tendency to grow in an infiltrating manner.  OK-432, which is the most widely used alternative treatment, showed promising results of regression of malformations, systemic inflammatory response syndrome may be a possible side effect with its use.

Biography:

Bao shan is a MD student in Sichuan university at the age of 26 years. Her major is pediatrics, especially on neonatology. She has published several papers in reputed journals, and done a lot of researches on clinical aspects of neonates.

Abstract:

Background Neonatal infection is one of the most common disease in Neonatal intensive care unit, and is also a crucial cause of neonatal death. An effectual therapy at the very beginning of the infection can significantly reduce the mortality of neonate. Object To uncover the status of neonatal infection and current antibiotic therapeutic proposal. Method An observational, retrospective study was performed, assessing all the infants that were dead during hospitalization between 2013.1.1-2014.12.31. Analyze the clinical data,  discover the risk factors and characteristics of infection, and summarize the current precaution and therapeutic proposal. Result 40(91%) out of 44 in total infants had infective symptom, and 68% of their mothers got infective symptom too, and only 38% of these mothers received antibiotic therapy, while the drug had low sensitivity and the duration of use was not correct. 35(88%) out of 40 infected infants received antibiotic therapy, while 5(12%) infants were unable to received effective therapy due to the unobvious clinical symptom and early on set of death. The positive rate of clinical pathogen samples was 17%, most of which was Klebsiella pneumonia Streptococcus viridans and Escherichia coli. Piperacillin tazobactam sodium and Meropenem is most common used. Conclusion Infection occupies a crucial role in neonatal death, by improving maternal infection treatment and enhancing the management of infants can significantly reduce neonatal mortality.

Biography:

Nisha Agarwal has completed her M.B.B.S. in 2012 from Stanley Medical College, India. She is currently doing her Pediatrics residency at Harlem Hospital Center, New York and is in her second year. She has participated in basic science research project in 2013-2014 which has been published in premier journals like American journal of respiratory and critical care medicine. She is also involved in multiple patient and quality improvement projects at Harlem hospital currently.

Abstract:

Bronchiolitis is one of the most common diagnoses requiring hospitalization in less than 2 years old and Continuous Positive Airway Pressure (CPAP) is the most common treatment strategy for providing positive pressure ventilation (PPV)in these patients. Recently, High flow nasal cannula (HFNC) has emerged as a new modality for providing PPV. Our study attempts to compare the two modes. It is a retrospective chart review including patients less than 2 years with a clinical diagnosis of bronchiolitis and no chronic lung disease. The study compares the outcome which is defined as escalation of therapy to BIPAP or mechanical ventilation between the two groups. CPAP group is an in built control as HFNC was not available during first year of data collection. Post HFNC introduction, all the patients were started on HFNC except for some who were started on CPAP based on HFNC availability. The study included total of 63 patients based on eligibility criteria. Among 63 patients, CPAP group had 14 and HFNC group had 19. In CPAP group, 2 patients got intubated and 1 patient got escalated to BIPAP. In HFNC group, 1 patient got intubated and 4 patients got escalated to BIPAP. Overall, among CPAP group 21% worsened and required escalation and among HFNC group 26% worsened and required escalation. P-value for the above study was 0.69 which was not significant. Therefore, our study shows there is no difference between CPAP and HFNC use in bronchiolitis patients. Our study was limited due to small sample size.

Biography:

Jenelle Fernandez is currently a Pediatric Resident at the Children’s Hospital Navicent Health affiliated with Mercer University School of Medicine. She has received her BS in Biology at the University of Florida, USA. She went on to receive her Medical degree from Ross University School of Medicine

Abstract:

Despite the high accuracy, sensitivity and specificity, radio nucleotide imaging, using (99mTc) pertechnetate to diagnose Meckel’s diverticulum may result in false positive studies. Early or late appearance of the dye in relation to that of the stomach can aid in distinguishing the false-positive causes from those due to ectopic gastric mucosa on a Meckel’s scan. The accumulations of  pertechnetate due to hyperemia appear early or late in the study and tend to fade over time. Whereas in a Meckel’s diverticulum, uptake of radio-tracer occurs simultaneously, usually between 10 and 20 minutes after tracer injection and persists throughout the study, increasing in intensity parallel to the intensity of the stomach. However, pitfalls to this rule may exist requiring additional imaging. A 13-year-old female patient presented with acute onset, colicky, right lower quadrant abdominal pain since the past one day, associated with recurrent bright red, painless rectal bleeding for the past one month. There was no history of hard bowel movements or painful defecation. Other than a history of a bilateral periacetabular osteotomy for hip dysplasia a month prior, past medical and family history were not significant. Laboratory evaluation included hemoglobin of 9.7 g/dL, Hematocrit of 31.2%, MCV of 80.5. Physical examination was normal. Meckel’s scan demonstrated diffuse streaky uptake of the tracer in the right lower quadrant, more lateral in location than normal coinciding with that of the stomach. Due to the persistent concern of MD in the patient SPECT was performed. Accumulation of the 99mTc was noted in the right joint capsule ruling out a MD. Although, MD was ruled out, magnetic resonance enterography (MRE) was performed to further assess this area of increased uptake on the perfusion scan. Soft tissue enhancement was noted around the right hip, deep to the iliacus and psoas muscle. The MRE findings were thought to be most consistent with post-surgical inflammation of the right hip. Our case highlights the importance of not only concentrating on the
timing of enhancement of the radio-racer in relation to that of the gastric mucosa but also on the shape and location of accumulation to avoid misdiagnosis and unnecessary surgical exploration. It is to be noted that localization of radiotracer, in the right lower quadrant, coincided with that of the stomach, in this patient mimicking activity noted with a Meckel’s diverticulum. Since tracer accumulation was broader, more lateral and streaky in configuration as compared to the focal small rounded appearance seen with
a Meckel’s diverticulum, the diagnosis was doubtful and led to further investigation with SPECT imaging and MRE, thus preventing unnecessary surgical exploration.

Biography:

Amy Issa D O is currently a Pediatric Resident at the Children’s Hospital Navicent Health affiliated with Mercer University School of Medicine. She has received her BS in Biology with a minor in Great Texts of the Western Tradition while in the Honors College at Baylor University. She went on to receive a Master of Science in Medical Science from the University of North Texas Health Science Center (UNTHSC) and received her Medical degree from Texas College of Osteopathic Medicine at UNTHSC.

Abstract:

A pre-duodenal portal vein (PDPV) is a congenital anomaly that is rare in both pediatric and adult patients. PDPV results from persistence of a primitive vitelline vein and rather than passing inferiorly and behind the pancreas, the portal vein crosses in front of the duodenum and pancreas. PDPV is usually found as an incidental finding during surgeries of the gastrointestinal tract but
can cause an extrinsic compression of the duodenum leading to intestinal obstruction. PDPV association with such a complication is extremely rare. In fact, in a 25-year retrospective study in a single center; PDPV was found only in five neonates. In all of them, the PDPV was asymptomatic and the duodenal obstruction was due to associated malformations, such as malrotation, duodenal atresia, duodenal web or annular pancreas. Most of the cases of PDPV reported have been described in association with other congenital anomalies including heterotaxia, polysplenia syndrome, situs inversus, cardiac defects, malrotation, biliary or duodenal atresia and annular pancreas. To our knowledge, out of the 100 pediatric and adult cases reported, an association with a Meckel’s diverticulum has never been described. We hereby, report a 14-month old male with a history of heterotaxy syndrome, left atrial isomerism, severe gastroesophageal reflux disease and failure to thrive with malrotation that was noted on an upper GI series. Surgical exploration revealed affixation of the midgut without volvulus without dilatation of the duodenum. A vascular structure crossing the duodenum anteriorly was noted and identified as a PDPV in association with a Meckel’s diverticulum, which was removed. The PDPV was left in place, since no signs of duodenal obstruction or inflammation were noted. Although, an incidental finding, this anomaly is of great surgical importance as it can cause unexpected surgical complications from accidental injury to the portal vein. Therefore, knowledge of this anomaly is essential for avoiding injuries during laparotomy for surgical correction of gastrointestinal anomalies such as malrotation.

Biography:

Mehrdad Modaresi currently working as an Associate Professor in the Department of Animal Science at Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, Iran. His research fields is herbal drugs and Animal Physiology. He has been recipient of few awards and grants. His research reflect in wide range of publications in various national and international journals. He completed his PhD at the age of 29 years from Islamic Azad University,Research and Science Branch. 

Abstract:

The liver has a key role in the regulation of many physiological phenomenon. Due to the use of traditional medicinal plants, in this study the effects of lavender (Lavandula officinalis) extract on tissue and liver enzymes were investigated. In this experimental study, 50 mature female mice were divided into 5 groups, each group including ten adult female Balb/C mice. The control group did not receive any extract, the placebo group received 0.5 cc normal saline every other day and 3 treatment groups received hydro alcoholic extract of lavender with 50,100,200mg/kg /2day doses that was used interperitoneal injection for 20 days..20 days later, blood samples were taken from all groups and the liver enzyme ALT, AST, and ALP were measured. Liver tissue was studied by light microscopy in all groups. Obtained data were analyzed using SPSS program (p<0.05). ALT enzyme increased significantly in 200 doses (p<0.05). AST enzyme levels at doses of 100 and 200 mg/kg compared to the control group showed a significant decrease, and ALP enzyme concentration in a dose of 200 compared to the control group showed a significant decrease(p<0.05). Observations in sections showed that the liver tissue in 50 and 100 were not significant pathological changes but obvious pathological changes of liver tissue (necrotic tissue) observed in 200 group.

Biography:

Dr oumer jemal has completed his medical under graduate school at the age of 25 year from Hawassa university,Ethiopia. He was a general practitioner and medical director in Desse Referral hospital for four years. He is now a senior surgical resident in Bahir Dar university, Ethiopia

Abstract:

Abdominal cocoon also known as sclerosing encapsulating peritonitis is a rare condition of unknown etiology which rarely causes intestinal obstruction. Commonly identified in young females in tropical countries.it is usually diagnosed intra operatively.in this condition variable length of bowel gets involved. Here we  present a case of recurrent intestinal obstruction in a 9 yrs old male patient with the whole small intestine involved to the abdominal cocoon. Its presentation, diagnosis and management will be discussed in detail.

Biography:

Dr Enyew Abate Belay has completed his doctor of medicine(MD) at the age of 24 years from Addis Ababa University in 2013 and now he is 2nd year resident student in obstetricss and gynecology in Bahir Dar University, College of medicine and Health sciences.
 

Abstract:

Introduction: Conjoined twins occurs  with a frequency of  about 1 per 50,000-60,000 deliveries. Parapagus is the term used where there is extensive side to side fusion joined anterolaterally resulting from two nearlly parallel notochords which are in close proximity to eachother..

Case report: We have got female parapagus conjoined twin born to 25 yrs old P I mother through cesaean section. The conjoined twins  has two heads, four arms and two legs. The diagnostic procedure, patient followup and outcome will be discussed in detail during the presentation.

Conclusion: Parapagus is very rare which represnts less than 0.5 % of all reported cases of conjoined twins. There are case reports presenting as dicephalic conjoined twins, some are reported to be stillborn, others will die shortly after birth and one case report living for 11 yrs.

Biography:

Dr. Yichalal Endayehu has completed his medical doctorate degree from Gondar University  on 2006 and his certificate on pediatric and child health from Addis Ababa University School of medicine on 2012. He completed IPPC (international postgraduate pediatric certificate) from The Children’s hospital at Westmead/ The University of Sydney 2016. He is currently working at Debretabor University College of health sciences involving in teaching, research and clinical activities. He is, head of department of head of pediatrics and child health.  So far, he has published one paper on BMC dermatology and others are on pipe line.

Abstract:

Background: Children with HIV infection may develop a wide variety of infectious and inflammatory diseases of the skin. These disorders are often more severe and more difficult to treat than in the immunocompetent child. In some cases, disorders of the skin or mucous membranes may provide an early clue to the presence of pediatric HIV infection. Methods: It is a descriptive cross-sectional study which was conducted at the pediatric infectious disease unit, department of pediatrics and child health, Tikur Anbesa specialized Hospital. Clinical information was collected using a questionnaire. The data was analyzed using SSPS 16.0 version. Chi-squared was utilized where appropriate and a p-value of less than 0.05 was considered statistically significant. Results: Two hundred seventy HIV infected children were recruited in this study. Out of these females were 51.5% and males were 48.5%. Most of the children 196/270 (72.6%) were suffering from one or more mucocutanous disorders. The most prevalent mucocutanous disorders were infectious dermatosis. Overall, mucocutaneous disorders were more prevalent in advanced stages of HIV disease P < 0.001. Two or more mucocutanous disorders were found in moderate and sever immunosuppression. Seventy three percent of the HIV-infected children with mucocutaneous disorders were already on HAART. Conclusions: The prevalence of mucocutanous disorders is high in HIV infected children. Advanced immunosuppression is highly associated with a wide spectrum of mucocutanous disorders.