24^th Annual World Congress on Pediatrics August 10-11, 2023 Vancouver, Canada

Biography:

Dr. Sarpal completed her MD and general pediatrics residency from University of Calgary in 2004 and 2008 respectively.  In 2010 and 2011, she completed fellowships in pediatric critical care medicine and pediatric palliative care medicine. She is also an Erickson Certified Executive Coach, and a member of the International Coaching Federation. She is currently the program director for the pediatric critical care medicine postgraduate medicine fellowship training program at Sidra Medicine and an assistant professor at Weill Cornell Medicine-Qatar, Qatar.  Her research/academic interests include medical education, end of life care in the intensive care unit, physician health and wellness and coaching in (and outside) medicine.

Abstract:

Palliative care is a specialized form of medical care intended for individuals with serious and potentially life threatening or life limiting illnesses/conditions and should be made available to patients based on their needs regardless of their expected prognosis.  As exposure to palliative care in medical school and throughout postgraduate training remains fairly limited in most settings, palliative care remains to a degree shrouded in mystery for many. While there are commonalities to adult palliative care, there are also stark differences that exist in comparison to pediatric palliative care.

Biography:

An ambitious final year medical student in Faculty of medicine and pharmacy of Rabat ,very passionate about research. Currently applying for a thesis master in Canada to improve my research skills before joigning a residency program ,in order to become a research physician.

Abstract:

Willebrand's disease (VWD) is a genetic bleeding disorder; a defect in the amount or structure of von Willebrand factor (VWF). VWF: An element of primary hemostasis, its two main roles are the adhesion of platelets to injured vessels, and the transport of factor VIII (FVIII). There are 3 types of variable severities: Type 1 (least severe): Partial quantitative deficit; VWF is made in less quantity, which can lead to factor VIII (FVIII) deficiency. Type 2 (more severe): the VWF is manufactured but does not fulfill its function. Type 3 (the most severe and the rarest): the deficiency in VWF is total and is associated with a constant and profound deficiency in FVII.

The diagnosis of VWD is a clinical and biological diagnosis, most often made in childhood or adolescence, especially in girls in puberty with menorrhagia.The clinical symptomatology is essentially cutaneous and mucosal, the interrogation must seek a history of hemorrhagic accidents as well as a family history of hemorrhagic symptomatology or known pathology of hemostasis. At the end of the interrogation, a haemorrhagic score can be established. This score developed by Tosetto has proven its relevance and has been approved and put online by the ISTH. There are pediatric adaptations.Type 3 VWD is defined by a total quantitative deficit of VWF. This is the most severe form of VWD. It represents less than 5% of the forms of the disease. The genetic abnormalities responsible for this type are nonsense mutations, allele expression defects or complete or partial deletions of the VWF gene. Transmission is recessive and symptomatic patients are homozygous or heterozygous.Routine biological tests are essential, but insufficient to detect VWD. They are carried out during the exploration of a hemorrhagic syndrome, the evaluation of the hemorrhagic risk preoperatively or in the presence of a family history of bleeding. These first-line biological tests include a complete blood count, prothrombin count (PT), thromboplastin time plus activator (PTA) and functional fibrinogen assay. Tests exploring primary hemostasis such as the measurement of platelet occlusion time PFA can be added as first intention. It is a non-specific test, but sensitive to qualitative and quantitative deficits of VWF. The specific biological tests, three in number, are to be carried out on the same sample, plasma VWF activity, called ristocetin cofactor activity, the antigen VWF assay and the coagulant FVIII assay.In VWF type 3 there is a total quantitative deficit. The antigen and the activity of the vWF are collapsed and the level of factor VIII is very low.To make a definitive diagnosis of VWD it is sometimes necessary to repeat the assays at different times.At present it is impossible to cure VWD, apart from accidents and situations at risk of bleeding, in the majority of cases, correction of VWF deficiency is not necessary, especially in the case of minor bleeding that has dried up. spontaneously. However, it is important to follow simple preventive measures.Type 3 patients do not respond to desmopressin, so VWF concentrates alone (Wilfactin*) or VWF concentrates in combination with FVIII (Wilstart*) are used. These treatments are instituted: Either in a curative way in order to treat an unforeseen hemorrhagic accident or, in a preventive way (before a scheduled surgery for example).

Conclusion: Willebrand's disease Type is a pathology of hemostasis, with a significant risk of bleeding, linked to a complete deficiency in vWF, it is the rarest and most severe type of VWD, its diagnosis is based on the clinic with a biological confirmation. The treatment is essentially preventive and is mainly based on the injection of VWF and FVIII concentrates

Biography:

Sarvin Sajedianfard graduated from Shiraz University of Medical Sciences. She is working at oncology center in Shiraz, Iran as a pediatrician for 2 years.

Abstract:

Background and objectives: Immunization against the coronavirus disease 2019 (COVID-19) began in January 2021 in Iran; nonetheless, due to a lack of vaccination among children under 12, this age group is still at risk of SARS-CoV-2 infection and its complications.

Case presentation: SARS-CoV-2 infection was diagnosed in a 6-year-old girl who had previously been healthy but had   developed a fever and pancytopenia. The bone marrow aspiration/biopsy demonstrated just hypocellular marrow without signs of leukemia. She was worked up for primary and secondary causes of pancytopenia. Except for a repeated reactive HIV antibody/Ag P24 assay, all test results were inconclusive. After a thorough diagnostic investigation, the cross-reactivity of the HIV antibody/Ag P24 test with SARS-CoV-2 antibodies was confirmed. The patient did not develop any COVID-19-related signs and symptoms, but she did get a severe invasive fungal infection and neutropenic enterocolitis. She died as a result of disseminated intravascular coagulopathy.

Conclusion: It is critical to recognize children infected with SARS-CoV-2 who exhibit atypical clinical manifestations of COVID-19, such as persistent pancytopenia. SARS-CoV-2 infection can cause severe and deadly consequences in children; thus, pediatricians should be aware of COVID-19's unusual signs and symptoms mimicking other conditions such as aplastic anemia.

Biography:

Dr. Peter Averkiou is a pediatrician and an Associate Professor of Pediatrics at the Charles E. Schmidt College of Medicine at Florida Atlantic University. He is the Co-Director of the four Foundations of Medicine Courses, the Director of the Service Learning Projects, the Director of the Newborn Nursery Clinical Rotation and the Director of the Synthesis and Transition Course at the medical school.

Abstract:

The Newborn Nursery Clinical Experience is an innovative, early exposure for medical students to the hospital setting and family medicine. Early in their second year, our medical students are immersed into the Newborn Nursery, while also experiencing the neonatal intensive care unit (NICU) and attending obstetrical deliveries. They witness, first hand, the interprofessional and interdisciplinary workings of pediatricians, obstetricians, neonatologists, anesthesiologists, nurses and other professionals. The medical students are also instructed on how to read a medical chart and on proper medical documentation and its importance. They also interact with the mother of the patient, as well as other family members that are in attendance, and long-term continuity of integrated care and the focus on the personal patient/patient’s guardian(s) - physician relationship is stressed. This experience is always well-received and highly evaluated by our medical students. It also helps to prepare them for their third-year clinical rotations in family medicine, pediatrics and Ob/Gyn.

Biography:

As an academic neonatologist and pediatric intensive care physician, Dr. Tsao work in neonatal and pediatric intensive care, congenital airway anomalies, newborn screening. Dr. Tsao’s current research interests include i) universal newborn screening program of critical congenital heart disease, congenital CMV infection, and congenital toxoplamosis, ii) diagnosis and therapeutic intervention of airway anomalies via flexible bronchoscopy, iii) underlying mechanism and management of pediatric ARDS and HIE, and iv) long-term outcomes of high-risk infants.

Abstract:

Introduction: Studies on risk factors for childhood hearing deficit (HD) are usually based on questionnaires or small sample sizes. Therefore we conducted a nationwide population-based case–control study to comprehensively analyze the maternal, perinatal, and postnatal risk factors for HD in full-term children.

Methods: We retrieved data from three nationwide databases related to maternal characteristics, perinatal comorbidities, and postnatal characteristics and adverse events. We used 1:5 propensity score matching to include 12,873 full-term children with HD and 64,365 age-, sex-, and enrolled year-matched controls. Conditional logistic regression was used to evaluate the risk factors for HD.

Results: Among the various maternal factors, maternal HD (adjusted odds ratio [aOR]: 8.09, 95% confidence interval [95%CI]: 7.16–9.16) and type 1 diabetes (aOR: 3.79, 95%CI: 1.98–7.24) had the highest odds of childhood hearing impairment. The major perinatal risk factors for childhood hearing impairment included ear malformations (aOR: 58.78, 95%CI: 37.5–92.0) and chromosomal anomalies (aOR: 6.70, 95%CI: 5.25–8.55), and the major postnatal risk factors included meningitis (aOR: 2.08, 95%CI: 1.18–3.67) and seizure (aOR: 3.71, 95%CI: 2.88–4.77). Other factors included acute otitis media, postnatal ototoxic drug use, and congenital infections.

Conclusions: Many risk factors for childhood HD identified in our study are preventable, such as congenital infection, meningitis, ototoxic drug use, and some maternal comorbidities. Accordingly, more effort is required to prevent and control the severity of maternal comorbidities during pregnancy, initiate genetic diagnostic evaluation for high-risk children, and aggressive screening for neonatal infections.  

Biography:

Sarvin Sajedianfard graduated from Shiraz University of Medical Sciences. She is working at oncology center in Shiraz, Iran as a pediatrician for 2 years.

Abstract:

Background and objectives: Wilson’s disease (WD) is a genetic disorder of liver affecting copper metabolism and is one of the common causes of liver failure. In this study we aimed to test the diagnostic value of a questionnaire for the diagnosis of WD in pediatrics age group.

Materials and Methods: Two groups of 70 children with the diagnosis of WD and 70 without WD were included in the study. The gold standard test for the diagnosis of WD was liver biopsy. Then a modified questionnaire with 4 items was used and the results were compared to the definite diagnosis made by pathology.

Results: The median (IQR) modified score in those with WD was significantly higher than that for the comparison group. The sensitivity and specificity were 100% and 98.6%, respectively, according to an NPV of 100%.

Conclusion: As WD is one of the causes of liver transplant, this modifies scoring system helps to diagnosis of WD in children especially in regions with limited access to specific laboratory tests for the diagnosis of WD.

Biography:

School of Medicine, China Medical University, Taiwan. 1993, M.D. Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, Pediatric Residency 1999. Research fellowship, Division of Infectious Diseases, National Health Research Institute, Taipei, Taiwan 2001. Research fellowship, Division of Pediatric Infectious Diseases, Children Hospital Boston, MA, USA 2007. Research fellowship, School of Medicine, Harvard University, MA, USA 2007. Associate Professor, School of Medicine, National Yang Ming University, Taipei, Taiwan 2016. Professor, School of Medicine, National Yang Ming University, Taipei, Taiwan 2023. Lately, I conducted several studies and published several SCI literatures in the field of ESBL E. coli infection in children, adults as well as environment and community carriage, such as the article Extended-spectrum β-lactamase-producing Escherichia coli bacteremia: comparison of pediatric and adult populations in  J Microbiol Immunol Infect. In 2018. Bloodstream Infection with Extended-spectrum Beta-lactamase–producing Escherichia coli: the role of virulence genes in J Microbiol Immunol Infect. In 2019. Prevalence and Risk Factors for Colonization by Extended-spectrum β-lactamase-producing or ST 131 Escherichia coli among Asymptomatic Adults in Community Settings in Southern Taiwan in Infection and Drug Resistance in 2019. Prevalence and Household Risk Factors for Fecal Carriage of ESBL-Producing, Sequence Type 131, and Extraintestinal Pathogenic Escherichia coli among Children in Southern Taiwan in  J Microbiol Immunol Infect, and Distribution and Genomic Characterization of Third Generation Cephalosporin Resistant Escherichia coli Isolated From a Single Family and Home Environment: A 2-Year Longitudinal Study in Antibiotics in August, 2022. Published and/ or presented over 70 abstracts and peer reviewed publications.

Abstract:

Background: Broad-spectrum drug-resistant (defined as resistant to 3rd generation of cephalosporines or new quinolones) Escherichia coli (E. coli), particularly clonal group sequence type 131 (ST131) that produce CTX-M types of extended-spectrum beta-lactamase (ESBL)-producing E. coli have dramatically increased worldwide. In our prior studies, we found that the prevalence of community-onset ESBLproducing E. coli UTIs among infants was similar in urban and rural populations in southern Taiwan. We also found in that study that most infants with UTIs were previously healthy with no apparent risk factors. The increase of ESBL-producing E. coli infections may be related to the infection by asymptomatic carriers or environmental circulation of ESBL-containing microorganisms. However, the distributions of resistant E. coli in households in different geographic regions of Taiwan are still unknown. Additional prospective multicenter studies are required to investigate the prevalence of community-onset E. coli infections in different geographic regions. Methods: E. coli isolates from the stool of children with uropathogenic or fecal carriage of BDR E. coli and their families and from their household environments were prospectively identified in different regions of Taiwan. The E. coli isolates identified as BDR were tested for ESBL, and multilocus sequence typing (MLST) was used to detect ST131. Fecal shedding duration of different regions was compared. Purpose: This study investigated the prevalence of BDR E. coli, particularly for ST131 and ESBL-producing strains, in human carriage, the environment, and households and the duration of shedding of BDR E. coli in different geographical regions of Taiwan.

Biography:

Dr. Roba Mideksa, MD Arbaminch University School of Medicine, 2022 . Trainer and Medical Doctor at Elbat Solution 2022. Assistant  Physician Soyas Clinic 2021. Life time member of Ethiopian  Red  Cross Society and Proud Volunteer . General Manager at Borif Cleaning and Disinfecting Services ,plc. 2020. Research enthusiast and interests-maximizing efficiency in technology in medical practices .

Abstract:

Background

Birth asphyxia is a leading cause of infant morbidity and mortality in developing nations, such as Ethiopia. Though Ethiopia has made considerable achievement in the reduction of under-five mortality rate, the neonatal mortality burden has not experienced the same reduction, which may be attributed to birth asphyxia. The aim of this research was to identify where the gap is and solve the problem and address good neonatal outcome

Objective

The objective of this study was to determine the prevalence and associated factors of perinatal asphyxia among neonates admitted to neonatal intensive care unit in Arbaminch General Hospital, Southwest Ethiopia in the study period.

Method

An institution-based cross-sectional study design was conducted .A simple random sampling method was used to select 372 neonates. A structured checklist was used to collect the data and analysis by SPSS, version 25 (IBM). Binary logistic regression analysis was performed to assess factors associated with PNA among neonates administered to NICU of AGH.

Result

Out of 630 source population 372 neonates were selected using simple random sampling technique data was coded and enter in to computer based statistical package for the social science( SPSS) version 25 for analysis after being collected using structured checklist the prevalence of perinatal asphyxia in the study area was determined to be 21.4% .

After multivariate analysis Complication during labor, Mode of delivery, Presence of ANC visit and Presence of MSA found to be independent variables or predictors for in neonates admitted to NICU (p<0.05). That is AOR shows that those who didnÂ’t have complication during labor are 88.7%   less likely to develop PNA than those who had complication during labor. Those neonates delivered by C/S are 11.35 times and those delivered by others (vacuum, forceps) are 3.37 times more likely to develop PNA than those delivered by SVD. Those who didnÂ’t have MSAF are 84.7% less likely to develop PNA than those who had MASAF. 

Biography:

Abstract:

Background and relevance: Intrauterine viral infections induce an increase in the levels of proinflammatory cytokines which inhibit the proliferation of neuronal precursor cells and stimulate oligodendrocyte cell death leading to abnormal neurodevelopment. Epidemiologic studies suggest maternal immune activation during pregnancy maybe associated with neurodevelopmental effects in infants which is of great concern. Given the large number of exposed individuals, even a modest increase in risk for adverse offspring neurodevelopment would still have a massive public health impact. Objective: To determine the neurodevelopmental outcome of infants born to mothers with COVID-19 infection during pregnancy. Methodology: This study utilized a meta-analysis design. Studies published up to September 30, 2022 were included in the analysis. Data Analysis: STATA MP Statistical Software, Version 13, College Station, TX: StataCorp LP was utilized for all statistical analyses. A p-value ≤0.05 was considered statistically significant. Since estimated heterogeneity is non-significant and not substantial, a fixed-effect model was utilized. Pooled risk ratio was utilized as the summary effect measure for the risk of neurodevelopmental delays and was estimated with their corresponding 95% confidence intervals. Heterogeneity was scrutinized using the following statistical tests: Q statistics test, I2 statistics, and tau squared statistics. I2 values greater than 50% imply substantial heterogeneity, while a Q-statistics with a significant p-value denotes a statistically significant heterogeneity. Results: Two studies with a total population of 7,848 patients met the eligibility criteria. Results indicated that all included studies have good quality of evidence in the areas of selection, comparability, and exposure. Appraisal of the included studies in these areas of evaluation also showed that all studies were of good quality. The pooled risk of neurodevelopmental delays among infants born to COVID- 19 positive mother was 2.00% higher than those born from mothers who were negative for COVID-19 infection. However, this was not statistically significant. Graphical analysis of publication bias showed funnel symmetry, suggestive that publication bias was unlikely. This result was confirmed with formal statistical tests using Begg’s adjusted rank correlation test and Egger’s regression asymmetry test. Conclusion: Although not statistically significant, infants born to mothers with COVID-19 infection during pregnancy have increased risk of neurodevelopmental delay. This may be attributed to the limited number of studies and articles available and in part because children born to women infected in the first wave of the pandemic are younger than two years of age. In addition, majority of developmental delay reflected developmental disorders of motor function or speech and language. Recommendations: Given the time-frame since the pandemic has started, little is known about the effect of in- utero exposure to COVID-19 in infants and children. Hence, this research topic remains to be of importance considering the increasing proportion of pregnant women being infected with COVID- 19. The author recommends future studies which assess the neurodevelopmental outcome in children with longer duration of followup should be ex

Biography:

Student Research Committee, Sabzevar University of Medical Sciences, Sabzevar, Iran

Abstract:

Purpose: Drug Resistant -Epilepsy is still a major challenge in pharmacotherapy of epilepsy. Pharmacogenetic pathways are one of the most important elements that can help clinicians determine medication response and provide more efficient drug therapy, especially in cases of drug resistance. Genetic alterations in drug target and transporter proteins, in part, could explain the development of drug-resistant epilepsy. We sought to assess the association of CYP3A5 (rs776746), SCN1A (rs2298771) and ABCG2 (rs2231137) candidate polymorphisms with drug-resistant epilepsy among Iranian children with epilepsy. Methods: In a hospital-based case-control study, 93 participants, including 45 men and 48 women aged 1.5 to 14 years old were recruited. Genotyping of CYP3A5 (rs776746), SCN1A (rs2298771) and ABCG2 (rs2231137) polymorphisms using the high-resolution melting (HRM) method were measured in 46 children with drugresistant epilepsy and 47 healthy control subjects. The binary logistic regression model was used to estimate the odds ratio (OR) for each polymorphism per effect allele increase. Results: The mean (standard deviation [SD]) age of the drug-resistant patients was 10.7 (9.0) years versus 7.3 (3.6) in the control group. In the case group, most of the patients with epilepsy were diagnosed with generalized seizure (about 87%) and negative epileptic history status (63%). Furthermore, idiopathic epilepsy was dominant in the case group (69%). There was a clinically meaningful increase in the chance of drug-resistant epilepsy in participants with candidate polymorphism in ABCG2 gene (per allele T increase, adjusted odds ratio [OR] 2.41, confidence interval [CI] 0.99 to 5.87, P=0.05). No significant association was found between CYP3A5 (per allele C increase, OR 0.92, CI 0.33 to 2.60, P= 0.88) and SCN1A (per allele *1 increase, OR 0.65, 95% CI 0.34 to 1.23, P= 0.19) with drug-resistant epilepsy. Conclusion: We found evidence for the relationship between the ABCG2 gene polymorphism and a higher chance of drug-resistant epilepsy in children. This finding may have important implications for understanding the role of ABCG2 gene polymorphism in children with drug-resistant epilepsy.

Biography:

Kumars Pourrostami, Department of Pediatrics, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran

Abstract:

Human astroviruses (HAstVs) have frequently been detected in individuals with acute gastroenteritis (AGE). However, a precise estimate of the overall prevalence of the virus in children with AGE as well as the possible association of the virus with gastrointestinal complications is not available up to now. The present study estimated the overall prevalence of HAstVs in children with gastrointestinal complications as well as the association between the virus and symptoms. We systematically searched four international databases (PubMed, Scopus, Web of Science, and Google scholar) to find studies on the prevalence of HAstVs in people with AGE published between Jan 2000 and Sep 2021. Analysis of the 223 included studies presented a 4.2% (95% CI 3.8%–4.8%) prevalence of the virus in AGE individuals. Based on case‐control studies, a significant association between these viruses and AGE was detected (OR: 2.059, 95% CI; 1.438–2.949). HAstV‐1 and HAstV‐VA‐2 is the most and least common genotypes in the AGE patients, respectively (59.0%, 95% CI: 52.1%–65.6% vs. 4.9%, 95% CI: 2.6%–9.1%). Due to the statistically significant association between HAstV and gastrointestinal complications, more attention should be paid to these viruses in people with AGE and more studies should employ case‐control design.

Biography:

Prof. Pierpaolo Maietta is medical doctor, specialized in thoracic general emergency medicine an cardiac surgery in Italy university of naples. He is full professor and chief  and researcher at Aversa hospital.

Abstract:

Purpose: Trauma may lead to serious complications in children patients. The purpose of this study was to investigate prognosis in children with traumatic injuries.

Methods: This cross-sectional study was conducted on all of the children (<18 years old) who had suffered traumatic injuries and transferred to the emergency department of Imam Hussein Hospital by emergency medical services. After selecting the children, a checklist including information such as demographic characteristics, trauma type, consciousness level, and final outcome was recorded. Finally, the data were analyzed using t-test, Chi-square test and ANOVA.

Results: In total of 564 children were investigated. Among them, 70% were males, and 33.2% were in the age range of 5-12 years. The mechanism of injuries in 97.9% of the cases was blunt trauma. The most common chief complaint among the affected children was nausea. The majority of them had stable vital signs and normal neurological tests results. However, 1.06% of them died during hospitalization. The results indicated that the final outcome in the children affected by traumatic injuries is significantly related to the type of trauma, the location of traumatic event, the vehicle used to transport them to emergency departments and their Glasgow coma scale score (p < 0.05).

Conclusion: Considering the young age of the child patients and over half of trauma happened at home, it is important to raise parents' awareness about the risky places and activities, which were likely to result in traumatic injuries for children.

Biography:

Abstract:

Back ground: Birth Asphyxia is one of the leading causes of neonatal and perinatal mortality in developing Asian Countries. Quick and safe neonatal resuscitation takes on priority in saving lives discovered for the first time in the world. Newly born resuscitation is unique in that displacement of lung filled fetal fluid requires continuous distending pressure as opposed to intermittent positive pressure ventilation is both scientifically and physiologically proven for uniform recruitment of alveoli and functional residual capacity to achieve optimal gas exchange. Aim: The only therapy for hypoxia is oxygen reducing Pulmonary Vascular Resistance (PVR) initiates breathing and reflex physiological mechanism of left to right shunting promotes vital cardio-vascular changes adapting to extra-uterine life. Method: Study comprised of 1,383 consecutive singleton live births during 14-month period from 1^st April 2016 to 31^st May 2017, I attended 830 cases among 1383 deliveries and exclusion criteria were 12 twin pregnancies and 10 stillbirths. Methodology includes three steps. Step one is Pulse oximetry score from zero to +5 based on peripheral oxygen saturation. Step two is classification of newborns into Grade I to V based on SpO₂, pattern of respiration, rate/min and heart rate (bpm) and step three is Lalana Newborn Resuscitation (LNR) Protocol I and II by Continous positive pressure ventilation by sustained nasal oxygen inflation. Results: Incidence of birth asphyxia was 21.4%, all 178 hypoxic/asphyxiated newly borns Graded I-V within 20-120 seconds of birth, were successfully resuscitated by sustained nasal oxygen inflation at flow rate of 4-15 Liters/minute directed towards baby’s nostrils through a wide bore tube for up to 1 to 3 minutes, initiating rhythmic respiration, rate 30-60/min, heart rate 120-160 beats per minute (bpm) and SpO₂>96% monitored continuously by Pulse Oximeter. Conclusion: ‘Lalana Newborn Resuscitation’ (LNR) proved effective in all 178 asphyxiated newborns, Grade I-V by continuous positive pressure ventilation with sustained nasal oxygen inflation at flow rates of 4-15 L/min who commenced rhythmic breathing within 1-3 minutes of birth, respiratory rate 30-60/min, heart rate 120-160 bpm and Zero pulse oximetry score, SpO₂ >96%.

Biography:

Marfel Coleen P. Vergara is a pediatrician from National Children’s Hospital, Philippines. She received a bachelor’s degree in cell and molecular biology from University of the Philippines, and finished Doctor of Medicine program at St. Luke’s Medical Center College of Medicine in Metro Manila, Philippines. She is currently in the Department of Health, serving a local hospital to help the needs and improve the health and wellbeing of the poor Filipino children. 

Abstract:

RATIONALE: Invasive candidiasis is a serious condition that occur more commonly in vulnerable populations, such as in preterm neonates especially those in intensive care units. Antifungal prophylaxis has been suggested to decrease mortality in this vulnerable population, with fluconazole as the drug of choice because of its ability to treat more than 90% of Candida species isolates. OBJECTIVE: To determine the efficacy and safety of fluconazole in preventing invasive candidiasis in preterm infants. METHODOLOGY: Publications were searched through PubMed, Cochrane, HERDIN plus, Google Scholar, ResearchGate, ClinicalTrials.gov, medRxiv, Epistemonikos, WHO International Clinical Trials Registry, and ALIBATA, without language restriction. Randomized controlled trials that compared the effect of prophylactic oral or systemic fluconazole versus placebo in preterm infants, done from January 2000 until present, were included. The methodological quality of the studies were assessed based on the (1) randomization process, (2) deviations from intended interventions, (3) missing outcome data, (4) measurement of the outcome, and (5) selection of the reported result, and a meta-analysis was conducted using STATA. RESULTS: A total of 5 studies were included, with a total of 1084 preterm infants. Prophylactic fluconazole significantly reduced the incidence of invasive candidiasis by 60% (RR=0.40; 95% CI: 0.21, 0.77; p=0.006). The incidence of mortality (RR=0.84; 95% CI: 0.6, 1.2; p=0.324) and necrotizing enterocolitis (RR=0.94; 95% CI: 0.61, 1.44; p=0.770) did not increase among infants give fluconazole prophylaxis as compared to placebo. Fluconazole prophylaxis resulted to a higher mean length of hospital stay versus placebo (SMD=0.16; 95% CI: 0.02, 0.30; p=0.022). Decrease in the incidence of IC also did not depend on the age at first dosage, whether given at 72nd or 120th hour of life (p=0.047, p=0.035), or the dosage used, whether given at 3mg/kg or 6mg/kg (p=0.0043, p=0.0002). CONCLUSION: The use of prophylactic fluconazole decrease invasive fungal infection in preterm infants. While there is no noted increase in mortality and adverse effects, larger clinical trials with longer follow-up periods are still recommended to comprehensively assess the safety profile of fluconazole prophylaxis among preterm infants.

Biography:

Gizachew Gobebo Mekebo (Assistant Professor of Biostatistics), Department of Statistics, Ambo University, Ambo, Oromia Regional State, Ethiopia

Abstract:

Background: Low birth weight (LBW) is a good summary measure of multifaceted public health problems including long-term maternal malnutrition, ill health, and poor health care during pregnancy. LBW results in a higher risk of dying in the first 28 days of life (neonatal death). LBW is a global public health problem with higher prevalence in developing countries. The prevalence of LBW in Ethiopia remains high. In Ethiopia, Oroma is one of the regions with high prevalence of LBW. This study aimed to determine prevalence of LBW and identify factors associated with LBW among under-five children (U5C) in Oromia regional state of Ethiopia. Methods: The data used in this study were extracted from the 2016 Ethiopian Demographic and Health Survey data. A multivariable logistic regression analysis was done to identify the potential predictors of LBW. An adjusted odds ratio with a 95% confidence interval was used examine associated of factors with LBW in multiple logistic regression analysis. Results: A total of 137 women of U5C were considered in this study. The prevalence of LBW in the study area was 15.3% (95% CI: 9.7-22.5). Rural residence (AOR:3.927, 95% CI: 1.104-14.676), females (AOR:3.058, 95% CI: 1.008-11.140) and multiple births (AOR:4.655, 95% CI: 2.557-15.644) were significantly associated with higher odds of being LBW babies while secondary and higher education (AOR:0.220, 95% CI: 0.056-0.861), being supplied iron during pregnancy (AOR:0.362, 95% CI: 0.105-0.781), ANC attendance (AOR:0.473, 95% CI: 0.203-0.614) and gestational age of 37 weeks and above (AOR:0.224, 95% CI: 0.312-0.811) were significantly associated with lower odds of being LBW babies. Conclusion: Place of residence, sex of child, maternal education, ANC visits, iron supplementation, birth type and gestational age were statistically significant factors associated with LBW. Thus, health care providers should encourage mothers to give attention to attend ANC services. Mothers should also be encouraged to get iron during their pregnancies. Furthermore, there should be preventive strategies for preterm delivery.

Biography:

Amin Gohary, DS, FRCS Eng ,FRCS Glasg, FRCS Edin, Professor of pediatric surgery, President of international organization of disorder of sexual development, Clinical dean of Gulf medical college, Burjeel Hopital, Abu Dhabi, UAE

Abstract:

Introduction

We are discussing common surgical disorders of the gastrointestinal system that warrant surgical intervention. Inguinal hernia repair is the commonest procedure performed in Preterm and Infants. The premature infants have higher chances of incarceration and complications and are recommended for early surgery. Etiology is mainly attributed to failure of the Process vaginalis to close .  These children have upto 30 % chances of having contra lateral inguinal hernias. Controversies exist for examination of the contralateral side for hernia in children less than 1 year of age due to higher incidence of contra lateral patent process vaginalis.  Different modalities have been used to diagnose coexisting patent processes vaginalis. Like exploration, U/S Herniogram and laparoscopy.

Material and mthods

Vomiting in children is common and mostly related to medical condition. However there are surgical conditions associated with vomiting  which needs to be acknowledge and diagnosed early. Bilious vomiting is an ominous symptom and needs to be taken seriously. Any baby who vomits bile should be considered as having an underlying intestinal obstruction until proved otherwise.

Conclusion:

More recently we have encountered a subgroup pf patients that have genuine intussusception on radiological examination but not causing complete bowel obstruction and still associated with had srool in the large bowel and still needs simple fleet enema to cure.

We hope by highlighting this new phenomenon to avoid unnecessary radiological investigation and unnecessary abdominal

Biography:

Professor at the University of São Paulo, Brazil Head of Adrenal Unit of the Discipline of Endocrinology and Metabolism at Hospital das Clínicas, Medical School, USP Assistant Physician and Principal Investigator Adrenocortical Cancer Studies at Cancer Institute of the State of São Paulo ICESP - Researcher at the Laboratory of Hormones and Molecular Genetics LIM42 – HC-FMUSP CNPq Senior Research Productivity Scholarship – HCFMUSP - ICESP Av Dr Eneas de Carvalho Aguiar 255 Sao Paulo, Brazil.

Abstract:

Abstract: Pediatric adrenocortical tumors (PACTs) represent rare causes of malignancies. However, the south/southeast regions of Brazil are known to have a high incidence of PACTs because of the founder effect associated with a germline pathogenic variant of tumor suppressor gene TP53. We aimed to retrospectively analyze the types of variables among hormone production, radiological imaging, tumor staging, histological and genetic features that were associated with the occurrence of malignancy in 95 patients (71% females) with PACTs from a unique center. The worst prognosis was associated with those aged > 3 years (p < 0.05), high serum levels of 11-desoxicortisol (p < 0.001), tumor weight  200 g (p < 0.001), tumor size  5 cm (p < 0.05), Weiss score  5 (p < 0.05), Wieneke index  3 (p < 0.001) and Ki67  15% (p < 0.05). Furthermore, patients with MacFarlane stage IV had an overall survival rate almost two times shorter than patients with other stages (p < 0.001). Additionally, the subtractions of BUB1B-PINK1 (< 6.95) expression (p < 0.05) and IGF-IR overexpression (p = 0.0001) were associated with malignant behavior. These results helped identify patients who are likely to have an aggressive course; further multicenter prospective studies are required to confirm our results. In conclusion, PACTs with these patterns of prognostic factors could be treated using an adjuvant approach that may improve the overall survival in such patients.