13^th European Pediatrics Conference September 20 - 22, 2017 Czech Republic

Biography:

Alice K Abdel Aleem has her expertise in the field of Human Clinical and Molecular Genetics with interest in Neurogenetics disorders. Her primary area of interest is to provide reliable and high-quality research results to health care Physicians to improve diagnostics in human genetic disorders. Her current Extramural Funded Research is focusing on genes identification in monogenetic disorders. She is mainly concerned with building clinical and genomic databases for patients, encountered in Qatar, with spastic paraplegias, heritable muscle diseases, brain malformation, and interesting unrecognized Mendelian disorders. Results of her research is functionally investigated in her lab and in collaboration with investigators of international academic institutes to be able to provide confirmed information to the health care Physicians to use in counseling and managing their patients.

Abstract:

Megalencephalic leukoencephalopathy with subcortical cysts (MLC) is a rare and genetically heterogeneous cerebral white matter disease. Clinically, it is characterized by macrocephaly, developmental delay, and seizures. We explore the clinical spectrum, neuroimaging characteristics, and gene involvement in the first patients with megalencephalic leukoencephalopathy with subcortical cysts described from Egypt.

Patients: Six patients were enrolled from three unrelated families. Patient inclusion criteria were macrocephaly, developmental delay, normal urinary organic acids, and brain imaging of diffuse cerebral white matter involvement. Direct sequencing of the MLC1 gene in patients’ families and gliaCAM in one questionable case was performed using BigDye Terminator cycle sequencing.

Results: Clinical heterogeneity, both intra- and interfamilial, was clearly evident. Developmental delays ranged from globally severe or moderate to mild delay in achieving walking or speech. Head circumference above the ninety-seven percentile was a constant feature. Neuroimaging featured variability in white matter involvement and subcortical cysts. However, findings of posterior fossa changes and brain stem atrophy were frequently (66.6%) identified in these Egyptian patients. Discrepancy between severe brain involvement and normal mental functions was evident, particularly in patients from the third family. MLC1 mutations were confirmed in all patients. Deletion/insertion mutation in exon 11 (c.908-918delinsGCA, pVal303 Gly fsX96) was recurrent in two families, whereas a missense mutation in exon 10 (c.880 C>T, p.Pro294Ser) was identified in the third family.

Conclusions: This report extends our knowledge of the clinical and neuroimaging features of megalencephalic leukoencephalopathy with subcortical cysts. It confirms the apparent lack of

selective disadvantage of MLC1 mutations on gamete conception and transmission as supported by the presence of multiple affected siblings in Egyptian families.

Biography:

Aysegul Isler Dalgic is an Associate Professor in Pediatric Nursing Department of Akdeniz University Nursing Faculty in Antalya/Turkey. She has worked as a Tutor for more than 17 years. She is educated as Nursing and her major topics are pediatric nursing, childhood epilepsy, abuse and neglect in children, sexuality in disabled children, neurology, and complementary therapies in nursing. She has many scientific studies which have been published in the national and international scientific journals. She has been organizer and gave lectures, speeches, conferences and presentations in congresses and symposia.

Abstract:

Objective: This research was conducted as single blinded, randomized controlled trial for determine of impact foot reflexology on infantile colic.

Method: The study was conducted in the Department of Pediatrics of Isparta Women, Birth and Child Disease Hospital between June 2016 and March 2017. The research population was comprised of infants who met research criteria and had infantile colic with regard to Wessel Criteria by Pediatrician together with parent and researcher. The study sample consisted of 20 control subjects and 20 study group subjects which is a total of 40 infants with colic and their parents who agreed to participate in the research. The data were collected by the researcher after written consent was taken from Ethics Committee, and the hospital where the research has been carried out. As data collection tool, data collection form, infant colic scale, pain assessment tool, cry following form and sleep following form were used. Both groups were observed four times during two weeks. While the infants in study group received foot reflexology, noneffective touch to foot applied by researcher to control group infants. For the data analysis, SPSS 20.0 packet program.

Results: According to the results it can say that foot reflexology decreased colic score mean, pain sense, daily crying time and crying violence, on the other hand; increased daily sleep times of babies in study group. While daily crying times decreased day by day since the third day of reflexology seance; daily sleep times increased day by day too since fourth day of reflexology seance in study group. The findings show that in proportion of 60% babies in study group not observed colicky cry during a month after the practice.

Conclusion: Foot reflexology was effective in relieving infantile colic symptoms.

Biography:

Dr. Ramy Mohamed, Researcher in biological anthropology department and consultant of pediatrics and neonatology in the national research center in Egypt. He has finished his Ph.D.in child health and nutrition at the age of 35 from institute of Postgraduate Childhood Studies, Ain shams university. Published four international publications in reputed journals. He was the organizer and speaker of many great symposiums in the national research center. Director of Ganna hospital, a hospital of children and neonates and in vitro fertilization. He is a member in the Arab society of medical research. He is a member in the Egyptian society of neonates.

Abstract:

Background & Objectives: Obesity is one of the most serious global health issues. The aim of this study was to assess the association between body fat distribution and different metabolic risk marker among obese adolescents aged 13 to17 years.

Subjects & Methods: The study included 100 obese children (50 boys and 50 girls) and 100 non obese controls (50 boys and 50 girls). Anthropometry, fasting glucose, insulin concentrations, total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides, systolic and diastolic blood pressure (BP) were measured. Insulin resistance was determined by Homeostasis Model Assessment of InsulinResistance (HOMA-IR). Different anthropometric measures were compared as predictors for metabolic risk markers.

Results: Obese children showed significant positive correlations between waist to hip ratio (WHR) and abdominal skin fold and metabolic risk markers including elevated levels of BP, insulin, HOMA-IR and LDL. WHR showed the highest levels of correlations with lipid parameters (triglycerides, LDL-C, HDL-C, and HDL) and other metabolic markers followed by abdominal skin fold in both boys and girls.

Conclusion: The study indicates that both the WHR and abdominal skin fold are better associated with metabolic markers and the WHR cut-off was 0.99 in boys and 0.89 in girls for detecting metabolic risk markers among Egyptian obese adolescents.

Biography:

Fatma Dilek Turan Gurhopur is 27 years old and continues her PhD at Akdeniz University in Turkey. She completed master education at Akdeniz University in Turkey too. She interested in pediatric neurology. She has articles in international and national journals about pediatric neurology.

Abstract:

Introduction: Epilepsy affects about 11 million children throughout the world. The management of childhood epilepsy is difficult undertaking but music therapy is an important approach in childhood epilepsy. 

Aim: The aim of the study was to evaluate impact of music therapy in management of childhood epilepsy.

Method: Akdeniz University electronic databases center including MEDLINE, CINAHL and PUBMED e.g. were searched studies published in English within the last ten years with key words such as “Music therapy in child with epilepsy”. Randomized control studies, original researches, systematic reviews, international guideline were reviewed.

Result: The literature searches identified 43 potentially relevant studies of which 10 trials met the inclusion criteria.  The results of these studies (Millichap, 2015; Lin et al, 2014a; Lin et al, 2014b; Lin et al, 2013a; Lin et al, 2013b; Bodner et al, 2012; Lin et al, 2011a) indicated that the number of seizures and epileptiform discharges in children with epilepsy decreased during and immediately after music therapy. Lin et al (2011b) evaluated the long-term effects of Mozart K448. %72.7 of children became seizure free or had a very good responses after 6 months of music therapy. The reduction was a significant change when compared with the premusic therapy seizure frequency. Coppala et al (2015) said that music therapy was associated with an improved daytime behavior and quality of nighttime sleep in children with epilepsy. Despite Yeon et al (2014) demonstrated that music therapy were not important approach in management of childhood epilepsy.

Conclusion: Music therapy is commonly used children with epilepsy. Research indicates that music therapy is a useful therapeutic approach regardless of mentality. Listening to Mozart especially decreased epileptiform discharges in children with epilepsy. However, music should be further studied in management of childhood epilepsy.

Biography:

Muhammad Riaz has completed MBBS from Punjab Medical College, Faisalabad affiliated with Punjab University, Lahore Pakistan. He has completed fellowship training in Paediatrics from Pakistan and completed MRCPCH in 2013. Currently he is working in Walsall Manor Hospital in a middle grade position in the Paediatrics Department.

Abstract:

Tuberculosis (TB) meningitis is the most severe manifestation of acute TB because morbidity and mortality are very high. Evidence suggests that Bacillus Calmette-Guerin (BCG) vaccination reduces the risk of disseminated TB however we present a case report of a 15-year old Bangladeshi girl who suffered from TB meningitis despite having had the BCG vaccination as a newborn but did not develop a scar. She was admitted with six weeks history of pyrexia, headaches and weight loss with no TB contacts or pulmonary signs. Her inflammatory markers were unremarkable and after an initial normal CT scan, her LP showed increased pressure of 40 cmHg. We drained 10 ml of CSF, which was clear and colorless with mildly raised protein of 0.98, glucose 1.2, RBC 1 and WBC 1. She was treated for acellular meningoencephalitis and TB workup was started. In the next 24 hours, her condition deteriorated with reduced GCS of 9-11. Her mantoux was strongly positive within 24 hours and she was started on anti TB medication. Repeated CT scan on day three, showed hydrocephalus and needed a ventricular drain insertion. CSF PCR and culture were positive for TB. GeneXpert claims to give a diagnosis within two hours for TB using gene PCR.

Biography:

Had MBBS from King Edward Medical College in 1986 and postgraduate diploma FCPS in Pediatrics from College of Physicians & Surgeons Pakistan in 2003. Working as postgraduate supervisor and examiner. member of pediatric faculty of  College of Physicians & Surgeons Pakistan. Teaching as Assistant Professor Pediatric in Azad Jammu & Kashmir Medical College Muzaffarabad Azad Jammu & Kashmir, Pakistan. Attending Pakistan Pediatric Association annual national conferences  since 2003 and read papers. Attended Indian Academic Pediatric Conference in 2005 at Kolkatta, India. Keen interest in teaching at undergraduate and postgraduate level. Research papers published in national journals. Area of interest is general pediatrics and neonatology.

Abstract:

Background: Febrile fits are common problem in children. Among other risk factors, iron deficiency anemia is considered as aggravating factor for febrile fits. Iron deficiency anemia is preventable and treatable disease.

Aims & Objectives: The primary objective was to find out iron deficiency anemia as risk factor for febrile fits.

Materials & Methods: It was retrospective, case control study. 30 cases of febrile fits were recorded. Control groups of 30 cases were taken at the same time with same variables but without febrile fits. Their temperatures and weights were recorded and laboratory hematological parameters hemoglobin, hematocrit value, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red blood cell (RBC) count and distribution width values were collected and analyzed statistically with SPSS Version 20.0

Results: Mean hemoglobin, hematocrit, RBC, MCV, MCH, MCHC and RDW had significant P value (P<0.05) in case group as compared to control group.

Conclusion: As iron deficiency anemia is a risk factor for febrile fits, treatment and prevention of iron deficiency anemia can decrease incidence of febrile fits.

Biography:

Aysegul Isler Dalgic is an Associate Professor in Pediatric Nursing Department of Akdeniz University Nursing Faculty in Antalya/Turkey. She has worked as a tutor for more than 15 years. She is educated as nursing and her major topics at the moment are pediatric nursing, childhood epilepsy, abuse and neglect in children espacially sexual abuse, sexuality in disabled children, neurology, and complementary therapies in nursing. She has many scientific studies which has been submitted and published in the national and international scientific journals, author of books. She has been organized and gave lectures, speeches, conferences and presentations in congresses and symposiums and had organized congress and symposiums.

Abstract:

Games play a crucial role for children to express themselves and to cope with stress during hospitalization processes. Theurapetic games are the core of psychosocial and cognitive development activities that improve child’s emotional and physical well-being. It has been suggested that theurapetic games reduce stress and traumas caused by the disease and hospitalization processes, help children to cope with stress before, after, and during the medical intervention, and enable the evaluation of child’s emotional reactions against medical interventions. This review aims to highlight the significance and efficiency of theurapetic games in nursing care. As children express their feelings verbally and/or nonverbally through games, theurapetic games are utterly functional for nurses explore children’s world. Theurapetic games are basically structured games and they should be structured in accordance with the child’s age, clinical condition, and cognitive development. Children may be allowed to play with medical masks, nursing uniforms, syringes, and stethoscopes. Nurses can demonstrate how to insert venous cathethers on a teddy bear or baby doll. It is recommended to use theurapetic games in coping with painful and agitative interventions, preparing children for surgical or invasive interventions, and routing pediatric nursing practices based on a traumatic care philosophy.

Biography:

Michail Sergentanis has been a Paediatrician for 10 years, 4 of which he has worked at the District General Hospital of Chania in Crete in Greece and 6 years in UK. He is currently working as a Paediatric Registrar at the Princess Alexandra Hospital in Harlow in UK. He has published more than 10 papers in reputed journals.

Abstract:

The majority of intracranial arachnoid cysts are asymptomatic and are detected incidentally. They are benign congenital cavities arising in the subarachnoid space. Rupture may result in symptomatic presentation, the most common symptom being headache. Raised intracranial pressure is a rare complication requiring surgical treatment. A 10-year-old girl presented to a district general hospital with a 2-month history of a strange sensation in her head during any physical activity. A week prior to admission she heard a “pop” in her head while performing a cartwheel, developed nausea and headache that was eased when standing up or tilting her head to the right. On examination, the patient was neurologically intact with no signs of raised intracranial pressure. However, MRI brain showed a ruptured 3.8×2.9×2.3 cm left middle cranial fossa arachnoid cyst with extensive subdural hygroma and mass effect (Image 1, 2). She was managed with burr hole drainage. Information was collected from the patient, parents, notes and hospital databases. It is essential to pay attention to the history, which may appear to be trivial on presentation (a sensation of “pop” while doing cartwheel) to avoid missing burst arachnoid cysts that may have disastrous consequences.

Biography:

Fatma Dilek Turan Gurhopur is 27 years old and continues her PhD at Akdeniz University in Turkey. She completed master education at Akdeniz University in Turkey too. She interested in pediatric neurology. She has articles in international and national journals about pediatric neurology.

Abstract:

Although there are alternatives in the treatment of epilepsy, the primary treatment is antiepileptic drug (AED) treatment. However, AEI treatment has side effects. This is more serious in children. The aim of this study was to determine the side effects of antiepileptic drugs used in children with epilepsy.

Methods: Literature review has been limited to the last decade and has been done in "Pubmed, Cinahl, Sciencedirect, Cochrane, Ulakbim Turkish Medical Directory, Turkish Medline" databases. Screening was conducted between April and May 2017 using the keywords "children and antiepileptic drugs side effects", "children with epilepsy and antiepileptic side effects". Five studies in accordance with the exclusion and inclusion criteria were included in the systematic review.

Results: The most frequent side effects in children who used antiepileptic drugs in the studies studied were; Weight gain, body mass index and serum glucose levels, gingival problems, hearing problems, and high renal tubules were noted as disfunctions.

Conclusion: The study results show that family and children should be informed about the definite side effects of antiepileptic drugs and awareness should be developed in this regard.

Biography:

PaweÅ‚ GaÅ‚ecki has completed his Medical Studies from Medical University of Warsaw. He is working at Neonatal Unit of PÅ‚onsk Hospital. He has also cooperated with Neonatal Pathology Unit of Second Degree Referenced Hospital in Ciechanów, Poland. He usually deals with issues in the field of care of infant from physiological pregnancy and childbirth. As a result of his cooperation with the Clinic of Pathology and Intensive Care of the Newborn of Medical University of Warsaw there is significant existence of work on ultrasound in Neonatal Care of Physiological Infant.

Abstract:

Ultra-sonography of newborns, born long before term and newborns with extremely low birth weight or other significant pathology has become a gold standard on the neonatal pathology units and NICU. It is a rather simple method and non-invasive; it does not bring the increased risk to the newborns, and is providing much information about the condition of the patient, the course of disease, the effectiveness of the treatment and further predictions. However, only 10–15% children are born below 35^th week of pregnancy and are being hospitalized on the II and III degree of neonatal care units. It will leave the majority of children left without ultrasound diagnostics, because very few centres of first degree of neonatal care are conducting that kind of diagnostics apart from very rigorous recommendations, acknowledging that these children are “from the assumption” healthy. Perhaps, such an assumption is not fully correct and many children from so-called physiologic pregnancy are burdened with certain diseases, which could be to recognize and be possibly healed, if all children were examined. In this paper we have studied ultrasound examinations of the central nervous system and the abdominal cavity carried out on children born after 35^th week of pregnancy at the Neonatal Unit of the Hospital in PÅ‚oÅ„sk (first level of neonatal care) from 01.01.2014 to 02.12.2014.

Biography:

Dr Omer Ahmed has joined The American Hospital, Dubai (in 2009), after 15 years as a Consultant Paediatrician in UK. He is a Fellow of the Royal College of Physicians of Ireland and the Royal College of Paediatrics and Child Health UK. His Paediatrics training was in Sabah Hospital- Kuwait, Alder Hay Hospital- Liverpool, Great Ormond Street and The Royal Free Hospital in London before taking a Consultant post in Stevenage, Hertfordshire UK. Earlier in his career, Dr Ahmed has worked in Sudan, Libya and Kuwait. His experience covers wide areas in Child Health as a General Paediatrician. Dr Ahmed has several publications and presented/attended in several Paediatrics meetings and conferences.

Abstract:

Headache is one of the most common complaints in children and adolescents.

The incidence of chronic or recurrent headaches in children is about 40% by the age of 7 years and goes to 75% by 15 years of age. Sex ratios of children affected varies by age: between 3-7 yrs boys dominate, gets equal mid childhood (7-11 years)but thereafter we see  more girls affected than boys.

Headaches in children almost always raise serious concerns in parents. We would always remember about 3,800 CNS tumours are diagnosed annually in US. There have been several reports of delayed presentations of childhood brain tumors. However, childhood headaches are rarely caused by serious underlying disorders. The evaluation of headaches in children varies widely depending on the presentation’s settings.  In a historical cohort of 48,575 children aged 5-17 years who were seen by primary care providers for complaint of headache, 19 percent were diagnosed with primary headache at the time of presentation, 1.1 percent was diagnosed with secondary headache, and 79.7 percent received no formal diagnosis.

Unfortunately, culturally children’s headaches are taken rather lightly in many communities. Most children who present to paediatric emergency departments with acute headache have a viral illness or an upper respiratory infection as the cause of their headache, although more sinister conditions occasionally are diagnosed. The lecture is an overview of this common problematic symptom. It partly covers epidemiology, pathogenesis, pathophysiology, classification, triggers, clinical evaluation and management of headaches in children and adolescents. It is rather a summary to this comprehensive subject.

Five short interactive clinical cases of this problem are presented in the last ten minutes for audience’s discussion.

Biography:

Jorina Elbers is working as an Assistant Professor of Neurology at Stanford University. She received her BSc from the University of Victoria before completing Medical School at the University of British Columbia in Vancouver, Canada. She continued her training in Pediatric Neurology at the Hospital for Sick Children and University of Toronto. Following her residency, she pursued a two-year Fellowship in Pediatric Stroke, also at the Hospital for Sick Children. In 2011 she joined the Child Neurology Team at Stanford, where her clinical work includes attending General Child Neurology Clinics and running a Pediatric Stroke Program. Her clinical research interests involve the study of arteriopathies, such as moyamoya arteriopathy, and novel neuroimaging techniques to study stroke and inflammation.

Abstract:

Objective: Pediatricians commonly see children reporting symptoms without a plausible medical explanation, even after extensive investigations. Such patients’ frequently present with multiple co-morbidities. We report the prevalence of children with multiple medically unexplained symptoms in a pediatric neurology clinic, describe their symptom profiles, and explore their association with adverse childhood experiences (ACEs).

Study Design: We retrospectively reviewed medical and social histories of 100 consecutive patients who had been treated at an outpatient pediatric neurology clinic. Patients were included if they were 5 years or older, and reported 4 or more medically unexplained symptoms (MUS) for longer than 3-months. Symptom profiles across six functional domains were recorded: 1) executive dysfunction, 2) sleep disturbances, 3) autonomic dysregulation, 4) somatization, 5) digestive symptoms, and 6) emotional dysregulation. ACEs were recorded and scored for all patients.

Results: Seventeen patients reported 4 or more MUS. Somatization, sleep disturbances and emotional dysregulation occurred in 100% patients, with executive dysfunction (94%), autonomic dysregulation (76%) and digestive problems (71%) in the majority. Forty-two children reported ACEs (42%); children with 4 or more MUS were more likely to report ACEs in comparison to other children (88% vs. 33%; p<0.0001). Of the 42 patients reporting ACEs, children with 4 or more MUS had a higher median ACE score (3 vs. 1; p<0.001).

Conclusions: Children with multiple medically unexplained symptoms should be screened for potential exposure to ACEs. A clinical profile of unexplained medical symptoms across multiple functional domains within the nervous system suggests putative neurobiological mechanisms involving nervous system dysregulation that require further stud

Biography:

Reem A Ali got her Graduate Degrees from prestigious universities in Canada. She is working as an Assistant Professor at Maternal and Child Health Department at Jordan University of Science and Technology for about six years. She has conducted a study examining the relationships between maternal attachment and infant sleep problems in preterm infants following discharge from hospital. Her work is fundamental to understand more about relationships between attachment, maternal settling behavior, and infant sleep. Also, she is conducting research studies on Health Promotion for newborn, children and their families, focusing on children’s eating behaviors and reproductive health for youth.

Abstract:

Health promotion is the most cost-effective method to reduce and prevent health problems. Using interactive teaching approach showed positive results in changing lifestyles and adopting more healthy practices among students. Little information was found on students’ knowledge and attitude towards reproductive health in Jordan. A study was conducted to examine the effectiveness of an interactive teaching approach in promoting reproductive health awareness in undergraduate non-medical students in Jordan. A quasi-experimental one group pre-test and post-test design was employed to examine the change in university students’ knowledge and attitude towards reproductive health. 210 students aged 18-24 years were used for this study. Knowledge and attitude regarding reproductive health issues were assessed using a computer-based questionnaire developed by the researchers. Descriptive and parametric analyses were conducted to analyze the data. A significant improvement in students’ level of knowledge and attitude towards reproductive health was indicated by the analysis. The results of a mixed between-within subjects analysis of variance showed a significant interaction between gender and students’ knowledge (pre-test and post-test), Wilks Lambda=0.98, F (1, 208)=4.09, p=0.04, partial eta squared=0.19. While, there was no significant interaction between gender and students’ attitude towards reproductive health on pre-test and post-test. The implementation of health promotion courses, tapping on reproductive health issues while using interactive style is an influential method for students at this age to improve their knowledge and attitude regarding reproductive health.