23^rd World Congress on Pediatrics, Neonatology & Primary Care November 21-22, 2019 Dubai, UAE

Biography:

Monika Kaushal has extensive experience and several publications in journals which are indexed both nationally and internationally indexed journals. She is currently undertaking MSc in Neonatology from Southampton University, UK. She is honored with Fellow of Royal Collage of Pediatrics and Child Health, UK (FRCPCH).

Abstract:

Most of ultrasounds are in tertiary care setting with radiologist supported services available, not all of these settings have pediatric radiologists and most of these settings would not be able to provide instantaneous service within minutes, however these patients are usually not mobile. To overcome these problems, the neonatologists should be performing point of care ultrasound at bed side to take quick decision. Machines have become smaller and portable, image quality has improved and cost has dramatically declined making inexpensive units available. Common problems in the NICU evaluated with sonography are: (1) Neuro – Screening for ICH and PVL – Monitoring evolution of ICH (including ICP) – Confirmation of prenatally suspected malformations or injuries – Evaluation for occult defects of the lower spin; (2) Renal/GU – Confirmation of prenatally suspected malformation, dysgenesis or obstruction – Assessment for obstruction of blood flow to or from the kidney in the setting of hypertension or hematuria – Suspicion for testicular torsion – Confirmation of bowel in inguinal hernia; (3) GI – Evaluation of biliary tree in the setting of cholestasis; (4) fECHO/TNE – PDA significance – Response to inotropic agents; (5) Umbilical line tip placement – Reduction in radiation exposure; (6) Bladder catheterization or tap; (7) Pleural effusion drainage; (8) PICC and PIV placement; (9) Increased ICH requiring LP; and (10) ETT placement. When neonatologist is performing the ultrasound the positive things are that he has the knowledge of the patient’s clinical history and needs, can rapidly return of information that can inform acute management, can have access optimized for non-mobile patients (timing, portable) and ultrasound has lower radiation exposure for line, tube placement as compared to X-ray. But the problems are that most of us lack of training in imaging, lack of knowledge of anatomy, lack of knowledge on physics of ultrasound, lack of technical knowledge regarding the machine, loss of control by radiologist (QI, reporting, billing), shortage of access to machine and dearth of technical support/service. To overcome this, we should get trained in point of care of ultrasound and save our little ones by timely management.

Biography:

Abeer Mohi El-Din Saleh has completed Bachelor’s degree from Ain Shams University Faculty of Medicine in 1995, Master’s degree from the same university in 2001 and MRCPCH London, UK in 2013. She has previously worked in Yeovil District Hospital, UK. She is currently is working as a Pediatric Consultant in the International Medical Center Hospital and Nasser Institute, Cairo, Egypt.

Abstract:

When a baby is born and it is difficult to determine whether it is a boy or a girl then it is said that the baby has ambiguous genitalia It is a traumatizing information to the parents and it should be dealt with in a very delicate manner It could signify a life threatening condition that’s why it is crucial to determine the etiology as soon as possible and start a plan of management The formation of a typical female or male external genitalia results from a series of genetic and physiological events starting with sex determination and progressing through differentiation of the internal and external sexual organs Failure of determination and differentiation in the usual manner can result in what is called disorder of sex development We will try to go through causes and management and ways to simply understand and deal with it.

Biography:

Wael Mohamed Abdelaal has graduated in Egypt completed his PhD 2009 from Ain Shams University faculty of Medicine. He had a lot of researches and has published many papers in reputed journals in the field of neonatal anemia and neonatal sepsis and his area of interest is Pediatrics hematology and infection. He was working in Zagazig university hospital (Egypt), Alsabah hospital (Kwuait) and Hamd medical corporation (Qatar), Currently he is working in NMC Royal hospital UAE.

Abstract:

All drugs are poisons.Only proper usage and proper dosage determine what is therapy and what is poison. Antibiotics are powerful medicines that fight against bacterial infection. Before the 1930s there were no treatments for bacterial infections, following the discovery of penicillin industry started searching for more antibiotics in nature In his 1945 nobel prize lecture, Fleming warned of the dangers of antimicrobial resistance: The time may come when penicillin can be brought by anyone in the shops. Then there is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant. Many bacteria have developed the ability to become resistant to antibiotics. These bacteria are now a major threat in our hospitals. Mechanisms Of Resistance Enzymatic inhibition: First is alteration of bacterial membranes:Outer membrane permeability, Inner membrane permeability and Rapid ejection of the drug [efflux] or reduced drug influx. Bypass of antibiotic inhibition: Alteration of target sites, Altered ribosomal target sites and altered cell wall precursor targetsand Altered target enzymes How antibiotic resistance can be prevented: Antibiotics should be the last line of defence NOT the first, Most common infections will get better by themselves through time, bed rest, liquid intake and healthy living, Only take antibiotics prescribed by a doctor, If prescribed antibiotics, finish the cours and lastely Do not use other peoples or leftover antibiotics they be specific for some other infection.

Biography:

Lamidi Isah AUDU is a Fellow of the National Postgraduate Medical College of Nigeria, previously Chief Consultant Pediatrician/ Neonatologist and Director of Clinical Services, National Hospital Abuja. He is currently a Senior Lecturer at Kaduna State University, Nigeria, Examiner for the National Postgraduate Medical College, Co-Chair Maternal and Perinatal Death Surveillance and Response Committee of the Federal Ministry of Health. He also reviews manuscripts for local and international medical journals.

Abstract:

Background: Although official age of fetal viability in Nigeria is 28 weeks, there are pockets of reports of survival of babies delivered at younger Gestational Age (GA) from different parts of the country. This is likely to generate important ethical and medical concerns in our approach to management of births occurring before the official GA of 28 weeks. Aim: To determine the gestational age specific neonatal mortality among preterm deliveries at the National Hospital Abuja. Methods: A retrospective review of relevant data from the National Hospital Neonatal Registry Database (REDCap) was undertaken to determine the mortality rate of preterm babies managed in NICU from January 2017 to February 2018. Disaggregated GA specific mortality rates were also computed to determine the fetal age at which extra uterine neonatal survival rate was at least 50%. GA estimation was based on mothers’ LMP in over 96% of cases. Results: Sixty two (62) of 305 preterm babies admitted died during hospitalization giving a mortality rate of 20.3%. This was significantly higher than the mortality rate among term babies (7.5%, P=0.01) hospitalized over the same period. Antenatal steroid use was low (11.2%), 188 (25.8%) received CPAP for RDS and none of the babies received surfactant. There were no survivors among babies delivered at GA of 22-25 weeks (11, 3.6%). However survival rate at 26 weeks gestation was 53.8% and this subsequently increased reaching a peak of 80% survival at 36 weeks. RDS accounted for 53.9% of all deaths. Conclusion: GA, place of delivery and birth weight were significantly associated with risk of death. It is concluded that the survival rate (53.8%) of babies at GA 26/52 despite minimal antenatal interventions and limited postnatal respiratory support was reasonably high and this could serve the basis for discussions for a downward review of age of fetal viability in Nigeria.

Biography:

Ahmed Mohamed Refaat has completed his MD in phoniatrics at the age of 34 years from Ain Shams University, after finishing his Master Degree in ENT and Phoniatrics at age of 27 and 31 years. Dr. Ahmed Refaat is lecturer of Phoniatrics at ENT department, Ain Shams Unviersity Hospital.

Abstract:

7 neonates with pharyngeal trauma due to forceful untrained use of nasogastric feeding tube causing a variety of signs and symptoms starting from excessive frothy secretions and difficulty in passing feeding tube, reaching pneumothorax, this articles presents these cases with the proper advices regarding the diagnosis and prognosis of such cases based upon observation of the cases and tracing the literatures.

Biography:

Ciba Sunil Raphael is currently the NICU Unit Manager/Training and Education Coordinator, NRP Instructor at Medcare Woman and Child Hospital, a prestigious division of Aster DM Healthcare Group of Hospitals in Dubai. She passionately continue to contribute more than 24 years of her clinical and management experience and expertise in the field of patient care and has crossed many milestones and received accolades during her extensive work experience.

Abstract:

Family-centered care is a philosophy of care that embraces a partnership between staff and families. It has become an integral part of providing high quality neonatal care Unrestricted parental presence in the NICU, parental involvement in infant care giving, open communication with parents are basic tenets of family-centered care in our Neonatal unit. By virtue of their continual presence and role in the NICU, Nurses are in a unique position to support family-centered care. There is growing evidence that relationship based, family centered and developmentally supportive approach to NICU Care is effective in reducing neonatal morbidity and improving neurobehavioral development of preterm infants. The main components of this approach are: opening of (NICUs) to parents, involvement of parents in care of their baby, parents’ psychological support, Neonatal Individualized Developmental Care Program (NIDCAP), breast milk feeding and kangaroo mother care. Neonatal care with a family focus helps minimize adverse effects with: * A Family-Centered Care philosophy * Family-friendly facilities * Family oriented training and support > Ensure appropriate environment for babies in NICU > Ensure safety & efficacy of neonatal treatments. > Develop policies & programs that promote parenting skills & encourage maximum involvement of families in care > Promote meaningful long-term follow-up for all high-risk NICU survivors. Evidence suggest that, family integrated care is the voice of the modern family in Neonatal unit and provides significant benefit not only in terms of infant medical outcomes, but will also reduce stress, anxiety and depression in the family; improve their ability to cope and through structured competency based educational programs will result in true partnership with parents. In this presentation the historical perspective and recent evidence will be discussed also highlighted the basic principles of A Family-Centered Care and then compared the various existing professional and parent focused neonatal care programs and the advantages over those traditional models of care. Family-Centered Care provides parents with training, education, support which enables them to be primary careers and gives them confidence, knowledge and independence to take care of their infants while in the neonatal unit and post discharge who may have complex medical needs.

Biography:

Monika Kaushal is MBBS, MD Pediatrics, DM Neonatolgy, FRCPCH and has extensive experience and several publications in journals which are indexed both nationally and internationally indexed journals. She is currently undertaking MSc in Neonatology from Southampton University, UK. Dr Monika started the Fellowship program in Neonatology with affiliation to National Neonatology Forum and Indian Academy of Pediatrics India. She is honored with Fellow of Royal Collage of Pediatrics and Child Health, UK (FRCPCH).

Abstract:

Neonates are the future of the society and care of the neonates in the first few days of life is extremely unique. The neonates who have some health problems right after birth need special care in special units like NICU or SCUBU. To take care of these babies especially those who need help for their breathing we need not only special unit, but special infrastructure, equipments and especially trained medical professionals that are doctors and nurses. When there are extreme preterm then the care required is much more important. The care required starts from antenatal period to the delivery room care and then postnatal period. There are very good research on improving the care of these premise. Some of them have really changed the outcome to an extent that we are able to have babies surviving at 22 week or so. The research starts from antenatal period of giving antenatal steroids, magnesium sulfate to the mothers and managing the infections. In delivery room temperature control, airway management, giving PEEP, sustained inflation, delayed cord clamping and to maintain normoxia, normocarbia, perfusion, are most important interventions. Stabilization of the neonate in delivery room and then transporting the premise maintaining the temperature and PEEP is important. We have new ways to give surfactant to these little ones and so we use less invasive ways to deliver surfactant to them this technique is called LISA and helps in preventing Bronchopulmonary Disease (BPD). We need to discuss on IVH prevention strategies to have good long term neurodevelopmental outcomes. Nutrition is another important factor which will decide on outcome of baby not only on growth but also on development. These premise in spite of all these measures may develop BPD and so when to give steroids and if we can give inhaled steroid to have better outcome.

Biography:

Maithili Joshi is a Junior Resident at Department of Pediatrics at Jawaharlal Nehru Medical College, Wardha, India. She is passionate for the field of pediatrics and wish to pursue a career in neonatology.

Abstract:

Background: Neonatal respiratory distress is a common clinical entity in the neonatal intensive care unit. The very first breaths of a newborn are distressed, but within minutes the respiration settles and becomes regular. There are many factors which can affect this transition from dependent fetal respiration to independent newborn respiration. The maternal factors causing neonatal respiratory distress are important in developing countries where socioeconomic variations exist. The preterm neonates are more likely to have respiratory distress. Regardless of the cause, if not recognized and managed quickly, respiratory distress can escalate to respiratory failure and cardiopulmonary arrest. Therefore, it is imperative that any health care practitioner caring for new born infants can readily recognize the signs and symptoms of respiratory distress, differentiate various causes and initiate management strategies to prevent significant complications or death. The neonatal mortality by respiratory distress can be decreased by proper monitoring of neonates in NICU and knowing the etiology of respiratory distress in neonates and managing according to the etiology; knowing the maternal illness and other conditions leading to respiratory distress. Objective: To study maternal causes of neonatal respiratory distress admitted in the NICU. Materials & Methods: The present study was conducted at a well-equipped NICU. NICU has separate inborn and out-born sections where neonates were admitted. It was conducted for a period of two years from 1st August 2014 to 31st July 2016. It was a prospective study of consecutively selected patient less than 1 month of age admitted in the NICU of this hospital fulfilling the inclusion criteria. All the newborns less than equal to 28 days admitted in the NICU (Inborn/Out-born) with clinically identified respiratory distress. In this study newborns who were admitted to the Neonatal Intensive Care Unit with clinically identified respiratory distress were included in the study. 400 newborns were recruited for this study as per the criteria. Results: Using the data gathered, a correlation coefficient of 0.5806 was obtained indicating a strong linear relationship between caesarian section and respiratory distress in the newborn. Babies born via caesarian section had likely chances of having respiratory distress. Conclusion: Caesarean section was the most common predisposing factor associated with the development of respiratory distress in neonates. Antenatal risk factors increase the incidence of respiratory distress. There is a need to prioritize antenatal care and counseling to pregnant mothers that includes multivitamin and folic acid supplementation, screening for diabetes, hypertension and, if possible, provision of detailed fetal evaluation in mothers with bad obstetric history or those having febrile illness during first trimester.

Biography:

Aida Ali Mohammed has completed her MBBS from Sana’a University at Yemen. She was the Director of training in emergency unit in Ministry of Health, Yemen. She has attended many international conferences. Now she is working as a pediatric specialist and nutritional consultant in Kuwait University Hospital, Yemen.

Abstract:

Severe acute malnutrition is defined by a very low weight for height (below-3z scores of the median WHO growth standards), by visible severe wasting or by the presence of nutritional edema. Severe acute malnutrition is a life threatening condition requiring urgent treatment. Child malnutrition in Yemen is a major public health problem, showing prevalence 200% for acute malnutrition (UNICEF report 2016) in 22 million of Yemeni children. 462000 Yemeni children suffer from acute severe malnutrition and 1.7 million Yemeni children suffer from moderate acute malnutrition compare to a prevalence of 53% for stunting, 46% for underweight and 13% for wasting among children under five in 2006. According to the WHO classification, the levels for stunting and underweight are considered very high severity and for wasting it is of high severity in Yemen (WHO 2006). Hospitalization of children suffering from this state is essential they are selected according to criteria and hospitalization goes through many stages according to guidelines and discharge is followed by follow up. Education of the mother, breast feeding normal healthy feeding and hygiene, poor, inability to reach to obtain food duo to war, lost healthy service are essential factors to prevent and develop such status.

Biography:

Pradeep Kumar Gupta is currently working as a Pediatrician in Department of Pediatrics in a non-government non-profitable hospital in Nepal. He has completed his post-graduation (MD in Pediatrics) from Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India. He has completed Fellowship in Neonatology by Indian Academy of Pediatrics. Currently he is doing research on septic markers in new-born and use of bubble CPAP in resource limited setting.

Abstract:

Background: Despite the advances in perinatal and neonatal care and use of newer potent antibiotics, the incidence of neonatal sepsis remains high and the outcome is still severe. Objective: To study the role of serum procalcitonin as a marker of neonatal sepsis and to compare procalcitonin with CRP as a diagnostic marker for neonatal sepsis. Methodology: Hospital based prospective observational study. 50 neonates (preterm and term) with clinically suspected sepsis were studied during 1 year from January 2016 to December 2016 in Chaitanya Hospital, Chandigarh. Conventional sepsis workup was done in all cases and the diagnosis of neonatal sepsis was proved based on the results of blood culture. The serum procalcitonin was measured by quantitative Enzyme Linked Immunofluorescence Assay (ELISA) and the results were compared to CRP levels between the neonates with or without proven sepsis. Results: Of the total 220 babies admitted in NICU during that period, 50 were eligible for study and analyzed. 24% babies had definite sepsis, 60% had probable sepsis and 16% babies had no sepsis. Of the neonates with suspected sepsis, 24% had culture positive and 76% were culture negative. Mean PCT level was 13.27±33.2 ng/ml. The mean PCT levels was highest in neonates whose TLC>5000 (Mean PCT-18.5) (p value-0.002). Evaluating CRP as a diagnostic marker for definite neonatal sepsis with cut off value as 0.5 mg/dl, had sensitivity of 41.67%, specificity of 89.47%, positive predictive value of 55.56% and negative predictive value of 82.93%. Evaluating PCT as a diagnostic marker for definite neonatal sepsis, the sensitivity, specificity, positive predictive value, negative predictive value were 83.3%, 26.32%, 26.32% and 83.3% respectively taking cut-off level of procalcitonin to be >0.5 ng/ml. Conclusion: The importance of procalcitonin in diagnosing neonatal septicemia cannot be denied but it becomes more useful when it is used along with other investigations for decision making.

Biography:

Khosro Shafaghi is currently working as a Lecturer in Gonabad University of Medical Sciences, Iran. He has completed his PhD in Community Nutrition in Universiti Putra Malaysia. His current research interest is on overweight/obesity and dietary patterns in adolescents.

Abstract:

Introduction & Aim: Physical inactivity can be defined as the amount of time spent in sedentary behavior. Sedentary behaviors range from ‘stroller time’ to time sitting in the classroom at school, doing homework, listening to music, surfing the Internet, talking on the phone or reading. Screen time (time spent watching TV/videos, playing video games, working at the computer) represents a major source of inactivity. Physical inactivity is recognized as an independent risk factor for cardiovascular disease and is related to other risk factors for cardiovascular disease. Spending too much time sitting increases the risk of becoming obese and may also increase the risk of chronic diseases and early death. Researchers found positive associations between television viewing and childhood obesity. The main purpose of this study was to determine sedentary lifestyle in secondary school children of Mashhad and its relationship with overweight/obesity. Material & Methods: This cross sectional study was conducted in urban low/high socio-economic area of Mashhad city. A total of 1189 secondary-school children aged 12-14 years were selected through a stratifiedmultistage random sampling. The samples recruited in 10 schools among total 501 schools. The validated Physical Activity Questionnaire for Older Children (PAQ-C) was used and then adolescents were classified based on their mean total physical activity scores. Watching TV and using computer were measured by using the modified questionnaire of Turconi, et al. (2003). Results: Data analysis showed that more than half of adolescents (55.8%) were physically inactive. Physical inactivity was more prevalent among females (66.6%) than males (46.3%) with significant difference (P=0.001). In terms of TV watching, 37.3% of adolescents watched TV for 3-4 hours per day and 13.4% of them watched TV more than 6 hours per day. The difference between males and females was not significant. This study showed that 11.7% of adolescents were obese and 17.3% were overweight. Conclusion: Childhood obesity is increasing in alarming rate in Mashhad. Some studies have showed screen time and PA are equivalent risk factors for overweight/obesity. In current study, females were found to be less active than males. Iranian national statistics showed that 49.6% and 21.5% of 15-24 year old urban female and males had low physical activities and time spent in sedentary activities per day was 5.1 and 4.5 hours among female and males, respectively

Biography:

Ahmed Mohamed Refaat has completed his MD in phoniatrics at the age of 34 years from Ain Shams University, after fi nishing his Master Degree in ENT and Phoniatrics at age of 27 and 31 years. Dr. Ahmed Refaat is lecturer of Phoniatrics at ENT department, Ain Shams Unviersity Hospital.

Abstract:

Biography:

Ahmed Mohamed Abdelaal has completed his graduation (M.B.B.S) from the Al Zagazig University, Egypt in 1989. He then acquired his Masters in Pediatrics (M.S) and his Doctorate in Medicine (M.D) in 1994 and 2006 respectively from the same university. He is also certified in Advanced Pediatric Life Support (APLS) and Advanced Cardiac Life Support (ACLS), postgraduate in pediatric nutrition PGEN (Boston University) and ENS (Munich University). Dr. Ahmed has more than 25 years of experience in General Pediatrics with a special interest in Pediatric Hematology and have a good experience in pediatric asthma.

Abstract:

Pediatric obesity has rapidly become one of the leading international public health challenges. Since the 1980s, rates have more than doubled for preschool-aged children (2 to 5 years) and adolescents (12 to 19 years) and have more than tripled for school-aged children (aged 6-11 years) in the United States. Childhood obesity is an issue of serious medical and social concern. In developing countries, it is a phenomenon seen in higher socioeconomic strata due to the adoption of a western lifestyle. Consumption of high calorie food, lack of physical activity and increased screen time are major risk factors for childhood obesity apart from other genetic, prenatal factors and socio-cultural practices. Obese children and adolescents are at increased risk of medical and psychological complications. Insulin resistance is commonly present especially in those with central obesity and manifests as dyslipidemia, type-2 diabetes mellitus, impaired glucose tolerance, hypertension, polycystic ovarian syndrome and metabolic syndrome. Obese children and adolescents often present to general physicians for management. The latter play a key role in prevention and treatment of obesity as it involves lifestyle modification of the entire family. This article aims at discussing the approach to diagnosis and work-up, treatment and preventive strategies for childhood obesity from a general physician's perspective.

Biography:

Marwa A Bebars has completed her Masters degree in Pediatrics from Zagazig University and Post-doctoral studies in Pediatric Oncology from Cairo University School of Medicine. She is a Member of Royal College of Pediatric and Child Health. She is currently working as a Senior Specialist in Dubai Hospital Tertiary Reffral Hospital and also published more 15 papers in reputed.

Abstract:

Malnutrition is an unspecific term used to define an inadequate nutritional condition. It is characterized by either a deficiency or an excess of energy with measurable adverse effects on clinical outcome. Malnutrition describes the consequences of insufficient protein-energy intake. An adequate proteinenergy balance is a prerequisite for age-appropriate growth and maintenance. Malnutrition also comprises circumstances of elevated energy supply resulting in overnutrition with an increase in adipose tissue. Even though malnutrition has been defined or described in many ways, no consensus exists regarding a specific definition to identify children at risk. The WHO recommends the weight-for-height index to assess the nutritional status of children and adolescents. However, it is proposed that a loss in body weight of 5% constitutes acute malnutrition and a height-for-age value below the 5th percentile may reflect chronic undernourishment in children. Ironically, many children suffering from cancer do not meet these criteria. Particularly those with large solid abdominal masses (e.g. embryonal neoplasms such as neuroblastoma,hepatoblastoma, or Wilms tumor) may present with normal weight despite severe malnutrition. Nutritional depletion may furthermore be masked in children by edema due to corticosteroid treatment. Even if no gold standarddefinition for undernourishment in children exists, concise definitions are needed for the institution of preventive policies. We provide a critical review of the current state of research and knowledge related to the nutritional management in childhood cancer.

Biography:

Anvar P Vellamgot MD, DCH, DNB (Ped), MRCPCH (UK) is currently working as an Associate Consultant in the department of neonatology, Hamad Medical Corporation.

Abstract:

Introduction: Significant hyperbilirubinemia (HB), defined as Total Serum Bilirubin (TSB) > 95th centile of hour specific Bhutaninomogram is observed in 8-11% of neonates and if severe, it may result in acute bilirubin encephalopathy, kernicterus, and subtle neurodevelopmental disorders. The objective of our study was to look for the risk factors for readmission with significant HB among late preterm and term babies who are discharged home without prior phototherapy. The study aimed to analyze the areas of quality improvement in discharge and follow up of such babies in our institution. Methodology: We performed a retrospective data review of all babies who are 35 weeks or more, born between January 2017 and December 2018, and readmitted due to jaundice with a TSB>300 micro mols/L (>95th centile for any baby during the first week of life).To look for additional risk factors, we compared the baseline data to that of the total population of babies who were born during the same period. Results: Between Jan 2016 and Dec 2018, our hospital recorded 16837 live births. Among them, 16498 babies were born at 35 weeks or more gestational age. From 239 Babies who had TSB >300 micro mols/L, 150 babies qualified the inclusion criteria. Risk factors like ABO/Rh isoimmunization, G6PD deficiency, late prematurity, cephalhematoma, and polycythemia were observed in 46% of the babies. When compared to the general birth cohort, Vaginal birth (P < 0.001, OR 3.09, 95% CI 1.96 to 4.87),instrumental delivery ( P <0.001, OR 3.018, 95% CI 2.02 to 4.49 ) and gestational age below 39 weeks( P <0.001 ) were significantly higher in the study group. We identified a gap between our current practice (43%) and the actual need (73%) for follow up. Conclusion: In addition to late prematurity, early-term gestations, namely 37 and 38 weeks, are significant risk factors of HB. Combining pre-discharge bilirubin with gestational age and risk factors enhances the chances of identifying babies with subsequent risk for significant and severe HB.

Biography:

Moloud Fakhri has completed her PhD from Mazandaran University of Medical Sciences, Sari, Iran, in medical sciences especially in Complementary Medicine studies. She is Assistant Professor of medical Sciences in School of Medicine, Traditional and Complementary Research Center. She has published more than 25 papers in reputed journals and has been working as a senior lecturer in university.

Abstract:

Neonatal jaundice is a prevalent clinical problem, particularly in the Asian region. Nowadays neonatal jaundice treatment methods, including phototherapy and blood transfusion, are associated with various complications. Since the use of medicinal plants for the prevention and treatment in traditional Iranian medicine is divided into the written and verbal practices. The aim of this study is to determine the neonatal jaundice treatment of newborns based on verbal traditional medicine and evaluating the HPLC analysis and characterization of manna from some cotoneaster species and assesing preventive effect of Cotoneaster nummularioides Pojark mana drop on neonatal jaundice. This study was conducted in three sections, in the first part, the society of traditional healers in Mazandaran province was surveyed by a crosssectional study. In the second section, four species of Cotoneaster plants that their manna as a secondary metabolite was most frequently prescribed were selected for laboratory test like HPLC study and making oral drop from chosen specie.Then in the third section of present study the preventive effects of Cotoneaster nummularioides Pojark manna drop as selected specie on neonatal jaundice in A double blind, randomized, controlled, clinical trials was assayed. Cotoneaster manna was the most frequently used in verbal traditional medicine and Cotoneaster nummularioides Pojark manna with the highest effective ingredient mannitol was selected to make oral drop for using in a clinical trial. Generally use of one gram Cotoneaster nummularioides Pojark manna oral drop as a verbal Iranian traditional medicine treatment has preventive effect on the neonatal jaundice and can be planned to study as a hyperbilirubinemia treatment in future.

Biography:

Payal maheshwari is M.Phil, from the Department of Human Development and Family studies, M.S. University, Vadodara, and presently doing her PhD in the field of children with learning disability. She is presently teaching as Assosciate Professor in the Department of Human Development, College of Home Science, Nirmala Niketan, Mumbai. She has been teaching for last 20 years to graduate and post graduate students different subjects in the area of Human Development and Family studies, as well as in the area of Individuals with special needs.

Abstract:

The research aimed at studying the level of socio-emotional skills in two groups of adolescents with SLD, one who played sports and the second group of adolescents who did not play sports. The study also aimed at finding out the differences in the socio emotional skills of the two groups of adolescents. The sample comprised of 120 adolescents with SLD (60 playing sports for at least 1hr/week and 60 not playing sports or less than half an hour in a week), in the age range of 12-15yrs of age residing in Mumbai, and having SLD as the primary disability. The socio-emotional skills assessment scale (Maheshwari, 2018) was used to gather the data on respective variable. The results revealed that majority of the adolescents with SLD (45) perceived themselves as having average level of socio-emotional skills while 22 rated themselves in the low level category. Further analysing the data for the two groups of adolescents, it was found that adolescent with SLD who were playing sports had average to high level of socio-emotional skills across the domains and within the sub-domains while, majority of the adolescents with SLD not playing sports rated their socioemotional skills level as average to low level. These differences were further confirmed by the T-test results, wherein strong significant difference was found between the socio-emotional skills of adolescents with SLD playing sports and not playing sports (t = 10.230, p=.000). The findings of the study clearly indicate the importance of sports in the life of adolescents with SLD. Opportunities should be provided in school and at home to the adolescents with SLD to participate in sports, which would help them to build and enhance their socio-emotional skills and further lead to positive beliefs about themselves and this will help them in in improving their learning skills too.

Biography:

Basma M. Shehata is a Lecturer of Pediatrics and Neonataology, Faculty of medicine, Ain Shams University since 2017 after completing the MD. She is a certified Neonatal Life Support instructor from the European Resuscitation Council.

Abstract:

Background: Neonatal hyperbilirubinemia is common in the neonatal period. Yet, serious pathological hyperbilirubinemia may cause detrimental neurologic sequalae. Carbon monoxide is the byproduct of the breakdown of heme, it is transported as carboxyhemoglobin to the lungs to be exhaled. Thus, carboxyhemoglobin levels increase as a result of hemolysis, and is therefore considered a sensitive index for the degree and severity of the subsequent hyperbilirubinemia. Objectives: To correlate between non-invasive measurements of carboxyhemoglobin levels and bilirubin levels in near-term and term neonates starting hour one of life. Subjects and methods: A total of 100 near-term and term neonates were studied, by measuring carboxyhemoglobin by a Pulse Co-oximetry and serum bilirubin level (hour1) as well as transcutaneous bilirubin (TcB) hourly since birth for the 1st 6 hours then every 6 hours till the time of discharge in a cross sectional case-control study. Results: A cut off value of 4 for non-invasive carboxyhemoglobin with sensitivity of 81.25%, specificity of 95.24% was found to the earliest noninvasive predictor for subsequent jaundice. In patients with proven hemolysis, carboxyhemoglobin when compared to TcB was found to increase significantly in the first 3 hours of life more than TcB. Starting hour 4 postnatally, it was increased yet statistically insignificant Conclusion: We found that non-invasive measurement of carboxyhemoglobin is an effective early predictor for subsequent jaundice starting first hour of life. It can be used as a screening tool for hemolytic jaundice especially in hospitals with early discharge policy. Key words: Neonatal jaundice, Carboxyhemoglobin, Hemolysis, Pulse co-oximetry.

Biography:

Lamidi Isah AUDU is a Fellow of the National Postgraduate Medical College of Nigeria, previously Chief Consultant [email protected]/ Neonatologist and Director of Clinical Services, National Hospital Abuja. He is currently a Senior Lecturer at Kaduna State University, Nigeria, Examiner for the National Postgraduate Medical College, Co-Chair Maternal and Perinatal Death Surveillance and Response Committee of the Federal Ministry of Health. He also reviews manuscripts for local and international medical journals.

Abstract:

Background: Neonatal mortality rate in Nigeria (37/1000) is reportedly among the top 10 highest in the world. Over the last decade, neonatal sepsis, perinatal asphyxia and prematurity have consistently been mentioned as the leading causes of neonatal deaths in the country. Interventions targeted at these neonatal morbidities have been implemented in the country with only modest impact on neonatal mortality. Aims: To determine the risk factors for mortality among hospitalized neonates and the case fatality rates for the causes of neonatal deaths at the National Hospital Abuja. Methods: We retrospectively reviewed the data on all neonates admitted in NICU at the National Hospital Abuja (NHA) over a period of 13 months (January 2017 to February 2018). Relevant demographic and clinical data were extracted from the neonatal registry database (REDCap) and analyzed to determine morbidities and mortality rate among hospitalized patients as well as case fatality rates for identified morbidities. Results: A total of 730 neonates were admitted, out of whom 391 (53.6%) were females, 396 (54.5%) were inborn and 396 (54.2%) were term. The most prevalent morbidities were respiratory distress syndrome (35.9%), neonatal jaundice (28.1%), perinatal asphyxia (12.3%), congenital malformations (11.2%) and sepsis (8.8%). Overall Mortality Rate (MR) was 12.9% while MR among term and preterm babies were 7.5% and 20.3%, respectively. The most important causes of mortality were prematurity (41.6%), congenital malformations (23.9%) and perinatal asphyxia (23%). However, congenital malformations had the highest case fatality (32%) followed by PA (28.6%), prematurity (20.7%) and sepsis (18.5%). Conclusion: Gestational age, birth weight and place of delivery were significantly associated with neonatal mortality, while prematurity was the most important cause of mortality among inborn babies, perinatal asphyxia and congenital malformations accounted for most cases of mortality among out born babies. This fact in addition to the individual case fatality rates have important implications for targeted interventions.

Biography:

Aida Ali Mohammed has completed her MBBS from Sana’a University at Yemen. She was the Director of training in emergency unit in Ministry of Health, Yemen. She has attended many International Conferences.

Abstract:

Infants may use pacifier or thumb or fingers to soothe themselves. Thumb sucking is a behavior found in humans, chimpanzees and other primates. It usually involves placing the thumb into the mouth and rhythmically repeating sucking contact for a prolonged duration. It can also be accomplished with any piece of skin within reach (such as the big toe) and is considered to be soothing and therapeutic for the person. Problems with thumb sucking in infants and toddlers are many which include: Fingers can become sore and even infected. Bacteria can be introduced into the mouth by dirty fingers and by this way the antigen and antibody reaction can occur and reduced the allergy in child. It also effect speech development and face growth and malocclusion when they do attempt to talk around a thumb or pacifier; they are less likely to be understood.

Biography:

Pradeep Kumar Gupta is currently working as a Pediatrician in Department of Pediatrics in a non-government non-profitable hospital in Nepal. He has completed his post-graduation (MD in Pediatrics) from Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India. He has completed Fellowship in Neonatology by Indian Academy of Pediatrics. Currently he is doing research on septic markers in new-born and use of bubble CPAP in resource limited setting.

Abstract:

Introduction: Studies comparing the Demyelinating GBS (Dmy-GBS) and axonal GBS (Ax-GBS) subtype in children are lacking. Methods: In this hospital based, prospective and observational studies, consecutive children with GBS were studied to compare the clinical profile and outcome among the subtypes. Results: Among 9847 children admitted to the emergency, 95 had acute flaccid paralysis, 57 of whom had GBS. Electrophysiologic studies were completed in 56, of whom 20 each had Dmy-GBS and Ax-GBS (19 motor axonal), 12 had non-reactive nerves and 5 unclassifiable findings. Mean age of onset in Dmy-GBS was 55 months while Ax-GBS occurred later at 84 months. Mean time from onset of symptoms to hospital admission was more in Dmy-GBS 18 days to 8 days in Ax-GBS. Asymmetry of motor findings was more likely in Ax-GBS (10 vs. 4, p=0.048). Respiratory muscle involvement (6 vs. 3) and artificial ventilation (5 vs. 2) was more in Ax-GBS. The average duration of hospital stay was more in Ax-GBS 16 days to 11 days in Dmy-GBS. Children with Ax-GBS less likely to be non-ambulant at discharge (12 vs. 6, p=0.036). Mean disability scores at hospital discharge (4.9±1.2 vs. 4±0.9, p=0.015) and at last follow up (0.7±1.01 vs. 0.05±0.2, p=0.016) were higher in Ax-GBS. IVIg was the treatment modality and was tolerated well with no side effects reported with no relapse of symptoms after treatment. Conclusion: Axonal and demyelinating subtypes of GBS are equally common in children of North India. Children with axonal GBS have severe clinical course and more short term morbidity and slower recovery.