Scientific Program

Conference Series Ltd invites all the participants across the globe to attend International Conference on Pediatrics & Pediatric Care Prague, Czech Republic.

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Scientific Program Day 1

Day 1 :

Keynote Forum

Hawal Amr I M

Prime Health Care Group, UAE

Keynote: Necrotizing enterocolitis in a preterm infant newborn and role of feeding …. an update!

Time : 10:10 am - 10:55 am

Conference Series Pediatric Healthcare 2019 International Conference Keynote Speaker Hawal Amr I M photo
Biography:

Dr. Amr Hawal is a Pediatrician and Neonatologist whose experience in the field spans 20 years, backed by a higher education degree from Ain Shams University in Egypt, one of the oldest and top-ranking universities in the MENA region. He is known for his astute skills in evaluation and strong passion for improving healthcare and wellbeing. He is pioneering an open and contextual evaluation model based on constructive responses, which has led in the creation of new methods to improve pediatric healthcare, neonatology and pediatric nutrition.

 

Abstract:

Statement of the Problem: It’s a clinical case presentation of a male preterm infant newborn (+31 weeks) who was delivered in our hospital and transferred to our NICU because of prematurity, VLBW and need to respiratory support. Baby shortly undergo necrotizing enterocolitis (NEC) on 5th day of life shortly after start of expressed milk feeding …! Which was early detected by use of Near infrared abdominal spectroscopy (NIRS). Baby was deteriorated clinically in a couple of hours and undergo intestinal perforation with peritonitis. So, Abdominal exploration surgery with intestinal resection and end – to end anastomosis was done urgently. Baby improved gradually and early feedings was started and gradually increased up to full feedings with use of human fortified milk (HMF), probiotics and Prebiotics.

Findings: The study stated the evidence-based feeding strategies guidelines for necrotizing enterocolitis (NEC) among very low birth weight infants and role of trophic feedings, probiotics, prebiotics and micronutrients in prophylaxis, prevention and management of NEC.

Recommendations: Prematurity is the single greatest risk factor for NEC and avoidance of premature birth is the best way to prevent NEC; The role of feeding in the pathogenesis of NEC is uncertain, but it seems prudent to use breast milk (when available) and advance feedings slowly and cautiously; NEC is one of the leading causes of mortality, and the most common reason for emergent GI surgery in newborns; NEC remains a major unsolved medical challenge, for which no specific therapy exists, and its pathogenesis remains controversial; A better understanding of the pathophysiology will offer new and innovative therapeutic approaches, and future studies should be focused on the roles of the epithelial barrier, innate immunity, and microbiota in this disorder; Bioinformatics modeling is a new emerging strategy aimed at understanding the dynamics of various inflammatory markers and their application in early diagnosis and treatment.

  • Neonatology

Session Introduction

Sebastian Gericke

Stellenbosch University and Tygerberg Children’s Hospital, South Africa

Title: Changes in cerebral blood flow and cardiac output in premature neonates in the first 72 hours of life

Time : 11:15 am - 11:50 am

Speaker
Biography:

Sebastian Gericke has obtained his MB ChB degree at the Stellenbosch University, South Africa. He is currently pursuing his Paediatric Speciality Training at Stellenbosch University.

 

Abstract:

Background: A major determinant of adverse neurodevelopmental outcome is the early acquisition of prematurity related brain injury associated with perturbations of cerebral hemodynamics. Several impediments however exist in establishing a causative relationship between systemic hemodynamic disturbances and prematurity related brain injury.

Methods: A nested cohort of a prospective cardiac output methods comparison in preterm infants was compiled and involved infants admitted to a tertiary level neonatal high care unit. An interim analysis of 63 premature infants meeting the inclusion criteria of gestational age between 26-34 weeks with recorded cranial ultrasound and echocardiographic data was performed. Excluded infants were those with birth weight <800 gm, gestational age <26 weeks, congenital defects and infants with asphyxia. Left Ventricular Cardiac Output (LVO), as measured by echocardiography was correlated to anterior cerebral artery flow velocities, derived from cranial ultrasound Doppler.

Results: Measurements were recorded at six hourly intervals up to 72 hours of life and analyzed in two subgroups: 31 infants (gestational age 28.6±1.25 weeks, range 26-30 weeks) and 32 infants (gestational age 32.4±1.0 weeks, range 30-34 weeks). LVO remained constant across gestational age categories. Peak-systolic flow velocity (PSV) and end-diastolic flow velocity (EDV) had initial low values with gradual increase over time. Lower mean values were detected in the 26-30-week gestational age group representing intrinsic differences in cerebral vasculature of the developing brain. Neither PSV nor EDV had a strong correlation with LVO.

Conclusion: In this population of relatively stable premature infants’ changes in PSV and EDV did not correlate with LVO suggesting intact cerebral autoregulation.

Maria Bertha Romo Almanza

Guadalupe Victoria Maternity Hospital, Mexico

Title: Invasive candidiasis in newborns report of cases and review of literature diagnosis, treatment and prevention

Time : 11:50 am - 12:25 pm

Speaker
Biography:

Maria Bertha Romo Almanza is the Head of the Intensive Care Unit of the newborn at the Guadalupe Victoria Maternity Hospital in Atizapan, Mexico as well as a Doctor in Neonatology Unit. She was previously the Head of Neonatology at the Star Médica Luna Parc Hospital at a private level.
 

Abstract:

Invasive candidiasis is an important cause of sepsis in the Neonatal Intensive Care Unit (NICU), whose incidence has increased considerably in recent decades in developing countries, due to the increase in survival of critically ill infants, predominantly preterm infants and it is also associated with a higher morbidity and mortality, including alterations in neurodevelopment in the long term. The frequency is variable according to each hospital center and the complexity of the patients that are managed with limited reports in Latin America. For this reason, this study is of greater relevance in order to establish an adequate surveillance, prevention, diagnosis and management strategy. This review proposes to carry out actions to prevent, give treatment and monitor invasive candidiasis in the newborn infant. The cases reported in the hospital center and in that way determine the modalities in which this condition occurs. Consequently, make an effective and timely management. Neonatal sepsis secondary to Candida sp. in the newborn is an important cause of morbidity and mortality in the NICU. In a newborn with risk factors and suspected infection, it is recommended to initiate an intentional search, with study and tracking of all the diana organs, when confirming the presence by blood culture and other indicators, specific antifungal treatment should be provided according to location or systems affected and the central vascular access lines should be removed within 24 hours to avoid colonization of the fungus. Also, implementation of essential actions of patient safety, as a method for the prevention of nosocomial infections.

  • Pediatric Neurology

Session Introduction

Sarah El Yaman

North Shore LIJ Health System, Lebanon

Title: Recognizing motor delays in children: Guidelines for the general pediatrician

Time : 12:25 pm - 13:00 pm

Speaker
Biography:

Sarah El Yaman, MD, MS, FAAP is an American Board-Certified General Pediatrician with special interest in Healthy Child Development and Growth. She has had multiple publications in the US and abroad in the Field of Pediatric Pulmonology (asthma education: changing the outcome – PAS 2015, San Francisco, USA), Pediatric Endocrinology (PES meeting, 2014, Chicago USA), and Pediatric Neurology (Long-Term Patterns of Weight changes During Topiramate Therapy: An Observational Study). After completing her training in New York, she works as a Teaching attending in Beirut General Hospital and collaborating with NGOS and international organizations providing care for underserved communities.
 

Abstract:

Pediatricians frequently encounter children with delays of motor development in their offices. Diagnosis of motor delays in young children is often delayed for years after symptoms emerge, resulting in missed opportunities for physical therapy and genetic counseling. Earlier identification of motor delays permits for timely referral for organic process interventions likewise as diagnostic evaluations and treatment coming up with. An algorithm for the surveillance and screening of children for motor delays within the medical home was developed by a multidisciplinary expert panel, offering guidance for the initial workup and referral. Highlights of this presentation embody suggestions for formal biological process screening at the 9-, 18-, 30, and 48-months well-child visits; approaches to the medical specialty examination, with stress on the assessment of muscle tone; and initial diagnostic approaches for medical home suppliers. We describe the use of diagnostic tests to evaluate children with motor delays, including brain MRI for children with high muscle tone, and measuring serum creatine kinase concentration of those with decreased muscle tone. We emphasize the importance of pursuing diagnostic tests while simultaneously referring patients to early intervention.

  • Pediatric Cardiology

Session Introduction

Paola Vidal Rojo

La Salle A C University, Mexico

Title: Treating congenital heart diseases with high tech procedures in an unequal country

Time : 14:10 pm - 14:40 pm

Biography:

Paola Vidal Rojo has completed her basic education by Cambridge University of London, has graduated from the Faculty of Medicine of the Universidad La Salle AC, and later graduated from the specialties of two of the largest Health Institutes in our country and in Latin America. She has initially in Pediatrics of Children's Hospital of Mexico, and later subspecialty in Pediatric Cardiology of the National Institute of Cardiology Ignacio Chávez, fulfilling functions of Head of Residents of the subdivision of Pediatrics. And finally she is high specialty in Medicine in Pediatric and Fetal Echocardiography in the Children's Hospital of Mexico Federico Gómez.
 

Abstract:

Mexico is a country with many inequalities, which are very notable, amongst other things, in high tech healthcare. Congenital heart diseases require in average $5,000 USD per child for a surgical treatment. Given that our average per capita income is quite low, only as few as 10% of the population can afford such healthcare, and even though 98% of the population have some sort of social security service, these are saturated, and patients may have to wait up to two years to be able to have surgery. And more so, over two million people have no access to medical services. So, we must turn to social enterprises and non-profit associations to be able to cope with this problem, and still are left with many patients without proper care. There are several areas within the country that do not have extracorporeal pump machines for open heart surgery, so they must perform surgeries without them, such as corpectomy or pulmonary banding, some of which are palliative surgeries. Many of the patients we attend arrive relatively late, considering their state. For example, we operate tetralogies of Fallot after two years of age, or anomalous pulmonary venous connections after three months. All these because of lack of planning; we have the resources and the infrastructure, but we do not yet find a way to properly manage these deficits. And so, we have so far eight nonprofit associations performing surgical procedures in congenital heart diseases throughout the country. Amongst all of them, over 1,000 children a year have been operated on, just a small percentage of all that we calculate are still awaiting surgery. Every year, more that 22,000 new children with congenital heart diseases are born, and we try to shorten the list. The first non-profit was founded in 1995, and the newest one barely this year. And all of them need mainly two things: Patients, and economical resources. We need pediatricians to redirect patients to the specialists as soon as possible and to begin medical treatment in case these referrals are not entirely feasible, and paediatric cardiologist to be familiar with all governmental, profit and nonprofit options for the patient's benefit. We intend with this paper to share our experiences and our results in case some other countries may find it useful, as well as to urge the need for pediatric alertness, the need for resources (both human and economic), as well as an early referral, to be able to help all he children awaiting surgery to improve their quality of life.

  • Special Session - Birth Defects

Session Introduction

Veronika Frisova

Profema- Fetal Medicine Centre,Czech Republic

Title: Prenatal screening for chromosomal defects

Time : 15:10 pm - 15:50 pm

Speaker
Biography:

Veronika Frisova is a Fetal specialist at Profema- Fetal Medicine Centre Ltd and has 9 years of experience. Her specializations include 2D/3D ultrasound, fetal medicine, invasive procedures services for patients & education of doctors.
 

Abstract:

Chromosomal defect affects around 0.4% pregnancies. To the most common chromosomal abnormalities belongs Down syndrome (0.2%), then trisomy 18, 13 and sex chromosome abnormalities. The only available prenatal diagnostic test for chromosomal defects is invasive testing, CVS (chorionic villus sampling), amniocentesis or cordocentesis. As these invasive methods are connected with about 0.5% of miscarriage, they are recommended only pregnant women having high risk of fetal chromosomal abnormality. Thus, all pregnant ladies are offered only safe screening tests, which estimate the risk of chromosomal defects. If the risk is high (more than 1:300, means 0.3%) an option of invasive testing is being discussed with pregnant lady. The most accurate screening test at this moment represents NIPT (non-invasive prenatal testing) methods, which analyses fetal DNA in maternal blood. These tests are expensive, therefore only some group of pregnant ladies decide for this testing. Most common and second most effective screening for chromosomal defects represents first trimester screening. The older screening methods like maternal age alone or second trimester biochemistry (triple or quadruple test) are considered to be much less accurate thus are not recommended. This presentation describes current available options of screening for chromosomal defects and explains their advantages and disadvantages.

  • Poster Sessions

Session Introduction

Hawala Amr I M

Prime Health Care Group, UAE

Title: Our daily use chemical products the enemy we trust phthalates, parabens and bisphenol A, risks and challenge to avoid .... an update!
Speaker
Biography:

Dr. Amr Hawal is a Pediatrician and Neonatologist whose experience in the field spans 20 years, backed by a higher education degree from Ain Shams University in Egypt, one of the oldest and top-ranking universities in the MENA region. He is known for his astute skills in evaluation and strong passion for improving healthcare and wellbeing. He is pioneering an open and contextual evaluation model based on constructive responses, which has led in the creation of new methods to improve pediatric healthcare, neonatology and pediatric nutrition.

Abstract:

Our Literature Review Study Reflects: The light on some chemical substances which are widely used in many and different aspects of our children daily practices and try to get the answers for the following important questions. Do these chemicals that our children are widely exposed to since even their prenatal period and throughout their lives have real high risks and dangers on their health? Is the use of these chemicals essential for our kids or we can avoid and replace them with other non-risky substances and hazardous chemical free products...!! Recently, a lot of systematic review studies have been done to investigate the possible relations between the most common chemical substances that we use daily and possible risks and health problems that may affect our children. Among the chemicals that have been studied intensively in the last few years are phthalate, bisphenol A and parabens which are known endocrine disruptors due to their anti-androgenic and/or estrogenic effects!

The Purpose & Objectives of Our Study: The main objective of this study are to provide an overview of some widely and commonly used chemicals that are introduced to many of the products essentially used by our children daily, and the possible relations between their use and some of the common health problems and disorders that affect children in order to raise the awareness among parents and health care providers regarding their potential health impacts on children and to provide a proper guidance that help to minimize the avoidable exposure to these risky chemicals and replace them with hazardous chemicals free products till we get enough studies that prove or disprove their risks and effects.

Methods & Results: Our study tries to search through, emphasis on and spot the light on the use of three chemical substances (paraben, phthalates and bisphenol A) that are commonly and widely used in most of our children life aspects, searches for their possible risks and hazards on our kids' health, tries to get relations and connections between these substances and common pediatric health problems and disorders. In our study we reviewed the data collected from many evidences based systematic reviews and Cohort studies have dealt with these hazardous substances and stated the high incidence of their risks and their bad impacts on our kids' health and prove the relation of these chemicals to certain respiratory problems specially wheezing in childhood, ADHD, some atopic conditions and endocrine disruptions among children.

Recommendations: Our study concluded and suggested that it is better to eliminate exposure to these chemicals as evidences are rising against their safety. It's very important to increase the awareness among parents and health care providers regarding the possible risks of these chemicals and provide them the most proven practical tips for their avoidance. Further epidemiological studies should be conducted in the future to enhance our knowledge in this area.

Eva Grudule

Riga Stradins University, Latvia

Title: Autoimmune encephalitis incidence, comparison of therapy tactics and efficiency in Children’s Clinical University Hospital from 2011-2018
Biography:

Eva Grudule is a 4th year resident in paediatrics at Rigas Stradins University, and work at Children’s Clinical University Hospital in Riga.

 

Abstract:

Introduction: Autoimmune encephalitis refers to a group of conditions that occur when the body's immune system mistakenly attacks healthy brain cells, leading to inflammation of the brain. The incidence of AE in US increased from 0.4 per 100,000 person-years between 1995 and 2005 to 1.2 per 100,000 person-years between 2006 and 2015. Early treatment decreases the likelihood for long-term complications, speeds recovery and reduces the risk of recurrence.

Aim: To find out the number of possible autoimmune encephalitis cases, compare therapy tactics and effectiveness in CCUH.

Method: Retrospective, descriptive analysis of data on non-infectious, possibly autoimmune encephalitis at CCUH during the years 2011-2018. Criteria for inclusion: subacute onset of altered mental status or psychiatric symptoms; CSF pleocytosis or MRI features suggestive of encephalitis; reasonable exclusion of alternative causes.

Results: Twenty-four patients (46% boys, 54% girls) aged one-17 years (average nine, one years) were included to this analysis. Acute disseminated encephalomyelitis (ADEM) was diagnosed in 13 patients, autoimmune encephalitis (AE) in 11. Ten (10) patients received treatment with i/v methylprednisolone for three-five days (ADEM-10, AE-2), 10 patients were treated with combination of several drugs (for six patients – i.v. methylprednisolone and i.v. immunoglobulin therapy, but for four patients’ immunosuppressive therapy and plasmapheresis). One patient did not receive therapy, because was stationed with relapse of AE. After treatment, 41% (n-10) of patients had no neurological symptoms at the day of discharge. Re-therapy stationary was needed for 12 patients, (50%) but re-examination for two patients (8%).

Conclusion: Immune-mediated encephalitis is a relatively rare disease in children’s but improving diagnostic capabilities the number of diagnosed cases is increasing. Early therapy is associated with a better therapeutic effect. One of the patients with delayed treatment, contiuned i.v. immunoglobulin therapy for four years.