12^th World Pediatric Congress December 13-15, 2018 Abu Dhabi, UAE

Biography:

Fette Andreas has earned his Doctoral degree from the Johannes Gutenberg University, Medical School in Mainz Germany in 1992. He has also completed his Clinical Training in all subspecialities in several accredited European Pediatric Surgery training centers before he passed successfully National and European Board certification in Surgery and Pediatric Surgery. In all day clinical practice he headed several WHO accredited projects and developed the specialty of pediatric surgery in many developing or Third World countries. In 2010, he has completed his PhD studies at the University of Pecs Medical School, Hungary. Since then, he received Professorship and acted as a Senior Lecturer at international universities. He has authored more than 20 book chapters, published nearly 100 peer reviewed journal articles and presented more than 200 lectures at international congresses

Abstract:

We report on a preterm infant (24+2 WGA, 490 g birth weight) who presented with an acute abdomen suspicious of a perforated NEC after a so far typical course of such a sick baby on our NICU. The baby was passing meconium flakes and urine and was on combined enteral and parenteral feeding since birth. Initial sequential ultrasounds and X-rays so far showed no serious abdomino-visceral pathology. During emergency surgery a subtotal continuous atretic intestine starting from the ligament of Treitz down to the sigmoid region was detected. No continuity of the intestine or visible mesenteric vasculature was found. In addition, an ischemic gastric wall perforation and a large liver hematoma with an ongoing DIC were detected. The final outcome was fatal. We concluded, that this might be an extremely rare variant of a hereditary multiple (subtotal) apple peal atretic bowel syndrome.

Biography:

The Honored Doctor of Russia, Head of the Speransky Department of Pediatrics of FSBEI FPE “Russian Medical Academy of Continuous Professional Education” MOH Russia, Honored Professor of the National Scientific and Practical Center of Children’s Health, Chairman of the Thesis Council Д 208. 071.01 Pediatrics and Child Surgery, Member of the Executive Committee of the Union of Pediatricians of Russia, Full Member of ESPGHAN, EAACI, ERS, Editor-in-Chief of the “Concillium Medicum Pediatrics” and “Medical Council Pediatrics”, Chairman of the Association of Doctors on Assistance in Training of Pediatricians of Russia, Chairman of the Association of Doctors on Vitamin D Research

Abstract:

Objective: To develop recommendations and schemes of medicamental prevention and correction of vitamin D deficiency in children of early age in Russia.

Methods: During the “Rodnichok” study 1614 children under three years of age were examined from November 2013 till December 2016 in different regions of Russia. Vitamin D status was evaluated based on calcidiol level in serum.

Results: Vitamin D deficiency in autumn-spring period is observed in more than half of Russian children of the first year of life (52.8%). The most vulnerable to vitamin D deficit group is breastfed infants. Formula feeding without cholecalciferol medications supplementation does not satisfy children’s need for vitamin D. Hypovitaminosis D should be prevented medicamentally in all children during the first year of life irrespectively of the type of feeding. Cholecalciferol medications supplementation raises level of vitamin D in children significantly and in most cases prevents deficit, but not necessarily leads to reaching 30 ng/ml. 25(ОН)D serum level correlates strongly with cholecalciferol medications dosage, at the same time intake of vitamin D medications during the first year of life in dosage 1000-1500 IU/day necessarily raises level of vitamin D without risk of overdose.

Conclusion: The unidirectional nature and comparable efficacy in young children in all cities of the study (Arkhangelsk, Moscow, Kazan, Stavropol) were demonstrated, which allows to recommend the proposed scheme of hypovitaminosis D correction in Russia.

Biography:

Dr. Afzal Abubakker Bapputty Haji from University Hospital of Wales, UK and Dr. Rubina Khambati from RAK Medical & Health Sciences University, UAE and Dr. Ijas Hassan from PGIMER, India will be organizing the workshop.

Abstract:

Pediatric basic ECG workshop will be showing.

Biography:

Consultant Pediatrician Emirates hospital clinics Fujairah since February 2017 till now. 35 years of experience in Neonatology, Pediatric Allergy, and immunology and General Pediatrics. MD pediatrics Cairo university 1998. Msc. Pediatrics Azhar university. 1984. MBBch AIN Shams University 1979. EAACI membership (European Academy of Allergy and clinical immunology) Egyptian Neonatology society Egypt. Previous experiences: Consultant pediatrician and HOD Massafi Hospital, 2014 till 11-2017, Consultant pediatrician and neonatology Dibba Hospital 2012-2014. Consultant Pediatrician and Neonatology Al Rahba Hospital. Abu Dhabi 2010-2012. Consultant Pediatrician and Neonatology Al Manea Hospital KSA 2005-2010. Consultant pediatrician & HOD neonatology ATFAL MISR hospital Egypt.

Abstract:

Febrile children account for 15% of emergency department visits and outcomes range from the presence of serious bacterial infection to benign self-limited illness. A clinically significant fever in children younger than 36 months is a rectal temperature of at least 100.4°F (38°C). Axillary, tympanic, and temporal artery measurements have been shown to be unreliable.15–18 Neonates whose parents report a clinically significant fever may have a serious bacterial infection, even if they do not have a fever at the time of their initial medical evaluation.

The evaluation of febrile children younger than 36 months has long presented the challenge for physicians of ensuring that children with serious bacterial infection are appropriately identified and treated, while minimizing the risks associated with invasive testing, hospitalization, and antibiotic treatment. The epidemiology of febrile illness in children has changed dramatically with the introduction of several vaccines targeted at this age group, and with the use of antibiotic prophylaxis during childbirth. Because of this, earlier guidelines have been questioned. This article focuses on previously healthy febrile children younger than 36 months. Those with significant preexisting conditions (e.g., prematurity, immune compromise) should be evaluated on a case-by-case basis.

The oral and rectal routes should not routinely be used to measure the body temperature of children aged 0–5 years.(4)

In infants under the age of 4 weeks, body temperature should be measured with an electronic thermometer in the axilla.

In children aged 4 weeks to 5 years, healthcare professionals should measure body temperature by one of the following methods:

• electronic thermometer in the axilla

• chemical dot thermometer in the axilla

• infrared tympanic thermometer

Forehead chemical thermometers are unreliable and should not be used by healthcare professionals.

Reported parental perception of a fever should be considered valid and taken seriously by healthcare professionals. (6).

Clinical red flags for serious infection in children more than one month:

·Global Assessment: Parental Concerns, Physician instinct 

·Child behavior:   Changes in crying pattern, Drowsiness, Consolability, Moaning                                                                                                                                                                                                

·Circulatory or Respiratory:  Crackles, Cyanosis. Decreased breath sounds. Poor peripheral circulation, Rapid breathing, Shortness of breath                                                                                                                                                                                                 ·Other Factors: Decreased Skin elasticity, Hypotension, Meningeal irritation, Petichial rash, Seizures, Unconsciousness 

Biography:

Consultant Pediatrician Emirates hospital clinics Fujairah since February 2017 till now. 35 years of experience in Neonatology, Pediatric Allergy, and immunology and General Pediatrics. MD pediatrics Cairo university 1998. Msc. Pediatrics Azhar university. 1984. MBBch AIN Shams University 1979. EAACI membership (European Academy of Allergy and clinical immunology) Egyptian Neonatology society Egypt. Previous experiences: Consultant pediatrician and HOD Massafi Hospital, 2014 till 11-2017, Consultant pediatrician and neonatology Dibba Hospital 2012-2014. Consultant Pediatrician and Neonatology Al Rahba Hospital. Abu Dhabi 2010-2012. Consultant Pediatrician and Neonatology Al Manea Hospital KSA 2005-2010. Consultant pediatrician & HOD neonatology ATFAL MISR hospital Egypt.

Abstract:

Febrile children account for 15% of emergency department visits and outcomes range from the presence of serious bacterial infection to benign self-limited illness. A clinically significant fever in children younger than 36 months is a rectal temperature of at least 100.4°F (38°C). Axillary, tympanic, and temporal artery measurements have been shown to be unreliable.15–18 Neonates whose parents report a clinically significant fever may have a serious bacterial infection, even if they do not have a fever at the time of their initial medical evaluation.

The evaluation of febrile children younger than 36 months has long presented the challenge for physicians of ensuring that children with serious bacterial infection are appropriately identified and treated, while minimizing the risks associated with invasive testing, hospitalization, and antibiotic treatment. The epidemiology of febrile illness in children has changed dramatically with the introduction of several vaccines targeted at this age group, and with the use of antibiotic prophylaxis during childbirth. Because of this, earlier guidelines have been questioned. This article focuses on previously healthy febrile children younger than 36 months. Those with significant preexisting conditions (e.g., prematurity, immune compromise) should be evaluated on a case-by-case basis.

The oral and rectal routes should not routinely be used to measure the body temperature of children aged 0–5 years.(4)

In infants under the age of 4 weeks, body temperature should be measured with an electronic thermometer in the axilla.

In children aged 4 weeks to 5 years, healthcare professionals should measure body temperature by one of the following methods:

• electronic thermometer in the axilla

• chemical dot thermometer in the axilla

• infrared tympanic thermometer

Forehead chemical thermometers are unreliable and should not be used by healthcare professionals.

Reported parental perception of a fever should be considered valid and taken seriously by healthcare professionals. (6).

Clinical red flags for serious infection in children more than one month:

·Global Assessment: Parental Concerns, Physician instinct 

·Child behavior:   Changes in crying pattern, Drowsiness, Consolability, Moaning                                                                                                                                                                                                                                      

·Circulatory or Respiratory:  Crackles, Cyanosis. Decreased breath sounds. Poor peripheral circulation, Rapid breathing, Shortness of breath                                                                                                                     

·Other Factors: Decreased Skin elasticity, Hypotension, Meningeal irritation, Petichial rash, Seizures, Unconsciousness 

Biography:

Amy E Hehre is a US Certified Physician Assistant, Kenyan Clinical Officer, CEO and Founder at OVI Children's Hospital. She is a Pediatric Oncology Enthusiast, Orphan Advocate and global visionary with a passion for helping others achieve their largest goals.

Abstract:

There are 34 million documented orphans in sub-Saharan Africa. Many, without any appropriate representation or resources to access care for their critical medical needs. Even more are the millions of undocumented children who are disabled by extreme poverty, loss and neglect within the communities. In these populations, even a fever that could be easily managed with a simple pain killer can escalate into a debilitating or even deadly febrile seizure. Cerebral palsy and other physical ailments can lead to severe malnutrition, wasting and bed sores in crowded institutions where caregiver to child ratio is alarmingly low. Temporary medical camps and health outreach centers are unequipped to provide advanced services to children with specialized medical needs such as cancer, kidney disease and conditions requiring advanced surgeries which require intensive care unit admission and lengthy follow-up measures. And so often, orphaned newborns are dying and helplessly abandoned because remaining family members are simply unable to nourish the child in the absence of the mother’s breast milk. OVI Children’s Hospital was established in December 2017 to provide representation and free, advanced medical services to this exact population. In their first year of operation, they have successfully used their work and research to stratify the need and means of implementation for enabling the best possible care for the world’s most vulnerable children.

Biography:

Panagioula Maxi Bourna is working as the Director NHS of Neonatal Intensive Care Unit in the 3^rd Pediatric Department, Attikon University Hospita, Athens, Greece. She is a Neonatologist since 1987 with special interest in Ultrasound and Doppler examination of newborns. She also is an International Board Certified Lactation Consultant since 2006. She is working exclusively with newborn babies in the nursery and in Intensive Care Unit. She is a Member of Greek Breastfeeding Committee, one of the two coordinators of BFHI in Greece and a BFH Assessor.

Abstract:

Lactation is a part of the reproductive cycle of all mammals, including humans. Breast milk has not only nutritional properties but is also a component of the immunological system and is almost more important for preterm than term healthy infants. Breastfeeding has both short- and long-term outcome benefits for premature infants, including a reduction of the rate of Necrotizing Enterocolitis (NEC). The mechanism underlying the effect of breast feeding in NEC is normal microbial colonization of the gut. Furthermore, human breast milk could be protective and therapeutic in neonates with NEC by inhibiting the activation pathway of NF-kappaB. Although mothers of preterm infants produce milk with different composition from that of mothers of term born infants, this milk may still not be adequate for the proper growth of preterm infants. Breast milk may need fortification. Both when fortification is required and when it is not, mother’s breast milk is the first choice for feeding premature infants according to the WHO. The second choice is milk from a milk bank. The goal for mothers of small preterm babies in neonatal intensive care units should be to produce the highest amount of their own milk. The truth is that although some mothers can produce the correct amount, the majority cannot. Procedures than can increase the amount of breast milk and breastfeeding rates include kangaroo care, finger feeding, nonnutritive sucking and special devices. Certain positions may also help. Best practices are important for high-dose human milk feeding for preterm infants during Neonatal Intensive Care Unit (NICU) hospitalization. Finally, special care must be given to babies 34-37 weeks, as they may not need complicated intervention but do need skin to skin contact and attention.

Biography:

Afzal Abubakker Bapputty Haji is a young enthusiastic Pediatric Clinical Fellow at the University Hospital of Wales, UK. He is a dedicated Doctor with special interest in pediatric cardiology, who has previous adequate experience in cardiology after his graduation in 2015. Being very passionate and motivated in the NHS, he is keenly involved in teaching medical students, research works and publications. He also had served as a WHO External Monitor in various community health programs in India.

Abstract:

Objective: Although wheezing is a common manifestation of bronchial asthma, this symptom could also result from an underlying heart disease. We present a 3-year old with Cor-triatriatum who did not respond to previous treatment for bronchial asthma.

Methods: The child was investigated and its results and management were reviewed. A Medline search using the keywords was performed and results summarized.

Results: We report a 3-year-old, under treatment for bronchial asthma for 2 years with no relief to his cough and shortness of breath on exertion. His mother noted that he had a prominent cardiac chest impulse and further investigations revealed right axis deviation and RBBB pattern on his electrocardiogram. His echocardiogram revealed a membrane across the left atrium with a small restrictive orifice in its anterosuperior aspect. The pulmonary veins were draining into the left atrium above the membrane and the left atrial appendage was below the membrane. Pulmonary hypertension was also evident from a tricuspid regurgitation jet velocity of 4 m/s. The membrane was surgically resected with prompt relief to his symptoms and the pulmonary hypertension resolved.

Conclusion: We highlight the importance of considering a cardiac anomaly in children with bronchial asthma who do not respond to treatment. An electrocardiogram can give a valuable clue to this anomaly. The diagnosis is all the more important as the anomaly can be surgically corrected with complete resolution of symptoms and restoration of normal cardiac function.

Discussion: Cor-triatriatum is a rare anomaly (0.1% of congenital heart diseases), characterized by a fibro muscular membrane, dividing the left atrium into two chambers and offering variable obstruction to LV inflow. Literature review emphasized the importance of early diagnosis and that clinical manifestations generally depend on the degree of inflow obstruction. The resultant pulmonary hypertension and right heart failure can lead to symptoms that resemble bronchial asthma.

Biography:

Robert J Hehre is a Physician Assistant from Kentucky, United States. He is the Co-Founder of Ovi & Violet International, Inc. He is a part of the team of medical providers as well as the Medical Director at OVI Children’s Hospital in Migori.

Abstract:

Sickle Cell Disease (SCD) remains a public health burden and a significant cause of morbidity and mortality worldwide, especially in sub-Saharan Africa. With more than 250,000 new cases of sickle cell disease diagnosed each year in sub-Saharan Africa alone, this disease places a significant strain on families as well as healthcare facilities of sub-Saharan Africa, particularly with the progressive nature and multiple hospital visits that accompany this disease. There has been ample evidence over the past decade demonstrating the efficacy and importance of hydroxyurea, the only effective drug proven to reduce the frequency of painful episodes, in the treatment of SCD in pediatric patients. With the implementation of pediatric hydroxyurea therapy in developed countries worldwide, as well as the introduction of the first U.S. FDA approved hydroxyurea treatment for pediatric patients in December 2017, there is promise for increased prevention of vaso-occlusive pain episodes and the long-term sequelae that follow. Although hydroxyurea is now included in the WHO Model List of Essential Medicines for Children, healthcare facilities across sub-Saharan Africa continue to remain behind the curve. Multiple factors have been proposed regarding the reasons hydroxyurea therapy is still lacking in low-resource settings and it is crucial that these barriers be addressed with haste so that the use of hydroxyurea can be a common practice in all recourse settings. This presentation will review the mechanisms of action, indications, monitoring, adverse reactions and contraindications, as well as the dosing regimen and titration for hydroxyurea therapy in children with sickle cell disease. This presentation will also review the presumed barriers that prevent the introduction and implementation of hydroxyurea therapy in rural sub-Saharan Africa, the possible complications that may accompany the use of a myelosuppressive agent in a rural, third world setting and the current research seeking to address these issues.

Biography:

Ubaidullah Khan is currently working as a Pediatric Surgeon in Alhada Armed Forces Hospital, Taif, Saudi Arabia. He has completed his Master’s degree from Quid-e-Azam Postgraduate Medical College, PIMS, Islamabad in 2010. He has then continued his EBPS in UK from 2013-2014.

Abstract:

Objective: In this study, we aimed to compare the clinical data of patients diagnosed with acute appendicitis in our center prospectively and then compared with others studies.

Methods: The patients who were diagnosed with acute appendicitis between 01.01.2014 and 01.08.2017 in our hospital were included in this study. Patient demographics, dates and times of emergency department application, dates and times of hospitalization in the pediatric surgery ward, duration of stay in the hospital, leukocyte count and its relationship with age, the perforation rate, the relationship of C-Reactive Protein (CRP) and leukocyte count, histopathology and the final diagnosis and ultrasound findings were assessed in this study.

Results: A total of 223 patients who were diagnosed with acute appendicitis [143 (64.1%) male, mean age 11; 80 (35.9%) female, mean age 10] were enrolled. The duration of stay in the hospital was between 0- 48 hours in 192 (86.1%) and more than 48 hours in 31 patients, respectively. The mean leukocyte count of these patients was 14.141/mm³. The CRP level in 161 of the patients was of diagnostic value with acute appendicitis. The most common presentation was vomiting and pain right iliac fossa in majority of our patient.

Conclusion: According to the present study results, acute appendicitis is commonly seen among male population. The coherence of CRP findings with the diagnosis and its association with leukocytosis is significant and supportive. Additionally, the ultrasonography findings, leukocytosis, medical history and physical examination are important and essential factors for the diagnosis of acute appendicitis.

Biography:

Mohamed Amin El Gohary is the Chief of the Department of Pediatric Surgery at Burjeel Hospital, Abu Dhabi. Earlier, he was the Chief of Department of Pediatric Surgery at Al- Noor Hospital, Abu Dhabi. He has published Illustrative Laparoscopy Text book 2005, Principles of Surgery for Nurses 1980, and Mafraq Dose Guide 1989. He has given several guest lectures and has over 30 years of experience in teaching and other academic pursuits. He has published several publications and has taken part in many conferences as keynote

Abstract:

Gohary’s disease is a new phenomenon that has not been described before. It depicts a group of children who present to emergency department with severe agonizing abdominal pain. The pain tends to start and ends abruptly, no predisposing factor and recurs after minutes or hours. Ultrasonography revealed mesas at right iliac fossa, which is usually diagnosed as intussusception. The underlying cause of such phenomenon is the fecal impaction of stool at terminal ileum which acts as intermittent intestinal obstruction. We have encountered 19 cases over the last 5 years, their age varied from 9 months to 8 years with the majority under the age of 2 years. The cadinal symptoms and signs are: Severe abdominal pain that warrants urgent attention, empty rectum on examination and ultrasound diagnosis of intussusception. All of these cases were managed by fleet enemas with immediate response. Awareness of this condition will help to avoid unnecessary investigation and unjustified exploration.

Biography:

Fette Andreas has earned his Doctoral degree from the Johannes Gutenberg University, Medical School in Mainz Germany in 1992. He has also completed his Clinical Training in all subspecialities in several accredited European Pediatric Surgery training centers before he passed successfully National and European Board certification in Surgery and Pediatric Surgery. In all day clinical practice he headed several WHO accredited projects and developed the specialty of pediatric surgery in many developing or Third World countries. In 2010, he has completed his PhD studies at the University of Pecs Medical School, Hungary. Since then, he received Professorship and acted as a Senior Lecturer at international universities. He has authored more than 20 book chapters, published nearly 100 peer reviewed journal articles and presented more than 200 lectures at international congresses.

Abstract:

Approximately 12% of patients with bowel emptying disorders under 16 years of age shows signs of mega bowel development. In addition, 25% adolescents and young adults with chronic constipation have already developed a megacolon. Thus, any bowel emptying disorder with signs of mega bowel will constitute a key indication for early and complete diagnostics to give these patients the opportunity to have a healthy large bowel in adulthood. However, among others, the development of a mega bowel is always an alarming sign in front of the immanent (irreversible) bowel wall injury. We would like to report on two Arab children, who have been presented with the main complaints overflow-incontinence and megasigma/rectum. In front of the language barrier, cultural issues and limited technical equipment taking history, clinical examination and compliance have been difficult. After exclusion of the key differential diagnosis elongated sigma and Hirschsprung’s disease, medical textbooks have been revisited for the exact definition of terms in regard to our potential final diagnoses “dolichosigma”, “megarectum”, “rectal inertia syndrome” and “(overflow-) incontinence”, respectively to create an individual treatment plan tailored for each of our patients. Both kids underwent elective surgery. Intraoperative, a massively enlarged bowel segment has been found, resected and sent for histopathology. The children’s postsurgical course have been uneventful, both kids have been reporting continence afterwards. In conclusion, the psychological strain of all children and families involved seems to be the same among all cultures. Pathophysiology is known to be manifold, too. All diagnostic steps and the treatment algorithm are standardized, however, at least for us, some questions remain unanswered.

Biography:

Samah Salah Alasrawi is a Pediatric Cardiologist at Al Jalila Children’s Specialty Hospital since 3 years. She has Bachelor’s degree from Damascus University, Syria, followed by a Master’s degree in Pediatric Cardiology. Besides having worked in numerous private hospitals in Damascus as a Consultant Pediatric Cardiologist, she also had a private practice with clinical and research interests in congenital heart diseases, pulmonary hypertension, cardiomyopathies and arrhythmias in children.

Abstract:

Kawasaki Disease (KD) is an acute, self-limited vacuities of unknown etiology that was first described in the Japanese literature in 1967. It has now become the leading cause of acquired heart disease in children. It occurs in young children, (80% of patients are under the age of 4 years). Kawasaki disease is diagnosed using clinical criteria that include fever for 5 days or longer and at least 4 of the following: (1) Nonexudative conjunctival injection; (2) oral involvement, including any of strawberry tongue, mucosal hyperemia and cracked or erythematous lips; (3) changes in the peripheral extremities, including edema or desquamation in convalescence; polymorphous rash; and acute cervical adenopathy greater than 1.5 cm in diameter. [3] There is no specific diagnostic test or pathognomonic clinical features; those previously mentioned clinical criteria have been established to assist physicians in diagnosing KD. So clinician should be aware of the possibility of KD. Incomplete (atypical) Kawasaki disease occurs in persons with fever lasting five or more days and with two or three of these findings. Echocardiography is essential. It can reveal dilatation and aneurysms of the coronary arteries, as well as allowing assessment of the pericardium and left ventricular/valvular function. Serial echocardiography is often needed to detect occult coronary artery disease as the illness evolves. Treatment for acute disease is intravenous immunoglobulin and aspirin. If there is no response to treatment, patients are given a second dose of intravenous immunoglobulin with or without corticosteroids or other adjunctive treatments. The presence and severity of coronary aneurysms and obstruction at diagnosis determine treatment options and the need, periodicity, and intensity of long-term cardiovascular monitoring for potential atherosclerosis.

Biography:

Gehan Hussein is the Professor of Pediatrics, Faculty of Medicine, Cairo University, Egypt (from 2009). She has completed his Graduation in 1990, Master Degree in Pediatrics in 1994 and MD Degree in Pediatrics in 1998. She has worked in Pediatric Cardiology Division (1995 till now). In addition to general pediatric experience, she has special interest in pediatric echocardiography for congenital and acquired heart diseases in pediatrics, post-operative care for pediatric cases after palliative and/or corrective cardiac surgery as well as interventional cardiac catheterization for 11 years (2005 to 2016), worked as unit head of inpatient pediatric cardiology department in new children hospital, Cairo University (2016-2017).

Abstract:

Background: Congenital Heart Diseases (CHD) with heart failure are growing health problem in Egypt. Nutritional status, especially micronutrients as zinc (Zn), in this group of patients is affected by many factors as impaired absorption, deficient intake, and use of medications that affect serum zinc level as diuretics and Angiotensin Converting Enzyme Inhibitors (ACEI).

Objectives: To assess serum zinc levels in pediatric patients with congenital acyanotic heart diseases in comparison to healthy controls, to examine the correlation of heart failure severity, pneumonia and anti-failure medications with serum Zn level.

Methods: Cross sectional descriptive study was conducted on 100 patients with congenital acyanotic heart diseases, with various stages of heart failure. Cases were compared to 50 age and sex matched control group. Clinical assessment of growth and stage of heart failure using ROSS classification for those ≤2 years of age and NYHA staging for those more than 2 years of age, measurement of serum Zn level using flame atomic absorption spectrophotometer and transthoracic color Doppler Echocardiography were done.

Results: mean serum Zn level was significantly lower in patients (76.71±19.74) than controls (132.33±20.96), p value <0.001. It was significantly lower in advanced stages of heart failure (p value ‹0.001 for ROSS) and p value 0.009 for NYHA stages. There was no significant correlation between serum zinc level and echocardiographic parameters or anti-failure medications.

Conclusion: Serum zinc level was low in congenital acyanotic heart, with no significant correlation with use of diuretics or ACEI

Biography:

Daniela Bezerra is a neuropediatrics and works in an Epilepsy Service in one of the present appointments (at Mario Covas State Hospital, in Sao Paulo). She is presently the Coordinator of the Pediatric Neurology Training Program at ABC Faculty of Medicine. She obtained a master’s degree in Health Sciences in 2013. She took part in ILAE’s VIREPA distant education courses: EEG basic course (2017) and Pediatric EEG (2018), and ILAE – commission on European Affairs neurophysiological and EEG-reading capabilities in a Summer School in Danish Epilepsy centre (2018). More recently I got interested in neuromodulation for epilepsy, and I am associated with a team performing preoperative evaluation and surgical treatment for epilepsy, headed by Dr. Cukiert. I am a member of the Brazilian Child Neurology Society since 2015.stitutions.

Abstract:

Statement of the Problem: The status epileptics in neonatal and children have many specifics characteristic and specificities that involve the neurobiological maturation in all the specifics ages for example how to identify seizures in neonatal and the management the seizures in this age and this situation is different in the older child . The neurobiological states for the brain is the key to be precise and control this situation and the time to begin all the procedments is the best way to previse the refractory status epileptic. In neonatal 1-5/1000 newborn has seizures and 43% became status epileptic. In children 60% of the cases with status epileptic do not have neurologic disease before this situation. Understand the development of the brain is the best way to choose the anti-epileptics drugs and try to identify the etiology is the other important way to avoid the mortality.

Methodology & Theoretical Orientation: The Brazilian Child Neurology society gave me this topic to discuss with the pediatrics, neonatologist and with the neuropediatrics in one symposium in November 2017, and i Did a review with the recents papers and brougth from ours services, hospitals ours experiences and the reality.

Findings: In Neonatal population the phenobarbital is the first choice but the doses must have to with a protocol to have the best response because when you add a phenytoin the response became in 50% only and the etiology is the very important thing to be focus because the risk of status epileptic subclinical is very high. In the old children the Time to begin the treatments is the most important focus.

Conclusion & Significance: The neonatal status epilepticus and the child Status epilepticus are the situation with mortality and morbidity, when they are not recognize and the time to start the treatment is not able to be effect this complications are very important for the patients, families and to the healthy care. Recommendations are made for treatment centers to become informed that would help this recognition and the conduction.

Biography:

Samah Salah Alasrawi is a Pediatric Cardiologist at Al Jalila Children’s from 3 years ago. After graduating from Damascus University, Syria, followed by a Master’s degree in pediatric cardiology. Besides having worked in numerous private hospitals in Damascus as a Consultant Pediatric Cardiologist, Dr. Samah also had a private practice with clinical and research interests in congenital heart diseases, pulmonary hypertension, cardiomyopathies, and arrhythmias in children. She has 7 articles published this Year (2018).

Abstract:

The diagnosis of cardiac disease is not always straightforward because physical examination, ECG, and CXR are often difficult to interpret in the newborn period compared to older infant or child

Although echocardiography is required to precisely define the anatomical abnormality, it is usually possible to define the functional abnormality on the basis of the clinical and radiographic findings

The timing of presentation and severity depends on:

ï‚— Nature and severity of defect

ï‚— The alteration in cardiovascular physiology secondary to the effect of the transitional circulation as ï‚— Closure of ductus / restriction of patent foramen ovale (PFO) ï‚— Fall in pulmonary vascular resistance (PVR)

The most important factors in narrowing down the diagnostic possibilities are:

1-The clinical presentation

ï‚— Shock (ductal dependent systemic circ.) (Grey baby)

ï‚— Cyanosis (ductal dependent pulmonary circ.) (Blue Baby) including severe Ebstein’s anomaly

ï‚— CHF (shunt lesions) (Pink Baby)

2- The timing of the presentation (age)

3-Associated non cardiac or genetic anomalies

Biography:

Gehan Hussein is the Professor of Pediatrics, Faculty of Medicine, Cairo University, Egypt (from 2009). She has completed his Graduation in 1990, Master Degree in Pediatrics in 1994 and MD Degree in Pediatrics in 1998. She has worked in Pediatric Cardiology Division (1995 till now). In addition to general pediatric experience, she has special interest in pediatric echocardiography for congenital and acquired heart diseases in pediatrics, post-operative care for pediatric cases after palliative and/or corrective cardiac surgery as well as interventional cardiac catheterization for 11 years (2005 to 2016), worked as unit head of inpatient pediatric cardiology department in new children hospital, Cairo University (2016-2017).

Abstract:

Echocardiography has become the primary imaging tool in the diagnosis and assessment of congenital and acquired heart disease in infants, children, and adolescents. Transthoracic echocardiography (TTE) is an ideal tool for cardiac assessment, as it is noninvasive, portable, and efficacious in providing detailed anatomic, hemodynamic, and physiologic information about the pediatric heart. 2 D echocardiography is used to evaluate cardiac anatomy, valvular morphology, to detect the presence of vegetation from endocarditis and to examine for the presence of pericardial fluid and for chamber or vessel thrombi. Colour Doppler is of great value in confirmation of intracardiac shunt and valvular regurgitation and/ or stenosis, while Doppler is used to estimate intracardiac pressures and pressure gradients across valves and vessels, pressure gradient across a defect, and to estimate filling pressure and fluid responsiveness. M- Mode echocardiography derived measurements are useful to quantify ventricular systolic function. The aim of this workshop is to establish the indications of TTE, to demonstrate various Echocardiographic views, explain the value of each one and to discuss the value of each modality of transthoracic echocardiography in evaluation of common pediatric cardiac problems as congenital and acquired heart diseases as well as the value of use of Echocardiographic findings in decision making of common pediatric cardiac problems

Biography:

Ubaidullah khan is currently working as a Pediatric Surgeon in Al Hada Armed Forces Hospital, Taif, Saudi Arabia. He has completed his Master Degree from Quid-e-Azam postgraduate medical college, PIMS,Islamabad in 2010. Then he continued his EBPS in UK from 2013-2014. He is  a dedicated and committed employee of Al Hada Hospital and is striving to achieve its vision of providing excellence in healthcare.

Abstract:

Fetus in Fetu (FIF) is a rare congenital anomaly in which a malformed parasitic twin is found within the body of a living child or adult. In this case report, a new born male child presented with a large abdominal mass and diagnosed on routine screening investigation at our nursery unit. Imaging studies confirmed the presence of a large retroperitoneal fetus in fetu with significant mass effect of the adjacent structures. A surgical resection was performed and pathology confirmed the diagnosis. These rare cases have less frequently reported and a review of the literature show up to 200 cases which describe the demographics, updated genetic findings, pathology and outcomes of this unusual tumor. Recent revive of past literature does not show any case report from the Kingdom of Saudi Arabia. In contrast, will also discuss cases such as off fail parasitic twining and teratomas that may warrant a longer follow-up.

Biography:

Beshair Al-Driweesh has passed successfully in Medical Council Of Canada Evaluating Examination in 2015. In 2013 she got her 2^nd honor degree from University of Dammam (UOD). In 2017 she got Best Poster Award at 3rd SCHS International Medical Education Conference-awarded by Saudi commission for health specialties.

Abstract:

Case presentation: 11 year old boy medically free presented with hx of voice hoarseness, not investigated before. No hx of Choking episodes No hx of Cough, dyspnea, DOB. No hx of Airway Traumanot in distress, vitally stable saturating well.

Bronchoscopy showed: Mobile vocal cords, Papillomatous mass, Normal subglottic area, Normal Arytenoids. What are we missing?

 It is the most common pediatric benign laryngeal neoplasm and second most common cause of childhood hoarseness. It is characterized by (wart-like) growths of the airway predominantly affecting the larynx and trachea (and occasionally bronchi and lung parenchyma). DNA has been retrieved from normal laryngeal and tracheal mucosa in 4% of cases. The mode of transmission include vertical and sexual.

Risk factors of acquiring JoRRP are mothers with active condylomata (2/3), young mothers, vaginal delivery, first child, low S E. Treatment objectives include relieve airway obstruction, improve voice quality, and to facilitate remission

Are we missing anything?

Counseling, the impact of a diagnosis of HPV infection; cultural issues- HPV testing may be seen as an indicator of infidelity or premarital sex, Positive test result could lead to excommunication from the family, Chart documentation. psychologist, sex therapist or social worker, adolescent sexuality-  Adolescents want to discuss issues of sexuality with their health care providers and are likely to discuss these issues in a nonthreatening environment. They prefer to be asked questions rather than being expected to volunteer information and need reassurance that their privacy will be respected and information will not be shared.

Future and Controversies: Use of medical therapy to eradicate latent papilloma virus found in 20% of normal-appearing mucosa, to determine the genetic predisposition via genetic studies, New human papillomavirus (HPV) vaccine recommended for preteen and teenage girls, Controversy still exists concerning the best mechanism of surgical removal, and addressing the socio-sexual environment in our conservative culture

Biography:

At the age of sixteen she started working with juvenile delinquents in the Lebanese prison system and continued during her time in New York working with homeless children and abused women and raising money for Lebanon from abroad. This work has continued all the way up until her current office as founder and president of Gift of Life Lebanon. Since its in foundation in 2015 Gift of Life Lebanon has managed to provide live saving heart surgery for over 200 children as well as preform over 1000 free medical checkups to disadvantaged children throughout Lebanon. In doing this work she has managed to mobilize and activate different strata within local communities particularly the youth, bringing people together across Lebanese society, in engaging the kind of work that can help foster the new leaders of the coming generation

Abstract:

Disease prevention of any kind is very challenging in developing countries. The World Health Organization “WHO” reported that 44% of countries have less than one physician per 1,000 people. Congenital Heart Disease “CHD” is the most common birth defect and the number one cause of death for children under the age of one. 1 in 100 children is born with congenital heart disease and half of these children will need to be treated either by surgery or catheter procedures. Although most heart defects in babies can be treated, if left untreated the patient will not be able to lead a normal life and many will die before they reach their first birthday. The most common congenital heart defects are: Ventricle septal defect (VSD), Atrial Septal Defect (ASD) and tetralogy of Fallot.

1.3 million babies are born every year with CHD and 93% do not have access to free cardiac care. Because of the complexity of these surgeries and lengthy stay at the intensive care units and hospital, surgery for CHD is significantly high and most families in developing countries cannot afford the cost. Organizations such as Gift of Life International (GOLI) play a very crucial role in saving the hearts of babies and children around the world. Non for profit organizations usually use the following three options for children that need heart surgery in third world countries:

1- Sending patients abroad for surgery.

2- Missions: Visiting surgeons that will perform surgeries at equipped hospitals within the country.

3- Cover the cost of surgery in countries where hospitals and cardiac surgeons are available and surgery is only partially covered by the ministry of health or the UN in the case of refugees.

4- Establish a pediatric cardiac center and train doctors and surgeons to treat patients in their own country.

Gift of Life International “GOLI” uses all of the above methods and has helped over 30,000 children from 78 different countries. It is a matter of life and Death!

Biography:

He qualified Diploma of medicine specialized in pediatrics obtained in Saint-Petersburg the 23 June 2000. He obtained specialized training certificate in pediatrics in 2003 Descartes Paris France. He has completed Diploma in paediatric infectious disease

Abstract:

Background
Neonates are at greater risk for sepsis and meningitis than other ages.

Early onset neonatal meningitis due to streptococcus group is serious but uncommon disease. The incidence of overall neonatal bacterial meningitis has also not changed: 0.22 cases/1000 live births (1985–87) versus 0.21 cases/1000 (1996–97), to 0.03 in 2002 in industrialized countries.   Complications of neonatal meningitis in full term and near term is a major challenge.

 OBJECTIVE
The aim of this study was to determine neurologic complication of neonatal meningitis due to streptococcus B in full and near full term newborn in one medical center.

Method:
We included newborns 0-28 j having been admitted to the Robert Debré Hospital between 1984 to 2014, the diagnosis of meningococcal B streptococcus has been proven by CSF culture. Laboratory data, clinical features, imaging and children were recorded (Table 1)

25 cases of neonatal meningitis B streptococcus between 1985 and 2010 have been reported, two were excluded because they had congenital anomalies; 14 records have not been found in the archives.

In total, only 9 cases have been analyzed.

Eight children had either a CT scan or MRI and head ultra sound (HUSS). All eight had an abnormal imaging: 5 cases 62.5% had a stroke, one case of ventricular leukomalacia perished was highlighted, as described above. Other abnormalities were asymmetric peri cerebral edema, a right temporal cortical subcortical lesions; 1 echogenicity and ventricular dilatation .

All children admitted were symptomatic: neurological symptoms were either in 66.66% of cases, breathing in all cases, or hemodynamic in 33% of cases.

The median admission was 13 days (3-20) age; the median temperature of 38.5 (36-39.9) Of the 9 cases, only three mothers had a history streptococcus B 95% CI (0.117-0.64). The average glucose level was 1.4 mmol: / l, the protein level of 1.75g / l with a corrected 5189 pleicytose; blood culture was positive in 33.33%, 95% CI (0.11-0.64). 25% had neurological symptoms between the ages of 1-4 years

DISCUSSION
The incidence of early onset sepsis due to group B streptococcus (GBS), 0 • 43 per 1000 live births [95% CI 0, 37-0, 49] and mortality 12, 1% is two times higher than those reported for late infections.

   The prevalence of neonatal meningitis is estimated 0.15-0.5per 1000 birth in industrialized countries.  With an estimated mortality in the international literature mortality is estimated between 8.5 to 15%. (4).

Complications imaging are known: ventriculitis; Stroke, abscess or consequences in the medium and long-term expectations of subtle neurological moderate or severe. 

CONCLUSION
Neonatal meningitis due to groupe B streptococcus is rare, but can cause complication in both term and preterm newborn.

Periventricular leukomalacia as the complication of infection is well described in preterm newborn, but research bibliographic in our study has not found similar complications in term and near term infant.

 Stroke is the main complication in our study and well described in literature as complication of neonatal meningitis due to streptococcus B.

Biography:

Alheraish Yasser Abdulrhman is a pediatric consultant in Heart Centre KFSHRC, Saudi Arabia.

Abstract:

He will give a talk on Validity of pro-calcitionin for diagnosing sepsis in children after cardiac surgery: ongoing study.

Biography:

She has completed his Post Graduation in Federal University of São Paulo in 2016. She has done Specialization Training in Scientific Research in Surgery in Federal University of Sao Paulo / Brazil in 2011. 

Abstract:

Cerebral Palsy (CP) arises due to an injury in the immature brain and even in patients in whom the disorder is considered to be non-progressive, the resulting disability is life-long. During the growth of a child with CP deformities get worse and lead to decreased function and ability to perform daily life activities, depending on orthopedic and general management program implemented. As many different aspects of orthopedics in general, management of children with CP has changed significantly over the past 10 years. It is a common ground that long term best results come from individualized and multidisciplinary approach. Functional priorities of a person with CP are, in order of importance, communication, activities of daily living, mobility in the environment and walking. International guidelines for early diagnosis and intervention for cerebral palsy were published in 2017. They state that early recognition of CP should occur as early as possible leading to provide diagnostic-specific early intervention and surveillance to optimize neuroplasticity and prevent complications, as well as to provide parents psychological and financial support, if available. It is a recent concept that low muscle strength and not spasticity, causes the greatest limitations in motor function in children with CP and this has shifted focus from spasticity management towards active, intensive and task specific training for these children. During the past 20 years, increasing emphasis has been placed on correction of soft tissue contractures and bony deformities in a Single Event Multilevel Surgery (SEMS), which has become the standard of care in CP management despite difficulties of make its results objectively measurable. One of the most important aspects of successful SEMS is to custom made the surgical technique and choosing right surgical dose according to patient’s functional level.

Biography:

Sadiya Zinjani has graduated from the prestigious Armed Forces Medical College in the state of Maharashtra in India. She is attached to the Max Hospital, Saket, Delhi, as a Visiting Consultant.

Abstract:

Garre’s osteomyelitis is also called periostitis ossificans, proliferative periostitis and Garre’s sclerosing osteomyelitis. It was first described by Carl Garre in 1893 as an irritation induced focal thickening of the periosteum and cortical bone of the tibia. The first case of proliferative periostitis affecting the jaw bone was described by Berger in 1948. Garre’s osteomyelitis mainly affects children and adolescents. Our case involved an 8 year girl who presented with a painful swelling right lower jaw, with difficulty in deglutition, there was no fever. Earlier the patient had been treated by Dentists & ENT Specialists with no relief. Relevant investigations were within normal limits. MDCT scan of the face/orbit showed cortical irregularity and erosions in the right hemi-mandible with a significant periosteal reaction and multiple irregular lytic areas in the marrow along with soft tissue changes suggestive of osteomyelitis. The OPG was normal. The significant periosteal reaction combined with osteomyelitis was suggestive of Garre’s osteomyelitis. No bone biopsies were considered due to the typical clinical and radiological features. With 4 weeks of antibiotic treatment the patient was completely relieved of her symptoms with a major correction in the facial asymmetry. Regular follow up demonstrated a remodeling of the mandible with normal results on bone scanning. Most cases of Garre’s osteomyelitis have followed an odontogenic infection. Our case had no evidence of any oral or dental infection, confirmed by a preadmission OPG and a post discharge CBCT, and thus responded well to conservative treatment. She in all possibility developed this osteomyelitis secondary to an infection elsewhere in the body, which was controlled by the time she came to us.

Biography:

Raghavendra M Shetty is a competent Academician and Clinician, graduated from A.B. Shetty Dental College, Mangalore, India and did his Masters in Pediatric Dentistry from PMNM Dental College, Bagalkot, India. He was conferred with PhD by Nitte University. He was awarded a Gold Medal for his highest score in Masters in 2004 by Rajiv Gandhi University of Health Sciences. He was also awarded with the ‘Young Pedodontist Researcher’ by the Indian Society of Pedodontics and Preventive Dentistry (ISPPD) in 2010. He is presently working as a Faculty in Gulf Medical University, Ajman, UAE. He is also a member of Faculty of Dental Surgery (Glasgow). He has co-authored 5 text books and has around 45 national and international publications. He has about 14 years of teaching experience for both undergraduate and post graduate level, along with immense clinical experience. He has got three patent registered under his name. He is serving as a Reviewer and Editorial Board Member in many of the reputed national and international journals

Abstract:

Pediatricians examine infants several times during the first and second year of life. These visits are considered ‘well-baby’ or ‘check-up’ examinations to note the developmental progress of the baby, provide necessary immunizations, give the parents guidance concerning nutrition and discuss cognitive development. Thus, pediatricians are considered to be in a unique position to provide preventive oral information and to diagnose oral diseases in their patients early on, because of the early age at which children are brought to their offices. Parents usually seek pediatricians’ guidance in securing their child’s normal growth and development. If proper counsel regarding the child’s development and eruption of teeth as well as guidance for prevention of various oral diseases is rendered at this age, better oral health can be attained for these children. In order to achieve this, pediatricians must have proper knowledge in addition to time and inclination to educate the parents. The study focuses on various scenarios where the pediatricians can play a crucial role in maintaining oral health of the child and preventing various diseases, as pediatricians are often the first health professionals whom children visit.

Biography:

Abel Gidey Kebedom has completed his MD and specialization of Pediatrics and Child Health from Mekelle University Collage of Health Science, Ayder Specialized Comprehensive Hospital. He is an Assistant Professor of Pediatrics, a Consultant and Lecturer in Ayder Comprehensive Specialized Hospital.

Abstract:

Background: Infective endocarditis, microbial infection of the endocardial surface of the heart, is the most feared complication of the structural heart lesions. Death due to infective endocarditis has been reported to be as high as 26% in sub-Saharan Africa. In Ethiopia, the prevalence of RHD in school children is about 19 per 1000 with mean age at death of 25.9 years in hospital inpatients. The mortality rate is augmented by conditions like infective endocarditis on which no regional data available.

Objective: To assess clinical presentation and determine outcome of infective endocarditis in Ayder Specialized Comprehensive Hospital from September 2011 to March 2018.

Materials & Methods: We retrospectively reviewed patient chart and analyzed with Chi-square test.

Result: An aggregate of 74 pediatric patients with infective endocarditis were seen in the study period males found 52.7% (39/74) of the population. More than half (54%) were in the age range 11 to 18 years. Rheumatic heart disease was the underlying condition in majority of the cases accounting 59 (79.8%). Clinical presentations included: Fever 60 (82.1%), pallor 59 (79.7%), splenomegaly 17 (23%) and clubbing 10 (13.6%). Complications were congestive heart failure 51 (68.9%), neurological findings 10 (8.1%) and renal complication (1.4%). There were 12 deaths with overall case fatality rate of 16.2%. Embolic phenomenon and shorter hospital stay harbors higher morbidity and mortality with P-value <0.001 and P -value 0.01 respectively.

Conclusion: In our setup, IE in children is still characterized by the high prevalence of RHD as an underlying heart disease. Fever, murmur and pallor were the commonest clinical presentation. Higher mortality was seen because of delayed referral and delayed presentation. Late presentations of cases were evidenced by high proportion of complications such as congestive heart failure and death with short hospital stay. Embolic phenomenon was also significantly associated with death.

Biography:

Simone has completed his Post Graduation in Federal University of São Paulo in 2016. She has done Specialization Training in Scientific Research in Surgery in Federal University of Sao Paulo / Brazil in 2011. Sofyen Tebbi, certified prosthetist orthoptist graduated at Kerschensteiner University of Technology, Stuttgart – Germany.  Sofyen has 19 years of clinical experience in different fields of orthotics and prosthetics management for children and adults. Currently working at MOBILIS in Dubai offering a custom on-demand manufacturer service with superior quality and leading-edged orthotics and prosthetics products. Sofyen has relocated to Dubai in 2018 from Saudi Arabia, where he worked as Prosthetic and Orthotic Supervisor and Educator since 2009. Previously working as supervisor and workshop leader of the Orthotic and Prosthetic Department of Nonnengaesser & Tebbi in Donzdorf, Germany (from 2003 to 2009).

Abstract:

To provide effective orthotic intervention for children with Cerebral Palsy (CP) it is important to clearly identify the functional abilities of each child in order to establish the aims of orthotic intervention. Although more than half of children with bilateral spastic CP walk independently with or without an assistive device, most have gait-related problems, such as reduced speed and/or an increased energy cost of walking. A multidisciplinary team including an orthotist, physical therapist and orthopedic surgeon can promote a continuum of care throughout development of a child with CP. According to the International Society of Prosthetics and Orthotics (ISPO), goals of lower limb orthotic management of cerebral palsy are to correct and/or prevent deformity; to provide a base of support; to facilitate training in skills and to improve the efficiency of gait. Other goals include increasing range of motion, maintaining or improving levels of function and stability; maintaining muscle length as the bones grow and preventing or overcoming some of secondary effects of the disability leading into adulthood. The type and design of orthosis is decided according to patient’s functional limitations (GMFCS) and can be changed periodically depending on the improvement of the patient condition. When an orthotic device is implemented successfully it will lead the child to achieve better joint motion and muscle function. Orthotics can provide a stable base of movement, improving gait pattern, reducing impact of spasticity on lower limbs and creating a better environment in which a child can function. As well as reducing excessive energy used to move, reducing muscular imbalance and potential risk of fall.  Orthotics is commonly prescribed to improve mobility in children with CP. However, clear concepts for orthotics management are missing in literature. Therefore, this workshop will describe our decision-making process of orthotics’ prescription in our practice, which is based on current best available evidence and our experience.

Biography:

Sadiya Zinjani has completed her Graduation from the prestigious Armed Forces Medical College in the state of Maharashtra in India. She is attached to the Max Hospital, Saket, Delhi, as Visiting Consultant but her major focus is her private clinic at her residence in Delhi, where she consults, conducts well baby clinics and does minor procedures. Her main interest is disease prevention.

Abstract:

This study was conducted some years back to assess the impact of excessive and unsupervised television viewing in children (5-15 years) in urban and rural settings in North India. This cross-sectional study was carried out in the out-patient department of Rural Health Training Centre (RHTC) and in the Urban Health Training Centre (UHTC) of the department of community medicine, J. N. Medical College, Aligarh. 47 children from RHTC and 53 children from UHTC were interviewed and the answers noted in a prepared questionnaire, which included questions on the children’s background, viewer-ship patterns, situation of TV in the house, time spent watching TV by the child, programmes watched, outdoor activities, behavioral changes, study time, supervised or unsupervised TV viewing and changes in health and behavior attributed to TV. The findings were then computerized and analyzed using SPSS 17. The study revealed that most children watched TV for more than 2 to 3 hours per day, the patterns being different in rural and urban areas. The time of day that children watch TV and the type of programmes watched were different in the two settings. In both groups, children liked to eat while watching TV. In rural areas TV viewing was rarely supervised. A large number of children watched violent and horror programmes, especially in rural areas. This we felt was responsible for the behavioral problems reported by the parents in the teens and pre-teens. Excessive TV viewing with reduced play time and increased consumption of junk food had we felt, a direct relation to rapid weight gain noted in the subjects under study. Here however obesity was more marked in urban children vis-a-vis rural children. Finally, excessive TV watching with the associated reduced social interaction negatively impacted the development of social, language and creative skills in both urban and rural children.