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.