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

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!