Scientific Program

Day 1 :

Keynote Forum

Bariah Dardari

Integrative Pediatrics Consultant, UAE

Keynote: Sensory Processing Disorder

Time : 10:00-10:40 am

Biography:

Dr Bariah is a leading expert in child health, with more than 15 years’ experience. She graduated with a Doctor of Medicine degree from Damascus University School of Medicine in Syria, then completed her training in New York Methodist Hospital/Weill Cornell Medical Center, obtaining certification from the American Board of Pediatrics in 2002.

In 2005, Dr Bariah transferred to Hackensack University Medical Center where she was part of a busy neonatology team providing care for extreme-premature and high-risk infants, as well as supporting the labor and delivery department.

Dr Bariah started her role as Consultant Pediatrician at American Hospital Dubai in 2006, providing care for premature newborns, inpatient care for all pediatric patients on the ward, emergency care and treatment such as biomedical interventions. She also assessed patients with ADHD and autism. Dr Bariah then joined Al Zahra hospital as a Head of the Pediatric Department in 2013 and was leading a team of 25 doctors providing care to high risk/ premature infants at the level III NICU; the well newborns in the newborn nursery and labor ward; the acutely ill pediatric patients admitted to the pediatric ward; and pediatric patients from 0-16 years old in the pediatric clinic for well-child checkups, vaccinations and sick visits. She also assessed and treated patients with developmental delay, speech delay, autism and ADHD.

Dr Bariah obtained Board certification in Integrative and Holistic Medicine in 2014. She established the first pediatric integrative medicine clinic in the UAE. She also completed a Global Executive Degree in Safety, Quality, Informatics and Leadership (SQIL) at Harvard Medical School in 2017. She is a Member of the American Academy of Pediatrics, and an Associate of Harvard Medical School.

She is fluent in English, Arabic, Spanish and French.

 

Abstract:

Sensory processing disorders (SPD) affect 5–16% of school-aged children can cause long-term deficits in intellectual and social development. Current theories of SPD implicate primary sensory cortical areas and higher-order multisensory integration (MSI) cortical regions.Over 90% of children with Autism Spectrum Disorders (ASD) demonstrate atypical sensory behaviors. However, there are children with sensory processing differences who do not meet an ASD diagnosis but do show atypical sensory behaviors to the same or greater degree as ASD

What is the prevalence of SPD?

In a study of children born between July 1995 and September 1997 in the New Haven, CT area 16% of 7 to 11-year-old had symptoms of SPD-SOR (Ben-Sasson et al., 2009). That is the same as 1 in 6 children study in younger children (Ahn et al., 2004) found a prevalence of 5%, which is 1 in 20 children. Children with(ASD) experience high rates of anxiety, sensory processing problems, and (GI) problems; however, the associations among these symptoms in children with ASD have not been previously examined. Risk factors: history of major maternal stresses during pregnancy, fetal distress, jaundice, significant childhood illnesses including chronic ear infections, sleeping and eating problems, and an absent or brief crawling phase, language delays, and a lack of separation from parents and mastery of motor skills by age three.

 

  • Pediatrics | Neonatology and Perinatology | Neonatal Congenital Effects
Location: Fleming Hotel Wien-Westbahnhof Neubaugurtel, Vienna Neubaugurtel 26-28, 1070 Wien, Austria Austria

Session Introduction

Laura Castells

Head of the Neonatal Department of Hospital Universitari General de Catalunya , Spain

Title: Lethal Perinatal Hypophosphatasia: Case Report
Speaker
Biography:

Dr. Laura Castells is a trained and board certified Pediatrician and Neonatologist. She has a long-running interest in congenital cytomegalovirus infection as well as in genetic and rare diseases. She is currently head of the Neonatal Department of Hospital Universitari General de Catalunya (Barcelona, Spain).

 

Abstract:

Hypophosphatasia (HPP) is a rare metabolic bone disease caused by loss-of-function mutations in the gene ALPL encoding the tissue nonspecific alkaline phosphatase (TNSALP).

In HPP, loss of function in ALPL-gene leads to high levels of inorganic pyrophosphate and pyridoxal phosphate which inhibits bone matrix calcification.

Here, we describe a newborn male with perinatal lethal HPP diagnosed after birth.

Prenatal ultrasound at 28 weeks showed femur length shortness. There was no previous family history of bone disease.

The patient was delivered by scheduled cesarean section at 37 weeks of gestation, requiring invasive ventilation immediately upon birth due to severe respiratory insufficiency.

Diagnosis of HPP was confirmed by low-serum ALP activity <20 UI/L (normal reference range 530-1610 UI/L 0-14dy) and whole body X-ray showing severe bone hypomineralization, and thoracic and pulmonary hypoplasia.

Pyridoxal 5’-phosphate (PLP) levels in plasma were >200 nmol/l (normal reference range 23.0-172.5), and phosphoethanolamine in urine was 7567 mcmol/g (normal reference range below 150), both substrates of TNSALP that accumulate endogenously in HPP.

Respiratory insufficiency due to the severity of this metabolic systemic disease, led to fatal outcome on day three after birth.

Further sequence analysis of ALPL using genomic DNA identified that the patient was heterozygous for two mutations: one in axon 5 of ALPL (p.Arg138Pro), previously unreported, and one in intron 5 of ALPL (c.473-2G>C), previously described. The parent DNA was analyzed being both of them heterozygous carrier.

Yacob Mathai

Chief Physician, Marma Health Centre,India

Title: The Purpose of Temperature of Fever
Speaker
Biography:

A practicing physician in the field of healthcare in the state of Kerala in India for the last 29 years and very much interested in basic research. My interest is spread across the fever , inflammation and  back pain,. I am a writer. I already printed and published nine books in these subjects. I wrote hundreds of articles in various magazines.

I presented 9 research papers in Indian Science Congress 2008 to 2017.And 2 papers selected for the coming 2018 Indian science congress. I presented 2 papers in kerala science congress2014and 2017.

After scientific studies for a long time, we have developed a theory, Which proves the temperature of fever is to increase blood circulation. we have developed 8000 affirmative cross checking questions. It  can explain all queries related with fever and  it considers the messages of the  body and the facts of physics

 

Abstract:

When the disease becomes threat to life or organs blood circulation decreases, Temperature of fever will emerges to increase prevailing blood circulation. And it acts as a protective covering of the body to sustain life.

When blood flow decrease to brain, the patient becomes fainted-delirious .If we try to decreases temperature of fever, the blood circulation will further reduced. Blood circulation never increases without temperature increase. Delirious can never be cured without increase in blood circulation.

The temperature of fever is not a surplus temperature or it is not to be eliminated from the body. During fever, our body temperature increases like a brooding hen`s increased body temperature.

The actual treatment to fever is to increase blood circulation.                           

Two ways to increase blood circulation.                                           

1. Never allow body temperature to lose                        
2. Apply heat from outside to the body. When the temperature produced by body due to fever and heat which we applied on the body combines together, the blood circulation increases.

Then body will stop to produce heat to increase blood circulation. And body will get extra heat from outside without any usage of energy.

How can we prove that the temperature of fever is to increase blood circulation?

If we ask any type of question related to fever by assuming that the temperature of fever is to increase blood circulation  we will get a clear answer. If avoid or evade from this definition we will never get proper answer to even a single question

If we do any type of treatment  by assuming  that the temperature of fever is to increase blood circulation , the body will accept, at the same time body will resist whatever treatment to decrease blood circulation.

No further evidence is required to prove the temperature of fever  is to increase blood  circulation. 

 

George Puplampu

Specialist in pediatrics at Juvenile/Children`s Health centre ltd, Ghana

Title: The need to do rectal examination on newborns with recurrent gaseous distension of the abdomen
Speaker
Biography:

Abstract:

Congenital Anal Stenosis occurs as a result of development aberration of the Gastrointestinal System, during the embryonal developmental period.  The occurrence being one in every 5000 live births (1:5000) (This is the incidence for all anorectal malformations not anal stenosis alone).  It may be necessary to consider routine digital rectal examination of the newborn in cases of recurrent meteorism (gaseous distention of the abdomen) in the neonatal period to avert more serious complications in case, the diagnosis is missed in this critical period. 

In low income countries, where paediatric surgeons are scarce, it may be necessary for the few paediatricians available to employ simple methods for diagnosis as well as therapy for congenital anal stenosis. Not all congenital anal stenosis can be treated by dilatation alone. In some cases, the finger may not be able to enter till smaller dilators are used. In others a surgical procedure such as posterior sagittal anoplasty may be required.

This is done through the cautious insertion of the well-lubricated gloved fifth finger in the anus. This method will work for some types of anal stenosis but not for all types. This would normally cause the anal muscles to relax without pain to the newborn.  In case the newborn should start crying as the examiner’s finger reaches the tight anal ring, this is at the same time a signal for the parents and the examiner that we are dealing here with the diagnosis congenital anal stenosis; the post digital dilatation process may result in gushing out of the residual watery stool and flatus after removal of the finger and this further more confirms the diagnosis, congenital anal stenosis to the parents as well.

To avert late serious complications of the gastrointestinal system as a result of missed diagnosis in the neonatal period, it is recommended that digital examination be done on any newborn with recurrent gaseous distention of the abdomen despite medications.

In conclusion, as it is mandatory to examine every casualty with abdominal problems rectally likewise it can be said that newborns with abdominal challenges should also be examined in that manner all the time, This may prevent complications in those with anal stenosis who respond to this treatment. It would also aid early diagnosis in those who may need referral to a surgeon for further management.

 

Speaker
Biography:

Evaline Maziku has completed her Masters from university of Dodoma and Bachelor of Science in Nursing from St John University of Tanzania, Also has a Diploma in clinical medicine from Lindi clinical officer college, Tanzania. She is the assistant Regional Reproductive and Child Health Coordinator. She is on final preparation to published more than two papers in pediatric infectious disease journal from the two research she did in Tanzania.

 

Abstract:

Background: Effective management of neonatal sepsis is essential in reducing mortality and  complications due to septicemia, for which an accurate diagnosis remains challenging in developing countries, due to lack of well-equipped laboratories and resources.

Objectives This study intended to determine the etiology and clinical features associated with blood culture positivity, among neonates with clinical sepsis admitted at Dodoma Regional Referral Hospital.

Methods: A cross–sectional study was carried out on 194 neonates admitted with clinical sepsis at Dodoma Regional Referral Hospital, from March to June, 2017. A total of 194 blood samples for culture and sensitivity were taken according to standard aseptic procedures. Clinical and other laboratory data were analysed. Logistic regressions model was used to identify possible clinical features associated with positive blood culture.

Results: Among the 194 study new-borns with clinical neonatal sepsis, 55 (28.40%) had blood culture positive, the most isolates were Coagulase negative Staphylococci n (45.50%). Most isolates were resistant to Ampicillin, whereas most of the isolates had highest sensitivity to Amikacin and Clindamycin. After adjusting for potential confounders, the abdominal distension (AOR 0.263, 95% CI [0.088- 0.787], p <0.001), signs of skin infections (AOR 0.179, 95% CI [0.029-1.124], p < 0.01), umbilical pus discharges (AOR 5.745, 95% CI [1.654-19.957] P<0.001) were independently associated with positive blood culture.

Conclusions: Usage of WHO clinical criteria only for the diagnosis of neonatal sepsis may overestimate the prevalence of neonatal sepsis leading unwarranted use of antibiotics.  The study has shown majority of the bacteria isolates in new-born with sepsis are resistant to first line antibiotic. Frequently research will guide the empiric treatment for neonatal sepsis.

 

Yacob Mathai

Chief Physician, Marma Health Centre,India

Title: During fever, why our body acts against Facts of Physics?
Speaker
Biography:

A practicing physician in the field of healthcare in the state of Kerala in India for the last 29 years and very much interested in basic research. My interest is spread across the fever , inflammation and  back pain,. I am a writer. I already printed and published nine books in these subjects. I wrote hundreds of articles in various magazines.

I presented 9 research papers in Indian Science Congress 2008 to 2017.And 2 papers selected for the coming 2018 Indian science congress. I presented 2 papers in kerala science congress2014and 2017.

After scientific studies for a long time, we have developed a theory, Which proves the temperature of fever is to increase blood circulation. we have developed 8000 affirmative cross checking questions. It  can explain all queries related with fever and  it considers the messages of the  body and the facts of physics

Abstract:

According to the facts of physics, if temperature increases, thermal expansion of an object is positive it will expand and with decrease of temperature it will shrink. Pressure will increase due to increase of temperature.

On the contrary, during fever we can see blood vessels and skin are shrunk, pressure decreases, body shivers, sleep increases, motion decreases, inflammation increases, body pain increases, blood circulation decreases, dislike cold substances etc. In fever, the firing rate of Warm sensitive neurons decreases, and the firing rate of Cold sensitive neurons increases. At the same time if we apply hotness from outside by thermal bag or if we drink hot water, our body acts according to the Facts of Physics- increase of temperature pressure will also increase, expands blood vessels and skin, body sweats, motion will increase, inflammation will decrease, body pain will decrease, blood circulation will increase, like cold substances etc.

During fever, why our body acts against Facts of Physics? when disease increases, pressure and temperature will decrease. Blood circulation will decrease due to decrease of pressure. If the essential temperature of the body is going out, essential temperature and pressure will further decrease. This will further endanger the life or action of organ. When disease increase, it is the sensible and discreet action of brain that tends to act against facts of physics to sustain life or protect organ. There is no way other than this for a sensible and discreet brain to protect the life or organ.  We will get a clear answer if we find out the purpose of fever, sensible and discreet action of brain. No medical books clarify this1

During fever, if the temperature of fever is not a surplus temperature or if it is not supposed to be eliminated from the body, the shrinking of skin and blood vessels, shivering of body, dislike towards cold substances etc are a protective covering of the body to increase blood circulation to important organs of the body it is against the facts of physics.

 

 

  • Pediatric Pulmonology | Pediatric Critical Care
Location: Fleming Hotel Wien-Westbahnhof Neubaugurtel, Vienna Neubaugurtel 26-28, 1070 Wien, Austria Austria

Session Introduction

Saif Awlad Thani

Pediatric Intensivist, Oman

Title: Pulmonary Hypertensive crisis
Speaker
Biography:

Dr. Saif Awlad thani is a pediatric Intensivist from  Sultanate of Oman. He finished his medical school in Sultan Qaboos   University and pediatric residency in Oman Medical Specialty board in Oman. He finished his PICU fellowship in McMaster university in Canada. Currently he is working in a tertiary hospital in Oman and acting as deputy director of cardiac ICU. He is the founder and leader of pediatric home ventilation team. He is interested in improving quality of care and PICU patient’s outcome. He participated in pilot RCT and qualitative study about early mobilization in critically ill children. He is interested in research and education and working in many research project and coordinating PICU teaching for PICU residents.             

Abstract:

Patients are often confined to bed rest for prolonged periods of time as they are perceived to be “too sick” to be mobilized (1). However, multiple adverse physical, neuromuscular, metabolic, and cognitive sequelae of immobility during critical illness are increasingly recognized (2). Survivors of critical illness are at risk of prolonged weakness, functional disability, and delayed recovery, resulting in suboptimal quality-of-life and high healthcare utilization costs (3-4. Prolonged immobility increases the risk of critical illness-acquired morbidities such as ICU-acquired weakness, delirium and sedation withdrawal, which in turn negatively impact on a patient’s duration of mechanical ventilatory support, length of stay, and even mortality (6).

A lot of clinicians are reluctant to mobilize critically sick children due to various factors including but not limited to: lack of knowledge of mobility importance, unawareness of current evidence, safety issue, lack of personnel and limited equipment and fear of adverse events (7).

Current evidence suggests that early mobility-based rehabilitation in critically ill patients can attenuate the complications of immobility and critical illness-acquired morbidities (8). Early mobilization (EM) may reduce the risk of delirium, improve functional recovery, and reduce overall resource utilization in (7). There are various modes of mobilization in critically ill children that varies according to age, baseline functional and cognitive status and clinical condition of the child. Therefor degree of mobilization should be individualized and developmentally appropriate in order to be successful, effusive and safe (8).We published recently an RCT pilot study evaluation feasibility of in-bed mobilization by cycle ergometer in addition to usual care physiotherapy to enhance early mobilization and we found safe with no adverse events that tell us the early mobilization can be achieved by different way and by new technology (9)    

Kaveri Subbiah

Professor at Sri Ramachandra medical college and research institute, India

Title: Comparison of Clinical Profile of Bronchiolitis in Children with and without RSV Infection.
Speaker
Biography:

Abstract:

INTRODUCTION – Acute bronchiolitis is a frequent cause of LRI in the first two years of life. RSV is the most common cause of LRI in children less than 1 yr.

OBJECTIVE – To identify the clinical features in infants with bronchiolitis and to compare the clinical severity and outcomes of those with and without RSV infection.

METHOD -  The study will be done with the approval of Institutional ethics committee and the written consent of the parents.

Type of study: Prospective, Cohort study.

Study setting: Department of  Paediatrics, SRMC and RI.

Study period: July 2016 – July 2018. (sample collection – July 2016 – July 2017).

Sample size: 150.

RESULTS-

The clinical profile of 150 children below 2 yrs was studied. 60 % boys and 40 % girls, 48.4% were below  6 months, 38% between 6 and 12 months and 14.6% above 12 months. Environmental factors, nutritional status and RSV status were studied. 53 % were RSV positive and 47% were negative. The clinical severity and number of recurrences between RSV positive and negative were studied. RSV positive cases were more severe and had more recurrences but the difference was statistically insignificant.

Speaker
Biography:

Abstract:

BACKGROUND: Among the many factors influencing the prevalence of asthma in developing countries from the tropics are geo-helminthic infections.

AIMS: This work aims to study the relation between bronchial asthma and parasitic infestation in Egyptian children.

PATIENTS AND METHODS: A cross-section, analytical study design was chosen to perform this research on 100 school aged children. All children were interviewed and examined clinically and laboratory.

RESULTS: Statistically significantly Negative correlations were found between blood level of IgE and FEV1% of predicted in patients with bronchial asthma as well as patients with parasitic infestation with r=-0.381, -0.325 at p=0.006, 0.021 respectively.Inverse relationship was found between blood level of IgE and FEV1/FVC% in patients with parasitic infestation with r= -0.358 with statistical significant difference at p=0.011.

CONCLUSIONS: 86%of patients with bronchial asthma lived in urban areas, while 64% of patients with parasitic infestation lived in rural areas.

 

Speaker
Biography:

Dr. Saif Awlad thani is a pediatric Intensivist from  Sultanate of Oman. He finished his medical school in Sultan Qaboos   University and pediatric residency in Oman Medical Specialty board in Oman. He finished his PICU fellowship in McMaster university in Canada. Currently he is working in a tertiary hospital in Oman and acting as deputy director of cardiac ICU. He is the founder and leader of pediatric home ventilation team. He is interested in improving quality of care and PICU patient’s outcome. He participated in pilot RCT and qualitative study about early mobilization in critically ill children. He is interested in research and education and working in many research project and coordinating PICU teaching for PICU residents.                      

Abstract:

Patients are often confined to bed rest for prolonged periods of time as they are perceived to be “too sick” to be mobilized (1). However, multiple adverse physical, neuromuscular, metabolic, and cognitive sequelae of immobility during critical illness are increasingly recognized (2). Survivors of critical illness are at risk of prolonged weakness, functional disability, and delayed recovery, resulting in suboptimal quality-of-life and high healthcare utilization costs (3-4. Prolonged immobility increases the risk of critical illness-acquired morbidities such as ICU-acquired weakness, delirium and sedation withdrawal, which in turn negatively impact on a patient’s duration of mechanical ventilatory support, length of stay, and even mortality (6).

A lot of clinicians are reluctant to mobilize critically sick children due to various factors including but not limited to: lack of knowledge of mobility importance, unawareness of current evidence, safety issue, lack of personnel and limited equipment and fear of adverse events (7).

Current evidence suggests that early mobility-based rehabilitation in critically ill patients can attenuate the complications of immobility and critical illness-acquired morbidities (8). Early mobilization (EM) may reduce the risk of delirium, improve functional recovery, and reduce overall resource utilization in (7). There are various modes of mobilization in critically ill children that varies according to age, baseline functional and cognitive status and clinical condition of the child. Therefor degree of mobilization should be individualized and developmentally appropriate in order to be successful, effusive and safe (8).We published recently an RCT pilot study evaluation feasibility of in-bed mobilization by cycle ergometer in addition to usual care physiotherapy to enhance early mobilization and we found safe with no adverse events that tell us the early mobilization can be achieved by different way and by new technology (9)    

 

 

  • Young Research Forum
Location: Fleming Hotel Wien-Westbahnhof Neubaugurtel, Vienna Neubaugurtel 26-28, 1070 Wien, Austria Austria

Session Introduction

Elham Habibi

PhD Student at Pediatric Neurorehabilitation Research Center, Iran

Title: An approach towards promoting Iranian caregivers’ knowledge on Early Childhood Development
Speaker
Biography:

Elham Habibi has developed an educational package to promote Iranian parental knowledge about Child Development during her PhD thesis. This package contains early interventions for zero to three years old children. In order to Implement the package and evaluate its effectiveness, she and her colleagues assessed the level of knowledge of Iranian parents. In addition they searched on the most appropriate method of parents training as their attitude by qualitative research. Besides that, she is director of monitoring and evaluation office in Deputy of Research and Technology, Ministry of Health and Medical Education, Iran.

Abstract:

Introduction: According to the WHO, parents need to be informed about Early Childhood Development (ECD). Different methods of parents’ education include group-based, face-to-face, book, booklet, web-based, technology-based, and mobile learning using laptops, tablets, and cell phones. Paying attention to caregivers' attitudes is the first step to their education. The objectives of this study were to determine parental education requirements and the best approach towards promoting caregivers` knowledge about ECD, from the perspective of the Iranian main child caregivers.
Methods: A qualitative approach with directional content analysis method was used. Participants were selected through purposive sampling. Thirty-one child-caregivers participated in 5 individual interviews and 5 focus group discussions (FGDs). Participants were parents and grandparents that had less than the 36-month child (grandchild) and kindergarten staffs. Four criteria namely: validity, transferability, reliability, and verifiability were used to validate data.
Results: According to the perspective of participants, two main themes were requirements for parent education (educators, educational content, time, place) and approach to educate child caregivers (mobile learning, group and face-to-face education, electronic learning, media, physical resources), totally 98 sub-themes. Finally, the best approach to educate child caregivers was a multi-model approach includes group or face-to-face education with mobile learning.
Discussion: Participants suggested a multi-model approach based on traditional and modern technological methods, especially mobile learning (smartphone). They believed that the educational approach should be flexible and selectable, so caregivers can choose an appropriate individual method.
Conclusion: It seems that the multi-model approach is appropriate to promote Iranian parent or caregivers` knowledge.