Day 1 :
- Neonatology and Pediatric
Session Introduction
Said Moustafa M, Eldeib
NMC Health Care Group, Abu Dahbi- UAE
Title: Necrotizing Enterocolitis in a Preterm Infant Newborn & Role of Feeding …. An Update!
Biography:
Dr. Said is a Pediatrician and Neonatologist whose experience in the field spans 15 years, backed by a higher education degree from royal college of pediatrics’and child health in UK,in addition to master degree from Ain Shams university in Egypt one of the oldest and top ranking universities in the MENA region. He is pioneering an open and contextual evaluation model based on constructive responses, which has led in the creation of new methods to improve pediatric healthcare, neonatology and pediatric nutrition. Dr. said has established this model following his years of experiences in medical practice, research and evaluation, and teaching and administration in hospitals and medical universities in the reigion, including Egypt, Kuwait and the UAE. Dr. Said has published studies in reputable international journals in neonatology and pediatric nutrition. He has also presented his findings in prestigious international conferences and symposia.
Abstract:
It’s a clinical case presentation of a male Preterm infant Newborn (+31 wks) who was delivered in our hospital & transferred to our NICU because of Prematurity, VLBW & need to respiratory support. Baby shortly undergo Necrotizing Enterocolitis (NEC) on 5th day of life shortly after start of expressed milk feeding …! Which was early detected by use of Near Infrared Abdominal spectroscopy (NIRS). Baby was deteriorated clinically in a couple of hours & undergo intestinal perforation with peritonitis , So, Abdominal exploration surgery with intestinal resection & end – to end anastomosis was done urgently.
Baby improved gradually & early feedings was started & gradually increased up to full feedings with use of Human Fortified Milk (HMF) & probiotics , Prebiotics.
Findings: The Study stated the evidence-based Feeding Strategies guidelines for necrotizing enterocolitis (NEC) among very low birth weight infants & Role of trophic feedings, Probiotics, Prebiotics & micronutrients in Prophylaxis, Prevention & Management of NEC.
Recommendations: 1) -Prematurity is the single greatest risk factor for NEC & avoidance of premature birth is the best way to prevent NEC. 2)-The role of feeding in the pathogenesis of NEC is uncertain, but it seems prudent to use breast milk (when available) and advance feedings slowly and cautiously. 3)-NEC is one of the leading causes of mortality, and the most common reason for emergent GI surgery in newborns. 4)-NEC remains a major unsolved medical challenge, for which no specific therapy exists, and its pathogenesis remains controversial. 5)-A better understanding of the pathophysiology will offer new and innovative therapeutic approaches, and future studies should be focused on the roles of the epithelial barrier, innate immunity, and microbiota in this disorder. 6)-Bioinformatics modeling is a new emerging strategy aimed at understanding the dynamics of various inflammatory markers and their application in early diagnosis and treatment.
Sitangshu Chatterjee
Apollomedics Superspeciality Hospital , India
Title: Posterior reversible encephalopathy in a child with anemia and hypertension
Biography:
Sitangshu Chatterjee is affiliated from Apollomedics Superspeciality Hospital , India
Abstract:
Posterior reversible encephalopathy (PRES) has been described In the literature as a clinic radiological syndrome characterized by CNS manifestations of a systemic disease of various etiology. Although its not a very common phenomenon in children, now a days its increasingly being recognized. We report a case of 9 yrs old child presented with one episode of focal seizure a day after blood transfusion while undergoing treatment for fever with anemia and hypertension. The inflammatory markers were raised without a specific etiological findings with a classical MRI picture. The patient was managed conservatively and discharged with normal neurological parameters.
PRES is often associated with hypertension especially in adults with superimposed inflammatory pathology and having a favourable outcome if intervened optimally. Clinical suspicion and a detailed MRI study is required in pediatric patients for a timely diagnosis.
Charles Sparrow
Casey Hospital, Monash Childrens Hospital, Melbourne, Australia
Title: How do doctors calculate medication doses in childhood obesity? A retrosepctive evaluation of prescriptions in paediatric patients in Casey Hosptial, Melbourne
Biography:
Dr Charles Sparrow studied medicine at the University of Southampton, United Kingdom, before completing his foundation training in Leighton Hospital, Mid Cheshire NHS Trust. He has been working in Australia since 2016, and is currently working in Paediatrics in Melbourne. Dr Linh Nguyen is a second year Paediatriac Trainee who studied medicine at Monash University, Melbourne. She has been working for Monash Health since graduating, and has an interest in Emergency Medicine.
Abstract:
Introduction - Pharmaceutical errors are a leading cause of unwanted side effects in paediatrics. With rising levels of childhood obesity worldwide, larger drug doses are being prescribed based on total body weight. To minimise harm, the Ideal Body Weight (IBW) is one suggested method for weight based calculations of certain medications in children, but not routinely used. We investigated the number of overweight children receiving medication doses based on IBW, and those on total body weight (TBW) in a paediatric ward in Melbourne, Australia.
Method - We performed a retrospective audit of children admitted as an inpatient over 1 month (January–Februrary 2019) and calculated those classified as overweight (>90th centile for weight on CDC growth charts). We used Scanned Medical Records to locate the data for each patient, and subsequently determined their weight, medications given, and if the calculated doses were based on IBW or TBW.
Results - 56 overweight patients were used, from an initial 126. 6 different medications were prescribed, of which 3.7% (n=2) doses were based on IBW, with 96.3% (n=54) prescribed based on the TBW. Paracetamol (n=45, TBW 95.6%, IBW 4.47%), and Ibuprofen (n=28, IBW 7.1%, TBW 92.9%) were the most common medications prescribed.
Conclusion - We are poor at prescribing medications based on IBW, with the majority of children prescribed doses based on TBW. Following this audit, we have created a proforma to be used to ensure the correct method of dosing is used for specific medications, to reduce potential long term side effects.
Narissa Juni
Senior private Clinic practitioner, Philippines
Title: TRENDS IN SUICIDE IDEATION AND SUICIDE ATTEMPTS AMONG FILIPINO ADOLESCENT EMERGENCY ROOM CONSULTS IN A TERTIARY HOSPITAL FROM 2016-2018
Biography:
Narissa Juni is a senior pediatrics resident in a JCI-accredited private tertiary hospital in Manila, Philippines. She finished her MD and MBA degrees in Ateneo de Manila University School of Medicine and Public Health, where systematic thinking and managerial applications to the medical field was emphasized alongside the clinical aspects of medicine. After obtaining her medical license, she worked in the Pharmacovigilance and Safety/ Regulatory Medicine Industry for 2 years before returning to the hospital to pursue her Pediatric residency
Abstract:
Background: There has been a worldwide increase in adolescent depression and suicide rates in the recent years. This objective of this study was to describe the trends and profile of Filipino adolescents who consulted at the Pediatric Emergency Room of a tertiary hospital who presented with suicide ideation (SI), suicide attempts (SA), or mortality from suicide from 2016-2018. Methodology: This is an ecological time series study. Data was obtained by a review of the Pediatric Emergency Room census from 2016-2018. The percentage of SI and SA encounters per month were obtained by dividing the number of SI and SA encounters by the total number of encounters in each month. Monthly trends were examined using an autoregressive integrated moving average (ARIMA) linear regression model. Characteristics of the population were summarized using percentages for categorical variables. Results: The number of SI and SA encounters almost doubled over the study period, increasing from 6.5 per 10,000 in 2016 to 12.5 per 10,000 in 2018. More than half of these consults resulted in hospitalizations, with 21.9% of admissions requiring intensive care. Over this period, total annual encounters for SI and SA increased by 66.67%. Upon analysis using the AutoRegressive Integrated Moving Average (ARIMA) time trend model, there is a significant increase (p-value: 0.09) in the monthly SI and SA encounters over the time period covered. This is consistent with reports of the progressively increasing prevalence of suicidality among adolescents worldwide. Other factors investigated such as sex, age, and seasonality were not significant statistically. Trends of categorical variables were consistent with worldwide adolescent populations. Conclusion: There was a significant increase in emergency room SI and SA encounters for adolescent patients over the time period of 2016-2018 in a tertiary hospital in Metro Manila, emphasizing the progressive prevalence of mental health issues among the Filipino Youth.