Day 2 :
- Special Session
The Children’s Medical Centre, UAE
Title: Improving motor function of children with cerebral palsy: What is the rational of early intervention?
Time : 10:00-11:00
Simone Battibugli is currently working as Pediatric Orthopedic Surgeon at The Children’s Medical Centre in Dubai. She has 10 years clinical and research experience as Faculty of Federal University of Sao Paulo. She has completed Pediatric Orthopedic Fellowship at Feinberg School of Medicine at Northwestern University, Children’s Hospital, Chicago, USA and also as a Pediatric Orthopedic Fellowship at Shriners Hospital for Children, Lexington, USA. Her interests are in (1) Evidence based nedicine (2) Systematic literature review (3) Management and clinical research on neuromuscular disorders; as cerebral palsy, spina bifida and arthrogryposis multiplex congenital and (4) Congenital foot and lower limb deformities and other congenital and acquired musculoskeletal pathologies in children.
Cerebral palsy is the result of a non-progressive lesion or injury to developing brain and has multiple causes and clinical manifestations, making a discussion on diagnosis and screening challenging. In the past, the diagnosis of cerebral palsy was largely a clinical diagnosis, with the development of imaging it has been recommended that clinical diagnosis of cerebral palsy should be confirmed by imaging. Although difficult, early diagnosis is extremely important as it provides opportunity early intervention. Recently, there is a renewed interest in qualitative assessment of general movements in newborns. This cost effective diagnostic tool consists of observing the infant’s spontaneous movements with promising results providing high specificity and sensitivity. Poor control of muscles and movement in children with cerebral palsy can be associated with a wide range of functional challenges. Traditional efforts to manage these motor disabilities have been directed to improving tone and promoting adequate motor patterns. Contemporary approaches to treatment are addressing muscle weakness as a common element of functional problems with encouraging results. Brain and muscle plasticity in response to specific types of therapy has been demonstrated in CP. The amazing developmental changes of the brain between preterm age and the age of 1 year post-term offers opportunities for early intervention. The goal of motor training is to optimize the development of skilled motor function. Fixed contractures are managed by lengthening of the muscle-tendon unit by the technique that delivers the safest and most effective surgical technique that gives appropriate amount of lengthening of the muscle for the child in question. Given that cerebral palsy presents at early in infancy and persists throughout an individual’s lifetime, the disorder needs to be thought of and managed in the context of development, functioning with a family based and community integration.
- Young Research Forum
Children’s Hospital of Philadelphia, USA
Time : 11:30-12:00
Rui Wang is an experienced RN, worked in neonatal nursing field for 24 years. She has multiple certifications related to neonatal nursing, PICC RN, RNC-NIC, ECMO, SDU (special delivery unit RN), BRN (breastfeeding resource RN). She serves as a Clinical Resource Nurse for bedside nurses, clinicians and families. She has successfully placed close to 400 PICCs for neonatal patients; the smallest patient weighed 450 grams. She was named as one of NICU PICC RN team co-leaders since May 2016. She has created online community for PICC team in 2016, which serves as an efficient communication and data collection tool.
Staff nurses sought to shorten time to central line access for a vulnerable population. This harm prevention initiative included reducing injury from peripheral intravenous lines. Critically ill infants often require long term parenteral medications and nutrition. More consistent delivery, along with lowered risk of injury from PIVs are benefits of Peripherally Inserted Central Catheter (PICC) access for neonates. Many factors are related to timely line placement such as location of procedure; NIICU bedside versus interventional radiology, expertise of staff for insertion and patient safety. We sought to increase bedside PICC access as best practice. Ten experienced registered nurses in our NIICU were selected. The group completed required pediatric PICC qualification training to function independently. The team's objectives included shortening time to PICC placement, reducing patient harm by decreasing PIV extravasation and infiltrates and decreasing Central Line Associated Blood Stream Infections (CLABSIs), thereby contributing to decrease costs and shortened length of stay. Team leaders developed resources to facilitate communication and guide practice using a web-based community to improve efficiency and provide data collection tools to track outcomes; also creating an algorithm for PICC placement, annual competency for PICC team and a bedside PICC attempt job aid. Positive outcomes included: Decreased PICC waiting time, increased number of PICC lines placed at bedside versus patient transport to IR, limiting time delay and potential infant safety risks and significantly decreased in grade 3 and 4 PIV infiltrations. Based on positive outcomes of this nurse-led project, PICC team provides 24*7 care for NIICU patients.
Brianna Twomey is currently working in St. Vincent's Hospital, Melbourne, Australia.
Introduction: Bezoars are collections of indigestible foreign material in the gastrointestinal tract that are further classified according to their composition.
Case Description: We report a case of a small bowel obstruction secondary to a trichobezoar in a 6 year-old-female requiring an emergency laparotomy and enterostomy.
Literature Review: A review of the literature was conducted to identify reports similar to our case. Data regarding clinical presentation, complications and management was extracted and evaluated.
- Poster Presentation
BP Koirala Institute of Health Sciences Dharan, Nepal
Title: Effectiveness of video-clip intervention related to birthing process on behavioral responses of women during labor at BPKIHS, Dharan Nepal
Time : 14:00-14:30
Nirmala Pokharel has her expertise in Maternal Health Nursing. Her research and publications related to Advanced Maternal Age of Pregnancy among women and Practice of Nurses in the Prevention of vertical transmission of HIV in Selected Hospital of Eastern Region of Nepal.
Background & Aim: Normal labor though a widespread term yet needs a crystal clear concept because birthing is a personal experience and perception differs in individually. Open and guided instructions in the form of a video-clip can impact a parturient perception and encourage her to act for self. The study aims to find the effect of video-clip intervention related to birthing process on behavior responses of primigravid women.
Method: An experimental study was conducted at antenatal ward and labor room of BPKIHS, Dharan from 24th Dec 2018-14th-21st Jan 2018. Total 30 respondents were divided randomly into two equal groups. Experimental group were given a 6-7 minute videoclip intervention about physiology of normal labour and behaviors to adopt during their first (latent) stage of labor and control group did not receive video-clip intervention. Both the group’s behavior was observed in first (active) stage of labor, hourly five times. Data was analyzed using Pearson’s Chi-square, Independent t test, Fisher exact and Mann-Whitney test.
Result: Most of the respondents belonged to age group 25-30 years in both the groups with mean age difference of 3 years. Experimental group had a higher mean behavior score of 180.73 as compared to 124 score in control group with (P<00.1) which shows a good statistical significance and shows the effect as a result of the intervention. The mean difference of scores between the two groups was 56.73. The findings articulate that experimental group had better behavior outcome as compared to the control group. There is no association between socio-demographic variables with behavior scores of respondents in both groups considering Chi-square and Fisher`s exact test (P<0.05).
Conclusion: Video-clip intervention was effective on improving the behavior responses of primigravid women during labor.
BP Koirala Institute of Health Sciences Dharan, Nepal
Title: Practice and problems associated with menstrual hygiene among homemaker women of reproductive age residing in a selected ward of Dharan, Sunsari, Nepal
Time : 14:00-14:30
Angur Devi Dhital has her expertise in community health nursing and reproductive health in improving the health and wellbeing of common people. Her research and publications related to her expertise have contributed to the nursing science and education. She has experience of research, evaluation, teaching and administration both in community and education institution. Her most favored professional interest is teaching the nursing students of both bachelor and master levels.
Introduction & Aim: Menstruation is a part of the female reproductive cycle that starts at the time of puberty. Any faulty belief or pertaining to menstruation will affect the health of large number of women in reproductive age group. The aim of the study were to assess practices and problems associated with menstrual hygiene among homemaker women of reproductive age residing in the selected ward of Dharan sub-metropolitan city and to find out the association between practices and problems associated with menstrual hygiene with the selected socio-demographic variables.
Method: Descriptive cross-sectional study design was used to conduct the study. Total 110 respondents meeting the eligibility criteria were included in the study using non-probability purposive sampling technique. Data were collected using semi-structured interview questionnaire. The data were entered in excel and analyzed using SPSS.
Result: About half i.e. 56 (50.9%) of the respondents were between 21-30 years. Majority i.e. 86 (78.2%) of the respondents was Hindu and 88 (80%) of respondents were literate. Almost entire i.e. 108 (98.2%) respondents were married. More than half i.e. 60 (54.5%) of the respondents had inadequate practices and about 78 (70.9%) of the total respondents experienced problems associated with menstrual hygiene.
Conclusion: The socio-demographic characteristics like age and educational status were only associated with practice regarding menstrual hygiene among the women of reproductive age residing in ward no-5, Dharan Sub-Metropolitan City.