29^th World Neonatal, Pediatric and Family Medicine Conference March 19-20, 2020 Amsterdam, Netherlands

Biography:

Jose Arnold Tariga has completed his Doctor of Philosophy in Development Education from Central Luzon State University, Philippines in 2019, Professional Diploma in Healthcare Administration from the American University of Ras Al Khaimah, UAE in 2015, Master of Science in Nursing (Major in Medical-Surgical Nursing) degree from Cebu Normal University, Philippines in 2012 and Bachelor of Science in Nursing in 2008. He is a Certified Professional in Healthcare Quality and is also Certified American Heart Association Basic Life Support Instructor. He is currently working as a Clinical Resource Nurse in Salma Rehabilitation Hospital based in United Arab Emirates where he is leading the Education and Training Department of the entire facility. He has published his researches in peer-reviewed journals and has also presented in various international conferences in UAE. He is a Member of the National League of Nursing and Sigma Theta Tau International Honor Society of Nursing based in US. With his valuable contribution in the healthcare community in the United Arab Emirates, he was recognized as the Healthcare Professional of the Year 2019 by The Filipino Times Awards in UAE.

Abstract:

Introduction & Aim: Nursing shortage is now becoming a global phenomenon with a projected need of 1.09 million nurses by 2024 in the US and a current shortage of 42,000 nurses in UK. According to DoH (2017), UAE will require 16,158 nurses by 2025. With the aim of developing a more sustainable solution for nursing shortage, the researcher developed a pediatric learning module to upskill adult-trained nurses and conducted this study to determine its effectiveness.

Method: The researcher utilized Solomon 4-Group Design to determine who will be assigned to receive the pretest, module and posttest. Data was collected using a test questionnaire and competency assessment checklists. Results were subjected to descriptive statistics and factorial analysis of covariance to assess if the demographic variables affect their level of knowledge and competency.

Figure 1: Module Development using ADDIE Model and the use of Solomon 4-Group Design to enhance knowledge and competency

Result: Results revealed that the module was successfully developed using the five stages of ADDIE Model namely: Analysis, Design, Development, Implementation and Evaluation. Majority of the respondents are married Asian females in their early adulthood, holding bachelor’s degree in nursing, with less than 5 years of experience. Factorial analysis revealed that demographic variables did not influence their level of knowledge and competency (p>0.5). The study also showed that the mean knowledge and competency levels of adult-trained nurses who received the module are significantly higher compared to those who did not undergo the module. Furthermore, the study revealed that there is a significant difference on the knowledge and competency levels between adult-trained nurses who used and did not use the pediatric module.

Conclusion: The Pediatric Adaptation via Learning Modules (PALM) initiative is effective in upskilling the skills and knowledge of nurses.

Biography:

Preetha Gopinathan Nair Sajidammal is an Associate Professor in International Institute of Health Management Research, India. She teaches Epidemiology, Research Methodology and Health Systems to the students of MBA Health Management. Her interest areas are non-communicable diseases and perinatal/ neonatal survival. She has led and been part of many research projects in public health. She has developed many research reports, case studies and scientific publications.

Abstract:

Low costs, high impact focussed interventions have been identified to improve neonatal survival. This paper assesses the health seeking for sick newborns who were declared seriously ill immediately after their birth and the constraints faced by the families to access care. The study was done as a social autopsy of a sample of 382 neonatal deaths which occured during a calendar year (January- December 2017) in four districts (Jhajjar, Rewari, Rohtak and Hissar) of Haryana in India.

Using a semi structured social autopsy tool, information on the final illness of the newborn was collected from the principal care taker. It was seen that 75% of the total sample of newborns (287/382), 60% of them males, were recognized to be seriously ill at or immediately after birth; 39% of them (113/287) died in the hospitals they were born or reached after delivering out of hospital. Majorities were early neonatal deaths, pre term and had low birth weight. Three quarters of them could not be breastfed. The most common reasons for referral to higher facilities were need for specialized care or lack of equipment or drugs or oxygen administration facilities or blood transfusion facilities.

Treatment was delayed for many newborns due to time taken in reaching the referral facilities. Families had to bear high out of pocket expenditure and had to overcome challenges of cost among others. It is imperative that intensive care facilities for newborns are strengthened at secondary and tertiary levels of care, also ensuring availability of drugs and equipment.

Biography:

Deepu Abraham is a Consultant Pediatrician and Neonatologist working at Zulekha hospital Dubai. He did his post-graduation and MD in Pediatrics from Kerala, India. He did his further Pediatrics and Neonatology subspecialty training from Midlands and London Hospitals in UK completing his CCT in pediatrics and neonatology. He has presented papers in multiple national and international conferences. His areas of interests include long term follow up of chronic lung disease and associated cardio pulmonary complications.

Abstract:

Kawasaki disease (KD) is one of the most common vasculitides of childhood. It is in fact the most common cause of acquired heart disease in childhood in the developed world. The underlying pathology is infiltration of inflammatory cells into vascular tissue resulting in predominantly medium-sized artery vasculitis with a predilection for the coronaries.

There are many diagnostic challenges for KD. These include absence of confirmatory laboratory or imaging investigations, dependence on clinical criteria to diagnose and the fact that presentation is often “incomplete”, especially in infant age group. The primary goal in KD treatment is to reduce inflammatory response early in the disease course there by preventing coronary complications.

The mainstay of treatment for KD is IVIG (Intra Venous Immunoglobulin) and aspirin therapy. However, there is an increasing incidence of patients who do not respond to IVIG therapy. The incidence of coronary complications is significantly higher in the refractory KD group of children. This presentation is looking into the diagnostic challenges and management options in refractory KD cases.

Biography:

Dhruba Shrestha has completed his MBBS from BP Koirala Institute of Health Sciences, Nepal and MD in Pediatrics from National Academy of Medical Sciences, Nepal. His special interest is in pediatric nutrition and non-invasive cardiology. He has done his special Postgraduate Diploma in Pediatric Nutrition from Boston University, USA. He has many publications in international and national journals. He is also an Executive Committee Member of Nepal Pediatric Society (NEPAS).

Abstract:

Streptococcus pneumoniae is considered as the leading cause of Pneumonia, Meningitis, Otitis media, Sinusitis and Septicaemia. WHO also estimates that 1 in every 20 children below 5 years of age will have an episode of pneumonia each year. S pneumoniae is the most important cause of pneumonia in young children. Pneumococcal Conjugate Vaccine (PCV) have shown efficacy against several serotypes of S. pneumoniae and it is now part of routine immunization schedule in many countries, including Nepal. PCV-10 was first introduced in Nepal on 18th January 2015 and is now included in National Immunization Schedule at 6 weeks, 10 week and 9 month of age.

This was a retrospective study conducted in the pediatric unit of Siddhi Memorial Women and Children’s Hospital. Data was reviewed from January 2014 to December 2018. There were altogether 601 children admitted due to pneumonia in the study period after exclusion 593 cases were eligible for analysis. 63% had diffuse involvement of lung in X-ray. PCV 10 was introduced in our hospital in October 2015 and there is significant decrease in the admission due to pneumonia after its introduction.

Most commonly used antibiotics were Crystalline Penicillin and Cefotaxime for treatment and both were equally efficacious. Failure rates were 8% and 1% respectively. To conclude, PCV is a very effective vaccine for S. pneumoniae. There has been dramatic decrease in the incidence of pneumonia since its introduction. Penicillin is still an effective drug for treatment of pneumonia.

Biography:

Magina Artikova studied at school Number 6 in Bukhara. From 2001 to 2008 she studied at Tashkent Pediatric Medical Institute (TPMI), faculty of pediatrics. From 2011 till 2017 she worked TPMI, assistant department Hospital pediatria. From 2018 till the present she has been working for researcher PhD at TPMI. Her scientific work is devoted to secondary oxalate nephropathy in children and the definition of disease development factors. She has studied the etiopathogenetic mechanisms of development of metabolic nephropathy in children, to develop a new methodology for effective therapy and prevent complication such uro and nephrolithiasis, urinary tract infection, chronic kidney disease.

Abstract:

Introduction & Aim: In recent years, there has been a steady increase in the number of children with hyperoxaluria along with various allergic pathologies. Hyperoxaluria is the main factor leading to the development of nephrolithiasis. The hyperoxaluria in children can be asymptomatic for a long time, leading to secondary oxalate nephropathy, urolithiasis and chronic kidney disease. Our objective was to assess the clinical features of patients with hyperoxaluria in combination with allergic pathology.

Materials & Methods: We observed 103 patients with secondary oxalate nephropathy (hyperoxaluria) aged 6 months to 7 years with a glomerular filtration rate above 60 ml/min. The median age of the patients was 3.48. All children underwent a general clinical examination: Oxalates in daily urine were determined, urine flow cytometry was performed, microalbumin in urine was determined, a general blood test, biochemical blood tests, determination of immunoglobulin E in the blood, bacteriological examination of feces for quantitative and qualitative composition of microflora were performed.

Results: Food allergies were identified in 18% of cases (9 patients), 7.7% of cases (8 patients) had urticaria, 23% (24 patients) had vasomotor rhinitis, 8.73% (9 patients) had atopic dermatitis. It was found that 28 children (27%) had a combination of allergic pathologies, such as vasomotor rhinitis and urticaria, atopic dermatitis and vasomotor rhinitis. In children with an existing allergic pathology, the clinical course of oxalate nephropathy was more pronounced than in children without allergic pathology. It was found that children with an aggravated allergic history were part of the often ill children group and therefore received frequent therapy with antibiotics in which the degree of hyperoxaluria was more pronounced, characterized by microalbuminuria and microhematuria.

Conclusion: The study showed that among children with hyperoxaluria a large number of children with allergic pathology were identified. Allergic pathology as a premorbid background often determines the peculiarity of the course of secondary oxalate nephropathy. In addition, the use of antibiotic therapy leads to a violation of the intestinal microbiome, which increases the risk of nephrolithiasis. Thus, allergopathology along with antibiotic therapy can be considered as risk factors for the adverse course of secondary oxalate nephropathy.

Biography:

Richa Prasad has been practicing as a dentist with special interest in Aesthetic and Restorative Dentistry, and provision of Botox and fillers, and Invisalign Orthodontics. In clinical practice, situations where young children have a low self-esteem due to the appearance of their teeth is common and often overlooked due to the empirical advantage of water fluoridation in oral health. This study and review of literature should highlight the less publicised downside of community water fluoridation and also points towards the innovative treatment methods that should be adopted to minimise the aesthetic impact on young children.

Abstract:

Introduction: Modern methods of caries control are individual and community based. Fluoridation of community water supplies was started as an efficient and costeffective way to reduce caries in the population. It has been named as one of the 10 great public health achievements of the 20^th century. However, with fluoride being more widely used in most dental products, the incidence of dental fluorosis appears to be on the rise. Traditional treatment for these white spot lesions has been highly invasive and not indicated in children. Low-viscosity resin-based materials are now proving to be game changers!

Aim: To assess the impact of water fluoridation on aesthetic appearance of teeth in children up to the age of 10 years and treatment with ICON resin infiltration.

Methods: Dean’s and Thylstrup and Fejerskov Fluorosis Index (TFI) was used to classify the degree and severity of fluorosis. A cross-sectional study was carried out among children along with review of literature about the incidence, effect and severity of dental fluorosis with community water fluoridation. Finally, treatment of dental fluorosis with minimally invasive methods for aesthetic improvement of the teeth was explored.

Results: ICON treatment is predictable (with case selection), is micro-invasive, and is a long lasting aesthetic solution that can be offered to growing children.

Conclusion: Awareness of fluoride intake with dental products, dietary fluoride and community water fluoridation is essential to prevent dental fluorosis. The advent of minimally invasive methods to treat white spot lesions has brought aesthetic treatment to children and is a valid micro-invasive alternative compared with traditional methods.

Biography:

Saraswati Budhathoki Shrestha has completed her Certificate Nursing from Madan Bhandari Memorial Nursing Campus, Bhadrapur, Nepal and Bachelor of Nursing from B.P. Koirala Institute of Health Sciences, Dharan, Nepal. She has worked in different hospitals of Nepal as a Nurse and also has experience in clinical research.

Abstract:

Vitamin D deficiency has been observed worldwide in pregnant women and their neonates. Maternal vitamin D deficiency can lead to deficiency in their newborn baby. It has been linked with various complications during pregnancy and delivery. There is risk of premature delivery and it is even linked with high neonatal mortality.79 pregnant women who came for delivery in the Siddhi Memorial Women and Children Hospital and their babies, after birth, were enrolled for the study. Maternal blood samples and umbilical cord blood samples of their babies were taken for the measurement of serum vitamin D and calcium level. Mean serum vitamin D and calcium level of pregnant mother before delivery were 14.67 ng/dl (8.5 SD) [95% CI (12.77- 16.58)] and 8.07 mg/dl (0.5 SD) [95% CI (7.89-8.26)] respectively. Similarly, the levels in the cord blood was 25.71 ng/dl (11.2 SD) [95% CI (23.23-25.81)] and 8.69 mg/dl (0.9 SD) [95% CI 8.48-8.89] respectively. Eighty-one percent (81%) of the mothers and 35.8% of their babies were found to have vitamin D deficiency. Although 97.5% of the pregnant women were taking calcium supplementation, serum calcium level was found to be lower than the normal reference value in 67% of the pregnant women and 64.2% of their babies. The study showed a positive correlation between the maternal and baby’s serum levels of vitamin D and calcium (p<0.001). There is high prevalence of vitamin D and calcium deficiency in pregnant mothers and newborn babies. Regular assessment of vitamin D and calcium level is essential during the pregnancy and pregnant women need to be supplemented with adequate amounts of these nutrients.

Biography:

Magina Artikova studied at school Number 6 in Bukhara. From 2001 to 2008 she studied at Tashkent Pediatric Medical Institute (TPMI), faculty of pediatrics. From 2011 till 2017 she worked TPMI, assistant department Hospital pediatria. From 2018 till the present she has been working for researcher PhD at TPMI. Her scientific work is devoted to secondary oxalate nephropathy in children and the definition of disease development factors. She has studied the etiopathogenetic mechanisms of development of metabolic nephropathy in children, to develop a new methodology for effective therapy and prevent complication such uro and nephrolithiasis, urinary tract infection, chronic kidney disease.

Abstract:

Introduction: Hyperoxaluria is the main factor leading to the development of nephrolithiasis. Hyperoxaluria in children can be asymptomatic for a long time, leading to secondary oxalate nephropathy, to urolithiasis and chronic kidney disease. The vast majority of kidney stones are calcium oxalate.

Limiting the intake of products containing oxalic acid is not the main way to prevent calcium oxalate microlites. In this regard, scientists were interested in the bacterium Oxalobacter formigenes, which exhibits a symbiotic relationship with the human body by reducing the absorption of oxalates in the intestinal lumen with a further decrease in their concentration in plasma and urine. Oxalobacter formigenes is currently the most effective intestinal absorbent microbial oxalate.

Objective: To determine the species and quantitative composition of intestinal microflora and Oxalobacter formigenes in feces in children with secondary oxalate nephropathy, who had a history of antibiotic therapy.

Materials & Methods: 35 children with secondary oxalate nephropathy (hyperoxaluria) aged 6 months to 7 years with a glomerular filtration rate above 90 ml/min were observed. The median age of the patients was 3.48. Children were divided into two groups: The main and control. The control group consisted of 10 children with secondary oxalate nephropathy with no history of antibiotic therapy. The diagnosis of secondary oxalate nephropathy was made according to the classification developed by M. S. Ignatova et al. and N.V. Voronina: moderate hyperoxaluria, pronounced oxalate-calcium crystalluria, microhematuria and/or proteinuria, increased microalbumin in the urine (tubular dysfunction). All children underwent a general clinical examination: Oxalates in daily urine, microalbumin in urine, bacteriological examination of feces for quantitative and qualitative composition of microflora, PCR identification of Oxalobacter formigenes in feces were determined. The severity of dysbiotic changes in the intestines in the examined children was determined taking into account the Industry standard 91500.11.0004-2003 “Protocol for the management of patients intestinal dysbiosis”.

Results: The results showed that all children in the main study group had higher levels of oxalate in daily urine of 1.2 mg/kg/ day (at a rate of 0-0.5 mg/kg/day) than in the comparison group (0.5 mg/kg/day). Gross or microscopic hematuria is found in 65% to 90% of children who have urolithiasis. All children in the main group showed a violation of the quantitative and qualitative composition of the intestinal microbiota. In the comparison group, no signs of intestinal microbiota disturbance were noted. Grade 2 dysbiosis predominated in severity in 18 children, in 2 children dysbiosis of 3 degrees was detected, in 4 children dysbiosis of 1 degree was noted. In 6 children with secondary oxalate nephropathy, Oxalobacter formigenes was not detected. It was found that children in whom Oxalobacter formigenes was not determined received a history of antibiotics of the 3rd generation cephalosporins group, Co-trimaxazole, more than 6 times for 12 months. In 21 children, Oxalobacter formigenes has been identified.

Conclusion: In most cases, in children with secondary oxalate nephropathy, the use of antibiotics was detected and a violation of the intestinal microbiota was found. In 5 children, Oxalobacter formigenes was not identified in feces.