Day 2 :
Amin Gohary completed his MB BCh in 1972 and his Diploma in General Surgery in 1975 at Cairo University, Egypt. Prof. Dr. Amin is well known in Abu Dhabi for his extensive interest and involvement in scientific activities. He is the President of Pediatric Surgical Association of UAE. Prof. Dr. Amin is also the founder and member of the Arab Association of Pediatric Surgeons. Currently, he is an external examiner for the Royal College of Surgeons.
In this presentation we are going to cover neonatal surgical emergencies with special references to gastrointestinal diseases. The role of the neonatologists and nurses will be highlighted together with details of the clinical presentations, radiological investigations and surgical management. We will cover our experience from 1995 to 2019 and discuss the importance of early referral for good outcome. Preterm babies need special care and this will be discussed separately
Saint Mary’s Hospital, UK
Anupam Gupta is a Consultant Neonatologist at Saint Mary’s Hospital, Manchester UK. He have trained and worked in world famous and prestigious pediatric and neonatal centers in India and UK and developed an expertise in neonatal ventilation and research. He was awarded his PhD by Durham University and he has carried out award winning projects and presented in prestigious international conferences like PAS, EAPS, ESPID, UENPS and helped to organize neonatal conferences here in the UK.
Introduction: Newborn infants often require support for their respiratory management. Ventilatory management of term and preterm infants is the most important and arguably most challenging part of NICU care. While it is a lifesaving modality, use of ventilation comes with its own risk of lung damage associated with ventilator induced lung injury. With the development of technology and increased resources, we are in a position to save very premature infants to babies with severe meconium aspiration syndrome. With increase in number of neonatal units a need for improvement in understanding of neonatal ventilation is more acute than ever.
Aim: To present and discuss a practical approach to neonatal ventilation based on current scientific and evidence base.
Method: By the end of the workshop, participants would be able to:
- Learn about historical evolution of ventilation in newborns.
- Learn about scientific principles underlying the different ventilation strategies.
- Learn about different modes of ventilation and how to choose the most suitable one.
- Learn about practical approaches to initiating, titrating and terminating mechanical ventilation in newborns.
- Learn about Pulmonary graphics and how their understanding can help in optimizing ventilation.
- Learn about high frequency ventilation in newborns and its use in difficult situations.
- Learn about ventilator induced lung injury and current evidence on strategies to reduce the impact.
- Learn about non-invasive ventilations – BIPAP/CPAP/HF
- Learn about less invasive surfactant administration (LISA) and its role in current practice
- Clarify practical dilemmas and difficulties with help of question and answer session
NMC Royal Hospital, UAE
Brankica Vasiljevic is the Head of Maternity and Child Health Services in NMC Royal Hospital DIP in Dubai, UAE. After completing her MD, she had completed her clinical postgraduate education (Pediatric and after that Neonatology fellowship) and academic postgraduate education (MSc in Pediatric and Ultrasonography field and PhD in Neonatology field) at Belgrade University School of Medicine in Belgrade, Serbia. She also completed Safety, Quality, Informatics and Leadership Program at Harvard Medical School in Boston, USA. She had won the ESPNIC Educational Grant at 5th World Congress on Pediatric Intensive & Critical Care in Geneva Switzerland (2007). She was a local coordinator for International Neonatal Immunotherapy Study-INIS for Serbia and Montenegro and participated in SIOP 93-01 Study, ITP Study and Twin Birth Study. She has published more than 35 international publications in international indexed journals (100 citations), 5 chapters in various fields of neonatal medicine and has more than 30 presentations in international conferences. She is a Member of Editorial Board of different international journals.
Each year 15 million babies are born preterm (<37 weeks of gestation (GA)) worldwide and their survival chances vary dramatically around the world. Most premature babies (>80%) are between 32 GA and 37 GA (moderate/late preterm). About 10% of preterm babies are born 28 to <32GA. Survival gap for preterm babies born in high-income countries and babies born in the low-income countries has widened dramatically. Multiple gestations are at increased risk for preterm delivery, intrauterine growth restriction, congenital anomalies and higher incidence of perinatal death. Prematurity is the leading cause of neonatal mortality and morbidity. Over 1 million children die each year due to complications of prematurity. Mortality is inversely proportional to birth weight (BW) and GA. Advances in neonatal intensive care during the last decades has decreased mortality in premature babies but morbidity is still high (at least 20-50%), especially in extreme preterm babies (<28 GA). The major neurodevelopmental morbidities (mental retardation, cerebral palsy, seizure disorders, hydrocephalus, visual or auditory impairment) in extreme preterm infants occur in approximately 20-30% survivors. Neonatal mortality rate for twins is 5 times more than in singletons. Discordant twins are present in 25% twins pregnancy (10x greater than singletons). In discordant small twins (IUGR) mortality is 6 times more than in concordant twins. Incidence of congenital anomalies is significantly related to the level of discordance (IUGR). Systematic team approach and safe and effective transport of high-risk mothers and newborns is an essential component of regional perinatal care and the goal is to provide the required level of specialized care.
- Neonatal Care| Women Health Nursing and Midwifery | Pediatric Nutrition | Pediatric Surgery
Location: MENA Plaza Hotel Albarsha | Dubai, UAE
Burjeel Hospital, UAE
The University of Manchester, UK
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.
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 20th 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.
Siddhi Memorial Women and Children Hospital, Nepal
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.
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.
Tashkent Pediatric Medical Institute, Uzbekistan
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.
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.