3^rd World Congress on
Pediatrics and Neonatology

Saw Hean Pat is a physician of pediatric and proffesional in newborn intensiive care unit at Chung Kang Branch, Cheng Ching General Hospital, Taichung, Taiwan. She completed her master of medical sciences and went on to earn her Ph.D from the Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan

Real-time continuous glucose monitoring (RTCGM) provides information about the direction, magnitude, duration, frequency, and causes of fluctuations in blood glucose levels. Compared with conventional intensified glucose monitoring, defined as three to four blood glucose measurements per day, continuous monitoring provides much greater insight into glucose levels throughout the day. Babies are more at-risk need routine blood glucose checks starting at about 2 hours of age and more frequently. Hypoglycemia or hyperglycemia might happened in those babies. Repeated painful procedures in the first days of life experience more intense pain and learn to anticipate it. Real-time continuous glucose readings that supply trend information can help identify and prevent unwanted periods of hypoglycemia and hyperglycemia. Real-time continuous glucose monitoring systems use a tiny sensor which inserted under the skin to detect and read the glucose levels in tissue fluid minute-by-minute and then transmits the data to a hand-held device. The aims of this study are to find out whether real-time continues glucose monitoring is correlated to intermittent blood sugar test and will detect more information of blood glucose fluctuation information in the high risk infants. By this way we will help the infants to avoid suffering from puncture pain, more accurate data collection and will help in the management.

Saw Hean Pat is a physician of pediatric and proffesional in newborn intensiive care unit at Chung Kang Branch, Cheng Ching General Hospital, Taichung, Taiwan. She completed her master of medical sciences and went on to earn her Ph.D from the Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan

Immature teratoma of the ovary is a rare entity in comparison with other ovarian cancers. The reported incidence is under 1%. Within the germ cell tumor group, it is the second most common malignancy. In women under 20 years of age, these tumors represent 10 percent to 20 percent of all ovarian malignancies. They may remain asymtomatic or may present with acute abdomen because of torsion, infection, or rupture. Treatment for an immature teratoma includes both surgery and chemotherapy depends on the age of the patient, staging and grading of the tumor. Early diagnosis associated with immediate therapy and close follow-up are essential for long term favourable outcomes since an uncommon recurrence of an immature teratoma has been reported. This case reflects the importance and challenging entity and requires awareness and a vigilant approach to reach the early diagnosis in case of abdominal discomfort or abdominal mass in children and adolescents which in turn helps to formulate appropriate management and treatment protocol causing least possible impact on life span and reproductive future in the young women.

Li Fang.Associate senior doctor. Doctor of urology. Specialized in diagnosis and treatment of urinary stone. Li Fang has been a urologist for 8 years since accomplished doctor research in Wuhan university. He focus on urinary stone treatment and prevention since 2012. He attended annual conference of south Korea Urology Association as a speaker on behalf of new generation of Chinese urologists. He visited University College London in 2013. He popularizes database of flexible ureteroscopy in 15 hospitals in China. His main research directions are flexible ureteroscpe laser lithotripsy, complex stone treatment with multi-endoscopies, standardized operational process of lithotomy and flexible ureterscopic database establish. He is one of the principle members of Cheng Yue stone clinic.

Background: To ascertain correct Shang Ring size for children circumcision with No Flip Technique. Material and Methods: 104 children participants aged 6-14 years were randomly assigned into three groups according to different ring-chosen methods for Shang Ring circumcision with no flip technique. Group A, the ring size was chosen according to the Shang Ring measuring tape; Group B, the ring size was consistent with the diameter of penis; Group C, the ring size was consistent with the diameter of glans. The operative time, foreskin dorsal slit rate, intra-operative and postoperative pain score, postoperative pain duration, and postoperative ring detachment duration, pain score of ring detachment, complications rate including postoperative edema, unsymmetrical foreskin, wound infection, wound dehiscence as well as postoperative satisfaction rate were compared.Results: Group A has the highest dorsal slit rate and the longest operative time. There were no significant differences in intra-operative pain duration, pain intensity, postoperative pain duration, postoperative ring detachment duration, and pain intensity during the ring detachment among three groups. The postoperative edema rate of Group A 40.62% was obviously higher than that of Group B 16.22% and Group C 2.86% (p<0.001). The unsymmetrical foreskin occurrence rates of three groups were 21.88%, 10.81% and 2.86% respectively, the difference (p=0.051) was obvious but not statistical at 0.05 level. Group C enjoyed the highest satisfaction rate and significant difference was found between Group A (97.14%) and Group C (75.00%). Further investigation showed that edema, unsymmetrical foreskin were increasing as the enlargement of difference between Shang Ring and glans, however, the satisfaction rate was decreasing simultaneously. Conclusion: The appropriate size of the Shang Ring device for children circumcision with no flip technique shall NOT be ascertained according to the reading of Shang Ring measuring tape, but the diameter of glans. Image

Dulat Tazhibaeyv is head of radiology department in National Medical university Astana in Kazakhstan.

Purpose: To evaluate fibroid size using ultrasonography (US) and magnetic resonance imaging (MRI) after uterine arteries embolization (UAE) of leiomyoma. Methods and Materials: From 2008 to 2017 to May 1023 women with symptomatic leiomyoma were treated by bilateral transcatheter UAE. Angiography and embolization were performed using 5F Cobra and Roberts uterine catheters by 355-1000µm of PVA particles. The size of particles depended on uterine arteries diameter and anastomosis between uterine and ovary arteries. Mean age was 29,5 years (range – 19-47). Results: The moderate reduction of leiomyoma’s size was observed in one month after UAE. Decrease of fibroid size determined by US – 18,4%, by MRI – 17,3%, in 1 month. Following reduction of fibroid’s size was in 3 months by US – 40,7%, by MRI – 42,9%, in 6 months by US – 60,4%, by MRI – 61,8%, in 12 months by US – 72,5%, by MRI – 74,7%, in 24 months by US – 70,8%, by MRI – 72,2%. Doppler US-control showed blood flow decrease during first month after UAE, in 3 months blood flow data were restored in uterine arteries. We noticed also significant reduction or disappearance of clinical symptoms - pain, menorrhagia, pressure symptoms. The partial vascularization of leiomyoma detected in 24 months after UAE only in one case. It was confirmed by MRI with contrast enhancement and by selective angiography of uterine arteries. Ovarian arteries wern’t involved in this case. It was a reason for reembolization of uterine arteries. Conclusion: UAE is an effective, minimal-invasive kind of leiomyoma’s treatment. MRI and US are the modalities that can accurately estimate fibroid’s changes and blood flow in uterine arteries. The tendency of fibroid's shrinkage after UAE is well-defined in period from 1M to 24M. After UAE the blood supply of myometrium is restored according to US Doppler data in the period from 1M to 3M.

Mandar Malawade is assistant professor in APJ Abdul Kalam college of Physiotherapy in India

Background: It has been seen that normal children have some behavioural problems that may affect their academic performance, despite of having no disability. The prevalence of such behaviour problems in children is alarmingly high. The number of affected children and adolescents is still staggering. Specially, in set ups where, there are very less number of teachers available for students, who are unable to pay attention on these behavioural issues of children. Thus, these problems are been overlooked, which in long run can create difficulties in shaping the future of the children. Hence, there is a need to pay attention by helping the children with the behavioural problems. There are some studies which show that behaviour therapy works to change problematic behaviours in children. Thus, these strategies will help the children to change their specific behavioural problems and adapt to the social environment more efficiently. Methodology: 78 participants were examined for the study. Their problematic behaviours were selected and the interventions for them were set. Intervention was given for a period of 8 weeks, twice per week and the session lasted for a period of 40 - 45minutes. Daily assessment was taken on time sampling and frequency recording forms. Behaviour Modification was applied. Results: Baseline data of Time sampling and frequency recording was collected and recorded on the first day before starting the intervention then at fourth week and then at eighth week. The results for the study were analysed through comparison of the results at baseline, fourth week and eighth week readings. The percentage increase or decrease in the behaviours was recorded according to the time sampling and frequency recording Conclusion: behaviour Modification Strategies are effective technique to reduce problem behaviours shown by students in the classroom

Purpose : Meconium related ileus (MRI) was defined as functional ileus in neonates characterized by imparired meconium excretion with preferential occurrence in premature infants. The aim of this study was to investigate the clinical characteristics and outcome of preterm infants who underwent surgical treatement, especially exploratory laparotomy and ileostomy, due to presumed MRI.Methods: A retrospective study was conducted on preterm infants born between January 2010 and December 2017 in Pusan National University Hospital. Infants were included if they were born at ≤31 weeks of gestational age (GA) and weighed ≤1,500 g at birth and underwent exploratory laparotomy for presumed MRI.In order to compare the clinical characteristics, matched controls for each subject were chosen based on gestational age and birthweight. Clinical data, including maternal, perinatal and neonatal characteristics, were analyzed. Results: A total 24 cases and 24 controls were identified. There was no significant difference between the both groups in perinatal and neonatal characteristics except lower apgar scores and higher incidence of intrauterine growth retardation in presumed MRI group. Day of full enteral feeding and hospitalization were significantly longer in presumed MRI group compared to control group (58.5 vs. 35.0 days, p=0.001 and 119.5 vs. 83.0 days, p=0.1 respectively). Although body weight at discharge were not statistically different, the proportion of less than 3 percentile for GA at discharge were significantly higher in presumed MRI group (70 % vs. 20 %, p=0.001).Conclusion: Early and aggressive conservative management of MRI is essential to spare surgical interventions. However, if not improved despite aggressive conservative treatment, surgical treatment should be considered promptly.