Scientific Program

Day 1 :

  • Keynote Forum
Speaker
Biography:

Afaf Korraa is a chief in the pediatrics department, AL- Azhar University. She completed her MD in 1990 and Nutritional diploma in 2009. she was a International lactation consultant from 2008 to 2009. She has 4 international published papers and more than 40 nationally published papers. Afaf Korraa is member of ILCA, Egyptian Pediatric Society and also editor of Egyptian Neonatal Safety Newsletter.

Abstract:

Background: There is growing evidence that breastfeeding improves the brain development of infants. Researchers have discovered that breastfeeding alone produces the best results for boosting a baby’s brain growth. Breastfeeding can increase a baby’s brain growth by 20 to 30 percent. Our aim was to compare the type of  feeding on sonographic brain changes in the first 6 months of life from July 2016 to April 2017. Subjects and Methods: It was analytical comparative study carried out our patient clinic of Al-Azhar university hospital. Fifty healthy infants at 6 months age deliverd  fullterm were included in the study. Congenital anomalies, chromosomal abnormalities, sepsis, jaundice, those with drug could affect affect the brain were excluded. We split the infants into three groups: those whose mothers reported they exclusively breastfed for at least six months, those fed a combination of breastmilk and formula (mixed), and those fed formula alone. Maternal and neonatal history including (feeding history), general examination including anthropometric and vital signs, neurological examination were done. Transfontanel ultrasound examination were performed for all infants. It was performed while the infant in supine position or holded by their mothers. The scan was performed in coronal, sagittal plan for measurement of the length of corpus callosum and the transverse diameter of the fourth ventricle in mid sagittal plan, and  parasagittal plans. The probes used were multifrequency curvilinear probe with transducer ranging from 3-5 MHZ in all cases, transducer ranging from 7-10 MHZ Right and Left ventricular horn ratio, length of corpus callosum. Results: Significant increase in right horn ventricular ratio in formula feeding and mixed feeding infants than exclusive breastfeeding infants (4.10 ± 0.23, 4.12 ± 0.29, 3.72 ± 0.54 2.8)  (ANOVA, 5.233 P value 0.009 ) respectively. Significant increase in left venricle horn ratio in formula fed and mixed in comparison to breast fed infants respectively (4.30 ± 0.65, 4.28 ± 0.69, 3.57 ± 0.98 (ANOVA 4.551,P value  0.015 ). No significant differ in length of corpus callosum between the 3 studied groups. Conclusion: enlarged ventricles diameters in infants feeds artificial or mixed milk may be associated with neurolodevelopmetal changes in the future. These findings add to a substantial body of research that finds positive associations between breastfeeding and children's brain/developmental health.

 

Speaker
Biography:

Abstract:

Newborn Screening, involves a complex set of interlocking systems that use population based screening test panels to identify newborn with condition that may benefit rapid identification and treatment. The American College of Medical Genetics (ACMG) outlines the minimum criteria for which disease should be tested.This paper will briefly review the importance of Newborn Screening and will discuss its application in Saudi Arabia. It will briefly review test for:

  • Tandem Mass Spectrometry (MS/MS)
  • hyperphenylalaninemia (PKU)
  • Amino Acids
  • Organic acid metabolism
  • Fatty  acid oxidation
  • Biotinidase deficiency
  • Congenital Hypothyroidism (CH)
  • Congenital Adrenal Hyperplasia (CAH)
  • DNA-based Techniques
  • Array
  • Sequencing, multiplex PCR
  • Multiplex for:
  • Hemoglonobinopathies
  • Transferrin Isoelectrofocusing (Tf-IEF) for congenital disorders of glycosylation (CDG)
  • Nanochip system for heteozygote detection in Premarital Genetic  Diagnostics (PGD)
  • High Performance Liquid Chromatography (HPLC) for Amino Acids Analysis (AAA)

These methods were used in this study:

Birth rate between 500,00-800,000 annually, with high prevalence of some inherited conditions due to high rate of consanguineous marriage, large families, multiple marriages, tribal communities, condensed and cities and empty rural areas. High rate of hemoglobinopathies, metabolic, neurogenic, genetic diseases. The following diseases are common in Saudi Arabia; Glutaric Academia, Hemoglobinopathies, Cystic Fibrosis (CF), Congenital Adrenal Hyperplasia (CAH), Glucose-6-Phosphate Dehydrogenase Deficiency (G6PD-D). Ministry of Health (1991), King Faial Specialist Hospital (2005), Prince Salman Disability Research Center (2005), covering one of five regions, testing only 25% of the population.

  • Pediatric Nutritional Care | Pediatric Neurosciences | Pediatric Urology | Neonatal Intensive Care Nursing | Pediatric Oncology and Cancer

Session Introduction

K. M. Yacob

Marma Heatth Centre, India

Title: Why Our body acts against Facts of Physics in Fever
Speaker
Biography:

A practicing physician in the field of healthcare in the state of Kerala in India for the last 30 years and very much interested in basic research. My interest is spread across the fever, inflammation and  back pain. I am a writer. I already printed and published nine books in these subjects. I wrote hundreds of articles in various magazines. 

Abstract:

When the disease becomes threat to life or organs blood circulation decreases, Temperature of fever will emerges to increase prevailing blood circulation. And it acts as a protective covering of the body to sustain life.

When blood flow decrease to brain, the patient becomes fainted-delirious .If we try to decreases temperature of fever, the blood circulation will further reduced. Blood circulation never increases without temperature increase. Delirious can never be cured without increase in blood circulation.

The temperature of fever is not a surplus temperature or it is not to be eliminated from the body. During fever, our body temperature increases like a brooding hen`s increased body temperature.

The actual treatment to fever is to increase blood circulation.

Two ways to increase blood circulation

1. Never allow body temperature to lose

2. Apply heat from outside to the body.

When the temperature produced by body due to fever and heat which we applied on the body combines together, the blood circulation increases. Then body will stop to produce heat to increase blood circulation. And body will get extra heat from outside without any usage of energy.

 

Speaker
Biography:

Abstract:

BACKGROUND: Among the many factors influencing the prevalence of asthma in developing countries from the tropics are geo-helminthic infections.

AIMS: This work aims to study the relation between bronchial asthma and parasitic infestation in Egyptian children.

PATIENTS AND METHODS: A cross-section, analytical study design was chosen to perform this research on 100 school aged children. All children were interviewed and examined clinically and laboratory.

RESULTS: Statistically significantly Negative correlations were found between blood level of IgE and FEV1% of predicted in patients with bronchial asthma as well as patients with parasitic infestation with r=-0.381, -0.325 at p=0.006, 0.021 respectively. Inverse relationship was found between blood level of IgE and FEV1/FVC% in patients with parasitic infestation with r= -0.358 with statistical significant difference at p=0.011.

CONCLUSIONS: 86%of patients with bronchial asthma lived in urban areas, while 64% of patients with parasitic infestation lived in rural areas.

RECOMMENDATION: Improving personal and environmental hygiene and regular screening, treatment and health education for children as regard parasitic infections is recommended.

 

Speaker
Biography:

Hazem Ahmed Mostafa is an internationally recognized neurosurgeon with over two decades of clinical and research experience. He has devoted his career to developing and providing rigorous, comprehensive and compassionate care to those with cancer, neurological degenerative diseases andpediatric disorders. He’s affectionately known as Dr Brain and Spine. He is a professor in the Department of Neurosurgery at Ain Shams University, Egypt since 2014. He is a Consultant of Neurosurgery at his own private clinics NeuroClinic Cairo and Hurghada - Red Sea, Egypt since 2001. Hazem has dedicated a significant part of his career to developing innovative educational research with over 33 published research papers in the Egyptian Society journal. Hazem is an active member of the Egyptian Society of Neurological Surgeons since 1997. He is an international Faculty at AO Trauma Foundation. He is also an international fellow member of the Institute of Brain Chemistry and Human Nutrition (IBCHNUK).

Abstract:

Introduction: Over the past 30 years there has been a significant reduction in mortality following severe TBI together with improved outcome. This has been largely due to the use of evidence-based protocols emphasizing the correction of parameters implicated in secondary brain injury. The main parameters are cerebral blood flow, cerebral oxygenation and management of co-morbidities. Neuroinflammation is a well-established secondary injury mechanism following TBI.

Evolving treatment strategies: Inspired by success in Parkinson’s and other neurodegenerative diseases, stem cell based therapy is believed to provide bio bridges, can stabilize blood-brain barrier, reduce the oxidative stress and provide immunomodulation and neuroprotection. Hyperbaric oxygen may alleviate secondary insult in TBI through the modulation of the inflammatory response. Animal studies showed that hyperbaric oxygen improves neuroplasticity, reduce the inflammatory markers and neuronal apoptosis following TBI

Sources of stem cells: Modulating endogenous stem cells or Cell transplantation (using exogenous stem cells) from fetal /embryonic, bone marrow stromal cells, umbilical cord cells or induced pluripotent stem cells (iPSCs). There is plenty of literature showing good response of stem cell therapy, mesenchymal stem cells in particular, on the outcome in rat TBI models.

The animal models indicate some vulnerability of the stem cells to the hostile environment of neuroinflammation, which may limit their potential.

Conclusion: The results although very encouraging, are still in the laboratory/preclinical phase and lots of technical, ethical and logistic issues have to be solved before shifting to clinical trials. Hyperbaric oxygenation can provide less hostile microenvironment helping with repair and provide better use of stem cell induced growth factors.

 

Speaker
Biography:

Abstract:

Background: Apnea of prematurity (AOP), the most common and frequently-recurring problem for preterm infants, is a major concern for caregivers in intensive care nurseries. Study of possible interventions for management of AOP in preterm infants is an urgent research issue.

Aims: This research was to develop an infant’s nest that can detect the events of apnea and low oxygen saturation on preterm infants and synchronized initiate the automatically physiological feed-back stimulations for interrupting the periods of apnea and low oxygen saturation of preterm infants or neonates. In addition, we will conduct a clinical research to examine the safety, accuracy and effectiveness of this prototype device for monitoring and interrupting apneic events in infants during hospitalization and homecare.

Methods: This research includes two stages of studies and will expend two years to reach research purposes. In the first year, we innovate an assembled infant’s nest that comprises the function of detecting physiological signals of neonates, and function of alerting and automated feed-back initiating stimulations to preterm infants who suffering the apnea and low oxygen saturation. In the second year, we will conduct a clinical research to examine the function of this device.  

Preliminary Research: Research subjects were six preterm infants. During the research periods, ten episodes of apnea were observed. Automatic stimulations successfully interrupted these ten apneic events in 6 participants by 100% after they received the first or second stimulation (maternal voices or tactile stimulation). Clinical staff did not notice an observe change in the preterm infants’ arousal state related to receive the automatic stimulations during apneic events.

Conclusion: We expect using this assembled infant’s nest for infant’s homecare that can effectively prevents the events of apnea and low oxygen saturation in infants and decreases the stress of homecare providers.

 

Speaker
Biography:

Abstract:

Background: anemia affects a significant part of the population in nearly every country in the globe. Iron requirements are greatest at ages 6-23 months, when growth is extremely rapid and critically essential in critical times of life. Even though infants and toddlers are highly at risk, they are not considered as separate populations in estimation of anemia. Despite this, a couple of activities done by the government, showed that prevalence of anemia among under 24 months of age is still at its highest point of severity to be a public health problem in Ethiopia. There is no study that documented the magnitude of the problem and associated factors in the study area. The main aim of this study was to assess the prevalence of anemia and to identify associated factors among children 6-23 months of age.

Methods: a community based cross-sectional study was carried out among 485 children of Damot Sore, South Ethiopia from March to April 2017. Data on socio demographic, dietary, blood samples for hemoglobin level and malaria infection were collected. Both descriptive and bivariate analyses were done and all variables having a p- value of 0.25 were selected for multivariable analyses. Multivariable logistic regression model was used to isolate independent predictors of anemia at p-value less than 0.05. Principal component analysis were used to generate household wealth score, dietary diversity score.

Results: out of 522 sampled children selected for study, 485 children underwent all the study components giving a response rate of 92.91%. Altitude and smoking adjusted prevalence of anemia was 255(52.6%). Larger proportion, 128(26.4%) of children had moderate anemia. In multivariable analyses, household food insecurity (AOR=2.74(95% CI: 1.62-4.65)), poor dietary diversity (AOR=2.86(95%CI: 1.73-4.7)), early or late initiation of complementary feeding (AOR=2.0(95%CI: 1.23-3.60)), poor breast feeding practice (AOR=2.6(95% CI: 1.41-4.62)), and poor utilization of folic acid (AOR=2.75(1.42-5.36)) were significantly associated with anemia.

Conclusion and recommendation: prevalence of anemia among children (6-23 months) was severe public health problem in the study area. Most important predictors are suboptimal child feeding practices, food insecurity and poor diet. Mullti-sectoral efforts are needed to improve health and interventions targeting nutrition security are recommended.

 

Speaker
Biography:

Dr. Kurtis Auguste graduated from Harvard University.  He conducted his medical training, internship and neurosurgery residency at the University of California, San Francisco School of Medicine.  He completed his pediatric neurosurgery fellowship at the Hospital for Sick Children in Toronto, Canada. Since 2008, he has directed the UCSF Pediatric Epilepsy Surgery Program.  He has been the Division Chief of Neurosurgery at the UCSF Benioff Children’s Hospital Oakland since 2014 and was elected Chief of Surgery in 2016.  His practice focuses on the the surgical management of pediatric seizure disorders, complex hydrocephalus, spinal dysraphism, neuro-oncology, neurotrauma and craniofacial disorders.  His research interests have included neural stem cell transplantation for the study of central nervous system migrational disorders, the role of aquaporin water channels in hydrocephalus, seizure propagation and astroglial migration, and the use of immersive virtual reality imaging for pre-operative and intraoperative neurosurgical planning.

 

Abstract:

Analysis of radiologic images for pediatric neurosurgical procedures typically involves review of multiple, separate, two-dimensional stacks of scans that are presented individually.  This exercise can be time-consuming and the end-goal of an assembled three-dimensional structure in the mind’s eye can be inaccurate.  Virtual reality (VR) surgical planning stations construct three-dimensional renderings for users, synthesizing multiple imaging modalities into one platform that can be navigated with immersive lenses in a 360 degree experience.  The authors use VR technology to prepare for tumor, epilepsy, arteriovenous malformation (AVM) and hydrocephalus surgery in children.  Pediatric patients undergoing neurosurgical procedures at the University of California San Francisco Benioff Children’s Hospitals were included in this study.  Images were processed on the Surgical Theater Virtual Reality surgical planning station.  Virtual models were evaluated pre-operatively by surgeons and with patients/families in patient engagement sessions in the outpatient clinic.  Questionnaires were distributed to assess the technology’s impact on patient/family understanding and anxiety. Preliminary surgical plans as designed by standard two-dimensional reviews were often modified as a result of 360-degree virtual fly-throughs.  Furthermore, anatomy was often visualized in three-dimensional viewing that was poorly-visualized in two-dimensional imaging. No significant delays were recorded as a result of VR analysis.  All patients and families reported increased understanding of their pathology and surgery as well as a decrease in their anxiety. Virtual planning is a useful adjunct in the preparation of neurosurgical procedures in children.  This immersive technology is an efficient, time-saving method for surgeons to visualize complex anatomic relationships.  VR can reveal anatomy that is poorly-represented or not visualized using conventional imaging reviews.  Coordination of intraoperative VR navigation is seamless with standard neuronavigation systems.  In addition to increased understanding of the diagnosis and treatment, pediatric patients and their parents report a significant reduction in anxiety levels as a result of their VR sessions.

 

Speaker
Biography:

Hazem Ahmed Mostafa is an internationally recognized neurosurgeon with over two decades of clinical and research experience. He has devoted his career to developing and providing rigorous, comprehensive and compassionate care to those with cancer, neurological degenerative diseases andpediatric disorders. He’s affectionately known as Dr Brain and Spine. He is a professor in the Department of Neurosurgery at Ain Shams University, Egypt since 2014. He is a Consultant of Neurosurgery at his own private clinics NeuroClinic Cairo and Hurghada - Red Sea, Egypt since 2001. Hazem has dedicated a significant part of his career to developing innovative educational research with over 33 published research papers in the Egyptian Society journal. Hazem is an active member of the Egyptian Society of Neurological Surgeons since 1997. He is an international Faculty at AO Trauma Foundation. He is also an international fellow member of the Institute of Brain Chemistry and Human Nutrition (IBCHNUK).

Abstract:

Craniofacial anomalies are rare complex pathologies which needs a craniofacial team composed of neurosurgeon, a craniofacial plastic surgeon, and an ophthalmologist. Anomalies at craniofacial region either due to developmental malformation of the brain (neural tube defects) or premature closure of cranial or skull base sutures resulting in skull deformities and problems in normal physiological neurological development. Each of pathologies needs special neurological surgery management, sometimes the management is multi-staged.  Neurosurgical management varied from diagnosis, the surgical procedures and long-term follow up. Hence, we describe the pathology of craniofacial anomalies and its associated syndromes in addition to the proper investigation needed for diagnoses and predict possible short and long-term complication. Also, what craniofacial anomalies care giver should be focusing on regarding neurological issues such as intra-cranial pressure early detection and treatment if high and optic nerve problems. Also dural repair, dealing with brain parenchyma and its vasculature, and better cosmetic outcome according to craniofacial metrics.

 

Speaker
Biography:

Abstract:

Introduction: The large global burden of rheumatic heart disease (RHD) has come to light in recent years following robust epidemiologic studies. As an operational research component of a broad program aimed at primary and secondary prevention of RHD, we sought to determine the current prevalence of RHD in the country’s capital, Lusaka, using a modern imaging-based screening methodology. In addition, we wished to evaluate the practicality of training local radiographers in echocardiography screening methods.

Methods: Echocardiography was conducted on a random sample of students in 15 schools utilizing a previously validated, abbreviated screening protocol. Through a task-shifting scheme, and in the spirit of capacity-building to enhance local diagnostic and research skills, general radiographers based at Lusaka University Teaching Hospital (UTH) were newly trained to use portable echocardiography devices. Students deemed as screen-positive were referred for comprehensive echocardiography and clinical examination at UTH. Cardiac abnormalities were classified according to standard World Heart Federation criteria.

Results: Of 1,102 students that were consented and screened, 53 students were referred for confirmatory echocardiography. Of those, three students had definite RHD, ten had borderline RHD, and 29 were normal. Eleven students were lost to follow-up. The rates of definite, borderline, and total RHD were 2.7 per 1,000, 9.1 per 1,000, and 11.8 per 1,000, respectively. Anterior mitral valve leaflet thickening and chordal thickening were the most common morphological defects. The pairwise kappa test showed good agreement between the local radiographers and an echocardiographer quality assurance specialist.

Conclusion: The prevalence of asymptomatic RHD in urban communities in Zambia is on par with that reported in other sub-Saharan African countries. Task-shifting local radiographers to conduct echocardiography was feasible. The results of this study will be used to inform ongoing efforts in Zambia to control and eventually eliminate RHD.