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:

Ahmed Bashir is a visiting Associate Project Scientist in Department of Human Genetics and Professor at David Geffen School of Medicine at UCLA. He is a Medical Director of AlMana Medical Center Saudi Arabia. He completed his Medicine in 1980, Ph.D in 1996 and MD in 2006. He has Executive level Leadership with extensive experience in Pediatrics, Neonatology, and Medical Genetics. He is the member of Jubail Pediatrics Club & Jubail Neonatal Club.

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, 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). 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. Aim: 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. Conclusion: 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:

IntroductionOver 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 strategiesInspired 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 cellsModulating 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. ConclusionThe 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:

Abstract:

Background: the view upon the surgical treatment of congenital biliary tract malformations has dramatically changed over the last decade. The approach tends to be laparoscopic in most cases. Nevertheless, in many studies it is stated that that the choice of laparoscopic procedures in choledochal cysts surgical treatment depends on the surgeons team skills. Materials and Methods: 18 patients with congenital choledochal cyst (CDC) were admitted to our hospital within the last 7 years. Their average age was 4 years (range 6 months- 12 years). There were  13 of the type I and 5 of type IV cysts according to Todani’s classification. 7 patients had large cysts up to 6-8cm. In all cases we used a 5mm camera positioned transumbilically, and 4 working trocars 5mm or 3mm- depending on the age of the patient. Patients were positioned in the “French” position. The average time of operation was 160 ±25 minutes. The Roux-en-Y jejunal loop was performed extracorporally through the umbilicus. A cyst excision with the Roux-en-Y hepaticojejunostomy was performed in 4 cases, and hepaticoduodenostomy in 14 cases. Results: We made a retrospective analysis of the laparoscopic treatment in children with CDC. All patients were presented with abdominal pain. In 4 cases pancreatitis was diagnosed, and three children had jaundice. The decision to perform a hepaticoduodenostomy after cyst resection was based on the small sizes of those cysts and their localization in the distal part of the common bile duct. There were no conversions in all the MIS cases. Analyzing intervention duration we distinguished that it takes lees time performing a hepaticoduadenostomy in comparison to hepaticojejunostomy by our team. However the average length of postoperative in-hospital stay was 6 days and did not essentially depend on the type of anastomosis performed. The follow-up was up to 3 years after operation with no stenosis, cholangitis, or other complications registered. Conclusion: Laparoscopic excision of CDC in children is an excellent treatment option in experienced hands. The type of reconstruction of the bile system - whether to perform a Roux-en-Y hepaticojejunostomy or a direct hepaticoduodenostomy depends on the cyst’s size and localization, and also the length of the bile duct after its excision.

 

Speaker
Biography:

Eda Alemdar her studies and researches at University of Goce Delcev, Faculty of Medicine in Macedonia. Alemdar has two international patents in medicine. She has two inventions, one for cataract treatment and the other one for sinusitis treatment. She was involved in several international projects. These projects are about biological clock & biological rhythm and diseases related to environment. 

 

Abstract:

The biological clock found in organisms is a biological rhythm that reflect the oscillations of night and day. This forms the psychological and physical, and provides both stable regulation and oscillations that occur in living beings. It also shapes the way the body functions. A failure of this biological clock amidst this cycle within the operational shape of this rhythm is accepted as a basic factor of many diseases. Researches summarized on internal and external factors in the formation of a biological clock, and found that external factors have a greater influence. Some studies by researchers looking at the relationship between biological rhythm and the moon, assumed that biological rhythms are an advantageous genetic adaptation and has a life value that results from the evolution of life forms in a changing environment thru the predictable cycles of 24-hour, month, and year. Of these periods, the 24-hour cycle of light/dark is the principle synchronizer. Circadian, monthly, and circannual rhythms (yearly cycle) are also the basic focus of considerable research. Indeed, we suggests that the reproduction over the same biological cycle observed in some plants and water-borne animals can be maintained between various species, including Homo sapiens. The best time for the treatment of diseases is the last three in the night and the last three in the day. Accordingly, the treatments are the time zone near to sunrise and sunset. It should not be forgotten that this situation may change according to the countries in the direction of latitude and longitude. The theses in our study offers theoretical information for future research. We believe that the data here will be a key resource for subsequent experiment-based studies.

 

Speaker
Biography:

Abstract:

Background: Extrahepatic portal vein occlusion (EHPVO), remains one of the most common reasons of portal hypertension in pediatrics. More than a half of our patients (56,2%) sought for medical attention for the reason of acute variceal hemorrhage. Despite the improvement in and endoscopic control, most patients require a surgical procedure to be performed to achieve the elimination of bleeding or re-bleeding risks. Shunt surgery is usually indicated when the ultimate cause is possible to be treated, that results in the portal pressure normalizing with the following decreasing of the variceal bleeding risks.  We addressed contemporary outcomes of surgical treatment of portal hypertension in our hospital. Materials and methods: A retrospective study on 624 children with portal hypertension that underwent treatment in our Children’s Specialized Hospital “OHMADYT” during the last 15 years (from October 2003 to August 2018). The age of patients varied from 4 months to 18 years. The EHPVO presented in 74 % (n= 460) children. Umbilical vein catheterization 36,3 % (n= 167) was found to be the primary etiologic reason for the EHPVO development. Cavernous transformation of the portal vein persisted in 83,2 % (n= 383) children. More than half of the patients presented with acute variceal bleeding – 62% (n= 289). There were 136 (24,8 %) surgical procedures performed with devascularization operations (16 of them were Sugiura-Futagawa operation), 325 (59,4%) splenorenal shunts, 71 (12,9%) mesocaval shunts and 15 (2,7 %) mesoportal shunts. Results: Surgical procedures efficacy was evaluated according to the acute variceal bleeding episodes recuperation. The efficacy of devascularization operations was 61,1 %, of splenorenal shunt – 84,5 %, of mesocaval shunt – 92.5 % and 80 % for mesoportal shunt by this indicant. ConclusionIn comparison to of devascularization operations, shunt procedures in children with portal hypertension showed efficacy range 61,1 – 90,3 %, and therefore we consider them to be the better choice for such a patients.

 

 

Speaker
Biography:

Abstract:

The Scope of the Problem: Viral hepatitis is considered one of the most important global issues of medical health care. Worldwide, 240 million people have some evidence of past or present HBV infection. Nonetheless, coinfection or superinfection with Hepatitis Delta Virus (HDV) described as a more aggressive form of hepatitis B virus is still poorly-elaborated. The prevalence of HBV and HBV-HDV has been unknown in Kazakhstan for a long time. However, in recent years more accurate and extensive data has been collected primarily due to implementation of the state program regarding the screening for viral hepatitis as well introducing the viral hepatitis into the list of socially significant diseases. In addition, establishing Centers of Hepatology and opening Departments of Hepatology within the regional hospitals play an important role in estimating the real prevalence in the country. According to the current statistics, 30 to 50 thousand people become infected every year in Kazakhstan. At least 25% of people become infected with HBV, an estimated 65-75% are infected with hepatitis C virus. What’s more, liver cirrhosis is ranked first among the disorders associated with the gastrointestinal tract. (Калиаскарова К.С., 2016). Kazakhstan is being considered as a high endemic country within the context of hepatitis B (more than 8%). With regard to the HDV prevalence, Kazakhstan has been referred as a medium endemic country. However, within the country the prevalence of the viral hepatitis is not homogenous and the statistical data are not completely reliable to the full extent. Implementation of the vaccination programs against hepatitis B for the prevention of the disease has resulted in the positive results.However, currently Hepatitis D is diagnosed in the late stages, which is therefore characterized by a rapidly progressive course of the disease, and low efficacy of the antiviral therapy. The epidemiology data regarding the prevalence of the hepatitis B and hepatitis D infection in Kazakhstan is still limited. Aim of the study: To determine prevalence and clinical characteristics of chronic hepatitis B virus with hepatitis D virus in different regions of Kazakhstan. Materials and Methods: The study utilizes epidemiological methods of descriptive statistics of the output data of the SPC "Sanitary-epidemiological expertise and monitoring" of the KZPP MNE RK. The current study analyzes the epidemiological data within the period of 5 years from 2012 to 2016. Results and Discussion: The incidence of chronic viral hepatitis B with the hepatitis D infection in various regions of Kazakhstan throughout the period of 2012-2016. Taking into account the fact that infection with Hepatitis D can only occur in the presence of hepatitis B virus, the prevalence of the chronic form of the hepatitis B virus has been investigated. It was found that in the five-year period from 2012 to 2016 there has been a decrease in the incidence of HBV infection from 35.4 to 29.6 cases per 100,000 people. However, with regard to the HBV infection with HDV, a substantial increase in the disease prevalence has been determined. In particular, the HDV infection disease incidence has increased by 40% reaching a value of 0.39 cases per 100,000 people in 2016.The following endemic regions of the country with the highest disease prevalence has been determined: South Kazakhstan, West Kazakhstan, Zhambyl, Aktobe regions and the city of Astana. The highest disease prevalence of HBV infection has found to be the capital of the country with the value of 1.7 cases per 100,000 people. What’s more, the disease prevalence in Astana has been consistently substantial in comparison to the other parts and regions of Kazakhstan.

 

Speaker
Biography:

Ravinder kaur is Director of Hardinge medical college and was Head of Mycology Division in the Deptt. of Microbiology at Maulana azad medical college. She involved in Diagnosis and Research in Fungal Opportunistic infections in Immunocompromised, Standardized Molecular identification of fungi. She is the Principal Investigator in 28 Research projects & Co-investigator in 35 Research projects in Mycology and Microbiology. She Published more than 70 papers in different International & National Journals.

 

Abstract:

Background: Candidemia represents a major challenge among healthcare-related infections causing increased mortality rates and emergence of antifungal drug resistance, especially in immunocompromised and severely ill patients. It needs an urgent intervention to salvage patients. Aim: To isolate and identify Candida species and to evaluate their antifungal susceptibility profile from blood stream infections in paediatric patients. Materials & Methods: Fungal cultures from blood recovered positive for yeasts were subcultured on Sabouraud dextrose agar. Suspected purified colonies of Candida were further identified upto species level by both conventional and automated techniques. Conventional identification was done by germ tube test, pigmentation on HiChrome Candida agar, morphology on Corn Meal Agar and sugar assimilation test. Automated identification was done by VITEK-2 YST ID. Antifungal susceptibility of isolates was evaluated using agar based Etest method for Fluconazole, Voriconazole and Caspofungin on Mueller-Hinton agar supplemented with 2% glucose.  Results: Total of 43 isolates of Candida species were recovered from blood samples. Non-Albicans Candida species were responsible for 88.30% cases; whereas 11.60% of cases were caused by C.albicans. C.tropicalis (39%) was the commonest isolate recovered in candidemia patients followed by C.parapsilosis (18%), C.albicans (12%), C.glabrata (12%), C.kefyr (9%), C.pelliculosa (5%), and C.krusei (5%). AFS results revealed Caspofungin demonstrated good activity against all Candida spp. C.tropicalis followed by C.parapsilosis and C.glabrata demonstrated high resistance to fluconazole. For voriconazole, maximum resistance was shown by C.tropicalis as compared to others.

 

Speaker
Biography:

Dr. Santosh Pathak is an assistant professor in Chitwan Medical College. He completed his MD from Universal College of medical sciences in 2016.  He published his paper in several national and international journals. He has attended several international and national conferences on pediatric.

 

Abstract:

INTRODUCTION: Scrub typhus, an important cause of pyrexia of unknown origin, is grossly neglected in low and middle income countries like Nepal. This study was conducted to study the clinical profile and complications of scrub typhus in children along with the outcome. MATERIAL AND METHODS: A prospective observational was study done in children (1-16 years) diagnosed as scrub typhus admitted to a tertiary care hospital of central Nepal in between July 2016- Aug 2017. Scrub typhus was diagnosed with IgM ELISA.RESULTS: All cases of scrub typhus presented with fever. Other common symptoms were headache (75%), myalgia (68.4%), vomiting (64.5%), nausea (59.2%), abdominal pain (57.9%), cough (35.5%), shortness of breath (22.4%), altered sensorium (14.5%), rashes (13.2%) and seizures (11.8%). Important clinical signs noticed were lymphadenopathy (60.5%), hepatomegaly (47.4%), edema (26.3%), jaundice (26.3%), and splenomegaly (15.8%). Necrotic eschar was present in 11.8%. Thrombocytopenia raised liver enzymes and raised creatinine values were seen in 36.9%, 34.2% and 65.8% respectively. The most common complications were myocarditis (72.4%), hypoalbuminemia (71.1%), renal impairment (65.8%), hyponatremia (48.7%) and hepatitis (34.2%) and severe thrombocytopenia (22.4%), Doxycycline was commonly used (69.7%) in the treatment followed by combination with azithromycin (18.4%). Overall mortality rate was 3.9%. CONCLUSION: Scrub typhus should be considered as an important differential in all patients with acute febrile illness in endemic areas. Presence of eschar along with thrombocytopenia, deranged liver enzymes and renal function test in a febrile child should arise a suspicion of scrub typhus and empirical doxycycline/azithromycin in such cases can be lifesaving. KEY WORDS:  Scrub typhus, rickettsial infections, clinical features, complications, children

 

Speaker
Biography:

Abstract:

Abstract: Acute lymphoblastic leukemia (ALL) is the most common type of cancer in children. Cholestatic jaundice is an unusual presentation of ALL. It is even rarer to be caused by involvment of the pancreas resulting in obstructive jaundice. Purpose: Describing obstructive jaundice secondary to a pancreatic involvment in childhood mature B cell ALL. Object: A four years old girl who had been diagnosed as mature B cell ALL in Pediatric oncology department, Viet Nam National Cancer Hospital. Method: Describing a clinical case. Result: Pancreatic involvement in ALL is rare and obstructive jaundice secondary to a pancreatic mass as a primary presentation of ALL has not been reported in the literature, only in some case reports. Primary result of treatment by FAB LMB 96 portocol is excellent. Conclusion: This is a rare clinical case of mature B cell ALL in children with very severe conditions. Exact diagnosis results insuccessful treatment. 

Speaker
Biography:

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.