Annual Pediatric Emergency Medicine Conference March 29-30, 2016 Atlanta, Georgia, USA

Biography:

Gwenyth Fischer is a Pediatric Critical Care Physician and Assistant Professor at Masonic Children’s Hospital and Medical Device Center Innovation Fellow alumni at the University of Minnesota. She is also the Founder and Director of the Pediatric Device Innovation Consortium based at the University of Minnesota. In addition, she serves as the Clinical Advisor to the University of Minnesota Medical Device Center and Pediatric ECMO and Cardiopulmonary Director at Masonic Children’s Hospital. She has disclosed over 25 inventions to the University, several in the pediatric space. Her research interests are in the area of design, development, testing and regulation of pediatric specific technologies.

Abstract:

Pediatric medical device development is approximately 10 years behind adult device development. The reasons for this are multiple, the primary being that most devices in the pediatric space are smaller markets. Innovation can be successful in pediatrics however, if inventors are willing to think outside the box when it comes to design, funding, regulation and research on devices for kids. This talk will cover the reasons behind the 10 year lag between pediatric and adult device development and methods that innovators across the country are using to overcome these hurdles. Examples of recent success in pediatric medical device and ways to innovate as a pediatrician will also be discussed.

Biography:

Jichuan Wang has completed his PhD from Cornell University and Post-doctoral studies from the Population Studies Center, University of Michigan. He is a senior biostatistician at Children’s Research Institute, CNHS. He has published three statistical books and authored/co-authored more than 100 peer-reviewed journal article with more than 30 first-authored. He has been serving as Editorial Board Members of five academic journals.

Abstract:

While many researches on symptoms in child patients are directed toward studying individual symptoms, interest in symptom clusters in patients has been increasingly expanded in recent years. The terminology of “symptom cluster” in literature has different meanings. First, symptom cluster refers to a group of symptoms that are associated with simultaneous occurrence and second it is defined as a group of individual patients sharing similar symptoms. These are conceptually different types of clusters. The former is about “variable-centered” symptom clusters that have to do with measurement dimensions and the latter is about “person-centered” symptom clusters that represent distinct subpopulations/groups in the target patient population under study. Latent class analysis (LCA) is one of the person-centered analytical approaches that can be applied to identify potential latent classes/groups (sub-populations) that are a priori unknown in the target population under study. Patients are similar within class, but differ cross classes with respect to a set of symptom measures. When symptom measures are continuous (e.g., scale scores of depression), LCA becomes latent profile analysis (LPA). LCA and LPA can be readily extended to latent transition analysis (LTA) to study latent transitions of the symptom cluster/profile status over time using longitudinal data. This study applied LPA to identify distinct latent profiles/groups in children with cancer in regard to the four PROMIS symptoms measures (depression, anxiety, pain, and fatigue). LTA was applied to examine the transitions of latent profile status over time and identify factors that influence such transitions.

Biography:

Xiaowei Dong has completed her PhD in Pharmaceutical Sciences from University of Kentucky and then joined Novartis Pharmaceutical Corporation working as a lead formulator for drug product development for about 4 years. In 2013, she joined UNT Health Science Center as an Assistant Professor in the Department of Pharmaceutical Sciences at the College of Pharmacy. Her research includes drug delivery and formulation development using nanotechnology and has special focus on pediatric formulation development.

Abstract:

Over 65% of current medications do not have commercially available pediatric formulations. Lack of pediatric formulations has led to the need to break tablets or open capsules for administration, risking reduced efficacy and adverse eff ects because of inaccurate dosing. Because of challenges and limitations on liquid dosage forms, flexible oral solid dosage forms are preferred for pediatric formulations. Recently, we discovered a novel platform nanotechnology to manufacture solid granules that produce in situ self-assembly nanoparticles (ISNPs) when introduced to water or other fluids (e.g. gastrointestinal fluid). Th e current ISNPs are lipid-based nanoparticles. We successfully applied the ISNP nanotechnology for ritonavir, lopinavir, a fixed-dose combination of lopinavir/ritonavir and a fixed-dose combination of four drugs. Drug-loaded ISNP granules achieved over 15% of drug loading, acceptable stability at room temperature and over 90% of drug entrapment efficiency. According to the evaluation using an electronic-tongue and dissolution, drug-loaded ISNP granules had similar taste to the placebo granules. Moreover, the pharmacokinetic studies showed that the ISNP granules improved drug bioavailability and biodistribution. Th e overall results demonstrated that the novel ISNP nanotechnology is a very promising platform to manufacture palatable, heat stable and flexible pediatric granules.

Biography:

Syed Zafar Mehdi did his MCPS and FCPS in Pediatric Medicine from college of Physicians and Surgeons Pakistan. He is an Associate Professor of Pediatrics in Baqai Medical University Karachi. During last 18 years in this profession, Dr. Zafar has worked with children suffering from protein calorie malnutrition, infectious diseases and neonatology. He has played an important role in promotion and support of exclusive breast feeding for first six months on which he has published several papers and has given various presentations. Dr. Zafar is also a consultant of Pediatrics at Patel Hospital Karachi. Patel Hospital established Pakistan’s first separate 50 beds burn unit with burn ICU. Dr. Zafar is a member of burn plastic surgery team. His several papers have been published on infantile burn. He has raised the voice for prevention of Pediatric burn both at national and international level.

Abstract:

Abstract Objective: The aim of this study is to determine the causes, incidence, sex distribution, nature of injury and outcome of infants with burn.

Methods: This is retrospective study done at plastic surgery, burn unit of Patel Hospital during period of 7 years from January 2007 to December 2013. Children ageing one year or less at the time of admission were included in the study. SPSS 21 version was used for statistical analysis.

Results: Total 789 paediatric burn patients were admitted in Patel Hospital during January 2007 to December 2013, in which 106 were infants. 83 (78.3%) infants had scald burn and 21 (19.8%) had fire burn. Male female ratio was 1.5:1. Common cause of scald burn was hot water 62.7%.The majority of infants 39.6% and 40.6% had <10% and 10-19% total body surface area burn respectively. Most of them (70.8%) had second degree burn. The mortality rate was 8.5%. 2 infants need reconstructive surgery of face. Out of 95 infants in follow up 7 (7.4%) developed contractures for which surgical intervention was done.

Conclusion: Burn injury is an important public health concern and is associated with high morbidity and mortality. The main cause of burn injury in infants is hot water. Safety measures must be taken while dealing with hot liquids and flame, especially in the presence of infants at home. Infantile burn injuries can be decreased and prevented by educating parents through seminars, posters and print media. In this aspect electronic media can play an important role along with social welfare organizations and housing departments.

Keywords: Infantile, burn, scald.

Biography:

Khaled El-Atawi has completed his Master and PhD degrees in Pediatrics from Ain Shams University. He also had Master degree in Healthcare Management from Royal College of Surgeon of Ireland. He is the Consultant Neonatologist and Clinical Quality Specialist in Latifa Hospital NICU, which is one of the largest tertiary units in the UAE. He is the Lecturer of Pediatric in DMCG and Pediatric Resident Supervisor in LH and a member of local and international societies and associations. He has published many papers and has been serving as an Editorial Board Member of many journals. His fields of interest are Neonatal Ventilation, Nutrition, Brain injury and protection.

Abstract:

Background: Since an objective description is essential to determine infant’s postnatal condition and efficacy of interventions, two scores were suggested in the past but were not tested yet: The specified-Apgar uses the 5 items of the conventional Apgar score; however describes the condition regardless of gestational age (GA) or resuscitative interventions. The expanded-Apgar measures interventions needed to achieve this condition. We hypothesized that the combination of both (combined-Apgar) describes postnatal condition of preterm infants better than either of the scores alone. Methods: Scores were assessed in preterm infants below 32 completed weeks of gestation. Data were prospectively collected in 20 NICU in 12 countries. Prediction of poor outcome (death, severe/moderate BPD, IVH, CPL and ROP) was used as a surrogate parameter to compare the scores. To compare predictive value the AUC for the ROC was calculated. Results: Of 2150 eligible newborns, data on 1855 infants with a mean GA of 28 6/7±2 3/7 weeks were analyzed. At 1 minute, the combined-Apgar was significantly better in predicting poor outcome than the specified- or expanded-Apgar alone. Of infants with a very low score at 5 or 10 minutes 81% or 100% had a poor outcome, respectively. In these infants the relative risk (RR) for perinatal mortality was 24.93 (13.16-47.20) and 31.34 (15.91-61.71), respectively. Conclusion: The combined-Apgar allows a more appropriate description of infant’s condition under conditions of modern neonatal care. It should be used as a tool for better comparison of group of infants and postnatal interventions.

Biography:

Chiranjib Barua Chowdhury obtained his MBBS in 1985 from Sylhet Medical College, Bangladesh; Post-graduation Diploma in Child Health in 1997; Fellowship in Pediatrics (FCPS) in January 2001 & Doctor of Medicine (MD) in Neonatology from Bangabandhu Sheik Mujib Medical University Bangladesh, in 2006. He has obtained PhD from Chittagong University in 2011. He has in total 15 publications in different topics of Neonatology & Pediatrics which were published in different national & international Journals. In December 2014, he was honored with Post-graduation in Pediatric Nutrition by Boston University. Currently, he is working as an Associate Professor in Neonatology, Chittagong Medical College, Bangladesh.

Abstract:

Introduction: Neonatal septicemia is a clinical syndrome of systemic illness accompanied by bacteremia occurring in the first 28 days of life. Micro-organism causing neonatal septicemia varies from country to country and also region to region and time to time. In many situations, conventional antibiotics are not sensitive to causative micro-organism. Our aim of the study is to identify causative organism and sensitivity pattern of micro-organism in Neonatal Intensive Care Unit, (NICU).

Biography:

Mir Anwar graduated Medicine from Bangladesh in 1975 He did his post-graduation in Pediatrics from Ireland in 1982. He did his MPH concentration Maternity and Child Health from University of Massachusetts, USA in 2003. Then he joins in UN/ WHO and worked as a Pediatric Consultant & Public Health Specialist, around the world including Asia, Japan, Middle East, Africa, Pacific Island, Ireland and USA. Since 2007 he has been working in South Africa in different provinces of South Africa with the Department of Health. Presently he is working as a Clinical Medical Manager in Richmond Chest Hospital, KZN. South Africa. His main interest presently is in Childhood TB and HIV in Sub-Saharan Africa. In his long carrier in Pediatric and Public Health he had attended several International Congress, Conferences, and Seminars and presented his original work. Some of them were published in International Journal Including American Child Neurology Journal, Japan Pediatric Neurology Journal, Pakistan Pediatric Journal, Bangladesh Child Medical Journal , Nigerian Journal of Obstratics and Gynecology Etc. For his work he is honored by American Academy of Pediatrics, Royal College of Health, UK, and International College of Pediatrics. Etc. His Biography was published in Who’s Who in Medicine Cambridge, UK in 1985.

Abstract:

Background- Sub-Saharan Africa still has the highest child Mortality rates in the world. Global child mortality has dropped by 53% - from 12.7 million in 1990 to 5.9 million in 2015. South Africa has reduced its child mortality rate from 60 deaths per every 1000 live births in 1990 to 41 in 2015. Though the MDG target is 20.

Biography:

Dr. Mirza Sultan Ahmad, did his graduation from Punjab Medical College, Pakistan. He complete his FCPS in 2001. For past 15 years he is working as head of department of Pediatrics in Fazle-Omar Hospital Rabwah, Pakistan. He has presented 10 research papers in national and international conferences, beside authoring 4 articles in peer review articles. Neonatal sepsis, iron deficiency, and electrolyte disorders are his special fields of interest. Beside his profession as Pediatrician, he is a freelance author on history. He has written 3 books on different topics of history.

Abstract:

Objectives: To ascertain the prevalence of hyperthermia and different categories of hypothermia among cases of probable and culture proven neonatal sepsis and to evaluate association of mortality rate with axillary temperature at admission.

Methods: All cases of probable and culture proven neonatal sepsis admitted in NICU, Fazle-Omar Hospital from January to December 2013 were included in this study. Using WHO classification, cases were categorized according to their temperature on admission and outcome was recorded. SPSS 2.0 was used for data analysis and chi-square test was used to compare frequencies.

Results: A total of 374 patients were included in this study and 47 (12.6%) cases died. Two hundred and seventeen (58%) cases had normal temperature, 49 (13.1%) had hyperthermia, 50 (13.4%) had mild hypothermia and 58 (15.5%) had moderate hypothermia. Mortality rate was high among cases with mild and moderate hypothermia i.e., 32.6% and 33% as compared with mortality rate incases with normal temperature i.e., 6.1% and 11.6% patients with hyperthermia died (p<0.0001). Hypothermia was more common in early onset and hyperthermia was more common in late onset neonatal sepsis.

Biography:

Angelica Marie B. Pineda has completed her Bachelor’s Degree in Nursing at the University of Santo Tomas, and currently studies at the University of the East Ramon Magsaysay Medical Center College of Medicine. She has published and presented her college research paper at the 16th East Asian Forum of Nursing Scholars held in Bangkok, Thailand on February 2013.

Abstract:

Literature shows that infant distress and care giving can be sources of stress of primary care givers, especially for first time mothers. The researchers wanted to determine whether Dunstan Baby Language (DBL) is efficacious in decreasing parenting stress among these primiparous women with 0-2 month infants over those utilizing standard newborn care. This research utilized a quasi-experimental approach, where 18 participants were gathered and divided into control (standard care) and experimental (DBL) groups. Descriptive statistics were used in the interpretation of the demographics, while a repeated measures mixed model was used for the Parental Stress Scale (PSS) results. A total of 27 participants were enrolled in the study. The experimental group had 18 participants, with a subsequent loss to follow up of 9, while the control group had 9 participants. These participants had babies with a mean age of 1 month in the experimental group, and 2 months in the control group. An apparent decrease was noted in the Time 1 to Time 2 and the Time 2 to Time 3 PSS scores in the experimental group, as opposed to the control group having minimal changes in their PSS mean scores, but p-values failed to demonstrate any significant difference among them (p-values ranged from 0.053-0.415). Use of DBL among newborn babies led to decreased parenting stress levels among primiparous mothers as reflected in the downward trend of PSS mean scores during the observation period. However, the difference was not statistically significant versus the standard newborn care.

Biography:

Professor Zareen Fasih completed her MBBS holding First class first position- Karachi University pediatrics at the age of 27 years from CPSP. She achieved her MRCP from Royal college of Ireland and was secretary general of Pakistan Pediatric Association 2010_2012. She is the chairperson of Neonatology. She is presently working as professor and consultant Neonatologist at Gulf Medical University, UAE. She has an experience in metabolic and critical congenital cardiac diseases screening at GMC hospital. She is on the editorial board of JppA.

Abstract:

Objective: To study risk factors for Enterobacter sepsis and sensitivity pattern of the organism.

Method: Prospective hospital based study conducted at tertiary neonatal intensive care unit of Ziauddin University Hospital from January 2011 to December 2014. Blood specimens for culture from 2166 babies were sent. Repeat cultures done when the neonate did not show improvement or deteriorated on first line antibiotics. Risk factors were looked for. Antibiotic resistance of the isolate was studied by the disk diffusion technique.

Results: There were 540 (24.93%) cases of culture proven sepsis. Enterobacter was grown in 84 (15.55%) cases. Among the gram negative organism Enterobacter was the commonest organism n=84 (15.5%) followed by pseudomonas n=54 (10%). Among the gram poansitive orgism, Staphylococcus lugdunensis seen in 150 (27.77%) cases followed by Staphylococcus aureus n=54 (10%). Increase incidence of late onset sepsis (4.6/1000 live births) was observed during this period. Univariate analysis of risk factors revealed a significant association between LBW 54 (P value=0.001), prematurity 78 (P value=0.001) and prolong stay 66 (P value=0.001) and Enterobacter sepsis. Resistance to the first line antibiotics (Cefotaxime sodium, Aminoglycoside) was seen in 72% of cases.

Conclusion: Prolonged stay in the nursery due to prematurity/LBW is important risk factors of Enterobacter sepsis. Prolonged use of antibiotics results in emergence of multidrug resistance. Further studies are needed to establish the role of antibiotics in the emergence of multidrug resistant microorganism.

Biography:

Namita Ravikumar has completed her MBBS from Bangalore Medical College and Research Institute Bangalore, India and MD in Pediatrics from Maulana Azad Medical College, New Delhi, India. She has participated in many national and international conferences and presented scientific papers. She is a life member of Indian Academy of Pediatrics and currently working as Senior Resident in Indira Gandhi Institute of Child Health, Bangalore, India.

Abstract:

Children presenting with disproportionate short stature and obvious skeletal deformities were evaluated for skeletal dysplasia in a tertiary care hospital in Northern India. Fift y one children were included from March 2013 to March 2014 in this cross-sectional study. Data collection included detailed history, development, antenatal ultrasonogram, anthropometry and dysmorphic assessment. Skeletal survey/infantogram, thyroid profi le, serum calcium, phosphate, alkaline phosphatase, urinary glycosaminoglycan and enzyme analysis were done in relevant cases. London Dysmorphology Database and European Skeletal dysplasia Registry were utilized. Molecular testing using PCR technique was conducted when feasible. 35 were males and 16 were females and maximum belonged to 6-10 year age group (27%). Twenty six (51%) were short trunk and 25 (49%) were short limb type, further grouped into Rhizomelic (72%), Mesomelic (19%) and Acromelic (9%). Forty five out of 51 skeletal dysplasias could be classified according to Spranger’s atlas, most common being mucopolysaccharidosis (MPS) (23%) followed by Achondroplasia (15%) with a mean age of presentation 70 months and 29 months respectively. Parental consanguinity was present in 23.5%, etiological diagnosis obtained in 88% and molecular confi rmation in 39% of cases. All Achondroplasia & Hypochondroplasia had the common hotspot in FGFR3, two novel mutations were found among the MPS and all cases of Desbuquois dysplasia belonged to the Kim variant. With team approach using clinical and radiological details, fi nal diagnosis can be reached in a large proportion of skeletal dysplasias. Since majority do not have a defi nitive treatment, focus is on the prenatal diagnosis by ultrasonography & molecular methods.

Biography:

Kazi S Anwar, MD (USSR), Mphil (England), Pub Health Training (Japan), is a Bangladeshi Public Health Physician & Microbiologist who devoted most of his research potentiality in child publlic health. He conducted several research projects both at the national (Bangladesh) and international level (Japan, England, Saudi Arabia, Korea, etc.). Currently he is teaching medical students and supervises MSc-thesis at the Faculty of Medicine, AIMST University, Malaysia. He published >50 papers in globally reputed journals, mostly in child public health and presented >26 papers worldwide. He remains a member in editorial/reviewer board of some globally reputed medical journals since long.

Abstract:

Childhood Pneumonia (CPnm) with its 120 million global episodes remains world’s leading cause of child-death and have an estimated 0.22 episodes/child year. While H. infl uenzae type-b causing CPnm has declined dramatically, the non-typeable and Hia, Hif have emerged. Since CPnm reportedly diff ers in population characteristics and socio-economic-status among various countries, this paper highlights cumulative fi ndings from a series of clinico-epidemiological and bacteriological studies on CPnm carried out in Bangladesh & Malaysia relating to socio-economic status, in particular. Posterior-nasopharyngeal samples taken from under-fi ve years-old pneumonnic children using specially designed cotton-tipped fl exible-plastic loops/ wires were streaked on-to supplemented chocolate-agar. Isolated haemophilus colonies were serotyped and antimicrobial susceptibility (disk-diff usion) were performed. In Bangaldesh (Dhaka Medical College Hospital), H.infl uenzae (H. inf) were isolated in 36.2% children, of which ~4.3% were type a-Hia, 1.9% Hid, 1.3% Hic and 0.6% each of Hie & Hif, while vast majority remained either non-typeable (18.2%) or Hib (9.3%). Contrarily, in Malaysia (AlorSetar-SBH Hospital) only 4.8% children (7/148) yielded H. inf all being non-typeable. While multidrug-resistance (MDR)-profi le did not diff er between Bangaldeshi & Malaysian Hin-isolates (p>0.59), child-health care practice diff ered between Malaysia and Bangladesh in terms of clolestrumintroducing (p<0.04), exclusive-breast feeding (p<0.02) and early-hosptalization (p<0.01). similar to parental education, cleanliness/personal hygiene/handwashing and less or smoke-free bedroom (p<0.03, on-average). To conclude, extrapolated data from these studies evidences that child-care practices, socio-economic norms and surronding environment remain plausible factor(s) for pneumonia among young children- a finding which needs more studies focusing causal relationships for further confirmation.

Biography:

William Bonadio MD is currently an attending Physician of Pediatric Emergency Medicine at Maimonides Medical Center in Brooklyn, NY. He has published more than 100 papers in reputed journals and has been serving as an Editorial Board Member of repute.

Abstract:

Background: There is controversy regarding whether in-hospital time delay to appendectomy in children with appendicitis affects risk for perforation. Objective: To evaluate the impact of time delay from ED presentation to OR appendectomy on rates of developing appendiceal perforation in children who present with CT-confirmed, uncomplicated [no radiographic evidence of perforation] appendicitis. Methods: Retrospective case review of 248 consecutive children aged <18 years with CT-confirmed uncomplicated appendicitis during a 4-year period. Results: There were 149 males and 99 females; all received subsequent appendectomy. Despite all receiving ED parenteral antibiotic therapy, 54 [22%] developed in-hospital appendiceal perforation [surgeon operative observation and/or pathologist histologic analysis]. No patient developed perforation when appendectomy was performed within 9 hours after ED presentation; the rate of perforation was approximately 6-fold greater in those with in-hospital delay >9 hours [25%] vs <9 hours [4.6%]. The rate of developing perforation increased to 21% during hours 9 - 16, and 41% after 24 hours. Regression analysis showed 3 factors were significantly associated with developing perforation: longer mean time delay from ED presentation to OR appendectomy, presence of fever, and presence of an appendicolith. The risk for developing perforation increased by 1.10 for each hour of time delay from ED presentation to OR appendectomy; the estimated odds ratio for developing perforation per interval of in-hospital delay is 2.05 at 8 hours, 4.22 at 16 hours, and 8.67 at 24 hours. Conclusions: Increasing in-hospital time delay from ED presentation to OR appendectomy is associated with increased risk for developing appendiceal perforation in children who present with CT-documented uncomplicated appendicitis. Risk is approximately 6-fold greater in those who experience delay >9 hours vs those whose delay is <9 hours. Antibiotic therapy does not reliably prevent progression of the disease. Appendectomy should be considered an urgent procedure to maximize outcome and prevent complications associated with appendix perforation.

Biography:

Zainab Kazmi is a final year medical student at the University of Manchester, based at Royal Preston Hospital. She completed her undergraduate medical studies from the University of St. Andrews. She is keenly interested in becoming an academic clinician who is actively engaged in research. She has been previously published in multiple journals and has presented at both national and international conferences.

Abstract:

Hydrosalpinx is a rare cause of acute abdominal pain in pediatric patients, though some cases are documented in the literature. Its aetiology differs considerably from traditional hydrosalpinx that is due to ascending sexually transmitted infection. Hydrosalpinx in children can present mimicking an acute abdomen or can be asymptomatic. Management of pediatric hydrosalpinx varies, but often involves surgical removal of the affected tube. In June 2015, a literature search using relevant keywords was completed on MEDLINE and EMBASE databases to determine best management of pediatric hydrosalpinx. In total, 66 cases were found from 38 articles. Surgical intervention took place in 74% of cases (n=49). The most common surgical intervention was salpingectomy. In 3% of cases (n=2), nonsurgical medical management with hormonal therapy was utilized, with post-operative improvement in symptomology. In 23% of cases (n=15), conservative management was utilized: 2 of these cases torted, 4 cases persisted and 9 cases resolved. Overall, the results of this review demonstrate that there are comparable outcomes between surgical, medical and conservative management. However, medical and conservative management was not often offered, and more research is needed on the subject.

Biography:

Mohamed Eltorki is a Clinical Assistant Professor at McMaster University. Prior to immigrating to Canada in 2009, he has completed his medical degree in the coastal city of Alexandria, Egypt. His interest in Constipation started during his pediatric residency training at the University of Toronto with a project looking at X-ray use for diagnosing constipation in the Emergency Department. He has recently completed a prospective cohort study of 512 patients with constipation to determine if accurate classification is related to outcome. He has completed his Pediatric Emergency Medicine Fellowship in Calgary prior to joining the department of Pediatric Emergency Medicine at McMaster Children’s Hospital.

Abstract:

The majority of patients seen with abdominal pain in the emergency department get diagnosed with constipation. Yet there is an unclear clinical and therapeutic relationship between abdominal pain and constipation. ROME III criteria are the most widely used and validated clinical criteria to diagnosed functional gastrointestinal disorders including functional constipation and irritable bowel syndrome. The untility of those criteria when used in the emergency department to appropriately classify children is unknown. Our recent prospective study of 512 patients helped illucidate the importance and association of accurate classification to outcome. The author will address the clinical outcomes and response to therapy of children with functional constipation and/or irritable bowel syndrome.

Biography:

Dr. Andualem Henok is currently working in the Department of public health at Mizan-Tepi University, Ethiopia. His research interest is maternal and child health care.

Abstract:

Background: Maternal and child health problems gained greatest attention due to their preventability and are the key indicators of development. Greater than two-third of world populations constitutes women and children who are highly vulnerable to preventable health problems and death. Objective: The community based survey was designed to assess maternal and child health problems in Kometa sub-locality, South West Ethiopia. Methods: A community based maternal and child health survey was conducted from September 12 to 15, 2014. The representative households were drawn based on systematic random sampling method. Interviewer administered questionnaire was used. The raw data were electronically encoded into Epi-Data 3.1 that exported to STATA 13 and SPSS 20 statistical software windows version. Descriptive analysis to determine epidemiological characteristics was used. Result: A total of 198 households that comprised of 840 individuals were involved in this survey. About 160 (86%) households reported, one or more women in marriage relationship were there in their family members, being lowest age of child marriage 108(70.59%) was 9 years. It is also common practices in this community to give birth before reproductive organs maturity in 41(26%) of respondents within less than 18 years. Generally 118(79.2%) of women in marriage relationship were using one or a combination of temporary birth control methods, being depoprovera users were the highest comparatively. Most of those pregnant women 8(53.3%) made a complete course of the third antenatal visit and fourth antenatal visit 4(26.7%). Among under-five children, one in 56(90.3%), two in 5(8.1%) and four in 1(1.6%) of households had immunization card. Child malnutrition was common problem in majority of interviewed households. Conclusion: High quality care services affects greatly effective utilization and hence, more likely to divert concerning maternal and child health problems. Harmful traditional practices which are deeply embedded within cultural beliefs demands efforts of professionals to control them.

Biography:

Ashok Pandey has completed his MPH from Rajiv Gandhi University of Health Sciences. He is the research associate of Nepal Health Research Council (NHRC). He was a constant name at the honor roll and graduated with honors. He had published more than half dozen of articles in different reputed international journals. He enjoys spending his time writing as it is a dream of him to have writing published. He also spends a great deal of time with rural village.

Abstract:

Background: Menstruation period is a risk factor for various infections. Adolescents’ school girls are more vulnerable to infection. The study was carried out to assess the knowledge and practices about menstruation among adolescent girls in Kathmandu Valley. Methods: An FGD was conducted in the two private and public school of Samakhushi. New Himalayan higher secondary school and Ranidevi School was selected with the help of teachers. Adolescent girls of age 12-18 years from one public school and another private school of Samakhushi, Kathmandu Valley were involved in this study. FGD was carried out with a total of 11 girls in New Himalayan School and the 10 girls were taken from the Ranidevi School. To make the respondents feel ease and express freely on the little discussion issues of menstrual practices closed well ventilated classroom was selected. And verbal consent was taken from the respondent prior to FGD. Results: From the study, young girls describe the onset of menarche as a shocking or fearful event. Information was mainly provided about the use of cloth, the practice of rituals in the form of restrictions on their movements and behavior towards males and, of course, the possible effects of her “polluting touch” and the equality polluting potential of the menstrual cloth. The socio-cultural beliefs behind are based on the concept of “pollution” surrounding the conditions of menstruation and usually mothers imparted these beliefs to the girls as important know how to related to the practices during menstruation. If any activities like touches of something is happened unknowingly then her mother, sister sprinkle the gold water through her body. Some of the girls say that (Amilo, Piro) foods were not allowed their mothers in their foods. Most of the girls expressed that first menstruation is often traumatic and very negative experience, culturally girls of Brahmins, Khsatris caste girls are put in seclusion they are not allowed to see sun and male relatives (brothers and fathers). Conclusions: Although knowledge was better than practice, both were not satisfactory. So, the girls should be educated about the process and significance of menstruation, use of proper pads or absorbents and its proper disposal. This can be achieved by giving them proper training and health education so, that there won’t be any misconception to the adolescent girls regarding menstrual hygiene.

Biography:

Mulatu Ayana has completed his Bachelor of Science in Public Health and Masters of public health in public Health Epidemiologist from Haramaya University, Ethiopia. He is the Vice Dean of College of Medicine and Public Health at Debre Markos University. He has been coordinator of community based education program at the college. He is also been working as Postgraduate coordinator at the college. He also worked in many other different postions outside the university like head of Health center, district HIV/AIDS prevention and controlling office coordinator. He has published more than 7 papers in reputed journals

Abstract:

Introduction: Early age at first sexual practice is now common around the world and has been found to pose both social and public health problems especially in the developing countries including HIV, STIs, unwanted pregnancy, induced abortion and Human Papilloma Virus infection. Objective: The aim of this study was to assess the magnitude and factors associated with early sexual initiation among governmental preparatory in-school adolescents in Addis Ababa, Ethiopia. Methods: An institution based cross sectional study was conducted using multi-stage random sampling method from February to March, 2014. Frequencies, means, tables and graphs were used to present data. Data was entered into a computer by using Epi Info version 3.5.1and analyzed using SPSS version 16.0 for windows. Logistic regression analysis was used in order to identify the association between predictor variables and dependent variable and to control confounders. Results: Of 636, study population 25.3% (50.9% of males and 49.1% of females) reported having practiced early sexual intercourse. The mean age at first sexual intercourse was 15.93±1.33 years and 16.14±1.34 years for males and females, respectively. From those sexually active adolescents 7.3% of males and 2.5% of females reported to having had sexual intercourse before the age of 14 years. Sex AOR=0.53; 95% CI (0.30-0.94), visiting night or day party AOR=4.00; 95% CI (2.25-7.13), using drugs AOR=5.23; 95% CI (2.40-11.39) and viewing pornographic materials AOR=2.84; 95% CI (1.43-5.65) were found to be significantly associated with early sexual initiation. Conclusion: There is a high prevalence of early sexual initiation among adolescents and using drug was the strongest predictor of early sexual initiation. Therefore, the government and other stakeholders should give due emphasis in educating adolescents on harmful sides of drugs and create strong and practical controlling mechanisms.

Biography:

Dra Belina Arias Cabello has completed her studies from Autonomous National University of Mexico. She is the Professor from the National Exam for Medical Residencies. She has published some articles related to her field, mostly pediatric ones. She is also the Attending Physician as Pediatric Ophthalmologist and Strabologist at the Association to Prevent Blindness in Mexico.

Abstract:

Introduction: A preventive measure only should be called “screening” when it complies with Frame and Carlson’s criteria. The sought disease must be a common morbid-mortality cause, it should be detectable in a pre-symptomatic stage and therefore the diagnosis tests must have sensibility and specificity. A big percent of children are taken to an ophthalmologist after 24 months after birth, thus the diagnosis of important ocular pathologies is late. Newborn eye diseases are detected in 1:70. There is not a written rule in which, how and with what we should do an ocular screening. From the simple Bruckner’s test, to the most detailed one like the RetCam@ Imaging Digital System, the documentation of the anterior segment and fundus findings for early diagnosis and opportune treatment. Material & Methods: A study was run from August 2013 to April 2015 using the PICTOR@ Digital Ophthalmic Imager/Volk. A complete ophthalmologic checking was performed in newborns in the nursery at the hospital and in the consulting room. Pictures from anterior segment and fundus were took, copied and delivered to the pediatrician. Results: 315 studies were performed before 4 weeks old. 53% were female and 47% male. 85% were made at the nursery hospital and 15% in the consulting room. 13.3% had an abnormal finding like cataract, conjunctival hemorrhage, optic disc pathologies and transitory hemorrhages. Conclusion: Similar findings to those in the literature. The sum of all the anomalies that could be found in the eye are the most frequent of the body. Benefit of newborns in a systemic and ophthalmic level.