Day 2 :
Keynote Forum
Igor Klepikov
Emeritus Professors, USA
Keynote: The value of the new doctrine of acute pneumonia for treatment outcomes
Time : 09:15-09:55
Biography:
Igor Klepikov is a Pediatric Surgeon of the highest qualification in Russia and Israel with experience of over 40 years. Currently he is retired and lives in United States. He has published a more detailed presentation and justification of the new doctrine AP and the results of the above-mentioned studies and clinical trials in the book: Igor Klepikov-"Acute pneumonia: a new look at the old problem", Lambert Academic Publishing, 2017, ISBN (978-3-330-35250-6). This book gives a detailed understanding of the unique mechanisms of the development of AP and the existing ways of influencing them in the direction of stimulation and inhibition. Materials give a real idea about the possibility of guaranteed prevention of suppurative and destructive complications of the disease.
Abstract:
Treatment of acute pneumonia (ÐÐ ) in recent decades focused solely on antibiotic therapy and does not include pathogenetic, specific methods of assistance and repeats the principles of treatment of other inflammatory diseases. Moreover, according to existing therapeutic and preventive recommendations, it is possible to assume that ÐP is a specific form of inflammation. Existing approaches to the treatment of ÐP are in stark contrast with the following well known facts: ÐP is not a contagious specific disease; approval- the priority role of specific pathogens in the etiology of AP have no absolute evidence, for the vast majority of these patients were cured and cure without clarifying the etiology of the disease; cause a significant increase in septic complications AP, contrary to expectations, on the background of total pneumococcal vaccination remains without a reasoned explanation and the etiology of ÐP is represented by many non-specific bacteria. These microorganisms are found as a rule among the symbionts of healthy people. Reducing the effectiveness of antimicrobial drugs, the emergence and the increasing number of antibiotic-resistant pathogens and a gradual increase in the frequency of purulent complications attach importance and urgency to the solution of this problem. The first step in this decision is a revision of ideas about the nature and mechanisms of ÐP. This work has been done and tested in a clinical setting in the years 1976-1984 in Novokuznetsk State Institute for Post-graduate Doctors (USSR, Russia). The basis of the new doctrine ÐP was based on the following scientific medical axioms, already having previous scientific justification. Scientific medical axioms includes: The body's response to any stimulus, including the initiation of inflammation is highly individual and unique; the basis for the inflammatory transformation of the body tissue is a vascular reaction with a specific stage sequence; small and big circles of blood circulation not only have a direct relationship, but an inverse relationship; among the nonspecific forms of inflammation, AP is the only process occurring in the system of lesser circulation and the same medical procedure can have different effects on inflammation in the small or big circles of blood circulation. Following private studies were additionally performed: Experimental model of AP (4 series of experiments, 44 animals) obtaining a model of pleural complications (certificate for invention No 1631574, A1, 1 November 1990, USSR); x-ray examination of 56 lung anatomical preparations with different forms of the AP, taken from the dead patients; record comparative rheopulmonography before and after performing medical procedures (36 patients) and analysis of the observation and treatment of 994 children with AP and its various destructive and pleural complications. The revised treatment guidelines were applied in 101 patients in the initial period of aggressive forms of ÐP. The received results allow to speak about possibility of the guaranteed prevention of suppurative and destructive complications of the disease.
Keynote Forum
Shakuntala Chhabra
Mahatma Gandhi Institute of Medical Sciences, India
Keynote: Hypertensive disorders during pregnancy dangers to fetal/neonatal survival
Biography:
Chhabra is Director-Professor of Obstetrics and Gynaecology, She has served as head of the Department, Obstetrics and Gynaecology at MGIMS (1984-2007), Medical Superintendent of the hospital (2005- 2007) and Dean (2007-10). She is right now helping MGIMS develop a child and mother care hospital at Village Utavali in Melghat, a region with a dubious distinction of high prevalence of severe malnutrition. She received MBBS (1970), DGO (1973) and MD (1975) from the Government Medical College Nagpur. She moved to MGIMS as a lecturer in 1975. In 1984, she was named head of the institute’s Obstetrics and Gynaecology department. She received several awards during her illustrious career. The list includes, but is not limited to: distinguished community services in Emergency Obstetric Care (Federation of International Gynaecologists and Obstetrician), best teacher (Maharashtra University of Health Sciences, Nashik) Dhanwantari Award (Coal India) and best academician-physician (Mahakali Education Society). She has received fellowship of Indian Academy of Juvenile & Adolescent Gynaecology and Obstetrics, Certificate for excellent work in National Family Welfare Programme in Wardha district and also Scroll of Honour of Breast feeding of Promotion Network of India. She also received International fellowships from the British Council; The Network of Community Oriented Educational Institutes for Health Sciences; The Netherlands WHO Aga Khan Foundation; Mother care International, Swedish International Development Agency; Dutch Education Ministry and Maastricht University; Global Health through Education, Training and Service. Over the last 33 years, she has mentored and guided several MD, DGO and PhD students. She is a prolific researcher: she has authored 405 scholarly papers and five chapters in books and some booklets and has held many editorial positions (International Journal of Gynecological Oncology, Women's reproductive health and Gynecological Oncology). She is a reviewer for several journals: British journal of Obstetrics and Gynaecology, Studies in Family Planning, Archives of Gynaecology and Obstetrics, Indian Journal of Medical Sciences, Indian Journal of Clinical Medicine, and Who’s Who in Science and Engineering. An Adviser for AGCO, she is a life member of Association of British Council of Scholars and also a member, faculty of Medicine, Rashtra Sant Tukdoji Maharaj Nagpur University. She is a member of the Women and Health Taskforce of the Global Health through Education Training and Services as well as Master trainer for the programme of Prevention of Parent- to- Child-Transmission of HIV, programme for breast feeding and young child feeding, Violence against Women. Dr Chhabra is assessor for National Baby Friendly Hospital Initiative, a WHO consultant and a supervisor and lecturer for the Swedish International Development Agency (SIDA). She was President of Association of Gynaecologic Oncologists of India in 2002. She is the officer- in- charge of the Sevagram Project for welfare of unwed mothers and Community based Reproductive Health Care project. For over two decades she has also served as Chief Executive Officer of Aakanksha. Her special areas of interest include women’s reproductive health, Gynecological Oncology, and education of health professionals.
Abstract:
Hypertensive disorders during pregnancy, labour (HDsP), dangerous disorders with persisting dilemmas, affect perinatal survival because of many reasons including gestation, and interventions done. In a recent study of 1046 cases of HDPs (11.73% of 8920 births), mean gestation at birth in early onset (EO) HDsP category A cases (>20 + <28 weeks pregnancy) was 30+1 weeks, B EO(>28 - <34 weeks) 32+6 weeks, C LO(>34-<37 weeks) 35+4 weeks and D LO(>37 weeks) 38+4 weeks. In category A preterm births were 97.5%, caesarean section rate 42.5%, category B, preterm births 84.29%, CSR 53.93%, category C, preterm births 31.37%, CSR 40.63%, category D, CSR 46%. Mean birth weight in category A was 1741.54 gms, B 1936.31 gms, C 2633.38 gms and D 2677.30 gms. Perinatal deaths in category A were 45%, (100% perinatal deaths in births before 28 weeks, 100% survival if reached term but only 2), B 25.13%, C 14.32%, D 14.00%. Critical gestation was 32 weeks plus. Around 34 weeks survival was similar to term. In our other study of HDsP, in cases with complete HELLP (Haemolysis, elevated liver enzymes Low platelets) or partial HELLP perinatal mortality rate was 275, overall in HDPs 150, in HDPs without HELLP it was 110. Overall PMR during same period was 50. In Eclampsia cases when conservatism was tried in cases of <32 weeks pregnancy, of 33(8%) cases, 14 intra uterus deaths, 1 fresh still birth + 3 neonatal deaths occurred. Mothers remained healthy. Babies birth weight got affected by premurity and dysmaturity affecting survival. In other study of HDsP lipid glucose metabolism affected birth weight. Calcium, vitamin C, E for prevention of HDsP in high risk cases continues to be controversial. Aspirin helps, controversy is when to start. Low-molecular-weight heparin has been studied with no effect on onset, severity. More research is needed.
Keynote Forum
Brenda Ivette Frias Madrid
Instituto Nacional de PerinatologÃa, Mexico
Keynote: Congenital tuberculosis in an extremely premature new-born: Report of a case
Biography:
Brenda Ivette Frías Madrid is a Specialist in Pediatric and Neonatal Intensive Care. Her graduated as a Surgeon at the National Polytechnic Institute (IPN), completed the Specialties of Pediatrics at the National Autonomous University of Mexico (UNAM) and Neonatology at the National Institute of Perinatology (INPer). Her positions range from being an Anesthesiological Doctor within the Department of Anesthesia of the Institute of Medical Sciences and Nutrition "Salvador Zubirán", and as Coordinator of the Center for the Development of Medical Skills (CEDDEM) of INCMNSZ. She has more than 10 years of experience and is an expert in Pediatrics, Neonatology and Neonatal Intensive Therapy. Dr. Frías Madrid has valid certification from the Mexican Council of Pediatrics, AC. and by the Mexican Board of Certification in Pediatrics, Neonatology Section, AC.
Abstract:
Introduction: Tuberculosis is still considered an infectious disease that causes an important morbidity and mortality in all the world. According to the WHO in 2015 there were reported 10,4 million new cases in the world, from those 3,5 million were women and 1 million sere children. Neonatal tuberculosis is rare and with a high mortality, approximately 50% of the cases
Objective: Describe a case of congenital tuberculosis in an extremely premature newborn (25.5 weeks of gestational age)
Results: Newborn with the next antecedents: Product of a mother of 36 years old, native and resident of Tula de Allende Hidalgo, Mexico. First pregnancy in which mother presents with oligohydramnios and fetal distress reason why it was interrupted by C-section with previous administration of betamethasone and neuroprotection with magnesium sulfate. We receive a feminine product with poor breathing effort who requires endotracheal intubation, APGAR 8/9, weight 830 grams, 25.5 weeks of gestational age. Programed extubation 18 hours post intubation, good breathing effort and oxygenation index. Patient with parenteral nutrition for 10 days and enteral feeding 24 hrs. after birth reaching total volumes for weight. When the patient reaches 32 days of life she courses with a urinary tract infection with urine culture positive for Escherichia coli sensible to amikacin for which she receives 7 day of antibiotic treatment; control of urine culture and renal ultrasound reported normal. At 63 days of life the patient presents with labored respirations needing CPAP for supplementary oxygen support reason why we did the complete study for neonatal sepsis. The thorax X ray had bilateral diffuse heterogeneous infiltrate. Hematic biometry with leukocytosis, toxic inclusions and high neutrophilic band cells, C-reactive protein 9.65 positive and started antibiotic scheme with cefotaxime and vancomycin. Due to the torpid evolution and the lack of improvement we escalated the antibiotic therapy to meropenem and vancomycin. The mother presents a bad surgical evolution, during her study they did a suprarenal gland biopsy isolating Mycobacterium tuberculosis leading to the diagnosis of military tuberculosis. We did bronchial aspirate with Ziehl-Neelsen stain and positive baciloscopy, C-reactive protein in bronchial aspirate positive for Mycobacterium tuberculosis sensible to rifampicin. Cephaloraquid liquid yellow clear, glucose 57,3, proteins 166, LDH 47.5, CRP CRL negative, quantiferon for TB positive. We initiate antifimic treatment with Isoniazid 10 mgkgday, Rifampicin 15 mgkgday, Pyrazinamide 15 mgkgdosis and Ethambutol 20 mgkgdosis Within seven days of treatment the patient presents a satisfactory evolution.
Conclusions: The sequence of events we describe in this case report demonstrate the difficulty of the correct diagnosis and treatment in neonates. The greater risk of transmission of this illness to the fetus is the military tuberculosis of the mother. The clinical symptoms and the findings in the X-ray tend to be unspecific. To stablish a definitive diagnosis in the newborns we need to obtain blood cultures, bronquial cultures, CRL, baciloscopy in gastric secretion and we must consider doing molecular tests such as C-reactive protein with better sensibility and specificity.
Keynote Forum
Elena Castro
Sociedad de Salud Mental, Chile
Keynote: Preserving the flame in the menthal life of premature babies
Biography:
Elena Castro was born in Santiago, Chile, at an extreme of the world, on February 1937. She studied Medicine at Universidad Católica de Chile. In the first promotion of women accepted to become medical doctors at this university, 1953 Years later she was certified as an American MD (ECFMG), but never went on to work abroad. She found Psychiatry as she was attending Medical School, and it has been her concern ever since. She acquired a degree as child and adolescent psychiatrist at Children’s Hospital Luis Calvo Mackenna. During this time she completed her psychoanalysis training at the Chilean Psychoanalytic Association (IPA). Years later, she is also recognised as a child and adolescent psychoanalyst having completed the training approved by the International Psychoanalytic Association. After years of work dedicated to private practice, teaching at the Institute of the Chilean Psychoanalytic Association and giving seminars and supervisions to wider audiences, she focuses her attention on very early childhood, with the idea that special care for babies, is fundamental for a healthy mental development later on. She has been interested, for many years, in the Bick method of baby observation. She is now a member of the International Association of Baby Observation Bick, AIDOBB. She has long participated as a psychoanalyst in several activities at the Neonatology Service in the Hospital San José de Santiago.
Abstract:
The aim of this article is to emphasize the necesity to protect the early psyque in premature new borns, separated from their mothers since birth. These babies survived and stayed alive thanks to a “complex life saver incubator”, handled by a professional team. We will present clinical vignettes, that show some of the delicate menthal mecanisms that are observable, and also the emotional intensity that these babies are able to project in the observer. We will show how early deprivation of a maternal object can affect the incipient mind of a child. In January 2016 it started a one year experience using the Esther Bick´s Observational method in a multiprofessional team in a neonatology Unit. This team takes care of the babies and the idea is to help them internalize an emotional model in order to contain and work through the intense emotions that are awaken while taking care of these babies, without acting or be overwhelmed by them. This experience will open a road through which we are going to be able to hold alive the flame of the menthal life in these little patients, and also build a road to widen clinical research in this field.
Keynote Forum
Mohammad Monir Hossain
Dhaka Shishu Children Hospital, Bangladesh
Keynote: Cause specific management of shock in neonate
Biography:
Mohammad Monir Hossain is currently working as Professor of Neonatal Medicine, NICU & Critical Care of Paediatrics at the Bangladesh Institute of Child Health (BICH) & Dhaka Shishu (Children) Hospital. He received his PhD from the University of Dhaka for his research work on neonate receiving intensive care in 2006. After his graduation (MBBS) in 1987, he completed Doctor of Medicine in Paediatrics (MD) in 1997. He became fellow (FCPS) of Bangladesh College of Physicians & Surgeons in 1999 and Royal College of Physicians and Surgeons of Glasgow (FRCP Glasg) in 2009, Royal College of Physicians of Edinburgh (FRCP Edin) in the same year and Royal College of Paediatric & Child Health (FRCPCH), UK in 2010. Since 2001 he has been serving as Assistant Professor, Associate Professor and Professor at Bangladesh Institute of Child Health & Dhaka Shishu (Children) Hospital. Professor Hossain has authored several publications in various journals and books. His publications reflect his research interests in critical care in neonatology. He was the Executive Editor of Bangladesh Journal of Child Health (BJCH).
Abstract:
Shock is characterized by inadequate oxygen delivery to tissues to meet demand because of circulatory failure. The immediate aim of management of neonatal shock is to optimize perfusion and delivery of oxygen and nutrients to the tissues. Understanding the pathophysiology of neonatal shock helps to recognize and classify shock in the early compensated phase and initiate appropriate treatment. Hypovolemic shock in neonate is usually due to antepartum hemorrhage, post-natal blood loss iatrogenic, or secondary to disseminated intravascular coagulation or vitamin K deficiency, or excessive insensible water loss in extreme pre-terms. Cardiogenic shock in the neonate may be caused by myocardial ischemia due to severe intra-partum asphyxia, arrhythmias, primary structural heart disease, mechanical reduction of cardiac function or venous return secondary to tension pneumothorax or diaphragmatic hernia and disturbance of transitional circulation due to persistent pulmonary hypertension in newborn, or patent ductus arteriosus in premature infants. Distributive shock caused by Neonatal sepsis, vasodilation, myocardial depression, or endothelial injury and obstructive shock is caused from tension pneumothorax or cardiac tamponade. The immediate aim of management of neonatal shock is to optimize perfusion and delivery of oxygen and nutrients to the tissues. The American College of Critical Care Medicine estimates that 60 min is the average time needed to provide adequate circulatory support and block the development of shock. The first step in managing shock in the newborn during the first 5 minutes is to recognize cyanosis, respiratory distress and decreased perfusion. This should be followed immediately by airway access and ventilation to optimize oxygenation. Rapid peripheral, central venous, or intraosseus access is of primary importance in the initial management of the newborn in shock. Any baby with shock and hepatomegaly, cyanosis or a pressure gap between upper and lower limbs should be treated with prostaglandin within 10 min of birth until congenital heart disease is excluded. Inotropes like dopamine, dobutamine, epinephrine and norepinephrine are indicated via iv or io route before central access is achieved when myocardial contractility remains poor despite adequate volume replacement. Delay increases mortality 20-fold.
Keynote Forum
Marie Claude Fadous Khalife
Holy Spirit University of Kaslik, lebanon
Keynote: Comparative study between fenton and intergrowth charts in premature babies
Biography:
Marie Claude Fadous Khalife, graduated in 1989, Pediatrics, Neonatology, Master in Biochemistry, Associate Professor Holy Spirit university of Kaslik, Pediatrics coordinator, Chief of Pediatrics Department, University hospital, Notre Dame Des Secours, Lebanon.
Abstract:
Introduction: Different charts are used to assess premature growth. Fenton chart which is based on prenatal growth was used in our newborns intensive care unit to assess premature newborns’ development. Intergrowth21 is a new multidisciplinary, multiethnic growth chart better adapted to premature growth. Our objective was to compare both charts Fenton and Intergrowth21 in order to implement Intergrowth in our unit.
Materials and Methods: We analyzed 318 files of premature babies born who were admitted to the NICU from 2010 till 2017. Anthropometric data (weight, height and head circumference) converted to percentile was filled on both charts from birth till 6 months of age. These values were compared by Paired T-test.
Results: We obtained a significant result in favor of Intergrowth 21 with a p value= 0,000 at different timings. Only at 3 months, charts showed no more significant differences with p>0.05.
Conclusion: Our study represented an additional proof that premature newborn growth is underestimated by the old growth charts. It also showed similar results to the classic charts. Pediatricians can fill their own curve starting 3 months.
Keynote Forum
Ruchi Sogarwal
PerkinElmer Inc, India
Keynote: Implementation of newborn screening program to improve newborn health: Policy to practice gap in India
Biography:
Ruchi Sogarwal, a professional in health and development sector for more than a decade, having a special focus on reproductive health and infectious diseases. She is currently working as Deputy General Manager, PerkinElmer, leads public policy matters of the company in South Asia. In the past, she served the Ministry of Health and Family Welfare, Government of India, and also led various CSR/philanthropy supported implementation science projects contributing to the national sustainable development goals to improve health outcomes. She is a PhD in Epidemiology and Executive Global Business Management from IIM, and had been trained in Public Health and Biostatistics at the University of Michigan, USA. She has published more than 40 papers in indexed Journals and has been serving as a member of various editorial and scientific committees of repute.
Abstract:
The need for a significant reduction in neonatal mortality rate-‘NMR’ has strongly been stressed upon by the Government of India through focused initiatives at the facility level like setting up of Sick Neonatal Care Units, Newborn Stabilization Units, and Nutrition Rehabilitation Centres and at the household level by Kangaroo care, etc. recognizing the birth defects as a major contributor to neonatal and infant mortality and disability, the Rasthtriya Bal Swasthya Karyakram-‘RBSK’ (National Child Health Program) was launched in 2013 to benefit 270 million children by screening and ensuring treatment and management of 4D’s–defects at birth, deficiencies, diseases and developmental delays, including disabilities. Furthermore, the India Newborn Action Plan was launched with the goal to attain single digit NMR by 2030. The purpose of this article is to explore the pertinent gaps from policy to practice in establishment and implementation of newborn screening to improve survival outcomes in India. This paper is based on review of relevant literature from the year 2007 to 2017, including policy guidelines, scientific articles and reports. Trend analysis indicates that India has initiated newborn screening in a research mode in public health institutions and shifted to pilot and state government programs. Pilot programs like the Goa and Gujarat fell apart and could not be scaled up due to various reasons; a large panel of disorders to be screened being one of them. Though at policy level utmost priority has been given to strategies for prevention of birth defects, however, the study recommends five strategic actions to address practice gaps of screening program, standardize newborn screening implementation model, capacity building of human workforce, strengthen coordination and linkages of newborn screening within the existing mother and child health program for effective follow up, long term public health budgeting and value based procurement.
Keynote Forum
Pushwinder Kaur
Punjab Institute of Medical Sciences, India
Keynote: Risk of hypoglycemia in normal, healthy and exclusively breast fed newborns in first 24-48 hrs of life
Biography:
Pushwinder kaur has her expertise in evaluation and passion in improving the health and well being. She has completed her MD pediatrics at age of 26 years from Baba Farid University of Health Sciences, Punjab, India and Fellowship in neonatology from Chaitanya hospital, Chandigarh, India. She is currently working as Assistant Professor in Department of Pediatrics, Punjab Institute of Medical Sciences, Jalandhar, India. She has clinical experience of 12 years in pediatrics and neonatology. She is member of IAP and NNF organization.
Abstract:
Objective: To assess risk of hypoglycemia in normal, healthy and exclusively breast fed newborns in first 24 – 48 hrs of life.
Methods: A prospective, longitudinal study conducted on 141 normal healthy, exclusively breast fed newborns. Blood glucose was measured at birth, 2hrs, 6 hrs, 12hrs, 18hrs, 24hrs, 36hrs and 48hrs after delivery. The impact of parity, mode of delivery and intrapartum intake of glucose on blood glucose was analysed.
Results: Of 141 newborns, 5 had asymptomatic hypoglycemia who responded to breast feed or formula feed. Incidence of hypoglycemia was 3.5% among all, 33.3% in LGA babies, 33.3% in SGA babies and 2.2% in AGA babies. Mean RBS at the time of hypoglycemia was 36.17+ 1.7mg/dl. Mean RBS among hypoglycemic babies at birth was 94+41.9 mg/dl. Mean overall age of presentation of hypoglycemia was 6hrs 20 min. Newborns born to mothers with higher intrapartum intake of glucose had higher blood sugar levels at birth followed by lower blood sugar levels at subsequent 2 hrs and 6 hrs of life. The fluctuations in the blood sugar values were significantly associated with intrapartum glucose intake by the mothers. There was no statistically significant difference in the occurrence of hypoglycemia based on gestational age, parity and mode of delivery.
Conclusions: A normal healthy and exclusively breastfed newborn had a significantly high incidence of asymptomatic hypoglycemia, more so in SGA, LGA and male babies. However parity, gestation and mode of delivery did not influence blood glucose levels.
Keynote Forum
Hamid Yahya Husain
Dubai Health Authority, UAE
Keynote: Three years follow up (cohort) study via population based intervention on adolescent and childhood obesity and overweight at schools setting
Biography:
Hamid Yahya Husain is a Professor at Dubai residency training program/ Community and family medicine/ Arab Board for health specializations. Professor of Community Medicine and Public Health Medicine at Faculty of Medicine, University of Baghdad.
Abstract:
Background: Obesity and overweight are recognized as major global public health phenomena. Its long term consequences are many of wide variety of chronic conditions including high blood pressure, type 2 diabetes, stroke, cardiovascular disease, and certain forms of cancer; which in turn are primary drivers of healthcare spending, disability, and deaths, childhood obesity is complex and multidimensional, which has been identified as a public health priority It is also recognized that obesity decreases the quality of life and life expectancy considerably.
Objective: To assess population based childhood obesity intervention over three year at school population in Dubai, To examine the childhood obesity intervention outcome.
Methodology: About 2600000 students age range( 5-18)years grade( 1 –12)over about 180 private schools in Dubai over three consequence academic years 2014-2015,2015-2016 and 2016-2017, BMI measurement as per CDC criteria and chart, WHO( mean + - SD)centile Body weight at the beginning of each academic year(September), wide variety of interventions been designed an applied e.g. health promotion, school Nutritional education activities, Food labelling, happy schools initiatives, 10/10 initiative physical activity platform, parents awareness, students health file initiative, City Makers(blue team initiative), community participation(private –public partnership, Governmental stockholders intersect oral collaborations school cantin policy and guideline, BMI and other age and gender based BMI and centile measurement done at the end of academic year(June )for(3)successive academic years.
Result: The current study revealed that about 8.7% of the total students population in private schools in Dubai were obese and about 1.4% of the total students were morbid obese in total of 10.1% of the total students were obese of different severity. The study showed that the prevalence of obesity among student population at private schools in Dubai during the academic year 2015-2017 was 9.05% the study showed 0.9% reduction of obesity comparing academic year 2014-2015 to academic year 205- 2016), the study reflected that prevalence of obesity among student population at private schools in Dubai during the academic year 2016-2017 was 8.2% which was about 1.3% less comparing to the prevalence of obesity during academic year 205-2016,). The study revealed that the trend of obesity prevalence among students population at private schools in Dubai is declining over that last three academic years (2014-2015,2015-2016.2016-2017) showing that about 2.2% total reduction the tree years period of applying effective intervention program.
Conclusion: mulitdisplenary public health intervention for childhood obesity is successful in producing weight loss in the short and long term, when stakeholders brought on board effective means.
- Young Research Forum
Location: RED CEDAR BALLROOM C
Session Introduction
Heber J Oliva
Nacidos Hospital Escuela Universitario, Honduras
Title: Social accountability to improve new-born health
Biography:
Heber Oliva is a 4th year Student of Medicine and Surgery with consistent experience, leadership, and capacity oriented to work by objectives. Volunteer Coordinator at Fundacion Angelitos Recien Nacidos Hospital Escuela, it was founded in mid-2012, inspired by the doctors who run the medical rooms of the Newborn Area, our mission is to ensure permanent support to the Newborn wing of the Hospital Escuela, through the delivery of supplies, equipment, medicine, and materials in order to contribute to the sustainability and improvement of health services through actions and activities with the community and interest groups. It was also member of the Organizing Committee of the I National Congress of Neonatology in Honduras, Integral Management of Perinatal Asphyxia Workshop and Neonatal Dialogues both by Inter-American Neonatal Society (SIBEN), Academic Tutor of Structure and Function and National Exchange Officer on Professional Exchange in IFMSA-Honduras.
Abstract:
Health should be at the center of sustainable development. Accountability will be an important part of the new development agenda. Ban Ki-Moon, UN Secretary General, May 2014. WHO has defined the social accountability of medical schools as “the obligation to direct their education, research and service activities towards addressing the priority health concerns of the community, region, and/or nation they have a mandate to serve. The priority health concerns are to be identified jointly by governments, health care organizations, health professionals and the public”. The concept of equity is firmly embedded within the right to health. “Health equity is both the improvement of a health outcome of a disadvantaged group as well as a narrowing of the difference of this health outcome between advantaged and disadvantaged groups-without losing the gains already achieved for the group with the highest coverage.” But how equity looks like in Honduras? 20% of the babies born in the maternal and child ward require special care, 50% of the babies that require a spot in the intensive care unit, die because of the lack of it, 7 out of 10 children who die in Honduras are newborns, 40% of the babies that are treated in the newborn area of the maternal and child ward, die from conditions associated with infections. According to international standards, the neonatal intensive care unit should have one available spot for every one thousand live births per year. In this case, this area in the Maternal and Child Ward has only 8 available spots for approximately 17,000 annual births. Social accountability of medical education means a willingness and ability to adjust to the needs of patients and health care systems both nationally and globally. We as medicine students must leave behind indifference, selfishness, the individualistic attitude and disregard of public affairs. We are not the future, we are the present and part of the solution, our opinion and proposals are indispensable
- Poster Presentations @ 17:25-17:45
Location: RED CEDAR BALLROOM C
Session Introduction
Rena Eudy-Byrne
Metrum Research Group, USA
Title: Development of a mathematical model of the effects of gastrointestinal disease and dietary nutrition on infant body composition in order to improve outcomes in those suffering from malnutrition
Biography:
Rena Eudy-Byrne, PhD has over 5 years of experience developing physiolgical systems models and other modeling and simulation applications for drug developent. Her training is in Biomedical Engineering.
Abstract:
Malnutrition in infants in low- to middle-income countries is a complex problem caused, in part, by underfeeding and an increased prevalence of gastrointestinal (GI) disease. To understand and separate the effects of nutrition and disease on infant growth, a physiologically-based mathematical model was developed describing fat mass (FM) and fat-free mass (FFM) from birth to 2 years. This effort was based on a published model describing growth dynamics, expanded to include effects of infection and nutritional status on nutrient absorption in the gut. Model calibration used published data to quantify the physiology of healthy and non-healthy GI function and resulting physical growth, including: Macronutrient absorption efficiencies, deposition of metabolizable energy into FM and FFM, total energy expenditure, dynamics of severe bacterial and viral infections, effects of malnutrition on GI/immune function, recovery from malnutrition. The model was validated using individual data from different geographical locations representing various phenotypes, dietary intakes, disease susceptibilities and child rearing patterns. One important insight from this work resulted from the differential FM and FFM composition of weight loss during infection and weight gain during recovery, dependent on the degree of malnutrition and individual phenotype. For example, an interesting phenotype has been seen in infants at risk of malnutrition whereby FM is increased despite energy intakes smaller than age-appropriate requirements. The model was able to mechanistically recapitulate this phenotype by imposing repeated cycles of weight loss/gain due to infections or underfeeding, indicating the potentially large impact of non-dietary factors on infant growth outcomes.
Biography:
Negar Sajjadian has completed her neonatology fellowship since 14 years ago and works as an Associate Professor of Tehran University of medical sciences since 13 years ago. She was the head of shariati hospital, sNICU and now is the head of baharloo hospital, sNICU. She has published more than 20 paper in reputed journals and also has written 3 books in neonatology fields. She is also a membere of Iranian society of neonatology.
Abstract:
Objective: To evaluate the effect of low intensity recorded maternal voice on the physiologic reactions of healthy premature infants in the neonatal intensive care unit (NICU). Methods: Physiologic responses of 20 healthy preterm infants in the NICU of Shariati Hospital, Tehran, were obtained during a 15min intervention including three 5min periods (no-sound control, audio recorded playback of mother's voice, no-sound post-voice). The intervention was presented three times a day for three consecutive days. During each intervention, oxygen saturation (%, OSPR), heart rate (HR), and respiratory rate (RR) were recorded at 1min intervals over the 15min and then averaged over each 5min period, resulting in 3 averages for each variable for each intervention. Results: Repeated Measures Analysis of Variance were employed to examine each variable separately. Over the three days, comparison of oxygen saturation over each of the three periods (before, during voice, after) revealed an increase in oxygen saturation during the voice period, compared to the pre-voice period, which persisted over the post-voice period; there were no differences between the voice and post-voice periods. Analyses of the HR and RR data showed a decrease in both variables during the voice period compared to the pre-voice period which persisted over the post-voice period. Again, there were no differences between the voice and post-voice periods. Conclusion: Exposure to low intensity recorded maternal voice has positive effects on the preterm infants 'physiologic responses.
- Video Presentation
Location: RED CEDAR BALLROOM C
Session Introduction
Papamichael Maria Michelle
La Trobe University, Australia
Title: The prophylactic potential of fatty fish consumption on airway inflammation in childhood asthma
Time : 17:45-17:5
Biography:
Maria Papamichael is a Registered Dietician/Sports Nutritionist who has dedicated her life in educating people the importance of good nutrition and exercise in the prevention and management of disease as well as in improving health and well-being. Being an asthma sufferer since childhood, has motivated her to undertake a PhD research project at La Trobe University (Australia) to investigate the prophylactic potential of a Mediterranean diet enriched with fatty fish in the management of asthma in children.
Abstract:
According to the World Health Organization, 235 million people worldwide suffer from asthma. It is the most common chronic disease among children responsible for hospitalization, emergency visits, 10 million missed school days per year, impacts the productivity of working parents and inflicts a societal economic burden due to increased medical costs. Although genetic, environmental and epigenetic factors have been identified, an effective therapeutic intervention is yet to be identified. We conducted a single-centred parallel randomized controlled trial of six months duration to examine the prophylactic potential of dietary omega 3 fatty acid intake in pediatric asthma. Seventy-two children (54.2% boys; 45.8% girls), 5-12 years old with physician-diagnosed ‘mild asthma’ were selected from a paediatric clinic in Athens, Greece and randomized to two groups. The intervention group consumed two fatty fish meals per week (≥ 150g fillet fatty fish/meal) and the control group, their usual diet. Pulmonary function was assessed using spirometry, bronchial inflammation with exhaled Nitric Oxide analysis (eNO), asthma control and quality of life by questionnaires. Multiple linear regression model showed a statistically significant change in eNO in the intervention group (95%CI: -27.39, -0.91; beta = -14.15; p=0.037) adjusting for confounders of age, sex, regular physical activity and BMI. Fatty fish intake twice weekly reduced bronchial inflammation by 14 ppb. No differences were observed for spirometry, asthma control or quality of life scores. This study suggests that two meals of fatty fish per week (≥ 150g/ meal), a rich source of Ω3 fatty acids, might be an effective therapeutic intervention targeting inflammation in pediatric asthma.