Biography:

Prachi Shah is currently working as Associate Professor of Pediatrics in University of Michigan, USA. She has published several papers in reputed journals. Her research interests focus on the development of emotional regulation in infants born in the late preterm period.

Abstract:

Objective: To examine the association of gestational age with poor school readiness in kindergarten reading and math skills. We hypothesized that compared to infants born at 39-41 weeks; infants born at lower gestational ages would have poorer school readiness.

Study Design: Sample included 5250 children from the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B), assessed with specialized reading and math assessments at kindergarten. Poor school readiness was characterized by reading and math theta scores ≥1.5 SD below the sample mean. The adjusted odds ratios (aOR) and 95% confidence intervals (CI) of poor school readiness were estimated using multivariate logistic regression, examining gestational age continuously and categorically (very preterm (VPT), moderate/late preterm (M/LPT), early term (ET) and term). Pairwise comparisons tested for differences by gestational age categories.

Results: There was an association between gestational age and poor school readiness for reading and math with suggestion of a threshold effect in children born ≥32 weeks gestation. In adjusted models, the odds of poor school readiness in VPT reading and math were aOR=2.58, 95% CI [1.29-5.15] and aOR=3.38, 95% CI [1.66-6.91], respectively. However, for infants born M/LPT and ET, the odds of poor school readiness in reading did not differ from children born full-term.

Conclusions: Compared with term infants, the highest odds of poor school readiness in reading and math were seen in VPT infants, with lower odds of poor school readiness in children born ≥32 weeks gestation. Ongoing developmental surveillance prior to kindergarten is indicated for very preterm infants.

Biography:

Yair Sadaka is a Pediatric Neurologist, Pediatrician with a PhD in Neurosciences and background in Behavioral Sciences, Computers and Electronics. He is currently working as a Pediatric Neurologist and Pediatrician at Soroka Medical Center and Lecturer at Ben Gurion University. He is an Entrepreneur since 2012 and CEO of LinkCaring Ltd. He was involved in several research fields in the past few years, namely: McDonald criteria for diagnosing pediatric multiple sclerosis at the Hospital for Sick Children, Toronto working on the Canadian Multiple Sclerosis Database; evaluating actigraph in children with epilepsy at the Hospital for sick Children Toronto and Avi Sadeh Tel Aviv University; building and analyzing the epilepsy and sleep database at the Hospital For Sick children. He is working on a web system with a vision of a better communication between the patient, the patient's parents and the health care provider at Soroka Medical Center.

Abstract:

Objective: The new diagnostic statistical manual (DSM) requires the presence of fewer symptoms to make a diagnosis of adult ADHD while the criteria for diagnosis in childhood are unchanged as compared to previous editions. This study examines the prevalence of adults meeting the revised DSM-5 symptoms cutoff as compared to the previous DSM-IV symptoms cutoff.

Method: This study is part of a larger nationwide study that evaluated the use of, and the attitudes toward, ADHD medications by university students. 445 students from four major university faculties were surveyed and filled out questionnaires for our study.

Results: The proportion of participants that met the minimum threshold of six out of nine current symptoms in either of the two DSM-IV symptom domains (inattentive presentation and hyperactive/impulsive presentation) for ADHD was 12.7% while the proportion that met the minimum threshold of five symptoms in either of the DSM-5 symptom domains was 21%.

Conclusion: Since the new DSM requires fewer current symptoms for a diagnosis of ADHD, a significant increase (65%) was observed in the number of participants meeting the new cutoff as compared to the old DSM-IV symptoms cutoff. This increase in the number of adults meeting symptoms cutoff may affect the rates of adults diagnosed with ADHD. Using the new criteria may identify more adults with ADHD and fewer diagnoses will be missed. However, meeting the new symptoms cutoff should be considered within the overall clinical context to prevent over-diagnosis.

Biography:

Cristina Alomar Dominguez has completed her Medical studies from Universitat Autonoma de Barcelona. Currently, she is working at the Department of Anesthesiology and Intensive Care at Innsbruck Medical University. In both, clinical and research fields, she managed to cooperate with the departments of Neonatology, Gynecology, Psychiatry and Anesthesiology for this pluridisciplinary project.

Abstract:

During pregnancy, birth and lactation various interactions occur between structural alterations of the maternal brain and placental metabolism. Functional and structural synaptic plasticity and dendritic remodeling occur in different regions of the maternal brain to maintain physiologic conditions and proper fetal and neonatal development during pregnancy. Cerebrospinal fluid concentrations of tau, phospho-tau-181 and amyloid ß42 proteins, as well as brain-derived neurotrophic factors, glial cellline- derived neurotrophic factors and vascular endothelial growth factors were investigated. We evaluated whether biomarkers vary during normal pregnancy and in women with preeclampsia and HELLP syndrome. Biomarkers in the cerebrospinal fluid of 90 pregnant women electively assigned for regional anesthesia during pregnancy or for cesarean section were measured using enzymelinkedimmunosorbent assays. Blood pressure, liver function, clotting activity and kidney function were significantly different in 11 women with preeclampsia and HELLP syndrome. The weight of the newly born, the weight of the placenta and concentrations for phospho-tau-181 correlated significantly with the disease. Phospho-tau-181 protein concentrations correlated with placental function supporting the hypothesis that altered expression of neuronal factors during pregnancy may affect development of the placenta. Levels of amyloid ß42 were significantly increased in 62 healthy pregnant women at term compared to 7 healthy women in the second trimester. Although not significant, the cerebrospinal fluid levels of growth factors, tau and phospho-tau-181increased during pregnancy. This may indicate a physiological adaptive response of the brain function to the growing metabolism of the fetus.

Biography:

M C Jaramillo Mejia is a Full Time Faculty Member from 2007 and Coordinator of MA Health Management from 1998 at the Icesi University. He pursued PhD at Universidad de Granada with major in Clinic Medicine and Public Health. He completed MS at Niversidad de Granada in 2009 with major in Preventive Medicine and Public Health and MA at Instituto de Ciencias de la Salud-CES in 1992 with major in Management of Public Health. He also did MA at Universidad EAFIT in 1990 with major in Hospital Management. He received BS degree at Universidad de Antioquia in 1984 with major in Medicine and Surgery.

Abstract:

Objective: The goal of this study was to inform public health policy which can reduce Colombia’s estimated infant mortality rate (IMR) by lowering preventable first day mortality (PFDM).

Methods: We combined a time series analysis, using a linear regression method, for examining the trends for 2001–2012 in Colombia’s infant mortality rate per 1000, and in the relative significance of PFDM by cause, with a cross-sectional analysis, using odds ratios and bivariate methods for the year 2012 to study first day mortality (FDM) and PFDM classified by biological, socioeconomic and medical correlates. Then, the study established the major causes of PFDM within major risk categories and groups.

Results: Between 2001 and 2012, the average annual rate of FDM declined by 6.30%, while overall infant mortality only declined by 4.20%. Yet, in 2012, 37.04% of FDM was preventable by using proper pregnancy control (7.00% of total preventable), proper care during childbirth (37.20%) and handling causes associated with late diagnosis and treatment (55.80%).PFDM is primarilysocio-economic phenomenon, even among normal weight and gestational age newborns, which account for 32.73% of PFDM due to improper management of pregnancy and delivery among lower socio-economic and outlying populations, specifically in rural areas and the inferior subsidized social insurance regime.

Conclusion: From efficacy and probable cost effectiveness perspectives, intervention priority should be given to handling babies with normal gestation age and birth-weight, and then to babies with very low gestation age and birth-weight. The use of fetal monitoring and echography methods by all general practitioners should be considered.Objective: The goal of this study was to inform public health policy which can reduce Colombia’s estimated infant mortality rate (IMR) by lowering preventable first day mortality (PFDM).

Biography:

Rigler Tohar has completed his MD from UMF Iasi. He is a Resident of Pediatric in Soroka University Medical Center. He is a part of a research group that practices mainly on ADHD.

Abstract:

Background: In recent years, there has been an increase in the use of ADHD medications among students who do not have a diagnosis of ADHD in an effort to improve their academic performance. This includes medications that have been obtained through a legitimate prescription and through other means. How healthcare trainees perceive and use these medications deserves a special focus as their current attitudes and choices may influence their future practice in managing the care of children with ADHD.

Methods: Students were asked about symptoms of ADHD according to the 18 criteria in the DSM 5 and were also surveyed about their attitudes towards the use of methylphenidate (MPH) and their personal use (both with and without prescription). A sample of 312 students was taken from a cohort of pediatric residents, and medical and psychology students. An additional 133 engineeringstudents were sampled for the sake of comparison.

Results: Overall, 22% of all healthcare trainees reported some MPH use. Healthcare trainees were far less likely to carry a formal diagnosis of ADHD than engineering students (9% vs. 23%), although they tended to meet diagnostic criteria to the same level (20% vs. 21%). Healthcare trainees were also more likely to use these medications without a formal ADHD diagnosis (only 37% of health care MPH users had a formal diagnosis vs. 60% among engineering trainees) and they were far more likely to believe that MPH has an effect on people without ADHD (71% vs. 55%).

Conclusions: High rates of health care trainees who do not have a diagnosis of ADHD report using MPH and may not be educated enough about the subject of ADHD. Healthcare trainees should be educated about the importance of appropriate diagnosis of ADHD and the responsible use of methylphenidate.

Biography:

Tatiana Papazian is a Clinical Dietitian and Nutrition Lecturer at the St. Joseph University (USJ), Faculty of Pharmacy since 1997. Her main academic interests are the medical nutrition therapy in pathologies. Currently, in her second year of Doctoral studies at USJ, she is working in the assessment of the nutritional status of pregnant females and the genetic polymorphisms regarding PgP transporters in the placenta, together with the inflammatory markers and its association to the Mediterranean diet and the aflatoxin exposure of both the mother and the child.

Abstract:

Accurate dietary assessment tools are required to ensure that maternal diet supplies all the nutrients needed for fetal development. However, no dietary method could accurately estimate food intake, especially during gestation, where physiological changes affecting nutritional status are frequent. Food Frequency Questionnaires (FFQ) are tools frequently used in epidemiological studies, because they can estimate long term nutritional status of the target population. However, it is recommended to create and validate a FFQ compatible with the dietary habits of the studied population, to avoid cultural and social discrepancies. Hence, this study aimed to develop and test the reproducibility and the validity of a semi-quantitative FFQ compatible with the diet of Mediterranean and Middle-Eastern population, in a sample of Lebanese pregnant women. 128 women participated in the validation study, while 38 took part in the reproducibility phase, which was repeated in a time frame of 21 days. The FFQ was validated against a 24 hr. dietary recall (DR). The intra class correlation coefficient (ICC) ranged from 0.935 for calcium to 0.984 for vitamin D (value<0.001), indicating an excellent reproducibility. Spearman’s and Pearson’s correlations coefficients varied between 0.294 for iron to 0.762 for caloric intake (p value<0.01) implying a satisfactory agreement between the two tools. Bland-Altman plot showed good agreement between these two dietary tools. In conclusion, the newly developed FFQ englobing Mediterranean food items was culture specific and assessed the nutrient intake of our population. Administering this tool in future researches will help us monitor the nutritional status of pregnant women, aiming at implementing more effective strategies for improving maternal and newborn health.

Biography:

Umesh Joshi is Post-graduate specialty resident in Pediatrics Department at the V S General Hospital, Ahmedabad. He received his MBBS from Smt. NHL Municipal Medical College and is currently pursuing MD from V S General Hospital. He completed his schooling from prestigious Sacred Heart Convent School and Delhi Public School, New Delhi. He had attended numerous seminars on autistic spectrum disorders and presented same in national conferences. He was given AAP certified Neonatal Resuscitation Program Certificate in 2015. He had been currently working under renowned Epileptologist Dr. Nitish Vora for 1 year. Apart from medicine, he had special interests in music and tennis.

Abstract:

Introduction: Epilepsy is one of the most urgent problems in pediatric neurology. Asserting the causes and types of seizure is important for diagnostic purposes and for evaluating therapy. Objectives: To identify the clinical & etiological profile of children and the characteristics of seizures in them along with therapeutic responses.

Methods: All patients who attended the epilepsy clinic & fulfilled the selection criteria were enrolled in study. This is a descriptive study of 12 months (June’15–June’16) & involved analysis of records of the patients who came to specialty OPD. Three groups were formed accordingly–focal, generalized & unknown onset with further etiological sub-divisions-Genetic, Structural/Metabolic, Immune, Infectious & Unknown.

Results: In all, 417 patients were studied. The distribution as per clinical presentation was- group I (generalized) 215 (58.5%)–group II (focal) 154 (36.9%), and group III (unknown) 48 (4.6%). The main etiologies were perinatal asphyxia (28.3%), NHBI (11.4%) in (structural–metabolic) sub group. In Genetic & Infectious, Channelopathies (10.5%) & Post Meningitis Sequelae (4.7%). 56.3% of the patient in group II were on more than 3 AEDs. 14.3% in group I were weaned of AEDs. 61.4% patients in group II were having neuro-developmental sequelae. EEG revealed abnormal activity in 30 (6.2%) in group I & 31 (19.3%) in group II. Maximum patient with refractory epilepsy were seen in group III.

Conclusion: To have a good management of epilepsy, we need to have multi-dimensional classification of epilepsy based on both clinical & etiological spectrum. Perinatal asphyxia & NHBI are one of the most common yet avertible etiologies.

Biography:

Fasih Zareen is a Consultant, a Pediatrician and Neonatologist at Gulf Medical College Ajman, UAE from 2014 till date. She is Consultant Neonatologist and Pediatrician at Al–Zahra Hospital, Sharjah, UAE. She is Chairperson and Professor of Pediatrics at United Medical and Dental College, Karachi, Pakistan from 2013. Also, she is Head of Department, Professor of Pediatrics and Neonatologist at Ziauddin Medical University Hospital since 1999 till date. She is a Gold Medalist and topped Karachi University, holding First Class First position in final year in MBBS, Examination and won President's Award, Pakistan. She has published 7 papers.

Abstract:

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

Method: Prospective hospital based study was 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 were 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 positive organism, Staphylococcus lugdunensis was seen in 150 (27.77%) cases followed by Staphylococcus aureus n=54 (10%). Increased incidence of late onset sepsis (4.6/1000 live births) was observed during this period. Univariate analysis of risk factorsrevealed 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 factor 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.