Biography:

Abstract:

Early onset sepsis (EOS) is a significant cause of morbidity and mortality in neonates, typically presenting within the first 72hours of birth. The management of infants at risk of EOS varies between units. The introduction of the UK NICE guideline: Antibiotics for prevention and treatment of early onset neonatal infection in 2012 aimed to provide clarity and consistency in the management of such infants. Since publication by NICE the impact of this guideline has prompted debate with several units reporting negative consequences including increased length of stay and number of laboratory investigations performed. We implemented the NICE EOS guideline in two tertiary perinatal centres in Glasgow in 2014 and 2015 after undertaking a robust education programme for all staff members who would be involved in utilizing the guideline. The new guideline came with significant changes in practice. We also introduced a neonatal early warning score chart (NEWS booklet) to be used simultaneously. Following implementation, serial interval audits were undertaken to assess impact on patient care and guideline adherence. In contrast to other published reports we have observed a positive impact on patient care with a reduction in length of stay and no increase in laboratory investigations performed. Furthermore no baby became unwell
following the changes in practice.

Biography:

Xin Ding，MD. PhD, ever as an visiting scholar at Boston Children’s Hospital of Harvard University. Her director is Xing Feng, the secretary-general and permanent member of committee of Pediatrics Branch of Chinese Medical Association. She has published nearly ten papers in reputed journals on circadian rhythm disturbance.    

Abstract:

Circadian rhythm disorder is a common neurological deficit caused by neonatal hypoxic-ischemic brain damage (HIBD). However, little is known about its underlying mechanisms. Our previous studies revealed a significant elevation of clock genes at the protein, but not mRNA, levels in the pineal gland after neonatal HIBD. To investigate the mechanisms of post-transcriptional regulation on clock genes, we screened changes of miRNA levels in the pineal gland after neonatal HIBD using high-throughput arrays. Within the miRNAs whose expression was significantly down-regulated, we identified one miRNA (miR182) that targeted the 3’-untranslated region (3’-UTR) of CLOCK, a key component of clock genes, and played a crucial role in regulating CLOCK expression after oxygen–glucose deprivation in primarily cultured pinealocytes. Our findings therefore provide new insight on studies of therapeutic targets for circadian rhythm disturbance after neonatal HIBD.

Biography:

Abstract:

A global reduction in cerebral blood flow in infants and neonates results in reduced oxygen and glucose supply to the brain which induces brain damage. This results in hypoxic-ischemic encephalopathy in the affected infants. The cerebral manifestations of HIE depend on the period during which ischemic insult occurs, the duration and severity of ischemia. Therefore in preterm infants the peri ventricular white matter ,which happens to be the vascular water shed zone in the developing fetus and is the region of high metabolic demand due to ongoing myelination, is extremely susceptible to ischemic injury.

When ischemia occurs in the term infants on the other hand, cortical and sub cortical injury is more common with lesser degree of hypoxia; while severe hypoxias involves the deep gray matter of thalamus and basal ganglia.

MR imaging is the best modality available today to evaluate infants and neonates of suspected cerebral ischemic injury. Conventional MRI sequences have an established role in detecting both acute and chronic changes of cerebral ischemia. Of late, diffusion MR has shown high sensitivity in detecting acute ischemic changes in the brain parenchyma.

MR imaging diagnoses the extent of damage in the brain, the site of involvement, differentiates between acute and chronic changes in the brain, thereby assisting in prognosticating the clinical course in patients of Hypoxic ischemic encephalopathy. I shall be discussing the spectrum of changes of hypoxic ischemia in pediatric neonatal population on MR imaging.

Biography:

Abstract:

Statement of the problem: (292 words)

The importance of Early Intervention programs' effectiveness acknowledged worldwide. Based on its effectiveness Neonatal Early Intervention (EI) Physical Therapy (PT) Program was established one year ago, in King Abdullah Specialized Children's Hospital in Riyadh. The program starts by screening, evaluating and treating Neonates during admission and continued after hospitalization discharge following in the Early Intervention Clinic in Outpatient Physical Therapy Department.

The purpose of the study:

To determine the effectiveness of implementing the EI Program starting from Neonatal Intensive Care Unit (NICU) admission until 12-18 months, Post Conceptual age, on the Sensory-Motor performance after hospitalization discharge, until following the Early Intervention Clinic in Outpatient PT Department in one year duration.

Methodology and theoretical orientation:

Retrospectively all Medical charts were reviewed for all patients and data were collected and statistically analyzed by SPSS, for all patients included in the EI - PT Program ranging from birth until 12-18 months of age. Therefore, patients not included in the EI - PT program since NICU admission will be excluded from the study.  Many factors, Information and Investigations were considered such as; Diagnosis, Respiratory support modalities, Gestational Age, Post Conceptual age, Radiology outcomes, Postural Alignment, Length of Stay in hospital and the developmental milestone level. Objective measures used are; Osteopathic approach assessment and evaluation, General Movements (GM), Alberta Infant Motor Scale (AIMS). The treatment approaches utilized are; NE-O Osteopathic approach, Bobath concept, family education.

Findings:

The results of Neonatal Early Intervention Physical Therapy Program outcomes will be finalized in 4 months' time. 

Conclusion and significance:

Some considerations as the co-relations between all factors and the collected data besides, the efficacy of Physical Therapy at the early age of intervention.

Biography:

Dr. Olaya-C is pediatric pathologist and PhD from Pontificia Universidad Javeriana. She is the director of Pathology Department and associated professor at the same University and its Hospital Universitario San Ignacio. She has published more than 25 papers and has worked for fetuses’ health for 20 yerars.

Abstract:

Introduction: Preeclampsia is an important syndrome associated with gestation that causes mortality and morbidity not only for fetuses but also for mothers. The rest of the Hypertensive Disorders of Pregnancy (HDP) (including chronic hypertension -from any cause-,chronic hypertension with superimposed preeclamp sia, and gestational hypertension) also cause an important impact. Likewise, umbilical cord complications have been recognized as potentially dangerous for the fetus and the newborn, in aspects such its length, diameter, insertion, entanglements, knots and coiled, increasing the risk of obstetric complications and fetal or newborn poor outcomes. Recently, a relation between umbilical cord abnormalities and preeclampsia has been found in the literature. Preeclampsia has been associated with abnormalities in the umbilical cord, in several ways: morphological, biochemical and functional. Alteration in blood vessels of the placenta, decidua and circulatory system of the fetus might be related to factors that cause preeclampsia and with alterations of the umbilical cord.

Objectives: This study aimed to analyze the relation between each type of umbilical cord abnormality and the different subtypes of HDP.

Methods: We conducted a prospective study on consecutive autopsies and its placentas, looking for abnormalities in the umbilical cord’s features and their clinical associations. Results: Umbilical cord abnormalities (length, diameter, insertion, entanglements, knots and coiled) were interestingly associated with maternal HDP.

Conclusion: Umbilical cord abnormalities might affect the prognosis of the fetuses and the newborn of mothers who suffer preeclampsia.

Biography:

Terence Lao graduated MBBS from the University of Hong Kong, and obstained his MD in 2002. He received training in Obstetric Medicine at the Queen Charlotte’s Maternity Hospital, London, UK in 1983-4, and completed the fellowship programme in Maternal-Fetal Medicine at the University of Toronto in 1989-93. He is professor at the Department of Obstetrcs & Gynaecology, The Chinese University of Hong Kong. He has published 300+ papers in international journals and is a reviewer for 24 journals, and serves on the editorial board of three international journals. His major interest is in maternal medicine and high risk pregnancy.

Abstract:

Thalassemia is the commonest monogenetic disease. Homozygous thalassemia manifests as severe anemia. The manifestation of the heterozygous form can vary from totally asymptomatic and being identified only on antenatal screening, to severe anemia even requiring blood transfusion. It is increasingly encountered outside the Mediterranean region, Africa, Middle East, and South East Asia, due to immigration. Pregnancy, previously uncommon in homozygous ß-thalassemia, is encountered increasingly due to improved management and assisted reproduction technology, but preconceptional problems that include anemia, iron overload, cardiac dysfunction, thromboembolism, alloimmunization, infections, and endocrine and bone disorders, could impact on maternal and obstetric outcome. Successful pregnancy in thalassemia trait carriers and women with hemoglobin H disease is more common, and the pregnancy outcome is usually similar to normal women, although there is still increased risk of obstetric and perinatal complications in case of severe anemia or iron overload. Prenatal diagnosis to exclude fetal homozygous thalassemia and other congenital anomalies, together with close monitoring of the pregnancy, would optimize pregnancy outcome. Further research is warranted to elucidate the fetal safety of iron chelation therapy, and potential impact of pregnancy on long-term maternal health outcome, especially following occurrence of maternal complications.

Biography:

Dr Ananya Das have completed MD Pediatrics from Medical College ,Kolkata. Now she is  doing senior residency in All India Institute Of Medical Sciences(AIIMS) in the Dept of Pediatrics. I have done thesis work on newborn hearing screening.

Abstract:

Background: Hearing impairment is one of the most common abnormalities in newborn. It is often detected late and associated with delayed language, learning, and speech development. New born hearing screening is essential to detect impairment early for improved outcome.

Aims and objective:

Comparison of prevalence of hearing impairment in high risk new-born and normal new-born.

Evaluation of different risk factors for hearing impairment.

Materials and methods:

Study design: Prospective longitudinal case control study

Study place: Medical College, Kolkata

Study period: Nine months

Sample size: Total 764 babies (545-normal newborn/219-high risk newborn) were screened. High risk group was allocation was performed using the Newborn Hearing Screening Programme (NHSP) Risk Factor Screening guidelines.

Methodology: 1st TEOAE was done on all the babies at the time of discharge. The result of the test was interpreted as “Pass” or “Refer.” Babies having ‘Refer’ response were sent for 2nd TEOAE screening 4 weeks later. Babies having a ‘Refer’ response in the second stage were sent for the third stage BERA screening immediately. Absence of wave V in BERA was taken as confirmation of hearing impairment.

Results:

Prevalence of hearing impairment in the normal newborn [0.56%] was significantly less than the high risk group[1.86%] with p value-0.049. Significant risk factors identified were - meningitis (p value 0.001), congenital infection (p value<0.001), mechanical ventilation >5 days(p value<0.001), serum bilirubin>20 mg/dl (p value<0.001).

Conclusion:

Hearing screening should be done in all new-born babies. UNHS (universal newborn hearing screening) protocol using OAE and BERA can be implemented in Indian setting.

Biography:

Dr.Damera Yadaih  Working as a consultant paediatrician at DH, Nalgonda since 23 years.

Working in SNCU from 2008 as CIVIL SURGEON ,HOD.

Instrumental in establish 1^st SNCU in INDIA ,1^ST level2 unit to get accreditation by NNF.

Working to strengthening the FBNC in India to reduce NMR.

Discharged 8000 babies till date, smallest baby discharged 650 gms, 28 wk GA,1^ST of its kind from dist.hospital

Abstract:

AIM : To evaluate the safety, feasibility and efficacy of KANGAROO MOTHER CARE  in VLBW babies.

 Background:Inorder to reduce NMR. Govt of INDIA with the help of UNICEF is strengthening FBNC through setting up SNCU in all districts. The KMC ward at Nalgonda established on our own by overcoming barriers in terms of space, infrastructure, human resources & training.Ours is the first pilot study done on KMC  at any district hospital in India.

Methods: All  VLBW <1.5kg. Were put on KMC & analysed  for the following parameters  : - weight on admission & discharge, breast feeding compliance, sepsis incidence, co morbidities and weight on follow up

 Results: Duration of NICU stay before KMC-9.8days ,Mean duration of KMC-14.3days ,Mean wt. at starting KMC-1.2KG ,Mean wt.at discharge -1.7KG ,Wt.gain/kg/day- 16gms,Mortality –Nil sepsis-nil,Breastfeeding at discharge 100%.

Conclusions: KMC should be implemented as a policy for care of LBW at all new born units.

Disclosure of Interest: None Declared

Biography:

Ida Fidelis Denosta has completed her degree of Bachelor of Science Major in Psychology at the age of 20 in Far Eastern University. She commenced schooling
at Our Lady of Fatima University-College of Medicine at the age of 25 where she graduated as Doctor of Medicine. She just completed her residency training in
Pediatrics at East Avenue Medical Center last December 2016 as an Assistant Chief Resident. She is a member of the Philippine Medical Association, Manila
Medical Society and currently affiliated with Caloocan City North Medical Center as a Junior Consultant in the Department of Pediatrics.

Abstract:

Objectives: This study aims to determine the maternal risk factors associated with the development of retinopathy of prematurity (ROP).
Design: A retrospective cohort study.
Setting: The study was done in a tertiary government hospital.
Patients: This study included admitted premature neonates in neonatal intensive care unit (NICU) who underwent ROP screening. All patients with congenital abnormality of the eyes were excluded in the study.
Methodology: List of admitted premature patients who underwent ROP screening was collected within the study period. Demographic data was collected from the patient’s medical records.
Statistical Analysis: Descriptive statistics were presented for categorical outcome measures. Wilcoxon rank sum test was used to compare two averages. Chi-square test, Yates’ chi-square test and Fisher’s exact test were used to compare proportions.
Univariate and multivariate regression analyses were used to estimate crude and adjusted odds-ratios, corresponding 95% CI and based on p-value ≤ 0.05 statistical significance.
Results: This study showed 57% cases of ROP, majority with Stage 1 (66%), mostly female infants (53.4%; p<0.001), mildly asphyxiated (51.2%, p=0.290; 77.2%, p=0.117) and were small for gestational age (57.3%; p<0.001). On the average, these infants underwent 1 day of either invasive or non-invasive mechanical ventilation, 2 days with FiO2 of >0.5 liters per minute, had two blood transfusions, and with shorter hospital stay (17 vs 26 days; p<0.001). The average age of mothers who delivered infants with ROP was 26 years old, multipara (59.2%), and underwent normal spontaneous delivery (67%). About half reported adequate prenatal check-ups (53.8%), and diagnosed with urinary tract infection (40.1%).
Conclusions: Data showed that mothers with urinary tract infection and preeclampsia are more likely to deliver infants with retinopathy of prematurity thus a significant maternal risk factors of ROP.

Biography:

K.I. has completed MD, PhD from Jichi Medical University and worked as a postdoctoral fellow at Penn State University (USA) and at Genzentrum of München University (Germany). Now she is a professor of Physiology in IUHW and doing experiments with her own hand.

Abstract:

Sodium pump (Na⁺, K⁺-ATPase) is a membrane protein that plays a critical role in maintaining Na⁺ and K⁺ gradients across the cell membrane. It consists of catalytic α and regulatory β subunits. Four α isoforms are found in mammals. In the central nervous system, the α₂ isoform is mainly expressed in glial cells and α₃ isoform in neuronal cells. Point mutations in the ATP1A2 (gene encoding α₂ isoform in human) cause Familial hemiplegic migraine type 2 (FHM2). Point and deletion mutations in the ATP1A3 (gene encoding α₃ isoform in human) cause alternating hemiplegia of childhood, apnea, and severe infantile epileptic encephalopathy often appear after birth. Through the analyses of knockout (KO) mice of the gene for α₂ (Atp1a2) or for α₃ (Atp1a3), here we report that both α₂ and α₃ subunits play important roles in respiratory rhythm generation. Homozygous Atp1a2 KO mice die shortly after birth due to respiratory malfunction resulting from abnormal Cl⁻ homeostasis in brainstem. On the otherhand, homozygous Atp1a3 KO mice showed various respiratory defect. Half of Atp1a3 KO mice made an effort to breath at birth, immediately followed by seizure attack, and resulted in their death. The other showed complete absence of spontaneous body movements and no breathing movements from the very beginning at birth. Consistently, we electrophysiologically recorded various abnormal respiratory activities in the brainstem of Atp1a3 KO mice. These data suggest that both isoforms are essential for survival at perinatal period and Atp1a2 and Atp1a3 play critical, but different roles in respiratory rhythm generation.