Scientific Program

Conference Series Ltd invites all the participants across the globe to attend 23rd World Nutrition & Pediatrics Healthcare Conference MENA Plaza Hotel Albarsha | Dubai, UAE.

Day 2 :

Keynote Forum

Mazen Abou Chaaban

Emirates Speciality Hospital, UAE

Keynote: Management of hypertension in children and adolescents
Conference Series Nutrition & Pediatrics 2019 International Conference Keynote Speaker Mazen Abou Chaaban photo
Biography:

Mazen Abou Chaaban is a Consultant Pediatrician and Pediatric Nephrologist at the Emirates Specialty Hospital in Dubai. He has received his higher education qualifications and skilled training in the field of Pediatrics and Pediatric Nephrology (kidney diseases) in Cologne, Germany and has more than 25 years of experience in Dubai. He is one of the few Doctors in the Middle East region to have vast experience in pediatric nephrology. He was also awarded a Fachartz (the highest specialty in pediatrics in Europe) and was recruited to the government hospital in Dubai to establish its first pediatric nephrology unit.

Abstract:

Blood pressure in pediatric age group varies with age, sex and height. It is categorized into primary and secondary hypertension (an underlying cause can be identified). Essential hypertension is being increasingly recognized in children especially in adolescents and form 12% to 18% of the etiology of hypertension in this age group. Treatment for essential hypertension is mainly non-pharmacological in the form of weight reduction, reduction of salt intake and exercise. Mild pharmacological treatment is needed in some patients as supplementary to the other. Hypertension in children and adolescents is mainly secondary in origin. Renal parenchymal disease is the most frequent (70-80%) causes of secondary hypertension while renovascular, cardiovascular and endocrinal disorders constitute only 20-30%. In secondary hypertension, treatment of the underlying etiology is in most of the cases, the key of success in the management of hypertension. Although the approach to the treatment of hypertensive children differs somewhat from that of the adult and the general principals are similar. Pharmacological treatment is mandatory in these patients and should be done under the following rules; should be used in stepwise fashion, the least toxic drug should be prescribed first, use maximum recommended dose of one pharmacological drug prior to adding another and when combined drug therapy is used, the drug being prescribed should have different sites or modes of action in order to attain an additional effect. Some of the antihypertensive drugs used are diuretics which are used as first line of treatment as well as in combination with other medications (e.g. Thiazine, Furosemide, etc.). Beta blockers can be used safely alone or in combination with others if there is no contraindication to their use as in bronchial asthma and congestive heart failure (e.g. Propranolol, Atenolol, Metoprolol, Pindol, etc.) Their mode of action is mainly by reduction in the heart rate and cardiac output and blockage of the release of renin from the kidneys in response to adrenergic stimulation. Alpha and beta-blocking agents (e.g. Labetalol) have added useful and safe lines in the treatment of chronic as well as acute hypertensive emergencies in pediatrics. Calcium channel blocking agents act on the smooth muscle cells of the blood vessels and inhibit the influx of calcium causing inhibition of the tone of the smooth muscles leading to peripheral vasodilatation and thus reducing the peripheral resistance (e.g. Verapamil, Nefidipine, Amlodipine and others.). Angiotensin converting enzyme inhibitors block the biotransformation of angiotensin I to angiotensin II and subsequently prevent the vasoconstriction and the release of renin and aldosterone. They are of great benefit in the treatment of high-renin hypertension. Other categories of antihypertensive drugs which are used in emergencies and in non-responder children and adolescents are alpha-adrenergic blocking agents, peripheral vasodilators and centrally acting alpha stimulators. Close monitoring, follow ups, parents and patients understanding and compliance are essential to assure proper and successful management of hypertension in children and adolescents. 

  • Breast Feeding and Family Nursing |Pediatric Obesity and Weight Management | Healthcare and Chronic Diseases| Pediatric Gastroenterology | Pediatric Endocrinology | Pediatric oncology | Health Care and Management
Location: Dubai
Speaker

Chair

Karthikeyan Gengaimuthu

International Modern Hospital, UAE

Session Introduction

Monika Kaushal

Emirates Specialty Hospital, UAE

Title: A quality improvement approach to reduce infections in neonatal intensive care
Speaker
Biography:

Monika Kaushal has completed her MBBS, MD Pediatrics, DM Neonatolgy from FRCPCH. This year faculty of Royal College of pediatrics and
child health UK granted her the honor of status of Fellow of Royal Collage of Pediatrics and child health UK (FRCPCH). She is currently pursuing
her MSC in Neonatology from Southampton University, UK.

Abstract:

Outcomes in neonatology has improved dramatically in the last 3 decades
Improved survival- associated with increasing short term and long term morbidity
Infections- important cause of morbidity and mortality
Majority of infections are potentially preventable
Early onset sepsis related to maternal and perinatal factors
NICU professionals have little control!
Late- 72 hrs / 7 days
Late onset usually HAI and linked to infection control measures
Controllable and potentially preventable
Reported Incidence – 15-50% depending on location and gestation
25% of VLBW in the NICHD network
Incidence falling in developed economies- eg:15% in Canada (2010/11) and drop from 38/1000 admissions to
20/1000 admissions in the UK 2006-2014
Gulf region – (2013-15) 56/1000 admissions
Seasonal variations have been described
To reduce the infection, we need to have policies in place.
• Hand hygiene policy
• Central line policy and bundles
• Isolation policies
• Antibiotic policies
• Cleaning and waste
We might have Disjoint between policy and care delivery
The metrics being used were nor accurate/fit for purpose
If we look at hand hygiene policy , it may happen:
• Policy in place
• IC team audits showing high compliance
• But fly on the wall observation revealed a different story
• Non-compliance widespread
• Accessibility of hand gel at bedside was an issue
• Turnover of new staff – eg . Residents who were poorly
Oriented
• Hand hygiene of parents not monitored or enforced
• Mobile phone use in the clinical area
• Publicity poor
So we need to work on the missing gap and improve the compliance.
Similarly, for central line bundle it may have issues in any of the following.
• Bundles in place
• IC team reporting high compliance- Wrong metric being used
• Was a tick box exercise with no empowerment of nurses
• No standardisation
• Application of antiseptic and adherence to aseptic technique suspect
• Type of antiseptic used
• Multiple breaks in to the line
• Indefinite line duration
When we do quality improvement then we can have infection free NICU.
 

Akumtoshi

Indian Academy of Pediatrics, India

Title: Respiratory distress syndrome in a nutshell

Time : 11:45-12:15

Speaker
Biography:

Akumtoshi has completed his MBBS from Rajendra Institute of Medical Sciences, Ranchi and MD in Pediatrics from Assam Medical College. He is currently working as the Treasurer of Indian Academy of Pediatrics in the state of Nagaland, India and also the State Academic Coordinator for Neonatal Resuscitation Program and a Member-Scientific Committee in the East Zone Academy of Pediatrics, India.

Abstract:

Respiratory Distress Syndrome (RDS) is an important cause of mortality and morbidity in preterm neonates. With the increasing number of preterm deliveries globally according to the World Health Organization, it is imperative to consider a safe place for delivery and a good obstetric care to start with. Antenatal steroids are helpful not only in reducing the risk of RDS but also reducing Necrotizing Enterocolitis (NEC) and intra ventricular hemorrhage which further improves the outcome of a preterm delivery. Delayed cord clamping is recommended as it reduces mortality in preterm newborns. Use of optimal oxygen and getting CPAP into the delivery room has improved the outcome and reduced the need for mechanical ventilation thus reducing the risk of Chronic Lung Disease (CLD). Timing the administration of surfactant is important to avoid mechanical ventilation. The increasing use of non-invasive ventilation has reduced ventilator induced lung injury and CLD. Many have embraced Heated Humidified High Flow Nasal Oxygen (HHHFNC) as an alternative to CPAP and its use has increased in view of its ease of use and lesser trauma. Caffeine facilitates early extubation in intubated preterms on ventilators and improves neuro developmental outcome. Adequate nutrition and proper temperature control starting from the point of delivery cannot be emphasized enough for this group of population. 

Biography:

Loan Minh Do is currently working as a Pediatrician at Vietnam National Children’s Hospital and also Director of Direction of Healthcare Activities Center. She has completed her Medicine Doctor's degree (PhD) at University of Gothenburg, Sweden.

Abstract:

Understanding parents’ feeding control practices and their associations with various factors is useful for prevention of childhood obesity. Two cross-sectional studies were conducted in urban Dong Da (n=1364) and rural Ba Vi districts (n=1313) Hanoi, Vietnam. Child Feeding Questionnaire (CFQ) was used. Mothers reported the use of more restriction, pressure to eat and monitoring than the fathers. The measured child’s Body Mass Index (BMI) and the mother’s perception of the child’s weight were negatively associated with pressure to eat and positively associated with monitoring. A positive association was found between restriction and the mother’s perception of the child’s weight. In the rural area, high consumption of fatty food, sweets and snacks was associated with high use of restriction and monitoring. The amount of food consumed was negatively associated with the use of pressure to eat. In the urban area, consumption of fatty food and sweets was positively correlated both with restriction and pressure to eat. Monitoring was negatively associated with consumption of fatty food and snacks and positively with the amount of food. Higher education of the mothers was associated with higher use of monitoring, restriction (in the urban area) and pressure to eat (in the rural area). Feeding practices in Vietnam differed between mothers and fathers and between urban and rural areas. This implies that parental roles as well as socio-demographic factors should be considered when designing programs for prevention of childhood overweight and obesity. 

Nasser Mohamed

Sheikh Khalifa Medical City, UAE

Title: Pediatric airway management
Speaker
Biography:

Nasser Mohamed has almost 30 years of experience as Neonatologist and Pediatric Intensivist. He has graduated MBBCh in 1989 from Zagazig Faculty of Medicine, Egypt and did Residency program in Mataria Teaching Hospital, Egypt. He has obtained his Master’s degree of Pediatrics in 1994 and then was moved to work in Kuwait where he spent 20 years working between NICU and PICU Mubark Al Kabeer University Hospital. In 2015 he joined Sheikh Khalifa Medical City PICU managed by Cleveland Clinic in Abu Dhabi as Pediatric Intensivist Specialist. He is a Senior Consultant of Pediatrics in Egypt and during this period he has participated in many of international pediatric conferences as speaker and he shared many of workshops in field of pediatric health care.

Abstract:

Airway management is an important skill for all medical staff to practice, particularly within difficult scenarios. To address this, we will create this workshop of airway management for introducing advanced airway techniques to all medical staff (physician, residents nurses and fellows) Emergency airway management is associated with a high complication rate. Evaluating the patient prior to airway management is important to identify patients with increased risk of failed airways pediatric airway management should be systematic and well planned. This workshop will describe the steps in appropriate airway management these steps include clinical assessment, preparation of equipment and staff, and a progression through a series of interventions. A good foundation of basic skills, such as understanding of pediatric airway-anatomy, head positioning, and correct bag-valve-mask or Bag-mask Ventilation (BVM), are necessary for appropriate airway management. The majority of patients requiring Endotracheal Intubation (ETI) can be successfully intubated with Rapid Sequence Intubation (RSI). A difficult airway may occasionally be encountered and the medical staff must have alternative methods for the support of ventilation and oxygenation if RSI failed Video laryngoscopes are claimed to improve airway management. Several studies showed an equal or better glottic view using the Glidescope compared with direct laryngoscopy in adults and in paediatric patients. Many case reports also described successful intubation in patients with a difficult airway. Learning Objectives At the conclusion of this educational workshop, participants will be able to apply a thorough understanding and practical knowledge of the basics of airway assessment in your clinical practice recognizes the signs of potentially difficult intubation and airway management. Develop a plan for dealing with a known difficult airway. Discuss indications for various airway management devices. Develop effective management strategies to deal with challenging airway scenarios. Demonstrate working knowledge and practice of a variety of airway management devices (oropharyngeal tube - Nasopharyngeal tune - Laryngeal mask airway -Endo tracheal tube - Ambu bag - video laryngoscop).

Komal Verma

Amity Institute of Behavioral and Allied Sciences, India

Title: Handling obesity epidemic: Through psychosocial intervention
Speaker
Biography:

Komal Verma is currently working as the Head of Amity Institute of Behavioral and Allied Sciences. She has published more than 25 papers in reputed journals and has been serving as an Editorial Board Member of repute.

Abstract:

In today’s world, one of the most grappling concerns with respect to health issues is obesity and especially pediatrics obesity. There have been cases where the causes for overweight were medical reason but the intervention which really made the difference was use of eclectic approach. In this approach, holistic health is taken care off by involving all the stakeholders related to the obese individual. According to WHO, obesity is a nutritional health issue that has excessive storage of energy in the form of fat as per height, weight, race and gender. Obesity can lead to various other health problems like diabetes, heart disease, high blood pressure etc. Though people have been trying out numerous ways of controlling/reducing weight but the fight against obesity has become a major challenge for children, adults and health practitioners worldwide. This research article aims to understand the bio-psychosocial causes and consequences of the obesity that can help to create an effective approach for the health professionals to handle current obesity epidemic. 

Speaker
Biography:

S K Mohanasundari is currently pursuing PhD in INC and working in College of Nursing as Faculty in AIIMS Jodhpur, India. She has published more than 40 articles in various national and international journals and published one book (Entrance Guide for Nurses to Succeed). She is the Member of Editorial and Review Board of three national and two international journals and Life Member of four associations such as TNAI, NRSI, IANN and NNF. She received Best Lecturer Award from Tayma General Hospital, Saudi Arabia. She has worked as an Assistant Professor in private nursing colleges in India, also worked in MOH Saudi Arabia as a Nurse Educator (2013 to 2014) and later worked in All India Institute of Medical Sciences Rishikesh, India. Presently she is working in College of Nursing as Faculty in All India Institute of Medical Sciences Jodhpur, India.

Abstract:

Introduction: Virtual reality (VR) is a computer technology that creates an artificial 3-dimensional simulated environment. Virtual reality consists of a head-mounted display and a thick pair of goggles that are connected to either a computer or a cell phone. Although originally designed for entertainment purposes, the potential use of VR in the medical field has recently been explored. Experimental trials using VR in therapy for anxiety or posttraumatic stress disorder and for coping with pain demonstrate potential for this technology. Distraction is a common non-pharmacologic technique used by health care professionals to manage and attenuate anxiety, and possibly pain, during painful procedures in pediatric patients. Both passive distraction (e.g., watching television, listening to a book) and active distraction (e.g., interactive toys, electronic games) have been extensively studied and cause a decrease in pain and anxiety. Virtual reality might offer even more distraction, as it completely immerses the patient in another world and involves multiple senses. Method: This study is conducted to assess the effectiveness of immersive virtual reality therapy on pain and anxiety among 60 children aged between 3 years to 12 years undergoing various painful procedures in UMAID Hospital, Jodhpur. India. Post-test only designs were adopted. The invasive procedure includes collecting blood samples, venipuncture, IM injection and SC injections. Ethical permission was obtained from institutional ethical committee and informed consent was obtained from children above 7 years and from parents of children below 7 years. Randomly children were assigned to control group and experimental group; 30 in each group. The children in control group received standard care (toys and verbal distraction, etc.) during invasive procedure and they were assessed for pain and anxiety level after 60 seconds of procedure by using numerical visual pain scale and Wong Baker facial expression scale. Children in the experimental group given head-mounted virtual reality display connected to smart phone (played 3D video) during invasive procedures and allowed to play the video for 5 minutes before the procedure and until 60 seconds after the procedure. The child pain and anxiety was observed during the time of procedure through Wong Baker pain scale and after the procedure children were asked to describe the level of pain and anxiety through numerical visual pain and anxiety scale for further validation. Result: The result showed that children in the experimental group experienced less pain and anxiety than the children in the control group. There is positive correlation exists between pain and anxiety level. The age and type of procedure has significant association with level of pain. The age, sex and type of procedure had significant association with level of anxiety. Conclusion: VR distraction appears to be most effective for children with the pain during invasive procedure. VR is thought to reduce pain and anxiety by directing children’s attention into the virtual world, leaving less attention available to process incoming neural signals from pain receptors. This solution can be easily applied by nurses in their clinical practice.

Speaker
Biography:

Marwa Bebars has completed her Masters degree in Pediatrics from Zagazig University and Post-doctoral studies in Pediatric Oncology from Cairo University School of Medicine. She is a Member of Royal College of Pediatric and Child Health. She is currently working as a Senior Specialist in Dubai Hospital Tertiary Reffral Hospital and also published more 15 papers in reputed.

Abstract:

Malnutrition is an unspecific term used to define an inadequate nutritional condition. It is characterized by either a deficiency or an excess of energy with measurable adverse effects on clinical outcome. Malnutrition describes the consequences of insufficient protein-energy intake. An adequate proteinenergy balance is a prerequisite for age-appropriate growth and maintenance. Malnutrition also comprises circumstances of elevated energy supply resulting in overnutrition with an increase in adipose tissue. Even though malnutrition has been defined or described in many ways, no consensus exists regarding a specific definition to identify children at risk. The WHO recommends the weight-for-height index to assess the nutritional status of children and adolescents. However, it is proposed that a loss in body weight of 5% constitutes acute malnutrition and a height-for-age value below the 5th percentile may reflect chronic undernourishment in children. Ironically, many children suffering from cancer do not meet these criteria. Particularly those with large solid abdominal masses (e.g. embryonal neoplasms such as neuroblastoma,hepatoblastoma, or Wilms tumor) may present with normal weight despite severe malnutrition. Nutritional depletion may furthermore be masked in children by edema due to corticosteroid treatment. Even if no gold standarddefinition for undernourishment in children exists, concise definitions are needed for the institution of preventive policies. We provide a critical review of the current state of research and knowledge related to the nutritional management in childhood cancer. 

Biography:

Priyadarshani has completed her Master of Science in Pediatric Nursing from MUHS. She has 9 years of teaching experience at graduate and Post-Graduate levels.

Abstract:

Not all areas in the world have resources to provide technical intervention and health care workers for premature and low weight babies. continuous skin-to-skin contact with their low birth weight babies to keep them warm and to give exclusive breastfeeding as they needed. Objectives To assess knowledge, practice and attitude scores of mothers regarding the kangaroo mother care before the administration of planned health teaching. 1. To assess knowledge, practice and attitude scores of mothers regarding the kangaroo mother care after the administration of planned health teaching. 2. To compare the pre test score with post test score of knowledge, practice and attitude of mothers regarding the kangaroo mother care. 3. To find the association between selected demographic variable with post test score of knowledge, practice and attitude of mothers regarding the kangaroo mother care. The research design selected for the present study was single group pre-test post-test quasi-experimental design. The study was conducted in the postnatal ward of selected hospital of Pune city The samples were selected by non-probability purposive sampling technique The sample size for the study consisted of 60 postnatal mothers with newborn. Sample were selected as per availability and fulfillment of the pre-set criteria. The tool contains four parts: Demographic data of the postnatal mothers. Semi- Structured Questionnaire. Attitude scale. Observational Check List. The reliability of the tool was established by using by Test-Retest method technique. Overall mean knowledge pretest sore was 3.70 which was increase in post test to 10.13. Overall mean attitude pretest sore was 42.98 which was increase in post test to 63.70 Overall mean practice pretest sore was 8.15 which was increase in post test to 12.30 Education is the demographic variable which is significantly associated with knowledge scores. There is no demographic variable which is significantly associated with attitude score. There is no demographic variable which has significant association with practices score. The planned teaching significantly brought out improvement in the knowledge of post natal mother regarding kangaroo mother care.