Scientific Program

Conference Series Ltd invites all the participants across the globe to attend 5th World Congress on Pediatric Disease, Care & Management Berlin, Germany.

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Scientific Program Day 1

Day 1 :

  • Pediatrics

Session Introduction

Li Jiang

The First Affiliated Hospital of Nanjing Medical Universtiyy, Nanjing, China

Title: Hemodynamic effects of dobutamine versus dopamine in preterm infants: an update meta-analysis
Biography:

Dr. Li Jiang has completed her MD at the age of 35 years from Nanjing Medical University. She is a pediatric cardiologist (associate chief physician) in the field of stuctrual congenital heart disease. She has published more than 10 papers in reputed papers.

Abstract:

Hemodynamic effects of dobutamine versus dopamine in preterm infants: an update meta-analysis: It is a meta-analysis to compare the effects and safety of dobutamine versus dopamine in preterm infants with abnormal hemodynamic status. Study sources were up to 2017 for RCTs in which dobutamine and dopamine treatment was adopted. Included studies were conducted on preterm infants with abnormal hemodynamic status that reported mortality < 28 days, treatment failure and organ effects. 7 articles were included with a total 286 patients. 5 studies reported mortality (180 patients), 4 studies reported P/IVL (145 patients), 4 studies reported P/IVH (160 patients), 2 studies reported severe P/IVH (105 patients), 3 studies reported NEC (140 patients), 2 studies reported BPD (55 patients), and 6 studies reported treatment failure (266 patients). Meta-analysis showed an increased probability in treatment failure using dobutamine treatment (RR, 1.67; 95% CI, 1.14-2.45; P = 0.008), whereas there was no significant difference in mortality < 28 days (RR, 1.16; 95% CI, 0.70– 1.91; P = 0.57), P/IVL (RR, 2.90; 95% CI, 0.93-9.11; P = 0.07), P/IVH (RR, 1.23; 95% CI, 0.73-2.08; P = 0.44), severe P/IVH (RR, 0.58; 95% CI, 0.21-1.62; P = 0.30), NEC (RR, 2.21; 95% CI, 0.60-8.09; P = 0.23) and BPD (RR, 1.04; 95% CI, 0.38-2.82; P = 0.94) between two groups. Dopamine was more effective in treatment success in therapy of preterm infants with abnormal systemic hemodynamic status. No difference was found existed in mortality < 28 days and incidence of adverse organ effects in two groups.

OFRI HAYOSH

Tel Aviv University, ISRAEL

Title: Influence of using POCUS (point of care ultrasound) in the management of limping OR pain in limb on duration care and additional workup studies in pediatric ED.
Biography:

Ofri has completed her MD at the age of 30 years from TEL AVIV University, Sackler School of Medicine. She is currently in her 3rd year of residency in Pediatric medicine, in Meir medical center, ISRAEL.

Abstract:

Backround: the use of Point of care Ultrasound (POCUS) is becoming increasingly widespread In emergency medicine. this is mainly due to its safety, minimal invasiveness, high accuracy, and its ability to provide a binary diagnostic result.

Limping or Pain in limb accounts for approximately 1.8/1000 of pediatric ED admissions. This is a very challenging diagnostic entity that often results in extensive and futile diagnostic workup because of its wide differential diagnosis. Therefore, POCUS provides an excellent opportunity to help avoid unnecessary tests and thus significantly shorten ED care duration.

Methods: In this retrospective cohort, performed at pediatric ED in major regional center, 335 cases of limping or pain in limb were included between 2015-2019. The cases were divided to 2 major groups: patients who underwent HIP POCUS (POCUS group), and those that underwent standard accepted workup (CONTROL group). Statistical analysis of the population was conducted (t-test and chi-square comparisons) while primary outcome was care duration in the ED and additional diagnostic workup.

Results: 135 cases underwent HIP POCUS between 2017-2019, and 200 cases underwent standard diagnostic procedure between 2015-2017. The mean age of POCUS group was 6.6 years (SD 3.5), while of CONTROL group 7.5 years (SD 1.5) with no significance difference. The groups didn’t differ significantly in their gender, ethnicity or clinical presentation (fever, prior minor trauma, prior upper respiratory tract infection, and hip joint tenderness on physical examination). Primary outcome significantly differed between the groups with shorter duration in POCUS group (166±90 min. vs 215±105 min. p<0.0001, CI 27.14-71.59). additional tests: blood sampling, orthopedic counseling and formal ultrasound were significantly more abundant in the CONTRROL group (p<0.0001 for each test, chi-square test).   

Conclusions: our results suggest that utilization of POCUS is of high clinical potential to reduce unnecessary tests and shorten duration care in the pediatric ED.

Sushil Rijal

King Edward Medical University, Mayo hospital, Pakistan

Title: Emergency Neonatal Surgery: Outcome in a University Hospital of Pakistan
Biography:

Dr Sushil has completed his Medical Graduation  at the age of 24 years from Kathmandu University Medical School, Nepal and doing postgraduation from  King Edward Medical University, Pakistan. He is the resident of pediatric surgery department in Mayo Hopital, Lahore Pakistan.  . He has published 2  papers in reputed journals and has been doing clinical research in stem cell application with Skin bgrafting in traumatic heel pad injury in children. 

Abstract:

Objective: The aim was to measure outcome of neonatal emergency surgery in a university hospital of Pakistan.
 
Methods: A 3 years retrospective study was carried out in department of Pediatric Surgery after ethical approval.
Records of all neonates operated in emergency, except orthopedic and neural tube defects repair, were collected.
Outcome was analyzed with different variables to see if any association was present using logistic regression.
 
Results: Total 188 neonates were included with mean age of 7.96± 7.88 days and mean weight of 2.59± 0.36 kilograms. 124(66%) were male and co morbid conditions were noted in 4.8% neonates, while associated congenital anomalies were seen in 11.7% neonates. Mean days of hospital stay were 7.56± 6.14 days. Gastrointestinal anomalies were noted in75.1%, tracheoesophageal fistula in 9%, diaphragmatic hernia in 2.7% and abdominal wall defects in 4.8% cases. Overall 39(20.7%) neonates died. There was association between outcome and diagnosis, findings, comorbid conditions (p value=0.0001). 
 
Conclusion: Overall neonatal surgical mortality rate in our set up was 20.7% and was mainly seen in cases of gastrointestinal anomalies like necrotizing enterocolitis, mid gut volvulus, pneumoperitoneum with sepsis and in cases of tracheoesophageal fistula with esophageal atresia and gastroschisis. 
 
Keywords: neonatal, emergency surgery, outcome, neonatal mortality.
 
IRB: Research proposal was accepted by Institutional review board, King Edward Medical University
(No.247/RC/KEMU Dated:19/04/2018) 

Magda M. Mohsen

Community Health Nursing, Egypt

Title: Fall Reduction Intervention for Hospitalized Pediatric Patients at Risk for falls
Biography:

Magda M. Mohsen has completed her Doctorate of Nursing Science, Community Health Nursing, February, 1989, Faculty of Nursing, Ain-Shas University- Egypt.

Abstract:

Background: Falls represent a major public health problem around the world. In the hospital setting, falls continue to be the number one adverse event with approximately 3-20% of inpatients falling at least once during their hospitalization. Fall measurements have been identified as important to patient outcomes by several organizations based on the fact that falls are the most frequently reported adverse patient event among adults in the inpatient setting.  Aim of this study is to identify the effect of risk reduction interventions for hospitalized pediatric patient, implement action to prevent injury, establish documentation guidelines, to provide a safe therapeutic environment. Subjects and Method; Design: This study was quasi-experimental study (Pre-/Post-test). Setting: The study setting was Menoufia University Pediatric Hospital- Egypt. Sample: a). A convenience sample of a total number of 60 pediatric patients.They was selected according to the following inclusion Criteria: all patients male and female with age 3-18 years already admitted to pediatrics words, at Menoufia University hospital and their caregivers, Exclusion criteria were those falls of visitors or patient falls from the other units not included in the study, such as outpatient and the neonatal intensive care units, B).  A convenience sample of 40 nurses were selected who take-care of 60 pediatric patients. Tools for Data collection: 1. The Humpty Dumpty Falls Scale to assesses pediatric inpatients’ risk for falls. 2. Interviewing Questionnaire for Nurses, 3. Interviewing Questionnaire for children' caregivers, and observational chicklist for nurses practice. Results: By using Humpty Dumpty Falls Scale 31.3% were identified as low risk, and 68.3% were identified as high risk fall of hospitalized pediatric patients. The present study revealed that 46.7 % of high risk fall of pediatric patients their age from 3years to less than 8 years. Compared to 23.3% of low risk fall at the same age. As regards to gender, it was clarified that 38.3% pediatric patients of high risk fall score represent male patients compared to 15% of female. Considering Children Caregivers' knowledge regarding; serious symptoms that may occur after his / her fall represents 60 % at post test. The present study showed that most of studied pediatric nurses was improved their knowledge in post test (satisfactory) than in the pretest (wrong answer) in the pretest regarding "Meaning of Fall". Most of nurses followed the General Strategies for Falls Prevention for High Risk Pediatric Patients in post–test than in pretest. Conclusions: The implementation of fall reduction intervention for hospitalized pediatric patients at risk for falls had significantly improve nurses knowledge and practice and improve caregivers of children knowledge in-order to manage fall correctlyand reduce fall occurance. Recommedations:- Implementation of risk assessment tool would allow all hospitalized children to be properly assessed for fall risk, and document of fall assessment tool into the electronic medical record would allow the nurse to implement fall reduction intervention for high risk children 
Keywords: Fall Reduction Intervention- Pediatric Patients- at Risk for falls