Day 1 :
Consultant Pediatric Surgeon at Queen Rania Al-Abdallah Hospital for Children
Consultant Pediatric Surgeon since 15 February 2012 till now.Working in one of three teams at Queen Rania Al-Abdallah Hospital for Children interesting in laparoscopic surgery performing and assissting in variety of cases such as Fundoplications, uretric reimplantation, lap. assissted pyeloplasty, cholecystectomy, nephrectomy, appendectomy and splenectomy. In addition to neonatal surgery, tumour surgery and wide variety of general pediatric surgerical conditions.
Historically the Cohen technique has been considered the “gold” standard in open surgical management of VUR. This technique has the inherent end result of placing the uretric orifice across the midline of the trigon and theoretically making future access to the uretric orifice possibly more difficult than if they remained lateralized. The Glenn-Anderson technique does not require contra lateral placement of the uretric orifice thus likely not complicating future UO access. We compared both techniques in pediatric age group at two separate institutes to assess the feasibility and short term outcomes. Methodology: Between April 2014 and April 2015, 90 consecutive cases of ureteral reimplantation performed for VUR were retrospectively analyzed in two different hospitals. Surgical complications, length of stay and short term outcomes were evaluated in an attempt to assess the equivalence or superiority of either procedure. Forty five cases ( 75 ureters) group (A) from Queen Rania Children Hospital, King Hussein Medical Center, Amman-Jordan, managed by Cohen procedure. Forty five cases, (65 ureters) ,group (B) from Rocky Mountain Children Hospital at Presbyterian St. Luke's Medical Center, Colorado. All patient had single system ureter without complex anatomy such as ureterocele, duplex collecting systems, or megaureters. Results: Surgical indication in all patients was VUR and VUJ obstruction. All patients in group A were discharged at day 4 to 5 post-operatively while patients in group B were discharged at second day post-op. Patients age was ranged between 8 months and 10 years while body weight ranged from 9 to 38 Kilograms. All patients in group A had local anesthetic incisional wound infiltration compared to group B whom received caudal block and bladder neck and trigonal local anesthesia in addition to incisional block. Five patients in group A developed urine retention while none in B. Four patients in group A had no resolution but downgrading of their VUR. No patient to date has required further surgical intervention. Conclusion: Glenn-Anderson procedure is a feasible and equivalent technique to Cohen cross -trigonal -ureteral reimplantation. Glenn-Anderson technique theoretically as a result of a more orthotropic uretric orifice placement should allow for easier ureteral access in patients that developed urolithiasis requiring retrograde ureteral access. Length of stay as a measure of postoperative convalescence was superior in the GA technique with all patients being discharged the day after surgery. Perhaps the adjunct local wound infiltration into the bladder neck and trigone played a major role in the ability for earlier discharge? It is not unreasonable to consider this technique as equivalent and potentially superior to others for these reasons. Further prospective study looking at postoperative pain measures and longterm surgical outcomes as well as latent need of additional ureteral access procedure will be necessary to confirm our initial impressions.
Pediatric Infectious Diseases Specialist
Time : 10:00 AM
Mir N Anwar graduated in Medicine from Bangladesh in 1975. He did his Post-graduation in Pediatrics from Ireland in 1982. He did his MPH concentration Maternity and Child Health from University of Massachusetts, USA in 2003. Then he joined UN/ WHO and worked as a Pediatric Consultant & Public Health Specialist, around the world including Asia, Japan, Middle East, Africa, Pacific Island, Ireland and USA. Since 2007 he has been working in South Africa in different provinces of South Africa with the Department of Health. Presently he is working as a Clinical Medical Manager in Richmond Chest Hospital, KZN. South Africa. Presently his main interest is in Childhood TB and HIV in Sub-Saharan Africa. In his long carrier in Pediatric and Public Health he attended several international congress, conferences, and seminars and presented his original work. Some of them were published in International Journal including American Child Neurology Journal, Japan Pediatric Neurology Journal, Pakistan Pediatric Journal, Bangladesh Child Medical Journal, Nigerian Journal of Obstetrics and Gynecology etc. For his work he is honored by American Academy of Pediatrics, Royal College of Health, UK, and International College of Pediatrics. His biography is published in Who’s Who in Medicine Cambridge, UK in 1985
Malnutrition occurs when an individual’s dietary intake is not balanced with nutritional needs.More than 75% of the children admitted in Public Hospital of sub-Saharan Africa for any reason are suffering from Malnutrition. 15% of South African infants are born with a low birth weight. the fact that 25% of pre-school children and 20% of primary school children in South Africa suffered from malnutrition.
Since 2011 to 2016 over the period of 6 years we followed total Paediatric admission in Stanger Hospital, KZN province, South Africa .Average annual admission is around 1400-1500(excluding neonates) in Paediatric wards, Around 9000 over last six years, female child are predominant, female and male ratio was found 60:40.The prevalence of malnutrition in South Africa varies across different geographical areas and socio-economic groups  Many infants in Africa suffer from malnutrition because their mothers do not breastfeed them. The 2010 South Africa Department of Health Study found that 30.2% of pregnant women in South Africa have AIDS and they are reluctant to Breast feed their children.
Malnutrition is an underlying cause of severe poverty in Sub –Sharan Africa. According to statistics from the year 2000, 50% of the South African population is under the poverty line.The World Health Organization showed that over the span of thirteen years (1995 to 2008), the deviation from the average height of children under age five in South Africa has decreased from 28.7% to 23.9%.The approach of Dietician and Pediatrician to fight back Malnutrition problems is a major problem in Africa, which is an ongoing effort.
Emeritus Professor of Pediatrics
Dr. Widness is Emeritus Professor of Pediatrics at the University. Dr. Widness received his his M.D. from Duke University.. The focus of his work encompasses neonatal anemia with a major focus on erythropoiesis—including the pharmacokinetics and pharmacodynamics of erythropoietin. More recently his interests have encompassed RBC survival and transfusion in newborn infants. Since fellowship, Dr. Widness has maintained continuous NIH support for his research. He has served as an ad hoc member of NIH study sections and as an Associate Editor for the American Journal of Physiology and for Neonatology. He has over 200 peer review publications
Objective Based on the hypothesis that neonatal autologous red blood cell (RBC) survival (RCS) is substantially shorter than adult RBC, we concurrently tracked the survival of transfused biotin-labeled autologous neonatal and allogeneic adult RBC into ventilated, very low birth weight infants.
Study design RBC aliquots from the first clinically ordered, allogeneic adult RBC transfusion and from autologous infant blood were labeled at separate biotin densities (biotin-labeled RBC [BioRBC]) and transfused. Survival of these BioRBCs populations were concurrently followed over weeks by flow cytometric enumeration using leftover blood. Relative tracking of infant autologous and adult allogeneic BioRBC was analyzed by linear mixed modeling of batched weekly data. When possible, Kidd antigen (Jka and Jkb) mismatches between infant and donor RBCs were also used to track these 2 populations.
Results Contrary to our hypothesis, concurrent tracking curves of RCS of neonatal and adult BioRBC in 15 study infants did not differ until week 7, after which neonatal RCS became shortened to 59%-79% of adult enumeration values for uncertain reasons. Analysis of mismatched Kidd antigen RBC showed similar results, thus, confirming that BioRBC tracking is not perturbed by biotin RBC labeling.
Conclusions This study illustrates the utility of multi-density BioRBC labeling for concurrent measurement of RCS of multiple RBC populations in vivo. The similar RCS results observed for neonatal and adult BioRBCs transfused into very low birth weight infants provides strong evidence that the circulatory environment of the newborn infant, not intrinsic infant-adult RBC differences, is the primary determinant of erythrocyte survival.
- Pediatric Obesity
Project Manager at Department of Materials and Mechanical Engineering, British University of Dubai, United Arab Emirates
The asymptomatic phase of type 1 diabetes is recognised by the presence of beta cell autoantibodies in the absence of hyperglycaemia. We propose that an accurate description of this stage is provided by the name ‘Autoimmune Beta Cell Disorder’ (ABCD). Specifically, we suggest that this nomenclature and diagnosis will, in a proactive manner, shift the paradigm towards type 1 diabetes being first and foremost an immune-mediated disease and only later a metabolic disease, presaging more active therapeutic intervention in the asymptomatic stage of disease, before end-stage beta cell failure. Furthermore, we argue that accepting ABCD as a diagnosis will be critical in order to accelerate pharmaceutical, academic and public activities leading to clinical trials that could reverse beta cell autoimmunity and halt progression to symptomatic insulin-requiring type 1 diabetes. We recognize that there are both opportunities and challenges in the implementation of the ABCD concept but hope that the notion of ‘asymptomatic autoimmune disease’ as a disorder will be widely discussed and eventually accepted.
- Perinatal/ Neonatal Pathology
SIMONE BATTIBUGLI, Children’s Medical Centre in Dubai.
SIMONE BATTIBUGLI relocated to Dubai 4 years ago.Currently working as Pediatric Orthopedic Surgeon at The Children’s Medical Centre in Dubai.10 years clinical and research experience as faculty of Federal University of Sao Paulo.
Pediatric Orthopedic training:
- Pediatric Orthopedic Fellowship at Feinberg School of Medicine at Northwestern University. Children's Hospital. Chicago, IL, USA.
- Pediatric Orthopedic Fellowship at Shriners Hospital for Children. Lexington, KY, USA.
- Evidence based Medicine Systematic
- Literature Review
- Management and clinical research on neuromuscular disorders; as Cerebral Palsy, Spina Bifida and Arthrogryposis Multiplex Congenita.
- Congenital foot and lower limb deformities and other congenital and acquired musculoskeletal pathologies in children.
Cerebral palsy is the result of a non-progressive lesion or injury to developing brain and has multiple causes and clinical manifestations, making a discussion on diagnosis and screening challenging. In the past, the diagnosis of cerebral palsy was largely a clinical diagnosis, with the development of imaging it has been recommended that clinical diagnosis of cerebral palsy should be confirmed by imaging.
Early diagnosis is challenging, however is extremely important as it provides opportunity early intervention. Recently, there is a renewed interest in the newborn qualitative assessment of general movements. This cost effective diagnostic tool consists of observing the infant’s spontaneous movements with promising results providing high specificity and sensitivity.
Poor control of muscles and movement in children with cerebral palsy can be associated with a wide range of functional challenges. Traditional efforts to manage these motor disabilities have been directed at improving tone and promoting adequate motor patterns. Contemporary approaches to treatment are addressing muscle weakness as a common element of functional problems with encouraging results.
Brain and muscle plasticity in response to specific types of therapy has been demonstrated in CP. The amazing developmental changes of the brain between preterm age and the age of 1 year post-term offer opportunities for early intervention. The goal of motor training is to optimize the development of skilled motor function. Fixed contractures are managed by lengthening of the muscle–tendon unit by the technique that delivers the safest and most effective surgical technique that will give appropriate amount of lengthening of the muscle for the child in question.
Given that cerebral palsy presents at early in infancy and persists throughout an individual’s lifetime, the disorder needs to be thought of and managed in the context of development, functioning with a family based and community integration.
- Pediatrics and Child Health
specialist of Pediatric & Neonatal Surgery in Rafedia hospital, Nablus, Palestine
ISLAM FAHED Nablus, West Bank, Palestine
Current job: specialist of Pediatric & Neonatal Surgery in Rafedia hospital, Nablus, Palestine
Dedicated neonatal and pediatric surgeon specializing in treating and operating neonatal children. Pediatric Surgeon with experience performing surgeries on both emergency and elective cases. Extensive knowledge of anesthesia, complex lacerations, surgery, trauma resuscitation andadvanced cardiac life support.
- Conducted hundreds of major and minor pediatric and neonatal operations independently
- Medical research comprehension
- Dedicated to integrity
- Strong interpersonal skills
- Open-minded communicative surgeon
- Compassionate professional
- Pediatric critical care medicine
- Culturally sensitive
- Good clinical judgment
The objective of this study was to find out the diagnostic accuracy Doppler ultrasound in diagnosis of testicular torsion children presenting with scrotal pain taking surgical findings as Gold Standard. In this diagnostic cross sectional study we took 120 male patients of 1-14 years of age with acute scrotal pain (12-48 hours) and with clinical suspicion of testicular torsion. Doppler ultrasonography was carried out in all the patients by a single radiologist. All patients were sent for surgery and intraoperative findings were noted. All surgeries were done by a single surgical team. All this information was recorded on proforma (attached). Statistical analysis was performed by entering all the data in SPSS version 20.
In this study the mean age of patients was 9 ± 2.52 years. The mean duration of scrotal pain 16.12 ±5.03 and average scrotal pain on visual analogue scale (VAS) was 7.17 ± 1.50. The Sensitivity, Specificity, Positive predictive value and negative predictive value of Doppler ultrasonography was 98.21%, 87.5%, 99.1%, 77.78% respectively. The overall diagnostic accuracy was 97.5%.
According to this study, Doppler ultrasonography can be used to detect testicular torsion in patients presenting with acute scrotal pain with reliable sensitivity (98.21%), specificity (87.5%) and good diagnostic accuracy (97.5%).
- Pediatric Cancers and Oncology
Department of Basic Sciences, School of Allied Medical Sciences, Dezful University of Medical Sciences, Dezful, Iran
Mr. Vahid Karami, MSc in medical physics at Dezful University of Medical Sciences, Dezful, Iran. I have 30 years old. My field of interest is radiation protection in diagnostic radiology and especially on pediatric imaging. I have 29 scientific papers in the field, 13 conference paper and one registered invention.
Background and Objective: Computed tomography (CT) is one of the powerful diagnostic tools that frequently request by physicians to address of the variety of clinical problems in patients. Medical applications and the radiation exposure associated with CT have continued to increase, especially in the two past decades. In 2011, 85 million CTs were conducted in the United States, up from about 3 million in 1980. Although patients can undoubtedly benefit from these procedures, their use involves some potential health risks. The radiation dose associated with most CT procedures is as much as 100 to 500 times more than those from conventional radiography and is in the range of levels known to increase the lifetime risk for developing cancer. The aim of this study was to addresses the cancer risk associated with CT.