Biography:

Zeinab Anwar Elkabbany is a Professor of Pediatrics at Ain Shams University since 1998. He/She is an honorary Consultant Pediatric Hepatology, Nutrition and Obesity and former Head of Pediatric Hepatology and Nutrition Units. He/She has over 200 local and international scientific publications. His/Her research interests include pediatric hepatology, hepato-endocrinology, nutrition and obesity.

Abstract:

Screening of Egyptian obese children and adolescents for insertion/deletion polymorphism in angiotensin-converting enzyme gene

Background & Aims: Relatively few studies have examined the contribution of Angiotensin-Converting Enzyme (ACE) candidate genes for development of childhood obesity-hypertension phenotype. Thus, we aimed to screen Egyptian obese children and adolescents for Insertion/Deletion (I/D) polymorphism in the gene encoding ACE and its relation to hypertension.
Methods: One hundred forty two (142) children and adolescents were included (70 with simple obesity and 72 controls). All were subjected to blood pressure measurement, anthropometric assessment and assessment of fasting lipid profile and fasting glucose and insulin. In addition, DNA extraction and genotyping for ACE I/D polymorphism was done.
Results: Obese children had higher frequency of DD genotype (cases 30% versus 11.1% in controls, p=0.01) and D alleles (Cases: 61.8% versus 48.6% in controls, p=0.01) and lower frequency of II genotype (Cases: 27.1% versus 34.7% in controls, p=0.04) and I allele (38.2% versus 51.4% respectively p=0.01) than controls. Also, obese children with hypertension and pre-hypertension had higher frequency of DD genotype and D alleles than II genotype and I alleles. DD genotype and D allele were risk factors for hypertension (OR: 9.86 and 11.57 respectively, p<0.001) while dyslipidemia and insulin resistance were not associated with I/D polymorphism in the ACE gene.
Conclusion: DD genotype and D-allele of I/D polymorphism in the ACE gene were associated with a higher risk of hypertension and pre-hypertension in Egyptian obese children. 

 

Biography:

                Chuk wud ebelu  V  ictor S  was one o f the poster presenters at the 10^th Asia Pacific Global Summit on  Healthcare, Singapore (March 12 to 14), 2018.       

Abstract:

     Child immunization 

Immunization is a way of creating immunity to certain diseases by using a small amount of a killed or weakened microorganism that causes the particular disease. Child immunization is designed to protect infants and children in the early life, when they are most vulnerable and before they are exposed to potentially life-threatening diseases. In order to improve immunization coverage, factors such as mothers’/care-takes’ practices are known to contribute to the success or failure of the immunization program. A qualitative phenomenological type of research design was employed in the study. The study was carried out in Carlatan, City of San Fernando, La Union. The researchers made use of an interview guide questions and a small group discussion as a method of accurate data collection tool on 15 participants. The participants were mothers who had children under one year old. The study showed that mothers engage in several practices before, during and after immunization such as observing daily routine, relaxation, massage and hot compresses. With regard to practices for their children, mothers’ practices include breast feeding, cooling, use of anti-pyretic and hot compresses. This helped the researchers to draw a conclusion that the participants have good immunization practices. The researchers recommend that mothers should continue to breastfeed their infants before, during and after immunization, mothers should use warm compress instead of hot or cold compress so as to avoid reducing the immunization potency and that researchers should conduct further studies on the health benefits of these practices.    

Biography:

Ulrike Brandenburg is a Staff  Neonatologist at Nepean Hospital NICU with extensive clinical experience in tertiary neonatal intensive care within Australia and Germany. Her expertise includes neonatal respiratory disease, pathophysiology, neonatal resuscitation and medical education. Her main area of interest is nutrition for extremely low birth weight infants, in particular supporting mothers in their choice of breast milk feeding and associated research.

Abstract:

Feeding the premature infant: Nutritional challenges and advances

There is increasing recognition of the role of nutritional care for preterm infants and the importance of early and high-quality enteral nutrition for even the smallest premature infants has been established. Inadequate nutrition with negative nitrogen balance can cause poor postnatal growth and impaired neurodevelopmental outcome. Improved energy intake resulting in better growth is associated with better cognitive outcomes but is thought to be associated with the risk of developing obesity, hypertension, coronary heart disease and impaired glucose tolerance or type-2 diabetes. In providing early enteral nutrition neonatologists are faced with unique challenges of the extreme immature gastrointestinal tract, higher energy expenditure ex utero and requirement of increased protein supplementation, the need and ability of exclusive human milk feeding while avoiding maternal lactation failure and monitoring quantity and quality of growth and weight accurately. The experience of the use of body composition data additional to the best available ex utero growth chart at our tertiary NICU will be discussed as well as improvement of current nutritional management of high-risk preterm neonates. This includes increasing breast milk feeding initiation and duration through skin to skin care and immune supportive oral care with colostrum, as well as the routine use of probiotic supplementation, pasteurized donor human milk and targeted fortification.

Biography:

Jemmarie Saraus Lomboy has pursued his Doctor of Medicine degree from the Far Eastern University-Nicanor Reyes Memorial Foundation, Philippines. She is currently an Associate Chief Resident of the Department of Obstetrics and Gynecology at the Far Eastern University-Nicanor Reyes Memorial Foundation, Philippines.

Abstract:

  Heterotopic pregnancy in natural conception with preservation of intrauterine pregnancy delivered at term: A case report

Heterotopic Pregnancy (HP) is a rare event in natural conception cycles. A high index of suspicion would help in timely diagnosis and proper intervention even in the absence of any predisposing risk factors. A case of heterotopic pregnancy in 35 years old Gravida 4 Para 3 (3003) who presented with hypogastric pain and vaginal bleeding with hemoperitoneum from ruptured tubal pregnancy is presented. However, on ultrasound she also has a live intrauterine gestation at seven weeks of amenorrhea diagnosed on ultrasound. She underwent evacuation of hemoperitoneum, exploratory laparotomy, salpingectomy-left. Among low risk patients, presenting with acute abdominal pain, even if the ultrasound findings are consistent with intrauterine gestation sac with or without an adnexal mass but with free fluid noted in the pelvis, heterotopic pregnancy should still be considered. Early diagnosis and treatment of HP will increase the likelihood of a favorable outcome for the intrauterine gestation.  

Biography:

Shiela Mae D Putol has completed her Residency training at East Avenue Medical Center in Quezon City, Philippines. She is currently a Medical Specialist in Obstetrics and Gynecology in Lanao del Norte Provincial Hospital, Philippines.

Abstract:

Prediction of preeclampsia and intrauterine growth restriction in low-risk pregnancies in East Avenue Medical Center using uterine artery Doppler velocimetry

Abstract

Preeclampsia, which is defined as elevated blood pressure after 20 weeks of pregnancy in a woman whose blood pressure had been normal, remains the second most common cause of direct maternal deaths (0.83 per 100,000 cases) worldwide. At present, no effective prophylactic measures have been identified in the prevention of preeclampsia and other pregnancy complications such as intrauterine growth restriction. Therefore, proper antenatal care remains the most important part of prevention. Identifying each woman’s individualized risk can allow further antenatal surveillance to be directed to those women who are most likely to develop preeclampsia. Such care leads to early diagnosis and intervention, both in terms of maternal/fetal monitoring and timing of delivery. The aim of this study is to predict the risk for the development of adverse pregnancy outcomes on the basis of mid-trimester uterine artery Doppler velocimetry. Statistical analysis showed that preeclampsia occurred significantly more commonly in the group with an abnormal Doppler result at 16-22 weeks of gestation, compared to pregnancies with normal doppler findings. That is 42.9% (3 out of 7) for abnormal Doppler result versus 7.2% (2 out of 27) for those with normal Doppler findings. However, none of the 34 evaluated cases developed intrauterine growth restriction. Abnormal uterine artery Doppler result at 16-22 weeks is associated with adverse pregnancy outcomes. In this study, it was well correlated with the development of preeclampsia. Hence, uterine artery Doppler can be used as a useful method for identifying high-risk pregnancies. Uterine artery Pulsatility Index (PI>1.45) can provide further information for the prediction of preeclampsia in order to conduct appropriate clinical interventions to avoid perinatal morbidity.

Biography:

Shu Wen Chen is an Assistant Professor in the Department of Nursing at National Taipei University of Nursing and Health Science, Taiwan. She has received her Master’s degree from Taiwan University in 1996 and PhD degree from Deakin University Australia in 2015. She has published over 10 maternal care books and articles and delivered over 10 professional presentations at international conferences. She is an active Member of several professional associations, journal Editorial Boards. She specializes in birth choice following previous cesarean section and shared decision-making and decision aids

Abstract:

            Women's decision-making processes  and the influences on their mode of birth following a previous caesarean  section in Taiwan: A qualitative study   

Background & Aim: Vaginal Birth after Caesarean (VBAC) is an alternative option for women who have had a previous Caesarean Section (CS); however, uptake is limited because of concern about the risks of uterine rupture. The aim of this study was to explore women’s decision-making processes and the influences on their mode of birth following a previous CS.

Methods: A qualitative approach was used. The research comprised three stages. Stage-I consisted of naturalistic observation at 33-34 weeks’ gestation. Stage-II involved interviews with pregnant women at 35-37 weeks’ gestation. Stage-III consisted of interviews with the same women who were interviewed postnatally, one month after birth. The research was conducted in a private medical center in Northern Taiwan. Using a purposive sampling, 21 women and 9 obstetricians were recruited. Data collection involved in-depth interviews, observation and field notes. Constant comparative analysis was employed for data analysis.

Results: Ensuring the safety of mother and baby was the focus of women’s decisions. Women’s decisions-making influences included previous birth experience, concern about the risks of vaginal birth, evaluation of mode of birth, current pregnancy situation, information resources and health insurance. In communicating with obstetricians, some women complied with obstetricians’ recommendations for Repeat Caesarean Section (RCS) without being informed of alternatives. Others used four step decision-making processes that included searching for information, listening to obstetricians’ professional judgement, evaluating alternatives and deciding regarding mode of birth. After birth, women reflected on their decisions in three aspects: Reflection on birth choices, reflection on factors influencing decisions and reflection on outcomes of decisions.

Conclusion: The health and wellbeing of mother and baby were the major concerns for women. In response to the decision-making influences, women’s interactions with obstetricians regarding birth choices varied from passive decision-making to shared decision-making. All women have the right to be informed of alternative birthing options. Routine provision of explanations by obstetricians regarding risks associated with alternative birth options, in addition to financial coverage for RCS from National Health Insurance, would assist women’s decision-making. 

Biography:

Abstract:

  Title: New tools in prediction of Preeclampsia

Preeclampsia remote from term (onset at or before 32weeks of pregnancy) is one of the major obstetric vasculopathies. As the cause remains elusive, its prediction is much sought after. History-based prediction of preeclampsia is very inefficient. So, currently, a combination of one imaging and one biochemical parameter is popularly used in prediction of this type of preeclampsia. This is logistically taxing and costly. However, we are using tools based only on uterine artery color Doppler to predict preeclampsia, efficiently. We use the uterine artery diastolic notch, its presence or absence as well as its configuration to predict preeclampsia. This is further reinforced by its combination with other parameters on color Doppler. In I-trimester, if the Diastolic Notch (DN) is absent and pulsatility index (PI) of the uterine artery is less than 1.7, the subject is low-risk for developing preeclampsia. On the other hand, if DN is present its configuration is studied. It is expressed as NDI or Notch depth Index. If NDI is more than 0.55 and DN is more than 1.7, this subject is at high risk for developing preeclampsia. Preventive measures like low dose aspirin as started in them. In II Trimester (at mid-trimester 20 weeks) if DN is still present and PI falls by less than half, we continue preventive measures. This indicates that the process of obstetric vasculopathy is still on. However in subjects in whom DN disappears at mid-trimester and PI falls by half or more as compared to I-Trimester, this is a low-risk subject for preeclampsia. In these subjects, if any preventive measures have been ongoing, they can be stopped. These new tools for predicting preeclampsia are found to be easy to perform, alleviates the need for biochemical marker and so only one technology is needed and are quite efficient.  

Biography:

Nira Khanal Bhattarai has completed her Bachelor’s degree in Nursing from Nepal Institute of Health Sciences in 2007. She has been working in NPI Narayani Samudayik Hospital, College of Nursing as an Assistance Lecturer since July 2013 to till date. She has been teaching community health nursing as well as other subjects and conducting researches in the community on different topics. She has also worked at Gynecology and Obstetrics ward in Manipal Teaching Hospital at Pokhara, Nepal.

Abstract:

Factors causing neonatal sepsis

Abstract

Neonatal sepsis is major cause of mortality and morbidity in newborn in Nepal. There are many factors contributed to neonatal sepsis. The organisms responsible for early onset and late onset sepsis are different. Descriptive hospital based study over the period of three months was conducted at Neonatal Intermediate Care Unit of Community Hospital and Research Center, Chitwan. Demographic information and outcome data were collected from primary and secondary sources. Blood samples from the suspected infants were collected and processed in the bacteriology laboratory. Out of 17 suspected cases, the septicemia was confirmed in 10 cases. Early-onset septicemia was observed in 6 infants and late-onset septicemia in 4 infants. Among the infants with early onset septicemia, Escherichia coli were found to be the most common organism in early onset septicemia whereas Staphylococcus aureus was more common in late onset sepsis. Preterm delivery (baby born at 32 to 34 weeks of gestation) and low birth infants (weighing less than 2.5 kg) have the highest rates of early onset infection and fewer infected cases were acquired by rupture of membrane lasting longer than 18 hours and frequent vaginal examination during labor. Likewise, most of the cases (3/4) were caused by having intravenous catheter more than 72 hours and only minimal cases staying for extended period of time in late onset sepsis. In managing these cases, both of these isolates were sensitive to most of antibiotics frequently used as first line drugs are injection Amikacin, Gentamycin, Ampicillin and Cefotaxim. Those antibiotics were administered at required dose. Other symptomatic treatment and conservative management were carried out in addition to antibiotic therapy during hospitalization. Patients were fully recovered and discharged from hospital. It is essential to make all stakeholders responsible every aspect to be responsible to minimize these cases.