Day 1 :
Keynote Forum
Sushil
Medical Graduation, Kathmandu University Medical School, Nepal
Keynote: 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.
- General Pediatrics
Location: webinar
Session Introduction
William Troutt
Director of Medical Education, Harvest Heath and Recreation, Arizona State University.
Title: Medical cannabis as adjunct, complimentary or stand alone therapy
Time : 11:30-12:00
Biography:
Dr. William Troutt an Arizona native was born in Phoenix and raised against the Superstition Mountain Wilderness. He graduated Magna Cum Laude from Arizona State University in 1999 with a degree in Biology. He received his Naturopathic Medical Degree from Southwest College of Naturopathic Medicine and was licensed to practice in the state of Arizona in 2004.
His passion for education and sharing information comes with years of experience in Medical direction and patient care.
Dr. Troutt currently maintains a Naturopathic Medical Practice in Scottsdale. Additionally he is the Medical Director for several Arizona State licensed Medical Marijuana Dispensaries.
Dr. Troutt has decades of practical experience in a wide spectrum of cannabis education; including requirements of the Arizona State Medical Marijuana Program from patient evaluations and qualifications to dispensary medical direction.
Dr. Troutt offers medical cannabis (marijuana) educational material, seminars and certifications for patients, dispensaries, healthcare professionals and other public servants.
Abstract:
Medical cannabis as adjunct, complimentary or stand alone therapy. This Discussion will cover: different constituants including cbd, thc and turpines;modalities of use; realistic expectations; conservative dosing techniques; safety profile, potential risks and. Cannabis medicine recently has been getting a lot of attention for it’s efficacy treating inflamatory issues, seizure disorders, pain management and palliating nausia to name a few. Currently there are 32 states with medical cannabis laws. Patients are asking questions and it is imperative that medical professionals have a fundamental knowledge of how this botanical medicine works and how patients can gain access and utilize products in responsible manner.
Sohail Daniel
Medical student, the School of Clinical Medicine, University of Cambridge.
Title: KAT6A Syndrome: Presentation & Profile
Time : 11:30-12:00
Biography:
Sohail Daniel is a medical student in his fourth-year at the School of Clinical Medicine, University of Cambridge. He graduated in 2018 with BA (Hons) degrees in Medical Sciences from the University of Cambridge, specialising in Psychology with Cognitive Neuroscience. Sohail has previously been involved in rodent probabilistic learning studies targeting the mesolimbic dopaminergic system. He is currently also involved in a national study analysing outcomes for patients after abdominal surgery.
Abstract:
Intellectual disability (ID) affects ~1% of children worldwide, with 25-50% of cases thought to result from a monogenetic cause. However, as a result of a nonspecific clinical phenotype, many go years without definitive diagnosis. KAT6A syndrome is a multi-system disorder resulting from a variant form of the KAT6A gene, which codes a lysine acetyltransferase protein. It functions to epigenetically regulate the expression patterns of genes involved in development and organogenesis. KAT6A syndrome has been identified as a major cause of ID. There has, in the past few years, been a rapid increase in the number of diagnoses. This is likely due to the heightened use of whole exome sequencing (WES), which is an effective means of diagnosing patients that carry de novo mutations. Despite this, the full extent of the phenotype has not been characterised. We present two individuals with variant forms of the KAT6A gene, who were identified through WES studies. Many of their phenotypic features, although diverse, fit with those reported in other individuals with mutations in the KAT6A gene. These include, but are not limited to: intellectual disability, global developmental delay, microcephaly, craniofacial dysmorphism, oromotor dyspraxia, GI complications, cardiac anomalies, ocular anomalies and abnormal muscle tone. We explore possibilities of how the variant forms of the KAT6A gene produce the clinical phenotype, and why there is such variability in the severity of presentation. A more focussed diagnostic criteria and increased awareness of the syndrome would facilitate more diagnoses, aiding early management, treatment and support.
RANIA HOSNY TOMERAK
professor of pediatrics and neonatology, Cairo University
Title: Echocardiogram Done Early in Neonatal Sepsis: What Does It Add?
Biography:
I am professor of pediatrics and neonatology in Cairo University. I was graduated in 1994, had my Master degree in pediatrics in 1998 and doctorate degree in pediatrics in 2001. I am an international board certified lactation consultant since 2004 (got the highest score in Egypt). I am a board member of Lactation education accreditation and approval committee in USA, which provides approval and accreditation to all breastfeeding programs allover the world. I have 21 published scientific papers (7 are pubmed cited: Tomerak RH, Tomairek RH)
Abstract:
Background: One of the major organs affected in neonatal sepsis is the heart. Echocardiogram provides real-time information on the cardiovascular performance rather than dependence on the clinical signs alone, which might lead to misjudgment.
Aim of the Work: To assess left ventricular (LV) functions in septic neonates early after admission using transthoracic color Doppler Echocardiography.
Patients and Methods: Echocardiography was done to 30 septic and 30 nonseptic newborns who were divided among 4 groups (septic full-term, 14; septic preterm, 16; nonseptic full-term, 21; and nonseptic preterm, 9). Comparisons were made among the 4 groups using analysis of variance and post hoc test regarding the systolic function (using ejection fraction and fractional shortening), the diastolic function (using the early patrial peak/atrial peak flow velocity ratio), and the global LV function (using myocardial performance index).
Results: The E-wave and the early peak flow velocity/atrial peak flow velocity ratio were significantly lower in the septic neonates, whether full-term or premature, compared to their corresponding age groups in the nonseptic newborns, suggesting LV diastolic dysfunction (P G 0.001 and P G 0.014, respectively). No difference was found in the diastolic function between the full-term and the preterm neonates whether lying within the septic group or in the nonseptic group. Myocardial performance index was significantly higher in the septic neonates who died
than in the survivors (P G 0.001).
Conclusion: Neonatal sepsis is associated with LVdiastolic dysfunction.
(J Investig Med 2012;60: 680Y684)
K. M. Yacob
Chief Physician, Marma Heatth Centre,Kochi ,Kerala,India.
Title: The pyrexia temperature never damage the cells of brain or harm the body.
Biography:
A practicing physician in the field of healthcare in the state of Kerala in India for the last 30 years and very much interested in basic research. My interest is spread across the fever , inflammation and back pain,. I am a writer. I already printed and published nine books in these subjects. I wrote hundreds of articles in various magazines.
After scientific studies we have developed 8000 affirmative cross checking questions. It can explain all queries related with fever
Abstract:
All treatments for fever are based on the belief that fits is the result of 41 degree Celsius temperature and it damages cells of brain and body. At the same time there is no evidence based tests or concrete diagnosing methods to the belief that fits and brain damage is the result of pyrexia [1].
Necessary ingredients to destroy brain cells and fits cannot be seen in fever.In pyrexia or absence of fever a fainted patient fell on the floor with unconscious state and destroy cells of brain, and necessary ingredients to become conscious are same.
When disease increases essential blood circulation and energy level also decreases. The vertical height between heart and brain is more than one feet. When the disease becomes severe, ability to pump the blood to the brain decreases. As a result of this brain cells are damaged. so the patient might be paralyzed or may even die.
In pyrexia or absence of fever, when blood flow to the brain decreases and fits are formed. There is no other way than this to increase blood circulation to the brain.It is a sensible and discreet action of brain to protect the life or organ.
Recovery from Fits.
The patient become conscious before the time to get decreasing the temperature of fever. When the fainted patient lie on the floor, the vertical height between heart and brain is decreased, blood circulation increased to brain.
Self checking methods.
When the fainted patient lie on the floor,The patient can stand straight and lie on bed alternatively.Then the patient can experience himself the intensity of blood circulation.T he patient can experience when he stand his blood circulation decreases and when lie on the bed the blood circulation decreases.Besides that he can also experience increased blood circulation when lie on the bed raise the foot higher than head.