14^th International Conference on Clinical Pediatrics June 14-16, 2018 Rome, Italy

M Hussein has completed his MD from Cairo University, Kasralainy and doing his Postdoctoral studies currently from Cairo University School of Medicine. He is Lecturer and Consultant at Obstetrics and Gynecology Department, Cairo university Hospital. He has published six papers in reputed international journals and has participated in oral presentations in 10 international conferences.

Background: Neonatal genital prolapse is a rare condition occurring at birth or the first few days after birth. It is commonly associated with neurological abnormality.

 

Objective & Methods: A full term, 3100 g female baby was born by elective C section delivery to a 25 years old, gravid 2 mother. Her obstetric history was unremarkable except for the baby having mild hydrocephalus and meningocele (discovered by ultrasound during antenatal care). The baby had a red mass protruding from the vulva since birth. On examination, the meningocele was ruptured and was repaired under anesthesia. After careful examination of the uterovaginal prolapse, manual reduction using vaginal plug made of gauze soaked with Betadine was done. Expulsion of the gauze was prevented using adhesive plaster tape at the labia. Vaginal packing was done at regular intervals. Follow-up at 6 months has revealed no further episodes of recurrence. Further follow-up visits have been scheduled.

 

Conclusion: Neonatal genital prolapse in absence of neurological defects is rare. Once the diagnosis has been made conservative manual reduction is an adequate treatment with good results.

Shefaly Shorey is an Assistant Professor at Alice Lee Centre for Nursing Studies, National University of Singapore. Her research areas focus on family and women health as well as nursing education. She has designed psychosocial and educational interventions for varied group of populations. She has conducted both quantitative (e.g. randomized controlled trials, descriptive quantitative studies) and qualitative (e.g. descriptive qualitative) studies. Her research studies involve national and international collaborations. Her research focus is on enhancing health outcomes, quality of care and students’ satisfaction in nursing education. She has received various awards for her academic and research excellence. She has been invited at various conferences and the findings of her research have been presented in national, regional and international conferences. She has published in high impact factor journals.

Aim: The aim of this project was to design, develop and test an M-Health App for the new parents in the early postpartum period.

 

Methodology: The randomized controlled trial, two-group, pre-test and post-test design was used. The study had two phases. The phase-I of the study examined parental needs and development of the Mobile-Health App according to their needs. The Phase-II of the study tested the intervention among 250 parents. The parents were randomly assigned to the intervention (n=126) or control (n=124) groups. The intervention group received the mobile-health application based educational programme on top of routine care while the control group received routine care only. For Phase-II the parental self-efficacy, social support, postnatal depression, and parenting satisfaction were measured using reliable and valid instruments. A linear mixed-method analysis was used to compare the percentage change of all outcome variables from the baseline to four weeks postpartum between groups. At the end of four weeks, 17 parents who used the App were interviewed which was audiorecorded to collect their views especially related to the strengths, weaknesses and areas of improvements of the App. Data were analysed using SPSS software and thematic analysis.

 

Results: The intervention group had significant improvements of parental self-efficacy, social support, and parenting satisfaction at four weeks postpartum when compared with the control group. Postnatal depression scores did not show a significant improvement when compared to the control group.

 

Conclusions: The mobile-health application was effective in improving parental self-efficacy, social support, and parenting  satisfaction, and hence, should be introduced and carried out in routine care by nurses. Further studies should focus on evaluating the effects of this programme in reducing postnatal depression among parents.

Tona Gillen is a Registered Nurse, a Registered Sick Children Nurse (RSCN) and Registered General Nurse (RGN) with Grad Cert Paediatric Nursing (Emergency) with thirty years clinical practice, almost exclusively in critical care areas, and dedicated specifically to paediatrics for more than two decades. She currently work as the Trauma Nurse Manager at the only paediatric Major Trauma Centre (hospital) in Brisbane, Qld. Australia. This hospital serves children not only in Queensland but also in Northern New South Wales and the Pacific Rim. She is an Ambassador of Kidsafe and she has been a coordinator of Emergency Management of Severe Trauma (EMST/ ATLS) since 2007, with the Royal Australasian College of Surgeons (RACS).

History tells us that intentional injury is not a new phenomenon, the terminology may have evolved over time, but intentional injury persists in the twenty first century. There are cutaneous subtle signs and obvious “red flag” signs plus injury constellations that require further investigation – these are discussed in this presentation. Having a high index of suspicion for intentional injury in conjunction with specifically developed tools such as the TEN-4 rule, will enable both attention to detail and objectivity in this regard. It is important to make appropriate referrals, adhere to mandatory requirements, facilitate investigations; treat clinical needs and assist with the safe disposition of the child. The impact that intentional injury may have on the child and the vicarious impact on the clinicians involved is acknowledged.

Isil Inan Erdogan has got her MD degree from Hacettepe University in Ankara, Turkey in 2010. She has completed her elective in King’s College London School of Medicine, Cardiology Department at St. Thomas’s Hospital in August, 2008. She started her Pediatrics Residency in Hacettepe University in 2012 and will become a Specialist in a few months’ time. She has been to Showa University Pediatrics Department in Tokyo, Japan for four months as an Observer/Researcher in 2016 and joined both clinical and research studies.

One of the most serious complications of anorexia nervosa, which is an important cause of physical and physiological morbidity in the adolescent age group, is its effect on bone density. Osteopenia or low bone mineral density (BMD) is the precursor of osteoporosis and it is found in at least one bone area in about fifty percent of anorexia nervosa patients. Since serious bone density deficit can be observed early after the initiation of the disease, determination of the correlation between BMD and genetic polymorphisms in anorexia nervosa cases can provide an opportunity for early identification of cases under greater risk and also earlier implications of necessary precautions for osteopenia. This study was performed at Hacettepe University Ä°hsan DoÄŸramacı Children Hospital Adolescents Medicine Clinic from April 2015-March 2017. Forty five  adolescents were diagnosed with anorexia nervosa between years 2009 2016, in accordance with the DSM-IV-5 criteria, within the age of 10 to 18 comprised the case group, and 46 age and sex matched healthy adolescents were the control group. Vitamin D (VDR Bsml ve VDR Fokl) and estrogen receptor (ESR1Xbal, ESR1Pvull) polymorphisms were studied for each group. BMD values of the case group were classified as low and normal, and polymorphisms were compared between these two groups. No statistically significant result could be found between polymorphisms and femur and lumbar bone density (g/cm2) and Z scores in the anorexia nervosa group. However, in female patients, a positive effect of bb genotype of VDR BsmI polymorphism on femur Z scores (p=0.103) and Ff genotype of VDR FokI polymorphism on vertebra Z scores (p=0.097) was observed. Similarly, in female patients, the existence of bb genotype of VDR BsmI polymorphism was found to have a positive effect on femur bone density when measured in terms of g/cm2 although it could not be shown statistically, (p=0.073). Different than the analysis performed with Z score, a positive effect of Ff genotype of VDR FokI polymorphism could not be found on the vertebra bone density on female patients. However, in male patients, a positive effect of Ff genotype on vertebra bone density in terms of g/ cm2 was observed (p=0.061). The effects of body mass index (BMI), duration of disease and amenorrhea on BMD were studied and an opposite relation between vertebra BMD and duration of illness and amenorrhea, and a positive relation between femur BMD and BMI was found to be statistically significant in female cases. In conclusion, vitamin D receptor gene polymorphisms BsmI bb genotype has positive effects on femur bone density, whereas FokI Fff genotype has positive effects on vertebra bone density. Statistically significant results of the effect of polymorphisms may be obtained when a larger case group is involved.

Azadeh Shojaei is working in Department of Medical Genetics and Molecular Biology. She is a Faculty of Medicine in Iran University of Medical Sciences, Tehran, Iran. She has published 5-7 papers in publication.

Background: Nephrotic syndrome is one of the most common kidney diseases in childhood. About 20% of children are steroid-resistant NS (SRNS) which progress to end-stage renal disease (ESRD). More than 53 genes are associated with SRNS which represent the genetic heterogeneity of SRNS. This study was aimed to screen disease causing mutations within NPHS1 and NPHS2 and evaluate new potential variants in other genes.

 

Method: In first phase of study, 25 patients with SRNS were analyzed for NPHS1 (exon 2, 26) and all exons of NPHS2 genes by Sanger sequencing. In the second phase, whole exome sequencing was performed on 10 patients with no mutations in NPHS1 and NPHS2.

 

Result: WES analysis revealed a novel mutation in FAT1 (c.10570C>A; Q3524K). We identified 4 pathogenic mutations, located in exon 4 and 5 of NPHS2 gene in 20% of patients (V180M, P118L, R168C and Leu156Phe). Also our study has contributed to the descriptions of previously known pathogenic mutations across WT1 (R205C) and SMARCAL1 (R764Q) and a novel polymorphism in CRB2.

 

Conclusion: Our study concludes that mutations of exon 4 and 5 NPHS2 gene are common in Iranian and some other ethnic groups. We suggest conducting WES after NPHS2 screening and further comprehensive studies to identify the most common genes in the development of SRNS, which might help in clinical impact on management in patients with SRNS.

 

 

Background: As early diagnosis of childhood tuberculous meningitis (TBM) cannot rely on mycobacterial confirmation, clinical, CSF and neuroimaging features are essential. We aimed to describe the evolution of serially-analyzed lumbar CSF parameters.

 

Methods: We performed a retrospective observational study including children <13 years with suspected TBM, prospectively enrolled in several research studies at Tygerberg Hospital, Cape Town, South Africa, over a 30-year period. Demographic and clinical data were analyzed, as well as CSF parameters at admission, week 1, 2 and 3.

 

Results: Of 318 children with suspected TBM, 53 (17%) had definite TBM and 265 (83%) probable TBM. Serial CSF analysis from admission to 3 weeks post-admission showed decrease in mean lymphocyte count (143 to 49/μL), neutrophil count (53 to 9/μL), protein concentration (3.29 to 1.85 g/L), and rise in mean glucose concentration (1.89 to 2.72 mmol/L). Longitudinal clustering revealed three distinct profiles, with 1 group atypically demonstrating initial increase in lymphocyte count, neutrophil count and protein concentration. The decreasing CSF glucose trend remained uniform amongst all groups. Conclusion: Serial lumbar CSF in TBM suspects may demonstrate different trends over time. A gradual decline in CSF lymphocyte, neutrophil and protein count, and rise in CSF glucose concentration is expected, however normal variability exists.