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TOPICS

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PORT SAID PEDIATRICS CONFERENCE TOPICS

• Brain storming talk about Pediatric Antibiotics Prof. Ahmed said Elblidi

• Controversy in EEG results in diagnosis & management of epilepsy in children Prof. Mohamad Al Mazahi

• Recent advances in thalassemia management and prevention Prof. Sonia Elsharkawe

• Updates in Familial Mediterranean fever Prof. Maha Yousief

• Non alcoholic Fatty Liver (NAFLD) as a Consequence of Obesity in Egypt Prof. Mortada El-Shabrawi

• Pervasive developmental disorder PPD (Autism) practical diagnostic criteria in pediatric clinic Prof. Olwea Abd El Baky

• Plastic Toxicity Prof. Maged Ashraf

• Clinical approach to chromosomal abnormalities in pediatrics Prof .Mohamed El Sawy

• When to refer to gastroenterologist: role of general pediatrician in pediatric GI practice Prof. Tarek Barakat

• Childhood stroke Prof .Afaf korraa

• Common Seven Pearls of Pediatric Surgery for Pediatricians Guidelines Prof. Sherif Mohamed Shehata

• Pediatric Respiratory Emergencies Prof. Irene M. Sabry

• Rehabilitation of children with special needs Prof. Mamdouh Torkie

• How to deal with pediatric drugs in preparation and preservation (pharmaceutical view) Prof. Ahmed Darwesh

• Idiopathic Constipation and Secondary Fecal Inconti nence in Pediatric age group; Surgical Perspective and Strategy of Management Prof. Mohamed Soliman El-Debeiky

• Inflammatory bowel disease, where we stand?! Prof. M. Osama Hussein

• Common Pitfalls in Asthma Management Prof. Hala Gouda Elnady

• Ultrasound role in diagnosis of Pediatric Emergency Prof. Azza Abd El-hamid

• Napkin dermatitis for D.D Prof. Maged Ali Mahmoud Elsheikh

• Patent Ductus Arteriosus Prof. Alaa Sobeih

• Junk food and how to protect our children Prof. Tarek El Walili

• Controversy in Lab diagnosis and results Prof. Ahmed Ellawah

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Editor Board

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4

Optimal intake

Unique to provide a sustainable intake in ARA and in DHA

up to 24 months with Celia Expert 1, 2 & 3

DHA is essential the 2 first years

Visual acuity

Brain development

Adapt the ARA/DHA as following :

Martinez M. J Pediatr. 1992 ; 120 : S129 - S138

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Editor Board (in alphabetical order)

• Prof. Afaf korraa• Prof. Ahmed Darwesh• Prof. Ahmed Ellawah • Prof. Ahmed said Elblidi• Prof. Alaa Sobeih • Prof. Azza Abd El-hamid• Prof. Elsayed Khalaf• Prof. Faten Shalaby• Prof. Hala Gouda Elnady• Prof. Hanan El-Refaay• Prof. Irene M. Sabry• Prof. M. Osama Hussein• Prof. Maged Ali Mahmoud Elsheikh• Prof. Maged Ashraf

• Prof. Maha Yousief • Prof. Mamdouh Torkie• Prof. Mohamad Al Mazahi • Prof. Mohamed El Sawy• Prof. Mohamed Soliman El-Debeiky• Prof. Mortada El-Shabrawi• Prof. Olwea Abd El Baky• Prof. Osama Arafa• Prof. Safenaz El Maraghy• Prof. Sherif Mohamed Shehata• Prof. Sonia Elsharkawe• Prof. Talal Abd Elaziz• Prof. Tarek Barakat • Prof. Tarek El Walili

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guest speakers

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Prof. Ahmed said Elblidi Professor of pediatrics

Head of pediatric departmentFaculty of medicine, Cairo University

Prof. Maha Yousief Professor of pediatrics,

Faculty of Medicine , Al Azhar University

Prof. Mohamad Al Mazahi Prof. of Pediatrics

Damietta Faculty of MedicineAl Azhar University

Prof. Mortada El-Shabrawi, MD Professor of Pediatrics and Pediatric

HepatologyFaculty of Medicine, Cairo University

Prof. Sonia El-SharkaweProf. of Pediatrics

Head of Pediatrics Department at Suez Canal University

Honorary President of the conference

Prof. Olwea Abd El Baky Post Graduate Childhood Studies Institute,Department of Medical studies of children

Ain Shams University

13

Prof. Maged Ashraf Professor of Pediatrics

Faculty of Medicine , Ain Shams University

Prof .Afaf korraa Head of pediatric department

Faculty of Medicine, Al Azhar UniversityIBCLC, DHPE

Nutritional diploma

Prof .Mohamed El SawyProfessor of Clinical Genetics

Pediatric Department, Faculty of Medicine, Ain Shams University

Prof. Sherif Mohamed Shehata MCh, MD (Surg), CST, PhD

Department of Pediatric Surgery, Tanta University, EgyptEgyptian Pediatric Surgery Association (EPSA) Secretary

General

Prof. Tarek Barakat Lecturer of pediatrics/Gastroenterology&

HepatologyFaculty of Medicine, Mansoura University

Prof. Irene M. Sabry, MD Assistant Professor of Chest diseases

Faculty of medicineCairo University

14

Prof. Mamdouh TorkieMD Pediatrics

Head of pediatric department, Suez Canal Authority

Prof. M. Osama Hussein, MDConsultant pediatrics & neonatology

President of Port said neonatology society

Prof. Ahmed DarweshAssistant lecturer of pharmacology and toxicology

Faculty of pharmacy

Prof. Hala Gouda ElnadyProfessor of Child Health, National research center

Head of pediatric pulmonary function unit

Prof. Mohamed El-Debeiky MSc.,MD,MRCSEd

Professor of Paediatric SurgeryAin Shams University

Prof. Azza Abd El-Hamid, MD

Professor of Radiology Faculty of Medicine, Suez Canal University

15

Prof. Maged Ali ElsheikhConsultant and head of Dermatology department at

El Galaa Military HospitalProfessor of Dermatology at the Military Medical

Academy Faculty of Medicine, Cairo University

Prof. Ahmed EllawahProfessor of Clinical Pathology

Faculty of Medicine, Al-Azhar University

Prof. Ahmed Yehia DarwishConsultant of genetics Cairo university

Member of the American college of genetics

Prof. Alaa Sobeih, MDPediatric Cardiologist

Department of PediatricsFaculty of Medicine, Cairo University

Prof. Tarek El Walili Professor of Pediatrics

Faculty of medicine, Alexandria University Head of the Egyptian Pediatric Association-Alex-

andria (EPA-A) WHO consultant IMCI program

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Program ataGlance

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TimeArrival and RegistrationOpening Ceremony and Welcome TalksSession (I) Devart lab. Symposium.Coffee BreakSession (I I)Infatrini Symposium

Session (III) Prayer TimeSession (IV)Coffee BreakSession (V)Closing Cermony

10:00 am – 11:30 am

04:30 pm – 06:30 pm06:30 pm – 07:00 pm07:00 pm - 09:00 pm

09:00 pm

01:00pm - 03:30pm03:30pm - 04:30pm04:30pm - 06:30pm06:30 pm - 06:45 pm06:45 pm - 07:00 pm07:00pm - 09:30pm09:30 pm - 10:00 pm

Thur

sday

Fr

iday

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ScientificProgram

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Time Thursday 25/02/2016

Prof. Ahmed El-BilidiBrain storming talk about pediatric antibiotics.

Prof. Mohammed El-MazahiControversy in EEG results in diagnosis and management of epilepsy in children

Prof. Sonia El SharkaweRecent advances in thalassemia management and prevention.

Prof. Maha Yousif Updates in Familial Mediterranean Fever.

04:30 pm – 05:00 pm

05:00 pm – 05:30 pm

05:30 pm – 06:00 pm

06:00 pm – 06:30 pm

Arrival and Registration

Opening Ceremony and Welcome Talks

Session (I)

Devart lab. Symposium.

Prof. Mortada El-ShabrawiProf. Sonia El-SharkaweProf. Faten Shalaby

01:00pm – 03:30pm

03:30pm - 04:30pm

04:30pm - 06:30pm

06:30 pm – 06:45 pm

Chairpersons

Coffee Break06:45 pm – 07:00 pm

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Time Thursday 25/02/2016

Prof. Mortada El-ShabrawiNon alcoholic Fatty Liver (NAFLD) as a Consequence of Obesity in Egypt

Prof. Olweya Abd El-bakyPervasive developmental disorder PPD (Autism) practical diagnostic criteria in pediatric clinic

Prof. Maged AshrafPlastic toxicity in children.

Prof. Mohammed El-SawyClinical approach to chromosomal abnormalities in pediatrics.

Prof. Tarek BarakatWhen to refer to gastroenterologist: role of general pediatrician in pediatric GI practice.

07:00 pm – 07:30 pm

07:30 pm – 08:00 pm

08:00 pm – 08:30 pm

08:30 pm – 09:00 pm

09:00 pm – 09:30 pm

Session (I I)

Prof. Hanan El-RefaayProf. Mohammed El-MazahiProf. Afaf Korraa

07:00pm - 09:30pm

Chairpersons

Infatrini SymposiumBy: Prof. Ahmed Yehia Darwish

End of the 1st day

09:30 pm – 10:00 pm

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Time Friday 26/02/2016

Prof. Afaf KorraaChildhood strock

Prof. Sherif M ShehataCommon Seven Pearls of Pediatric Surgery for Pediatricians Guidelines

Prof. Ireen M Sabry Pediatric respiratory emergencies.

Prof. Mamdouh TorkieRehabilitation of children with special needs.

Open discussion

10:00 am – 10:20 am

10:20 am – 10:40 am

10:40 am – 11:00 am

11:00 am – 11:20 am

11:20 am – 11:30 am

Session (III) valuable gifts will be rewarded for session attendance

The Golden Session

Prof. Talal Abd ElazizProf. Mamdouh TorkieProf. Maha Yossef

10:00 am – 11:30 am

Chairpersons

Prayer Time

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Time Friday 26/02/2016

Prof. Ahmed DarwishHow to deal with pediatric drugs in preparation and preservation from pharmaceutical view

Prof. Mohamed Soliman El-DebeikyIdiopathic constipation and secondary fecal incontinence in pediatric age group; surgical prospective and strategy of management.

Prof M. Osama HusseinInflammatory bowel disease, where we stand?!

Prof. Hala GodaCommon pitfalls in asthma management.

Prof. Azza Abd El-Hamid Ultrasound role in diagnosis of pediatric emergency.

04:30 pm – 04:50 pm

04:50 pm – 05:10 pm

05:10 pm – 05:30 pm

05:30 pm – 05:50 pm

05:50 pm – 06:10 pm

Session (IV)

Prof. Tarek El-WaliliProf. M.Osama HussinProf. Maged El-Sheikh

04:30 pm – 06:30 pm

Chairpersons

Coffee Break

Open discussion

06:30 pm – 07:00 pm

06:10 pm – 06:30 pm

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Time Friday 26/02/2016

Prof. Maged El-SheikhNapkin dermatitis for differential diagnosis.

Prof. Alaa SobeihPatent Ductus Arteriosus

Prof. Tarek El-Waliljunk food and how to protect our children.

Prof. Ahmed EllwahControversy in lab. Diagnosis and results.

07:00 pm – 07:30 pm

07:30 pm – 08:00 pm

08:00 pm – 08:30 pm

08:30 pm – 09:00pm

Session (V)

Prof. Olweya Abd El-bakyProf. M.Osama ArafaProf. Hala Goda

07:00 pm - 09:00 pm

Chairpersons

CLOSING CERMONY

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Benefic Intestinal Microbiota as breast milk

Langhendries J.P. and al; JPGN 1995; 21 : 177-81 Saavedra J.M. and al; Lancet 1994: 1046-9

Replacement of Promaternum page by BB12

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abstract book

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Brain storming talk about Pediatric Antibiotics

Antibiotics are among the most frequently prescribed medications in modern medicine. There are

over 100 different antibiotics are available to cure minor and life threatening infections. Choosing

an antibiotic is based on the most likely cause of the infection and other factors such as medication

cost, dosing schedule, and common side effects are often taken into account. Patterns of infection

in the community may be considered also in choosing an antibiotic. In some cases, laboratory tests

may be used to help in making an antibiotic choice. In this lecture we will try to discuss antibiotic

prescription strategy toward different pediatric diseases in a brain storming talk to establish stand-

ards of care and improve patients’ outcomes..

Prof. Ahmed said ElblidiProfessor of pediatrics

Head of pediatric departmentFaculty of medicine, Cairo University

30

Controversy in EEG results in diagnosis & management of epilepsy in children

The human electroencephalogram (EEG) which is entirely harmless and relatively inexpensive, is the

most important investigation in the diagnosis and management of epilepsies providing that it is

properly performed by experienced technicians and carefully studied and interpreted in the context

of a well-described clinical setting by experienced physicians.

More than one-half of children and adults currently referred for a routine EEG are suspected of suf-

fering from or do suffer from epilepsies. The EEG is indispensable in the correct syndromic diagnosis

of these patients.

However, there are several reasons why EEG alone cannot be used to make or refute a specific di-

agnosis of epilepsy as most EEG patterns can be caused by a wide variety of different neurologic

diseases and many diseases can cause more than one type of EEG pattern.

In this talk we will focus on when to ask for EEG and how to use it in diagnosis and management of

epilepsy.

Prof. Mohamad Al MazahiProf. of Pediatrics

Damietta Faculty of MedicineAl Azhar University

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Recent advances in thalassemia management and prevention

The thalassemias are among the most common inherited diseases worldwide. Recent advances in

the management of thalassemia have significantly improved life expectancy and quality of life of

patients with this hemoglobinopathy.As the diseases require long-term care; prevention of the ho-

mozygous state constitutes a major armament in the management. In this talk we will focus on the

recent approaches in the management of thalassemia, and will discuss the Prevention strategies

that encompass carrier screening, genetic counseling and prenatal diagnosis.

Prof. Sonia El SharkaweProf. of Pediatrics

Head of Pediatrics Department at Suez Canal University

Honorary President of the conference

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Updates in Familial Mediterranean fever

Familial Mediterranean fever (FMF) is the most frequent hereditary autoinflammatory disease, affect-

ing an estimated 100,000 people worldwide. It is is more prevalent among non-Askhenazi Jewish,

Turkish, Arabic and Armenian populations. It is characterized by self-limited intermittent episodes of

fever and serositis, each lasting approximately 24–72 h. Historically, it was named ‘benign recurrent

polyserositis’ and ‘familial paroxysmal polyserositis’ prior to the coining of the current name

The goal of this talk is to review recent advances in children with FMF, with emphasis on diagnosis,

complications and treatment of FMF.

Prof. Maha Yousief Professor of pediatrics,

Faculty of Medicine , Al Azhar University

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Non alcoholic Fatty Liver (NAFLD) as a Consequence of Obesity in Egypt

Overweight and obesity is the new “epi-demic” of the new millennium with significant adverse ef-

fects on child health. One-third of North American children are overweight or obese [Gumani et al.,

Pediatr Clin North Am. 2015 Aug;62(4):821]. Estimates in Egypt are at ~20%. Obesity and overweight

in children is associated with a wide spectrum of adverse outcomes and can negatively affect vir-

tually every organ in the body. Consequences can be hypertension, dyslipidemia, insulin resistance

and non-alcoholic fatty liver disease (NAFLD). In addition, overweight and obese children are often

stigmatized and might experience social problems with their peers. Obesity in childhood tracks into

adulthood, and it is estimated that up to two thirds of affected children become obese adults, thus

potentially creating a life-long condition.

NAFLD in children has been recognized as a major health burden. Prevalence of NAFLD is increas-

ing in parallel with the growing proportions of childhood obesity. The high prevalence of NAFLD is

due to the contemporary epidemics of obesity, unhealthy dietary pattern, and sedentary lifestyle.

Although it was first reported in 1983, NAFLD has rapidly emerged as the most common cause of

chronic liver disease in children and adolescents in Western countries as a result of the increas-

ing prevalence of pediatric obesity [Della Corte et al., Curr Opin Endocrinol Diabetes Obes. 2016

Feb;23(1):66]. The prevalence of NAFLD in children varies widely depending on geographical area

and diagnostic methods used. Several studies have demonstrated a prevalence of 3–10% in the

general pediatric populations; which increases up to 60–70% in selected obese children. The clinical

implications of NAFLD are derived mostly from its common occurrence in the general population

and its potential to progress to cirrhosis, liver failure and hepatocellular carcinoma.

Unfortunately, the diagnosis of NAFLD in Egypt is largely overlooked, although it is rather easy with

a better understanding, awareness and the presence of a high index of suspicion in pediatric and

adult practitioners. The treatment of pediatric NAFLD represents a challenge. Lifestyle modification

and diet remain the mainstay of treatment of pediatric obesity and NAFLD, but with disappointing

results because of the difficulty in obtaining sustained long-term results. Both time-honored and

novel drug therapies are still far from being satisfactory. Therefore PREVENTION is the best available

policy to date.

Prof. Mortada El-Shabrawi, MDProfessor of Pediatrics and Pediatric Hepatology

Faculty of Medicine, Cairo University

34

Pervasive developmental disorder PPD (Autism)practical diagnostic criteria in pediatric clinic

Autism affects thousands of children with complex restrictions to their learning capabilities and ac-

tivities. According to the American Academy of Pediatrics and the Centers for Disease Control and

Prevention, an estimated 1 in every 110 births have autism in the United States and it affects almost

1 in 70 boys.

Although most of these children receive routine pediatric care or attend preschool programs, their

problems frequently do not come to the attention of health professionals and teachers until the

window of opportunity to make the most impact has past.

Autism is a complex, social developmental disability that typically appears during the first three

years of life. It is the result of a neurological disorder that affects the normal functions of the brain,

impacting development in the areas of social interaction and communication skills.

Children with autism typically show difficulties in verbal and non-verbal communication, social in-

teractions, repetitive behaviors and leisure or play activities.In this lecture we will clarify the early

criteria of diagnosis and how important to put them on an intervention program.

Prof. Dr. Olwea Abd El Baky Post Graduate Childhood Studies Institute,Department of Medical studies of children

Ain Shams University

35

Plastic Toxicity

Plastic, one of the most preferred materials in today’s industrial world is posing serious threat to en-

vironment and consumer’s health in many direct and indirect ways. Exposure to harmful chemicals

during manufacturing, leaching in the stored food items while using plastic packages or chewing

of plastic teethers and toys by children are linked with severe adverse health outcomes such as

cancers, birth defects, impaired immunity, endocrine disruption, developmental and reproductive

effects etc.

In this talk we will focus on types of plastic materials that children usually expose to it and symptoms

of plastic toxicity in children.

Prof. Maged AshrafProfessor of Pediatrics

Faculty of Medicine , Ain Shams University

36

Clinical approach to chromosomal abnormalities in pediatrics

Chromosome diseases are genetic diseases where a large part of the genetic code has been

disrupted. Chromosomal abnormalities cause a variety of clinical syndromes with a variety

of clinical features. In this talk we will discuss the presentation of the most common chro-

mosomal abnormalities in pediatrics and how to approach to diagnosis on clinical base.

Prof .Mohamed El SawyProfessor of Clinical Genetics

Pediatric Department, Faculty of Medicine, Ain Shams University

37

When to refer to gastroenterologist: role of general pediatrician in pediatric GI practice

Gastrointestinal problems and diseases are commonly seen daily in pediatric clinics. Some

of these GI diseases and symptoms persist and resist the usual management so referral

to gastroenterologist is a must for proper diagnosis and management, so awareness and

cooperation between Pediatricians and gastroenterologist is important for the health care

of our children.

In this talk we will clarify the guidelines for referral to gastroenterologist in pediatric GI

diseases.

Prof. Tarek BarakatLecturer of pediatrics/Gastroenterology&Hepatology

Faculty of Medicine, Mansoura University

38

Childhood stroke

Childhood stroke is increasingly being recognized as an important burden not only for affected chil-

dren and families, but also for socioeconomic reasons. The most important is hemiparesis (with/

without dysphasia or facial palsy), ataxia, seizures, and many more are also possible. Suspicion of

stroke has to be ascertained by neuro imaging, gold standard being (diffusion weighted) magnetic

resonance. Risk factors are multiple, but their presence might help to increase the suspicion of stroke.

The most important factors are infectious/parainfectious etiologies, frequently manifesting by tran-

sient focal cerebral arteriopathy (FCA), underlying cardiological problems are the second most im-

portant. Arteriopathies can be detected in about half of the children, besides FCA and dissection.

Hereditary coagulopathies increase the risk of stroke. There is still a controversy on best treatment

in children: platelet anti aggregation and heparinization are used about equally. Thrombolysis is

being increasingly discussed. About two-third of the children have significant residual neurological

problems and a majority cognitive and behavior problems.

Prof .Afaf korraaHead of pediatric department

Faculty of Medicine, Al Azhar UniversityIBCLC, DHPE

Nutritional diploma

39

Common Seven Pearls of Pediatric Surgery for Pediatricians Guidelines

The guidelines for common practiced are mandatory despite it is challenging. Awareness and coop-

eration between pediatric surgeons and Pediatricians is pivotal for the health care of our children

and community. There are seven common diagnoses seen commonly by both subspecialties which

are; 1) umbilical hernia, 2) inguinal hernia, 3) undescended testis, 4) hydrocele, 5)gastroesophageal

reflux, 6) abdominal pain and 7) acute scrotum.

The aim of this presentation is to standardize the management guidelines for pediatric surgery con-

ditions seen in pediatric outpatient clinics based on the world and local experiences.

For the best intended outcomes, standard evidence based guidelines are needed to be followed by

all who are dealing with children. The guidelines with current update for each will presented includ-

ing differential diagnosis, diagnostic aids and management plan till definite diagnosis is settled and

definite treatment is done. Updated treatment regarding timing and approach to each diagnosis

which is medical or surgical will be discussed. Also, inclusion of training of pediatricians and pedi-

atric surgeons in some common scenarios with the concept of co management will be highlighted.

These seven pearls (diagnoses) represent more than 85% of common conditions electively seen in

either clinic

Prof. Sherif Mohamed ShehataMCh, MD (Surg), CST, PhD

Department of Pediatric Surgery, Tanta University, EgyptEgyptian Pediatric Surgery Association (EPSA) Secretary General

40

Pediatric Respiratory Emergencies

Respiratory failure is the most common cause of cardiopulmonary arrest in pediatric patients. There-

fore, prompt recognition, assessment, and expert management of respiratory emergencies are crit-

ical to obtaining the best possible outcome. Anatomical differences between pediatric and adult

patients render children more susceptible to acute airway compromise.

Acute obstructive respiratory emergencies in children are a common cause of emergency depart-

ment visits. They are first cause of:

▪ Pediatric hospital admissions

▪ Death during first year of life except for congenital abnormalities

This lecture will discuss general principles of assessing and managing respiratory emergencies in

children, as well as clinical characteristics and special emphasis on management of specific condi-

tions such as croup, epiglottitis, bacterial tracheitis, bronchiolitis, acute severe asthma, pneumonia,

retropharyngeal abscess and foreign body inhalation.

Prof. Irene M. Sabry, MDAssistant Professor of Chest diseases

Faculty of medicineCairo University

41

Rehabilitation of children with special needs

Children with special needs need rehabilitation in order to live as independent life as possible. Sup-

port given to special needs children should combine with “natural environment”: home - family, in-

fant school, kindergarten, school. Family is the core of the best early intervention programs. Parents

are considered to be active partners in their child’s care planning.

In this talk we will focus on the obstacles they face and how to deal with them and the importance of

early intervention rehabilitation programs from the first weeks and months of a special needs child’s

life to reduce mental subnormality and complication.

Prof. Mamdouh TorkieMD Pediatrics

Head of pediatric department, Suez Canal Authority

42

How to deal with pediatric drugs in preparation and preservation (pharmaceutical view)

Drugs must be properly formulated for administration to patients, regardless of age. Pediatric pa-

tients provide some additional challenges to the formulator in terms of compliance and therapeutic

efficacy. Due to the lack of sufficient drug products for the pediatric population, the pharmaceu-

tical industry and compounding pharmacies must develop and provide appropriate medications

designed for children.

The purpose of this talk is to review the physical, chemical, and biological characteristics of drug

substances and pharmaceutical ingredients to be used in preparing a drug product. In addition, sta-

bility, appearance, palatability, flavoring, sweetening, coloring, preservation, packaging, and storage

will be discussed.

Prof. Ahmed DarweshAssistant lecturer of pharmacology and toxicology

Faculty of pharmacySuez Canal University

43

Idiopathic Constipation and Secondary Fecal Incontinence in Pediatric age group; Surgical Perspective and Strategy of Management

Children presenting with constipation represents a great challenge. Many of them are due to surgi-

cally correctable causes but more common to be due to medically treatable factors. Incontinence in

Pediatric age group is mostly secondary to these etiological factors or to the treatment modalities

available.

Patients and methods: Between November 2007 to November 2010, 273 patients presenting with

either chronic constipation or incontinence were included. Patients with clinical history suggestive

of congenital malformations were excluded. Patients with milk allergy were excluded as well.

Patients were subjected to clinical examination and contrast enema. Patients (n=196) presented be-

fore February 2010 were treated by regular colonic evacuation using saline enemas. Patients who

were still on enemas and could not be weaned (n=45) after 6 months of regular enemas were sub-

jected to Malone Ante Grade Continent Enema (MACE). Starting February 2010, new patients (n=77)

received stimulant purgatives instead of enemas. Patients who were on MACE (n=45) were changed

to stimulant purgative as well. Patients (n=4) who required high doses of laxatives were subjected to

sigmoid colectomy. Follow up was depending on clinical examination and plain x-ray.

Results: All patients were diagnosed as retentive type and were clean on enemas or MACE as well

as on stimulant purgatives. Only 4 patients required more than 5 times regular dose of stimulant

to get clean, and after sigmoid colectomy 2 had their dose decreased to quarter the previous and

2 did not need laxatives any more. Most of patients (n=39) who moved from enemas to stimulants

appreciated the abstinence of enema and 6 preferred using their MACE.

Conclusion: In selected pathologies, proper diagnosis and correct choice and application of thera-

peutic option provides a high success rate approaching 100% that is appreciated by the child and

his family.

Prof. Mohamed Soliman El-DebeikyMSc.,MD,MRCSEd

Professor of Paediatric SurgeryAin Shams University

44

Inflammatory bowel disease, where we stand?!

Inflammatory bowel disease is a disease entity that widely used to describe a diverse group of chron-

ic inflammatory conditions of the gastrointestinal tract, including of the colon and small intestine.

The major types of IBD can be characterized as Crohn’s disease and ulcerative colitis, and about

10%-15% of the patients are diagnosed as having indeterminate colitis. However, the differentiating

characteristics between Crohn’s disease and those of ulcerative colitis are usually obvious, the main

difference between these two conditions is the location and type of inflammatory changes. We are

going to shed light on major characteristics of both types & recent updates in diagnosis & manage-

ment.

Prof. M. Osama Hussein, MDConsultant pediatrics & neonatology

President of Port said neonatology society

45

Common Pitfalls in Asthma Management

Prof. Hala Gouda ElnadyProfessor of Child Health, National research center

Head of pediatric pulmonary function unit

46

Ultrasound role in diagnosis of Pediatric Emergency

Ultrasound (US) imaging has several advantages over other radiologic imaging modalities,

particularly in the emergency department (ED). It is a low cost, non-invasive, easily accessi-

ble and painless imaging modality that can be quickly performed at the bedside of an un-

stable or very ill patient. It is easily reproducible and can be repeated multiple times with-

out any risk. However, the greatest advantage of US over other imaging modalities, such

as computed tomography (CT), is the absence of ionizing radiation. As evidence of harmful

effects of radiation due to CT continues to increase, US is gaining greater acceptance as the

imaging modality of choice in the pediatric emergency setting. The main disadvantage of

US is operator dependence. This lecture highlights the use of US in evaluating common

emergency conditions in children presenting to the ED.

Prof. Azza Abd El-hamid, MDProfessor of Radiology

Faculty of Medicine, Suez Canal UniversitySuez Canal University

47

Napkin dermatitis for D.D

Napkin dermatitis is one of the most common dermatoses occurring in infancy. It is an

irritant dermatitis, in which a variety of factors act in concert to produce inflammation of

the diapered skin. The differential diagnosis includes many common and some uncommon

conditions.

A diverse group of diseases can cause skin conditions in the diaper area including those

which are directly caused by diapers or the diaper environment, some which are not direct-

ly due to, but are worsened by, the wearing of diapers, and those which are independent

of the presence of the diaper or its resulting environment. Many of these conditions are

limited to this area of the skin, but others extend to skin outside this area, and some are

signs of systemic disease.

In our lecture we will review many of the important causes of eruptions in the diaper area

and emphasize key points in the differential diagnosis.

Prof. Maged Ali Mahmoud ElsheikhConsultant and head of Dermatology department at El Galaa Military Hospital

Professor of Dermatology at the Military Medical Academy Faculty of Medicine, Cairo University

48

Patent Ductus Arteriosus

Patent ductus arteriosus (PDA) – persistence of the fetal ductus arteriosus – is the most

common form of congenital cardiac abnormality in newborns. PDA is associated with sig-

nificant hemodynamic abnormalities and has varying influence on pulmonary function.

Incidence and severity of complications of PDA vary in different subgroups of the preterm

neonates. No specific clinical or echocardiographic criteria have been developed on which

treatment of PDA could be based. Possibilities for assessing ductal significance include

clinical and echocardiographic methods, and possibly biochemical markers. The main ar-

gument against active intervention in PDA is significant adverse effects related to both

medical and surgical treatments. This talk will focus on the decision about conservative

approach versus active intervention in PDA in a preterm baby.

Prof. Alaa Sobeih, MDPediatric Cardiologist

Department of PediatricsFaculty of Medicine, Cairo University

49

Junk food and how to protect our children

The term junk food dates back at least to the early 1950s. Although it has been reported

that it was coined in 1972 by Michael F. Jacobson of the Center for Science in the Public

Interest. Andrew F. Smith, in his book, Encyclopedia of Junk Food and Fast Food defines

junk food as “those commercial products, including candy, bakery goods, ice cream, salty

snacks, and soft drinks, which have little or no nutritional value but do have plenty of calo-

ries, salt, and fats”

Effect on Mental Health… A study published in 2013in the “Journal of the American Acad-

emy of Child and Adolescent Psychiatry” examined the diet of children age 6 months to 5

years old, as well as the diet of the mother while she was pregnant. Researchers concluded

that the diet of both the pregnant mother and the child after birth can have an effect on

mental health of the child; a diet high in unhealthy junk food and low in nutrient-dense

food were linked to behavioral and emotional problems, including anxiety and depression.

Effect on Obesity and Disease Risk…According to the Centers for Disease Control and Pre-

vention, obese children are more likely to have high cholesterol or high blood pressure,

both risk factors for cardiovascular disease. Additionally, obese kids are at higher risk of

prediabetes, bone and joint problems, sleep apnea and social and psychological problems

• Anti-junk food measures…. Taxation- Advertising restriction

Prof. Tarek El WaliliProfessor of Pediatrics

Faculty of medicine, Alexandria University Head of the Egyptian Pediatric Association-Alexandria (EPA-A)

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Controversy in Lab diagnosis and results

The appropriate ordering and interpreting of laboratory tests is an essential element of a

physician’s clinical skills. Along with history taking, physical examination, and the thought-

ful use of imaging techniques, the clinical laboratory is a major tool in the clinician’s arma-

mentarium.

The introduction of sophisticated quality improvement techniques into the clinical arena

has evolved substantially in the past decade. It makes sense to integrate the changes that

we make in our daily practice of medicine with quality improvement changes in the clinical

laboratory in order to maximize the functionality of both areas for the safety and quality of

care for our patients.

Prof. Ahmed EllawahProfessor of Clinical Pathology

Faculty of Medicine, Al-Azhar University

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5 common serotypes in 1 vaccineA pentavalent rotavirus vaccine for baby

RotaTeq includes reassortant rotaviruses representing 5 common circulating serotypes

RotaTeq is an oral pentavalent vaccine indicated for the prevention of rotavirus gastroenteritis in infants and children caused by the serotypes G1, G2, G3, G4, and G-serotypes that contain P1A[8] (eg, G9). RotaTeq may be administered as early as 6 weeks of age.

• ~75% of rotavirus infections worldwide were caused by 5 strains: G1P[8], G2P[4], G3P[8], G4P[8], and G9P[8]2

aP[8] is associated with several G-serotypes, eg, G9.1

References: 1. Santos N, Hoshino Y. Global distribution of rotavirus serotypes/genotypes and its implication for the development and implementation of an effective rotavirus vaccine. Rev Med Virol. 2005;15(1):29–56. 2. Bányai K, László B, Duque J, et al. Systematic review of regional and temporal trends in global rotavirus strain diversity in the pre rotavirus vaccine era: insights for understanding the impact of rotavirus vaccination programs. Vaccine. 2012; 30(suppl 1):A122–A130.

G2 G3 P[8]aG1 G4

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Sponsors

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