Day 2 :
Keynote Forum
Sherwin Morgan
University of Chicago Medicine, USA
Keynote: A new horizon for pediatricaerosolized medication delivery to infants via high flow nasal cannula and vibrating mesh nebulization
Time : 09:00-09:40
Biography:
Sherwin Morgan completed his respiratory care training from Malcolm X College of Respiratory Care in Chicago, IL. He is an advanced respiratory care practitioner with the National Board for Respiratory Care in the United States. He is Clinical Practice and Development /Educator/Research Coordinator for the Department of Respiratory Care Services, Section of Pulmonary and Critical Care Medicine at the University of Chicago Medicine. He has published more than 25 peer review papers in multiple medical journals. He has designed, engineered, and collaborated with a number of research studies with the pulmonary medicine department.
Abstract:
Introduction: Th e global gold standard for delivering aerosolized medication to infants in respiratory distress has been via the Small Volume Jet Nebulizer (SVJN) with a face mask. The medication most commonly used is albuterol 0.083%. During the procedure, a parent must hold the mask on the babyface, which can make the child combative. Therefore, the standard oxygen treatment is moving from face mask to High Flow Nasal cannula (HFNC) in conjunction with aerosolized beta-agonist treatments. A recent study of aerosol drug distribution using a face mask with TC99 label albuterol demonstrated that < less than 1% of the aerosol drug reached the lung and deposition was even less when the infant was crying or upset. Medication delivery is decreased even more when the patient has a nasal cannula in their nose and a pacifi er in their mouth. Children are mostly nasal breathers. In vitro pediatric lung model studies with the combination of HFNC&ANB, estimated aerosol deposition at 18 to 26%, although effi cacy is low, it is enough to exert a clinical eff ect when the treatment process was changed to delivery via HFNC and the vibrating mesh nebulizer (Aerogen® Solo Nebulizer), there was improvement with patient and parent comfort levels. Most children were calm and able to sleep throughout the treatment, keep the pacifi ers in and some were able to breastfeed during treatment. The clinical indicator that there was better aerosol medication deposition was that many kids experienced an increased heart rate of 10 to 15% from baseline, although they were not being touched or stimulated.
Bedside clinician could see medication aerosol exhalation around the pacifiers.
Conclusion: This development has revolutionized aerosolized inhaled medication delivery with the ultra-sonic vibrating mesh nebulizer for infants in respiratory distress. More study is needed in this area.
Keynote Forum
Mir Anwar
Richmond Chest Hospital, South Africa
Keynote: Malnutrition in children- South Africa’s present scenario
Time : 09:40-10:20
Biography:
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, Pacifi c 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 Gynaecology etc. For his work he is honoured 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.
Abstract:
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. Department of Health of South Africa publish that 15% of South African infants are born with a low birth weight. Th ere are 25% of pre-school children and 20% of primary school children in South Africa suff ered from malnutrition. Since 2011 to 2016 over the period of 6 years we followed total paediatric admission in Stanger Hospital, Natal 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. Lack of breast feeding is also a cause for the malnutrition. The 2010 South Africa department of Health Study found that 30.2% of pregnant women in South Africa have HIV/AIDS and they are reluctant to breast feed their children. Malnutrition is the 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. Th e World Health Organization showed that over the span of thirteen years (1995 to 2008), the deviation from the average height of children under age fi ve in South Africa has decreased from 28.7% to 23.9%. Th e approac
Keynote Forum
Kaye Talijancich
Princess Margaret Hospital for Children, Australia
Keynote: The role of laser in tongue tie division: A pilot study
Time : 09:40-10:20
Biography:
Kaye studied Bachelor of Science – Nursing, at Curtin University and graduated as a Registered Nurse in 2008. She currently works as Registered Nurse (parttime) looking after babies under 28 days at Neonatal Department at Princess Margaret Hospital for Children, Subiaco, Perth (WA). Her previous paediatric nursing experience includes working at the Emergency Department, Gastroenterology and Immunology Departments at Princess Margaret Hospital for Children. She has also worked for Edith Cowan University as a Paediatric Clinical Facilitator. Kaye commenced at Perth Paediatrics in 2016. She brings her skills and dedicated passion of working with children, to the fi rst multi-specialty private paediatric clinic in Western Australia.
Abstract:
Background: Laser tongue tie division is an option suitable for neonates, older children, and adults. No general anesthetic is used, but an analgesic gel is applied. Th e procedure is very quick, taking only 2 to 3 minutes to perform.
Aim: To assess the outcome of patients who underwent tongue tie division with Diode Laser at Perth Paediatric.
Methods: We conducted a retrospective review of the 49 children who underwent laser repair of tongue tie at Perth Paediatrics between 30/01/2017 and 10/7/2017. Th e age of the children ranged from 4 days to 6 months. We assessed the outcome aft er 1 to 6 months, with a questionnaire via telephone. Of the 49 children’s mothers telephoned, a total of 41 children were contactable. The outcome was assessed in terms of improvement of breastfeeding comfort to the mother and procedural complications.
Results: The outcome was assessed in terms of improvement in breastfeeding and lack of discomfort. 41 mums had immediate relief, which was rated good to excellent. 3 mums had poor immediate relief but there was an improvement aft er 2 weeks of procedure and was rated good. Only 2 out of 41 mothers reported no relief in improvement in breastfeeding. Furthermore, it was noted that refl ux symptoms in 3 children decreased post laser treatment and a weight gain increase was noted. There were no immediate or delayed procedural complications in terms of post-operative bleeding, infection, scarring or recurrence.
Conclusion: 95.2% (39/41) of children, who underwent tongue tie division with laser, were reported by their mothers, to have improvement in breastfeeding improvement in terms of latch/leakage. This outcome also included an improvement in the mother’s discomfort. Ie. nipple pain, nipple damage, and mastitis.
Keynote Forum
Christina YK Leung
University of Hong Kong, China
Keynote: Drugs use in Biliary atresia and the roles of clinical pharmacist
Time : 11:15-12:55
Biography:
Christina Leung completed two Bachelor degrees in England, BSc Management Sciences followed by the BPharm Pharmacy. Following the registration as a pharmacist in the UK, she worked in different London Teaching Hospitals for 16 years. In UK, she specialised in Paediatrics (especially in PICU and Paediatric Liver), Obstetrics and Gynaecology. She published a number of articles including drugs use in paediatric liver diseases in the UK and management of vomiting in pregnancy and hyperemesis gravidarum. Ms Leung is also a registered pharmacist in Hong Kong. Since 2012, she had worked as the Senior Pharmacist (Clinical Pharmacy in Charge) at the University of Hong Kong-Shenzhen Hospital, a reformed hospital in China. Currently, Ms Leung is the Honorary Tutor at the University of Hong Kong. She delivers lectures to the Master and Undergraduate Pharmacy students relating to drugs use in Paediatrics, Obstetrics and Gynaecology.
Abstract:
Biliary atresia (BA) is a condition in which inflammation develops within the bile ducts around the time of birth. Th is leads to bile duct damage and reduces the flow of the bile which subsequently causes scarring of the liver. Th e initial treatment for biliary atresia is a surgical operation called the “Kasai Porteoenterostomy” (KPE). Th e aim of KPE is to make a drainage channel to allow bile to drain from the liver. Before the surgery, the patient will be prescribed with fat-soluble vitamins for patients with prolonged jaundice. Examples are multivitamin preparations (Abidec® or Dalivit® drops in the UK), vitamin K preparations (phytomenadione injection which can be given by oral, IV or IM routes and menadiol tablet), Vitamin E (tocopheryl acetate), and Vitamin D (Alfacalcidol). 24 to 48 hours before the surgery, the patients will receive bowel preparations and the common ones are Lactulose liquid, Neomycin liquid, and Metronidazole suspension. After the operation, the patient will receive drugs via intravenous or intramuscular route for about 3 to 5 days, standard maintenance IV fluid will be given for about 3 to 4 days. Nurse Controlled Analgesia (NCA) IV pump with morphine is always used for the initial 3 days, and the patient is also prescribed with regular paracetamol (IV or rectal) for breakthrough pain for about 3 days then change to oral. Prophylactic IV antibiotics will be given after the surgery for at least 72 hours. Examples are Gentamicin and Piperacillin/Tazobactam as dual therapies. After 72 hours, if no high temperature is developed and the oral feeds are started, the prophylactic antibiotics can be changed to oral for 28 days (an example is oral Cefalexin). Ranitidine is also used to prevent a stress-induced ulcer. Intramuscular vitamins are used post-surgery. Examples are Vitamin D 30,000 units (60,000 units if radiological rickets is present), Vitamin E 10mg per kg, Vitamin A 10,000 units are given at the discretion of hepatologist (usually for patients with late diagnosis). After day 5 of operations, the patient may start oral therapies. Additional oral vitamins are necessary post-surgery for about 6 months. Examples are Vitamin K, Vitamin E, and multivitamin drops. Oral Phenobarbitone (alcohol-free liquid or tablet) helps to increase bile fl ow and hence to reduce itching symptom. Th e recommended dose is 15mg daily, increasing to 45mg daily in steps of 15mg per week. Colestyramine helps to remove the bile salts which cause jaundice and itchiness. Since Colestyramine can reduce the absorption of some drugs, especially vitamins, it is recommended to leave vitamin preparations at least 2 hours before or 4 hours after giving Colestyramine. Spironolactone suspension helps the patient reduces the amount of fluid accumulated as a result of ascites, but it is not needed in all cases. Th ere have been clinical studies to use high dose oral steroids (oral prednisolone) post KPE to benefit in reduction of postoperative bilirubin and clearance of jaundice. However, the findings show that the effect of steroids may be limited or inhibited by an increasing degree of fibrosis and onset of cirrhosis. If KPE is successful, many of these medicines can be stopped over time. If KPE fails, the liver transplant can be one of the treatment options. Th e care of the biliary atresia patients is best with the multi-disciplinary approach, and clinical pharmacists play a significant role in this care management. Examples of the contributions are dosage recommendations, choice of drugs, stopping or initiation of a therapy, guidelines development, drug history talking and medication reconciliation, therapeutic drug monitoring and other blood results monitoring to optimize drug therapies, patient education such as developing of patient leaflets and delivering of patient education talks, patient counselling of discharged medications such as using of tailored-made discharge medication card, discharge planning to reduce the waiting time, adverse drugs reactions monitoring, medication incidents management, drugs interactions, advice on drug administration (e.g. with or after food, timing of drug administration, method of IV drug administration), review of medications in the out-patient clinics after discharge, and participation in the clinical trials.
- Pediatric Drug delivery and Dosage forms | Pediatric Surgical Pathology | Paediatrics and Child Health | Pediatric Pharmacology | Pediatric Cardio Pharmacology | Pediatric Dermatology
Location: FREDERICK
Chair
Regina Folster Holst
Past President of European Society for Pediatric Dermatology, Germany
Session Introduction
Ahmad Shah Farhat
Mashad University of Medical Science, Iran
Title: Comparison between two & twenty four hour salt powder coverage in infant umbilical granuloma treatment
Time : 14:40-15:05
Biography:
Ahmadshah Farhat assistant professor of neonatology has completed neonatology subspecialty in Mashhad University of Medical Sciences, Iran. He is a vice chancellor of Neonatal Research Center in this university since 2006 and consultant neonatologist of neonatal intensive care unit since 1992 up to now. He had published 66 papers locally and international journal, 19 books, 71 supervision of thesis in general medicine, pediatric, and neonatology, 120 participation in national and international congress with lecture and poster presentation. He was a member of 50 national scientific committee during last 23 years. He had 10 scientific honors in pediatric and neonatology.
Abstract:
Objective: To compare the eff ect of 24 hours and 2 hours salt (NaCl) treatment. for infant umbilical granuloma.
Methods: Th is study took place during two years at NICU and infant follow up clinic of Emam Reza Hospital related to Mashad University Medical Sciences Mashad North East Iran. Th e study consist of two groups, 20 infants in 24 hours treatment with salt or case group and 20 infants in 2 hours treatment with salt or control group.
Results: 40 infants completed the study ,there were 18 boys and 22 girls. In both groups there weren't significant differences between the sex, birth weight, time of umbilical separation and age of enrollment. The treatment days in case and control groups were respectively 1,.25+ 0,55 and 2,10+0,44 days and according to p=0.00 the difference was significant.
Conclusion: 24 hours treatment of umbilical granuloma is more effect.
Jamel Hajji
Gafsa University, Tunisia
Title: Validation of the Arabic version of the Inventory of Coping Strategies of Competitive Sport (ISCCS)
Time : 15:05-15:30
Biography:
Hajji Jamel is a Researcher at the field of coping and anxiety. He successfully completed his master and Ph.D in the field of Higher Institute of Sport and Physical Education Gafsa, Gafsa University, Tunisia.
Abstract:
The aim of our study is to validate the Arabic version of the Inventory of Coping Strategies of Competitive Sport (ISCCS) using factor analysis. After critical analyses of adapted sports versions, Gaudreau and Blondin (2002) proposed the ISCCS questionnaire to measure coping strategies in the fi eld of competitive sports (Andre & Laurencelle, 2010). The ISCCS identify ten coping strategies that are divided into two dimensions: The coping task-oriented and the coping emotion-oriented. 419 athletes (273 men and 146 women; age 16.79±3.82 years, 14 to 34) in different individual and team competitions, volunteered to participate in the study. Data were collected and analyzed for reliability and validity using the test-retest method, reliability,correlation analysis and confirmatory factor analyses. Statistical analysis was performed with SPSS version 22.0.0 the IBM AMOS. The confi rmatory factor analyses showed good adjustments for coping models of task-oriented (chi-square 359.35, CFI: 0.92; TLI: 0.91; GFI: 0.93; RMSEA: 0.040 and p-value < 0.001), and the coping oriented emotion (chi-square 215.45, CFI: 0.93; TLI: 0.91; GFI, 0.94; RMSEA: 0.054 and p < 0.001). In conclusion, ISCCS was translated and validated in various languages, including French, English, Spanish, and Turkish, Arabic version demonstrated good psychometric properties adjustments and can be used in other surveys in the area of sports competition.
Jeng-Sheng Chang
China Medical University, Taiwan
Title: Regression of neonatal cardiac rhabdomyoma in two months through low-dose Everolimus therapy
Time : 15:30-15:50
Biography:
As a director of pediatric cardiology and pediatric intensive care unit, Jeng-Sheng Chang is specialized in diagnosis, management and follow-up of the congenital and acquired heart diseases in children. His team is team also integrated other subspeciality teams, including cardiovascular surgeon, anesthesiology, Pharmacists, respiration therapist, nurse practitioners and nutrionist, etc., for combining care of patients with critical disease his patient-centered projects for the critical heart disease children have won the grands for quality improvement, Taiwan Institute of Health and Welfare, 2015-2016 two successive years. The open heart surgery for congenital heart disease, interventional cardiac catheterization, Extracorporeal Membranous oxygenator(ECMO) therapy, and Kawasaki disease, both in clinical management and researches, are among our best works. His researches in Kawasaki disease, collaborative with the bench team in Central Research Institute, have published important papers in the Journals of Nature Genetics and Circulation Research. A biomarker for early detection of Kawasaki disease has also been put on the markets of Asian countries.
Abstract:
Cardiac Rhabdomyoma (CR) is the most common cardiac tumor in newborns. Approximately 75% of cases are associated with tuberous sclerosis complex. Although these tumors usually spontaneously regress aft er 2 years of age, they can be life-threatening when they obstruct major cardiac infl ow or outfl ow pathways. Everolimus is an inhibitor of mammalian target of rapamycin, reducing its production of the proteins harmartin and tuberin. Everolimus has demonstrated a remarkable suppression eff ect in children with tuberous sclerosis complex at doses of 4.7–5.6 mg/M2/day and serum trough levels of 5–15 ng/mL. Since 2012, fi ve case reports of neonates with CR have also reported the tumor-regressing eff ect of everolimus. However, the optimal dosage for neonates is still unknown. Over the past 2 years, we have deliberately used a low dose everolimus regimen (0.3–0.67 mg/ M2/ day) in three neonates with large CRs, in an eff ort to maintain serum trough levels at 3–7 ng/mL. In all three cases, the tumors regressed smoothly within 2 months. Regarding the drug’s side eff ect of predisposing patients to infection, we observed that adenovirus pneumonia occurred in one case at 3 months of age, and chicken pox occurred in another case at 9 months of age; both recovered smoothly. Our three cases of neonatal CR demonstrate that a low-dose everolimus regimen is an eff ective treatment for tumor regression.
Sura Mohammad Alrawabdeh
Royal Medical Services, Jordan
Title: Xanthogranulomatous appendicitis in a child: Report of a case and review of the literature
Time : 16:10-16:35
Biography:
Sura Al-Rawabdeh a senior specialist in Pediatric pathology is currently working in the royal medical services in Jordan. She got fellowship training in Pediatric
Pathology. In nationwide children’s hospital Columbus Ohio USA
Abstract:
Xanthogranulomatous inflammation is a well-described infl ammatory process, which may involve any organ but is most frequently encountered in the gall bladder and the kidney. There are rare reports of Xanthogranulomatous Appendicitis (XA) in the adult population, but only one brief mention of such a diagnosis in a child. In this report, we describe the case of an 11-year-old boy who presented with clinical signs and symptoms of acute appendicitis necessitating appendectomy. Upon microscopic examination, the appendix showed the typical features of XA. To the best of our knowledge, this is the first welldescribed case XA in a noninterval appendix in a child. We also reviewed the limited medical literature on the subject.
Â
Case Report: Th e patient is an 11-year-old boy who presented with a 1-day history of abdominal pain and emesis but no fever. His past medical history was unremarkable. In particular, there was no history of hemorrhagic problems or systemic disease. The family history was also unremarkable. On physical examination, he had persistent and well-localized right lower quadrant and right fl ank tenderness at the expected location of his appendix (McBurney’s point). The laboratory findings were unremarkable. WBC was 4.9 K/microliter with the following diff erentials: 49% segmented neutrophils, 41% lymphocytes, 9% monocytes, and 1% eosinophils. Th ere was no evidence of anemia or thrombocytopenia (hemoglobin = 13 g/dL, hematocrit = 36%, and platelet count = 291 K/microliter). A computed tomography scan (CT-Scan) of the abdomen showed an enlargedappendix without inflammation; however, ultrasound images showed a fl uid-fi lled appendix with a diameter within the upper rages of normal. A subsequent physical examination revealed an increase in abdominal pain and tenderness, and, consequently, the patient underwent a laparoscopic appendectomy. Gross evaluation showed a pink-tan appendix, measuring 8.3 cm in length and 1 cm in diameter. Th eserosal surface was unremarkable and cut surface demonstrated no fecalith. Microscopically, hematoxylin-eosin-stained sections of the tip of the appendix revealed numerous lipid-laden xanthoma cells in the mucosa which were surrounded by lymphocytes and plasma cells admixed with multiple mult- inucleatedgiant cells containing cholesterol clefts. The rest of the mucosa showed patchy mild neutrophilic infi ltration. The postoperative clinical course was unremarkable. The patient was discharged home the following day and had an unremarkable physical examination on a follow-up visit three weeks later.
Â
Discussion: Xanthogranulomatous inflammation is a rare form of chronic infl ammation, manifested by the presence of lipidladen macrophages admixed with lymphocytes, plasma cells, neu-trophils, and often multinucleated giant cells with or without cholesterol cleft s. It was initially described in the kidney by Osterlind in 1944. It has also been reported in other organs, such as gall bladder, prostate, epididymis, ovary, urinary bladder, kidney, appendix, and the exact etiology of xanthogranulomatous inflammation is uncertain.
Â
Conclusion: Xanthogranulomatous Appendicitis (XA) is a rare clinical entity, particularly in the pediatric population. It may be encountered in specimens resected in the acute phase, but is much more common in interval appendectomy specimens. As observed in the present case and in previous reports, most patients with XA present with a picture of acute or sub- acute abdominal pain, and occasionally with a mass lesion.
Sarah S Nierman
Community Health Network/Butler University, USA
Title: Pediatric antimicrobial stewardship in an adult hospital
Time : 16:35-17:00
Biography:
Sarah Nierman is the Pediatric/PICU/NICU Clinical Pharmacy Specialist at Community Health Network and a Clinical Instructor at Butler University in Indianapolis, Indiana. She is a member of the health system’s antimicrobial stewardship program committee.
Abstract:
Statement of the Problem: Antibiotics are often associated with overuse, antibiotic resistance, medication errors and adverse events. Antimicrobial stewardship is a collaborative effort to improve the appropriate use of antibiotics by focusing on selection of the correct agent, dose, frequency, route and duration.
Discussion: Community Health Network established an antimicrobial stewardship committee in 2014. This committee has thefollowing goals based on expert guidelines:
a) De-escalation of antibiotics based on clinical factors and microbiologic data
b) Optimize antibiotic duration
c) Change from parenteral to oral antibiotic route
d) Dose optimization for effi cacy and safety
e) Avoid duplicate therapy
Th e committee utilizes the following to achieve the goals:
a) Establish evidence based guidelines for disease state diagnosis/ antibiotic use
i. Physician user input and buy in up front
ii. Provide education regarding guideline to physicians/ pharmacy/ nursing
b) Prospective auditing and physician intervention by pharmacy and peer feedback to prescribers.
c) Provider, unit, and Hospital Days of Th erapy (DOT) data for review and comparison to peers and national benchmarks
d) Antibiogram review
e) Formulary review with P&T committee
Conclusion & Significance: Pediatric antimicrobial stewardship is starting on the pediatric, pediatric intensive care and neonatal intensive care units. The goals and initiatives established in the adult population are a solid foundation for identifying pediatric opportunities.
Mersedeh Enshaei
Gilan University School of Medical Sciences, Iran
Title: Iron status profi le in children with hyperkinetic movement disorders: A comparison with normal children
Time : 17:00-17:25
Biography:
Mercede Enshaei has completed her Pediatric Specialty at the age of 32 years from Gilan University of Medical Sciences. She studied Genetic Counseling at Tehran University of Medical Sciences, and she will begin the Pediatric Hematology and Oncology Subspecialty from September 2018. Arya Mahdavi Baramchi has a Master Degree in Clinical Psychology. She is a member of Psychology and Counseling Organization of Iran.
Abstract:
Movement disorders are a growing field of pediatric neurology. Unlike adults, it seems children are more likely to suffer from hyperkinetic movement disorders. Some studies have been done on serum iron in aff ected adults, but there are limited data in pediatrics. Th is survey case-control study was aimed to compare iron profiles in children with hyperkinetic movement disorders with healthy children. 50 children of 2-12 years of age are examined with hyperkinetic movement disorders fifty healthy children as age and sex-matched controls were enrolled too. In children with hyperkinetic movement disorders serum iron, TIBC, and serum ferritin were 51.8 ± 2.77μg/dl, 450± 9.42 μg/dl and 47.92 ± 7.87 ng/ml; while in normal children these amounts were 81.4±3.94 μg/dl, 356 ± 12.34 μg/dl and 140.68 ± 13.61 ng/ml respectively. Th e diff erences in each parameter between two groups were statistically significant. (P-value < 0.05). There was a significant difference between patients with hyperkinetic movement disorders and healthy controls regarding iron profi les. Our findings suggest that decreased blood iron levels may have a predisposing eff ect on hyperkinetic movement disorders, although the knowledge about the mechanism is still limited. Since these disorders affect the quality of life, it seems further studies are needed to understand the mechanism and make some recommendations on prevention or control of the disease.
Reza Saeidi
Mashhad University of Medical Sciences, Iran
Title: Comparison of oral recombinant erythropoietin and subcutaneous recombinant erythropoietin in prevention of anemia of prematurity
Time : 17:25-17:50
Biography:
Saeidi R is assistant professor of neonatology has completed neonatology subspecialty in Mashhad University of Medical Sciences, Iran. He published 66 papers locally and international journal, 19 books, 71 supervision of thesis in general medicine, pediatric, and neonatology, 120 participation in national and international congress with lecture and poster presentation.
Abstract:
Background: Premature neonates are at risk for severe anemia and erythropoietin is the most important hormone in erythropoiesis. The aim of this study was to evaluate the infl uence of oral recombinant Human Erythropoietin (rhEPO) in proving erythropoiesis in neonates.
Methods: This was a randomized clinical trial study. Thirty neonates were enrolled from September 2007 to September 2008. The first group received oral rhEPO and Fe and the second, subcutaneous rhEPO and Fe. Th e patients' Hb, HCT and the need for blood transfusion were recorded. We included all infants with gestational age <34 weeks, birth weight <1500 gr, without respiratory distress (O2 Saturation> 85%, FiO2 of 30%), full feeding tolerance so that oral Fe can be administrated.
Results: In the first group (oral=PO), 65% of neonates were female and 35% were male, mean weight was 1140 g and mean GA was 32.6 weeks. In the second group (subcutaneous=SC), 42% were female and 58% were male. The mean weight was 1245 g and mean GA was 31.2 weeks and this was not statistically significant. In the first group, the mean Hb and HCT were 9.7±1.9 and 29.6±5.9 g/dl. In the second group, the figures were 12.5±1.7 and 38.8±5.1 which were statistically significant. There was no difference in the weight gain between two groups. In the first group, 3 neonates (20%) and in the second one, 1 neonate (15%) needed the blood transfusion.
Conclusions: rhEPO administration either PO or SC could prevent anemia of prematurity but SC route was more effective.
Jamel Hajji
Gafsa University, Tunisia
Title: Validation of the Tunisian version of the French version of the competitive state anxiety inventory-2 revised (CSAI-2R), including frequency and direction scales
Time : 17:50-18:15
Biography:
Hajji Jamel is a researcher at the field of coping and anxiety. He successfully completed his masters and Ph.D in the field of Higher Institute of Sport and Physical Education Gafsa, Gafsa University, Tunisia.
Abstract:
The Competitive State Anxiety Inventory-2 Revised (CSAI-2R), is one of the most frequently used instruments in the evaluation of situational anxiety in sports competition.
Objectives: The objective of this study was to validate the Tunisian version based on the French version of the Competitive State Anxiety Inventory-2 Revised (CSAI-2R), including the direction and the frequency scales.
Method: 418 athletes ranging in age from 14 to 34 years in different individual and team competitions, volunteered to participate in the study. Data were collected and analyzed for reliability and validity using the test-retest method, reliability, correlation analysis and confi rmatory factor analyses. Statistical analysis was performed with SPSS and the IBM AMOS version 21.0.0
Results: The Confi rmatory factor analyzes showed acceptable adjustments for the 3-factor model of CSAI-2R. For the intensity model [X2=343.19; X2/df=3.40; CFI=0.92; TLI=0. 90; GFI =0.91; RMSEA=0.076; p-value<0.001]. for the direction model [X2=360.83; X2/df=3.57; CFI=0.93; TLI=0.92; GFI=0.90; RMSEA=0.079; p value<0.001]. And for the frequency model [X2 =140.31; X2/df=2.58; CFI=0.93; TLI=0.92; GFI =0.92; RMSEA=0.062; pvalue<0.001]. And a good internal coherence of three scales was between 0.76 and 0.90.
Conclusion: Th is study provides support for the reliability and validity of the Tunisian version based on the French version of CSAI-2R, including the direction and the frequency scales. Among others the Tunisian version has demonstrated robust psychometric properties and can be used in other investigation.