Day 2 :
Keynote Forum
Ashutosh Kumar
Penn State Milton S Hershey Medical Center, USA
Keynote: Tourette syndrome and comorbid neuropsychiatric conditions
Time : 10:00-10:40
Biography:
Ashutosh Kumar has completed his MBBS from Manipal University, India, Residency in Pediatrics from The Brooklyn Hospital Center, New York, USA and fellowship in Pediatric Neurology from University of Alabama at Birmingham (UAB), USA. He recently started working as a Assistant Professor in the Department of Pediatrics and Neurology at Penn State Milton S Hershey Medical Center. He is involved in multiple clinical trials as a Principal Investigator in Duchenne Muscular Dystrophy.
Abstract:
Tourette syndrome is a neuropsychiatric condition characterized by both motor and phonic tics over a period of at least one year with the onset in childhood or adolescence. Apart from the tics, most of the patients with Tourette syndrome have associated neuropsychiatric comorbidities consisting of attention deficit hyperactivity disorder, obsessive compulsive disorder, rage attacks, sleep issues, depression and migraine. Patients may also have physical complications directly from violent motor tics which can rarely include cervical myelopathy, arterial dissection and stroke. The purpose of this article is to review the associated neuropsychiatric comorbidities of Tourette syndrome with emphasis on recent research.
Keynote Forum
Marina Reznik
Albert Einstein College of Medicine, USA
Keynote: A cluster randomized controlled trial of a school-based asthma intervention: preliminary findings
Biography:
Marina Reznik is Associate Professor of Pediatrics at the Albert Einstein College of Medicine and a General Pediatrician and a Child Health Researcher at Montefiore Medical Center. Her research focuses on development and evaluation of community-and school-based interventions to improve the health care services and outcomes for medically underserved minority children with asthma. She teaches and mentors medical students, residents and post-doctoral students, and provides clinical care to children from 0-21 years of age. She is an author of over 60 articles, book chapters and editorials and her research has been presented both nationally and internationally.
Abstract:
Physical activity (PA) is important for asthma management. However, child and parental illness beliefs such as fear about asthma attacks with exercise may preclude child PA participation. We developed a multifaceted school-based intervention to address this and other barriers to PA. Our objective was to assess intervention effects on asthma and exercise risk perception, self-efficacy and outcome expectancy in urban schoolchildren with asthma and their parents. We conducted a pilot cluster RCT in children (7-10 years) with asthma attending 4 Bronx, New York schools (2 intervention, 2 control). Intervention consisted of a school-wide asthma awareness event, collaboration with child’s physician to assure optimal treatment, classroom-based PA, and asthma education for families and school personnel. Parents and children completed surveys at baseline and 6-months post-intervention to assess asthma and exercise risk perception, self-efficacy and outcome expectancy. ANOVA was used to compare scores controlling for baseline. We recruited 109 child-parent dyads (mean age 8.6 (SD .99) years, 53% male, 80% hispanic). Post-intervention, parents were significantly less likely to believe that exercise is harmful to asthma and were less worried about stigma than controls. Children tended to feel more competent in overcoming barriers to PA, had a greater intention to participate in PA, were less likely to feel that exercise would have negative consequences on asthma, and were less worried overall and about asthma-related stigma. Our intervention improved child and parental illness beliefs about asthma and exercise. These results may have implications for policy change to incorporate intervention components in urban schools.
Keynote Forum
Philip O Ozuah
Albert Einstein College of Medicine, USA
Keynote: A cluster randomized controlled trial of a school-based asthma intervention: preliminary findings
Biography:
Ozuah’s background includes a medical degree from the University of Ibadan, Nigeria, and a rotating internship at the University of Nigeria Teaching Hospital. He later earned a master’s degree in Education from the University of Southern California, Los Angeles, and a PhD in Educational Leadership and Administration from the University of Nebraska-Lincoln. He obtained his pediatric internship and residency at Albert Einstein College of Medicine and Montefiore Medical Center, and his post-doctoral research fellowship in Medical Education at the University of Southern California, School of Medicine, Los Angeles. Dr. Ozuah joined the faculty of the Department of Pediatrics at Montefiore and Albert Einstein College of Medicine in 1992 and served as director of the Residency Training Program in Social Pediatrics from 1999 to 2005.
Abstract:
Physical activity (PA) is important for asthma management. However, child and parental illness beliefs such as fear about asthma attacks with exercise may preclude child PA participation. We developed a multifaceted school-based intervention to address this and other barriers to PA. Our objective was to assess intervention effects on asthma and exercise risk perception, self-efficacy and outcome expectancy in urban schoolchildren with asthma and their parents. We conducted a pilot cluster RCT in children (7-10 years) with asthma attending 4 Bronx, New York schools (2 intervention, 2 control). Intervention consisted of a school-wide asthma awareness event, collaboration with child’s physician to assure optimal treatment, classroom-based PA, and asthma education for families and school personnel. Parents and children completed surveys at baseline and 6-months post-intervention to assess asthma and exercise risk perception, self-efficacy and outcome expectancy. ANOVA was used to compare scores controlling for baseline. We recruited 109 child-parent dyads (mean age 8.6 (SD .99) years, 53% male, 80% hispanic). Post-intervention, parents were significantly less likely to believe that exercise is harmful to asthma and were less worried about stigma than controls. Children tended to feel more competent in overcoming barriers to PA, had a greater intention to participate in PA, were less likely to feel that exercise would have negative consequences on asthma, and were less worried overall and about asthma-related stigma. Our intervention improved child and parental illness beliefs about asthma and exercise. These results may have implications for policy change to incorporate intervention components in urban schools.
- Pediatric Psychiatry | Pediatric Endocrinology | Child and Adolescent Obesity
Location: Captain A
Chair
Marina Reznik
Albert Einstein College of Medicine, USA
Co-Chair
Omer Abbas Ahmed
American Hospital Dubai, UAE
Session Introduction
Fatma Dilek Turan Gurhopur
Akdeniz University, Turkey
Title: Side Effects of Antiepileptic Drugs Used in Children with Epilepsy: A Systematic Review
Biography:
Fatma Dilek Turan Gurhopur is 27 years old and continues her PhD at Akdeniz University in Turkey. She completed master education at Akdeniz University in Turkey too. She interested in pediatric neurology. She has articles in international and national journals about pediatric neurology.
Abstract:
Aim: Although there are alternatives in the treatment of epilepsy, the primary treatment is antiepileptic drug (AED) treatment. However, AEI treatment has side effects. This is more serious in children. The aim of this study was to determine the side effects of antiepileptic drugs used in children with epilepsy.
Methods: Literature review has been limited to the last decade and has been done in "Pubmed, Cinahl, Sciencedirect, Cochrane, Ulakbim Turkish Medical Directory, Turkish Medline" databases. Screening was conducted between April and May 2017 using the keywords "children and antiepileptic drugs side effects", "children with epilepsy and antiepileptic side effects". Five studies in accordance with the exclusion and inclusion criteria were included in the systematic review.
Results: The most frequent side effects in children who used antiepileptic drugs in the studies studied were; Weight gain, body mass index and serum glucose levels, gingival problems, hearing problems, and high renal tubules were noted as disfunctions.
Conclusion: The study results show that family and children should be informed about the definite side effects of antiepileptic drugs and awareness should be developed in this regard.
Paweł Gałecki
Institutions of Marshal Józef Piłsudski, Poland
Title: Should screening ultrasound of central nervous system and abdomen in infants ≥35th weeks of pregnancy be recommended?
Biography:
PaweÅ‚ GaÅ‚ecki has completed his Medical Studies from Medical University of Warsaw. He is working at Neonatal Unit of PÅ‚onsk Hospital. He has also cooperated with Neonatal Pathology Unit of Second Degree Referenced Hospital in Ciechanów, Poland. He usually deals with issues in the field of care of infant from physiological pregnancy and childbirth. As a result of his cooperation with the Clinic of Pathology and Intensive Care of the Newborn of Medical University of Warsaw there is significant existence of work on ultrasound in Neonatal Care of Physiological Infant.
Abstract:
Ultra-sonography of newborns, born long before term and newborns with extremely low birth weight or other significant pathology has become a gold standard on the neonatal pathology units and NICU. It is a rather simple method and non-invasive; it does not bring the increased risk to the newborns, and is providing much information about the condition of the patient, the course of disease, the effectiveness of the treatment and further predictions. However, only 10–15% children are born below 35th week of pregnancy and are being hospitalized on the II and III degree of neonatal care units. It will leave the majority of children left without ultrasound diagnostics, because very few centres of first degree of neonatal care are conducting that kind of diagnostics apart from very rigorous recommendations, acknowledging that these children are “from the assumption” healthy. Perhaps, such an assumption is not fully correct and many children from so-called physiologic pregnancy are burdened with certain diseases, which could be to recognize and be possibly healed, if all children were examined. In this paper we have studied ultrasound examinations of the central nervous system and the abdominal cavity carried out on children born after 35th week of pregnancy at the Neonatal Unit of the Hospital in PÅ‚oÅ„sk (first level of neonatal care) from 01.01.2014 to 02.12.2014.
Omer Abbas Ahmed
American Hospital Dubai, UAE
Title: Headaches (Cephalgia) in children- An Overview Lecture
Biography:
Dr Omer Ahmed has joined The American Hospital, Dubai (in 2009), after 15 years as a Consultant Paediatrician in UK. He is a Fellow of the Royal College of Physicians of Ireland and the Royal College of Paediatrics and Child Health UK. His Paediatrics training was in Sabah Hospital- Kuwait, Alder Hay Hospital- Liverpool, Great Ormond Street and The Royal Free Hospital in London before taking a Consultant post in Stevenage, Hertfordshire UK. Earlier in his career, Dr Ahmed has worked in Sudan, Libya and Kuwait. His experience covers wide areas in Child Health as a General Paediatrician. Dr Ahmed has several publications and presented/attended in several Paediatrics meetings and conferences.
Abstract:
Headache is one of the most common complaints in children and adolescents.
The incidence of chronic or recurrent headaches in children is about 40% by the age of 7 years and goes to 75% by 15 years of age. Sex ratios of children affected varies by age: between 3-7 yrs boys dominate, gets equal mid childhood (7-11 years)but thereafter we see more girls affected than boys.
Headaches in children almost always raise serious concerns in parents. We would always remember about 3,800 CNS tumours are diagnosed annually in US. There have been several reports of delayed presentations of childhood brain tumors. However, childhood headaches are rarely caused by serious underlying disorders. The evaluation of headaches in children varies widely depending on the presentation’s settings. In a historical cohort of 48,575 children aged 5-17 years who were seen by primary care providers for complaint of headache, 19 percent were diagnosed with primary headache at the time of presentation, 1.1 percent was diagnosed with secondary headache, and 79.7 percent received no formal diagnosis.
Unfortunately, culturally children’s headaches are taken rather lightly in many communities. Most children who present to paediatric emergency departments with acute headache have a viral illness or an upper respiratory infection as the cause of their headache, although more sinister conditions occasionally are diagnosed. The lecture is an overview of this common problematic symptom. It partly covers epidemiology, pathogenesis, pathophysiology, classification, triggers, clinical evaluation and management of headaches in children and adolescents. It is rather a summary to this comprehensive subject.
Five short interactive clinical cases of this problem are presented in the last ten minutes for audience’s discussion.
Jorina Elbers
Stanford Childrens Health Pediatric Neurology, Canada
Title: Profile of medically unexplained symptoms associated with adverse childhood experiences
Biography:
Jorina Elbers is working as an Assistant Professor of Neurology at Stanford University. She received her BSc from the University of Victoria before completing Medical School at the University of British Columbia in Vancouver, Canada. She continued her training in Pediatric Neurology at the Hospital for Sick Children and University of Toronto. Following her residency, she pursued a two-year Fellowship in Pediatric Stroke, also at the Hospital for Sick Children. In 2011 she joined the Child Neurology Team at Stanford, where her clinical work includes attending General Child Neurology Clinics and running a Pediatric Stroke Program. Her clinical research interests involve the study of arteriopathies, such as moyamoya arteriopathy, and novel neuroimaging techniques to study stroke and inflammation.
Abstract:
Objective: Pediatricians commonly see children reporting symptoms without a plausible medical explanation, even after extensive investigations. Such patients’ frequently present with multiple co-morbidities. We report the prevalence of children with multiple medically unexplained symptoms in a pediatric neurology clinic, describe their symptom profiles, and explore their association with adverse childhood experiences (ACEs).
Study Design: We retrospectively reviewed medical and social histories of 100 consecutive patients who had been treated at an outpatient pediatric neurology clinic. Patients were included if they were 5 years or older, and reported 4 or more medically unexplained symptoms (MUS) for longer than 3-months. Symptom profiles across six functional domains were recorded: 1) executive dysfunction, 2) sleep disturbances, 3) autonomic dysregulation, 4) somatization, 5) digestive symptoms, and 6) emotional dysregulation. ACEs were recorded and scored for all patients.
Results: Seventeen patients reported 4 or more MUS. Somatization, sleep disturbances and emotional dysregulation occurred in 100% patients, with executive dysfunction (94%), autonomic dysregulation (76%) and digestive problems (71%) in the majority. Forty-two children reported ACEs (42%); children with 4 or more MUS were more likely to report ACEs in comparison to other children (88% vs. 33%; p<0.0001). Of the 42 patients reporting ACEs, children with 4 or more MUS had a higher median ACE score (3 vs. 1; p<0.001).
Conclusions: Children with multiple medically unexplained symptoms should be screened for potential exposure to ACEs. A clinical profile of unexplained medical symptoms across multiple functional domains within the nervous system suggests putative neurobiological mechanisms involving nervous system dysregulation that require further study.
Reem A Ali
Jordan University of Science and Technology, Jordan
Title: Effect of an educational intervention on university student’s knowledge and attitudes toward reproductive health in Jordan
Biography:
Reem A Ali got her Graduate Degrees from prestigious universities in Canada. She is working as an Assistant Professor at Maternal and Child Health Department at Jordan University of Science and Technology for about six years. She has conducted a study examining the relationships between maternal attachment and infant sleep problems in preterm infants following discharge from hospital. Her work is fundamental to understand more about relationships between attachment, maternal settling behavior, and infant sleep. Also, she is conducting research studies on Health Promotion for newborn, children and their families, focusing on children’s eating behaviors and reproductive health for youth.
Abstract:
Health promotion is the most cost-effective method to reduce and prevent health problems. Using interactive teaching approach showed positive results in changing lifestyles and adopting more healthy practices among students. Little information was found on students’ knowledge and attitude towards reproductive health in Jordan. A study was conducted to examine the effectiveness of an interactive teaching approach in promoting reproductive health awareness in undergraduate non-medical students in Jordan. A quasi-experimental one group pre-test and post-test design was employed to examine the change in university students’ knowledge and attitude towards reproductive health. 210 students aged 18-24 years were used for this study. Knowledge and attitude regarding reproductive health issues were assessed using a computer-based questionnaire developed by the researchers. Descriptive and parametric analyses were conducted to analyze the data. A significant improvement in students’ level of knowledge and attitude towards reproductive health was indicated by the analysis. The results of a mixed between-within subjects analysis of variance showed a significant interaction between gender and students’ knowledge (pre-test and post-test), Wilks Lambda=0.98, F (1, 208)=4.09, p=0.04, partial eta squared=0.19. While, there was no significant interaction between gender and students’ attitude towards reproductive health on pre-test and post-test. The implementation of health promotion courses, tapping on reproductive health issues while using interactive style is an influential method for students at this age to improve their knowledge and attitude regarding reproductive health.