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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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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
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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
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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
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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
20
ScientificProgram
21
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
22
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
standard IMF Celia Expert Breast milk
Bifidobacteria in stools
% o
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Bifi
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Decrease risk of Gastrointestinal Infections by 4
p<0,05
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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
31
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
32
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
33
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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