Biography:

I am Amin Gohary. I am working in Burjeel hospital, Abu Dhabi, UAE 

Abstract:

Intussusception is a common condition that present with abdominal colic and is usually diagnosed by ultrasonography with appearance of (Target Sign).

Over the last 35 years we have noticed a new phenomenon that mimic intussusception both clinically and radiologically but is not cause by bowel intussusception but by impacted stool at he terminal ileum.

Whereas  intussusceptions an emergency that require urgent attention to reduce either by air, saline or Barium and my need urgent exploration , Gohary’s phenomenon  if recognized can be treated  by simple fleet enema.

We have encountered 56 cases between 1983 and 2018 , their age varied from 9 months and 7 years

They have the common features of

1. Severe abdominal colic that is not responding to analgesic or antispasmodics

2. US feature suggestive of ileo-colic intussusception

3. No red current jelly stool .intussusception

4. Good response to fleet enemas

More recently we have encountered a subgroup pf patients that have genuine intussusception on radiological examination but not causing complete bowel obstruction and still associated with had srool in the large bowel and still needs simple fleet enema to cure.

We hope by highlighting this new phenomenon to avoid unnecessary radiological investigation and unnecessary abdominal exploration.

Biography:

Brankica Vasiljevic is Head of Maternity and Child Health Services in NMC Royal Hospital DIP in Dubai, UAE.  After completed her MD she had completed her clinical postgraduate education (Pediatric and after that Neonatology fellowship) and academic postgraduate education (MSc in pediatric and ultrasonography field and PhD in neonatology field) at Belgrade University School of Medicine in Belgrade, Serbia.
She has completed also Yugoslav School of Ultrasound and different courses in ultrasonography and echocardiography in Serbia and UK, Post Graduate Program in Pediatric Nutrition at Boston University School of Medicine and Visiting scholar and Internships in Greece (Alexandar Hospital, Iaso Hospital and Elena Hospital in Athens), USA (Morgan Children’s Hospital in New York) and Austria (General Hospital of Salzburg in Salzburg and Regional Hospital (LKHLandeskrankenhaus) in Graz). She had won the ESPNIC Educational Grant at 5th World Congress on Pediatric Intensive & Critical Care in Geneva Switzerland (2007). She was a local coordinator for International Neonatal Immunotherapy Study-INIS for Serbia and Montenegro and participated in SIOP 93-01 Study, ITP Study and Twin Birth Study. She has published more than 35 international publications in international indexed journals (100 citations), 5 chapters in various fields of neonatal medicine and have more than 30 presentations in international conferences.

 

Abstract:

Despite recent advances in neonatal intensive therapy, still is present significant morbidity associated with extreme prematurty that includes both short-term and long-term pulmonary,  neurologic and visual impairments. These complications of prematurity  not only affect the quality of life of these children in the rest of their lives, but can also cause numerous medical and economic burdens in the society.

No single therapy has proven to be effective in preventing or treating either developmental lung, brain and retinal injuries in preterm infants or the hypoxic-ischemic brain injury  in full-term infants.  Stem cell–based therapies are emerging as potential alternative treatment for such complex diseases (BPD, IVH, ROP and HIE) with multifactorial  etiologies.

Recently, various preclinical studies have shown that stem cell therapy significantly attenuates injuries in newborn animal models of BPD, HIE, IVH and ROP. 

Caution is warranted, however, because stem cell-based therapies for regenerative purposes represent innovation, mechanisms of action are still not completely understood, and standardization, clinical indications, timing and dosage are required to permit safe clinical translation of stem cell therapy in animal models for newborn infants in the near future,

No disclosure of any conflicts of interest.

References:

• Spencer ND, Gimble JM, Lopez MJ. Mesenchymal stromal cells: past, present, and future. Vet Surg 2011;40:129-39.

• Park WS, Sung SI, Ahn SY, Yoo HS, Sung DK, Im GH, et al. Hypothermia augments neuroprotective activity of mesenchymal stem cells for neonatal hypoxic-ischemic encephalopathy. PLoS One 2015;10:e.

• Ahn SY, Chang YS, Sung DK, Sung SI, Yoo HS, Lee JH, et al. Mesenchymal stem cells prevent hydrocephalus after severe intraventricular hemorrhage. Stroke 2013;44:497-504.

• Park WS, Sung SI, Ahn SY, Sung DK, Im GH, Yoo HS, et al. Optimal timing of mesenchymal stem cell therapy for neonatal intraventricular tricular hemorrhage. Cell Transplant 2016;25:1131-44.

• Waszak P, Alphonse R, Vadivel A, Ionescu L, Eaton F, Thebaud B. Preconditioning enhances the paracrine efect of mesenchymal stem cells in preventing oxygen-induced neonatal lung injury in rats. Stem Cells Dev 2012;21:2789-97.

• Chang YS, Ahn SY, Yoo HS, Sung SI, Choi SJ, Oh WI, et al. Mesenchymal stem cells for bronchopulmonary dysplasia: phase 1 dose-escalation clinical trial. J Pediatr 2014;164:966-72.

• Stitt AW, O’Neill CL, O’Doherty MT. Archer DB, Gardiner TA. Vascular stem cells and ischaemic retinopathies. Prog Ret Eye Res 2011; 30:149e166e.

 

Biography:

Dr Rachel Ariyanayagam, MBBS, BSc, FRCA, is an Anaesthetic Specialty Registrar at Southend University Hospital, UK, with an interest in clinical paediatric anaesthesia.

 

Abstract:

Challenges in paediatric anaesthesia during the COVID-19 pandemic include the impact of personal protective equipment (PPE) on communication, the infection risks of carers being present for induction of anaesthesia, the potential infection spread with gaseous anaesthesia induction techniques, and management of the child with mild upper respiratory tract infection (URTI). We surveyed anaesthetists in a UK hospital that undertakes emergency and elective paediatric surgery, regarding these issues.

Concerning children with various COVID statuses, we surveyed what PPE doctors would wear, whether they would allow carers to be present for anaesthesia induction, the use of gaseous induction of anaesthesia, and willingness to proceed with surgery in a child with mild respiratory infection symptoms.

Survey response was 47% (n=48). Even if the child tested COVID negative, 65% of respondents would wear a visor, 40% a FFP3 mask, and 31% a fluid resistant gown. For some, this decision depended on the type, timing and number of tests conducted. For anaesthetic induction, there is reluctance to allow parents/guardians with untested COVID status in the operating theatre or anaesthetic room, and reluctance to use gaseous techniques in a COVID positive child. 12.5% stated they would cancel surgery for a child with mild URTI symptoms (even with a negative COVID test), for whom they would have proceeded with surgery pre-pandemic.

This survey highlights the debate over the reliability of COVID testing in children and what is best anaesthetic practice for a COVID positive child, emphasising the need for further understanding of this disease.