34^th European Pediatrics Conference October 09-10, 2023 Zurich, Switzerland

Biography:

Naguib has many years of clinical experience in pediatrics. He has contemporary experience in the management of young children and teenagers with endocrine disorders specially childhood diabetes and obesity, including modern therapeutic interventions like insulin pump and continuous blood glucose monitoring. He also runs a general pediatric clinic that deals with common pediatric problems like fever, asthma and common respiratory problems, vaccinations, common gastrointestinal disorders; follow up of nutrition, growth and development.

Abstract:

Does medications work in childhood obesity; Strategies and principles for dealing with chronic weight management in children and adolescents is mainly accomplished through Lifestyle and behavioral interventions including Dietary change, increased physical activity, Decreased sedentary behaviors, and Improved sleeping pattern. Failure of this approach leading to consider other interventions mainly Pharmacotherapy, endoscopic procedures and Bariatric surgery.

Until recently, there has been a treatment gap between lifestyle modifications and bariatric surgery in terms of available, highly effective medications for obesity treatment. Now, this treatment gap is being filled with new medications. This is a truly exciting time for our patients with obesity.

FDA and EMA approved Anti-obesity medications include Orlistat, Phentermine/Topirmate, Bupropion/Naltrexone, Liraglutide 3 mg and Semaglutide 2.4 mg.

These medications don’t work by themselves. They reinforce the patient’s intention to reduce food intake. They are biologic adjuncts to behavior change. The goal of anti-obesity medications is to decrease the body fat mass set point, as the body fat mass set point is decreased or reset, weight loss will follow. Most the anti-obesity medications work in the brain.

As with any medication, if there is not a satisfactory response, these medications should be stopped. When satisfactory weight loss occurs and then plateaus, this is not a sign of tolerance or loss of efficacy. In clinical trials, when the drug is withdrawn, weight regain occurs. Maintenance of lost weight is a sign of success. The prescribers should be aware of side effects of these medications before prescribing them.

Because obesity is a Heterogeneous disease the response to anti-obesity medications is variable. Some patients may have an inadequate response - but in others, the medication may prove to be effective, or even highly effective. Obesity is also a complex disease; therefore combination pharmacotherapy is often needed, just as it may be needed for any other complex disease. Finally, Obesity is a chronic disease, necessitating continued, lifelong treatment.

Biography:

Zhonggui Xiong has his expertise in diagnosis and intervention of child developmental disorders, for example the growth rates and influencing factors of preterm and full-term infants. I participated in establishing the reference standard of infant growth rates which was supported by the special fund for basic work, Ministry of Science and Technology of China (Project No.: 2006FY230200) in 2006. Furthermore, I took charge of clarifying the pathogenesis of infant growth rates which was supported by the Maternal-Infant Nutrition and Health Research Project, the National Center for Women and Children’s Health of the Chinese Center for Disease Control and Prevention (Project No.: 2020FYH009).

Abstract:

Abstract

Statement of the Problem: Infant growth rates are a nonlinear and significant variation which is a series of alternating processes of rapid growth and stagnation. However, the growth pattern of preterm infants is significantly different from that of full-term infants at different ages of life. Longitudinal follow-up has seldom been used to explore the growth rates, IGF-1 and IGFBP-3, and influencing factors of preterm and full-term infants. Therefore, this study aimed to clarify the pathogenesis of the growth rates of preterm and full-term infants, and to take effective intervention measures to promote infant growth and development.

Methodology & Theoretical Orientation: Longitudinal follow-up data were collected regularly from routine health visits for preterm and full-term infants. Pediatricians monitored the length and weight of preterm and full-term infants at birth, 1, 3, 6, 9, and 12 months of ages using the standard method of physical measurements. A birth cohort study was used to analyze the pathogenesis of the growth rates of preterm and full-term infants.

Findings: The growth rates of the length and weight of preterm infants were significantly lower than those of full-term infants from birth to 3 months of age (P < 0.05), and gradually caught up to the level of full-term infants after 3 months of age (P > 0.05). The serum titers of IGF-1 and IGFBP-3 of preterm infants were significantly lower than those of full-term infants at 6 and 12 months of ages (P < 0.05). Meanwhile, there were some influencing factors that had significant differences by their contribution to the growth rates of preterm and full-term infants.

Conclusion & Significance: The interaction of various biological and environmental factors regulated the pathogenesis of IGF-1 and IGFBP-3 through DNA methylation, and jointly affected the growth rates of preterm infants. Therefore, multidisciplinary interventions should be developed to promote the growth rates of preterm infants within the first 3 months of corrected age.

Biography:

Jonnah Marie Yabut is a dedicated pediatric resident striving for excellence in the field of pediatrics and research. Her medical journey started when she became a board-certified medical technologist. Later on, her passion for pediatric care led her into pursuing medicine. Jonnah Marie excelled by gaining an academic scholarship in the medical school and by being a pediatric resident in St. Luke’s Medical Center Global City, a distinguished institution in the Philippines. Her written case reports gained recognition in the same institution. Presently, she is working on her dissertation entitled Validation of a Filipino translation of the Strategic Advisory Group of Experts (SAGE) Immunization Hesitancy Scale. Beyond her field of practice, she aims to contribute to the continuously evolving body of knowledge in medicine globally.

Abstract:

In these times where prenatal checkups and administration of prophylactic newborn medications are prioritized, neonatal hematemesis and melena have become uncommon for newborns. We report a case of a term newborn male delivered via cesarean section for placenta prevail totalize and end cervical polyp, at a tertiary hospital presenting with hematemesis and melena at the first day of life. Patient was initially treated as swallowed maternal blood syndrome after ruling out other causes. However, the patient also presented with prolonged prothrombin time (PT) and partial thromboplastin time (PTT) which was attributed to decreased circulating coagulation factors due to immature liver and decreased Vitamin K despite being given routine newborn prophylactic dose. Additional doses of Vitamin K and fresh frozen plasma transfusion were done then noted with improvement on the levels of bleeding parameters and resolution of bleeding episodes. This case report highlights the different causes of hematemesis and melena in term well newborns, the diagnostics that were utilized, and the recommended management.

Biography:

Marian Kamal Mankaryous Hendy is a Specialist in the Department of Paediatrics at the Town Square and Motor City branches of Medcare Medical Centre. She obtained her MBBS and Master's Degree in Paediatrics and Neonatology from Assiut University in Egypt. She completed both her internship and residency at Assiut University Hospital. She started practising as a Paediatrician at Assiut University Hospital and the Ministry of Health in Egypt. She then joined the Sohar Hospital in Oman where she worked as a Paediatric Specialist. Subsequently, she also worked as a Paediatric Specialist at Zulekha Hospital in Dubai then in Medcare medical centres and hospital currently.

Abstract:

HDN or its new name; VKDB (vitamin K deficiency bleeding), because vitamin K deficiency is the commonest cause of HDN, but there are other causes as haemophilia, thrombocytopenia and others… HDN can be inherited or acquired. VKDB is a bleeding problem that occurs in a baby during the first few days of life. Babies are normally born with low levels of vitamin K, an essential factor in blood clotting. Vitamin K is needed to form blood clots and to stop bleeding, its deficiency can lead to a serious bleeding problem known as (VKDB). Hemorrhagic disease of the newborn can lead to brain damage and death. Classic VKBD occurs between the 2-5 days of life with most of the cases being idiopathic. Late VKBD is characterized by bleeding in infants aged 2-16 weeks due to severe vitamin K deficiency, occurring primarily in exclusively breast fed infants. VKDB is associated with significant morbidity and mortality. On physical examination, there will be pallor and cooling of the extremities, vital signs will start to deviate from normal, tachycardia being the first vital sign to increase, which is followed by tachypnea. For early and classic forms of hemorrhagic disease of the newborn, the treatment is with oral vitamin K (2mg dose) repeated at 2-4 weeks and at 6-8 weeks. For infants weighing less than 1500 gm, 0.5 mg IM single dose is given. Hemorrhagic disease of the newborn is a life-threatening condition associated with high mortality and morbidity, but, it can easily be prevented by administering 1 mg IM of vitamin K within 1 hour of birth.

Biography:

Damini Batra has been academically oriented since her schooling days. She studied biology, chemistry, physics and mathematics. She then graduated with Bachelor of Medicine and Bachelor of surgery (M.B.B.S.) from Maulana Azad Medical College, followed which she completed her post-graduation and residency training from Lady Hardinge Medical College in the Department of Pediatrics.

Abstract:

Background: Shock is a state of tissue hypoxia wherein early recognition is associated with increased survival. Near-Infrared Spectroscopy (NIRS) is a promising tool to measure tissue oxygenation non-invasively and its saturation values have a good correlation with central venous oxygen saturation (S_cvO₂).

Aim: To assess whether NIRS variables (static-cerebral and peripheral saturations; dynamic- ischemic and reperfusion slopes) correlated with other parameters of septic shock and to judge their prognostic value.

Methods: This prospective observational study entailed 87 pediatric septic shock patients admitted in the emergency and PICU. Clinical, lab and NIRS parameters-static (cerebral and peripheral tissue oxygen saturations) and dynamic (by vaso-occlusive test) using INVOS Oximeter 7100 were recorded at baseline and pre-decided time intervals. Patients with severe acute malnutrition, chronic illnesses or brain pathology were excluded.

Results: The mean cerebral and peripheral saturation values were 63.38 and 50.55 respectively. The dynamic NIRS variables (ischemic and reperfusion slopes) showed a positive correlation with mean arterial pressure (Table 1). The correlations of CrSO2 and lactate were also statistically significant (p =0.0005, 0.000 and 0.001 at 0, 12 and 48 hours from admission respectively). All NIRS parameters at 24 and 48 hours had a strong significant correlation with pSOFA score (p=0.000). Persistently low cerebral and peripheral saturation values, ischemic and reperfusion slopes could well differentiate between survivors and non-survivors (Figure 1).

Conclusion: NIRS is a good non-invasive marker of impaired micro circulation especially when combined with vaso-occlusive testing. The measurements have a significant role in organ dysfunction and mortality prediction.

Keywords: Cerebral saturation, ischemic slope, Near-infrared spectroscopy (NIRS), reperfusion slope, septic shock

Biography:

Naguib has many years of clinical experience in pediatrics. He has contemporary experience in the management of young children and teenagers with endocrine disorders specially childhood diabetes and obesity, including modern therapeutic interventions like insulin pump and continuous blood glucose monitoring. He also runs a general pediatric clinic that deals with common pediatric problems like fever, asthma and common respiratory problems, vaccinations, common gastrointestinal disorders; follow up of nutrition, growth and development.

Abstract:

Abstract

Overweight/obesity is common in UAE as in many parts in the world. Obesity in children is a real health hazard and is associated with many medical, psychological and social complications.  Obesity is a complex disease; it includes biological, behavioral, social, environmental, and economic factors. Interactions of these factors lead to obesogenic environments and affect children’s weight. Because management of obesity is usually unrewarding, prevention has been identified as a key to fight the growing obesity epidemic. Leading health organizations, including the World Health Organization and Institute of Medicine expert panel, have recommended comprehensive interventions to fight obesity. Weight misperception of parents and physicians can be a significant barrier for obesity prevention programs.

This study looks at weight perception among parents and health care providers in Sharjah, UAE. The study showed that Most of parents in UAE are unaware of overweight/obesity as a medical disease. It also shows that weight counseling in children is not a routine practice among most physicians.

The study concludes that Health education of parents and training of physicians for weight and lifestyle counseling for all children visiting OPD is important for success of any obesity prevention program.

Biography:

Farida Anvarovna Mindubayeva is a Doctor of Medical Sciences (awarded in 2000) and a Professor (since 2004) at the Department of Morphology and Physiology at the Medical University of Karaganda, Kazakhstan. She completed her medical education at the Karaganda State Medical Institute in 1974 and has had a long and distinguished career in medical research and education.

Abstract:

Abstract Background: The role of serotonin (5-HT) in the development of heart and vascular diseases, congenital heart defects (CHDs) complicated by pulmonary hypertension is being discussed in the world literature. The exact mechanisms responsible for the pathogenesis of the development of pulmonary arterial hypertension (PAH) have not yet been fully elucidated, endothelial dysfunction is associated with disorders of the 5-HT system.

The purpose of our study: was to study the metabolism of 5-HT against the background of surgical correction of CHDs in children.

Materials and methods: The study included 30 children with CHDs and different degrees of PAH. In addition to the generally accepted standard studies, indicators of the 5-HT system were determined: number of platelets, concentration of 5-HIAA in plasma, urine, platelets, 5-HT transporter (SERT), 5-HT2A receptors in platelets.

Results: of the study showed that despite the fact that 5-HT2A receptors on platelets do not undergo any special changes. SERT decreased by almost 20% after surgery (347.35±87.27 vs. 284.66±55.29 pg/10*9, p=0.03). Concentration of the 5-HIAA in and in platelets did not change significantly. However, concentration of 5-HIAA in urine before surgical treatment was 19.81±46.66 ng/mmol creatine, after - 6.51±10 ng/mmol creatine. Using the regression analysis, it was found that it is 5-HIAA in plasma that is determined by the level of the calculated average pressure in the pulmonary artery with a correlation coefficient of -0.59 (p<0.05).

Conclusion: The conducted studies and the results obtained the involvement of 5-HT metabolism in the pathophysiological mechanisms of the development of PAH associated with CHDs.  Further study of the indicators of the 5-HT system will make it possible to identify early biomarkers for the development of PAH associated with CHDs.

Biography:

Zahra is a graduate with an MD-MPH degree from Tehran University of Medical Sciences. Currently, she holds a post-doctoral research position at the Cardio Genetic Research Center of Rajaei Cardiovascular Institute. Her research her researches are mainly focused on multi-Omics studies, utilizing cutting-edge techniques to understand the complex interactions between genetic, metabolomics, transcriptionist profile in cardiovascular diseases.

Abstract:

Abstract

Background: Kawasaki disease is a childhood vasculitis known for its potential to cause coronary artery complications. The identification of patients at higher risk of developing such complications is of utmost importance to mitigate their severity. Therefore, this study aimed to explore metabolomics profiles in patients with Kawasaki disease (KD) and uncover potential prognostic biomarkers capable of predicting coronary aneurysms.

Methods: A total of 26 Kawasaki patients and 28 healthy controls were subjected to metabolomics profiling analysis. The Liquid Chromatography with Tandem Mass Spectrometry method was utilized to analyze 44 metabolites, including 12 amino acids, L-carnation, and 31 acylcarnitines. Coronary arteries were evaluated using echocardiography.

Results: Isovalerylcarnitine (C5) and Hydroxytetradecanoylcarnitine (C14-OH) exhibited differential expression in Kawasaki patients compared to healthy controls (Figure1). Additionally, Tetradecanoylcarnitine (C14) was identified as a potential biomarker for predicting coronary artery aneurysms in Kawasaki disease. According to the KEGG database, the most enriched pathways in Kawasaki disease patients were Arginine biosynthesis and Alanine, Aspartate, and Glutamine metabolism pathways (Figure2).

Conclusions: Our results provide valuable insights into the metabolic pathways underlying Kawasaki disease by identifying differentially expressed metabolites associated with this disorder, which may serve as predictive biomarkers for coronary artery aneurysms. These findings have the potential to enhance Kawasaki disease patient outcomes through earlier identification of high-risk cases and improved treatment strategies.

Biography:

Charu Tiwari is currently working as Assistant Professor in Dept. of Pediatric Surgery at All India Institute of Medical Sciences, Raipur, CG, and India. She completed her Super specialization (MCh Pediatric Surgery) in 2015 at TNMC & BYL Nair Hospital, Mumbai and has 8 years of experience post-super specialization. She is interested in Congenital Anomalies, Pediatric Gastrointestinal Surgery, Neonatal and Pediatric Emergencies of aero-digestive tract and Minimal Access Pediatric Surgery. She is interested in Research work and has more than 50 publications in indexed journals and has received Young Women Research Scientist Award in July 2021 awarded by VDGOOD, Mysore, India.

Abstract:

Abstract

Background: There are around 300 methods for surgical correction of the hypospadias. Amongst these, both Classic Tubularized Incised Plate Urethroplasty (C-TIP) and Grafted Tubularized Incised Plate Urethroplasty (G-TIP) are well known techniques of hypospadias repair. The present study aims to systematically compare the reported outcomes of TIP and G-TIP in children undergoing primary hypospadias repair.

Materials and Methods: We conducted this systematic review and meta-analysis to compare the reported outcomes of TIP and Grafted TIP in children undergoing primary hypospadias repair. This study was conducted in accordance with PRISMA guidelines. PICO was decided. Electronic searches were done in different databases with search term Hypospadias, Snodgrass urethroplasty, TIP, Grafted TIP, DIGU, Snodgraft, Dorsal inlay graft using Boolean Search strategy. UCF, meatal stenosis, glans dehiscence, total complications were outcomes for analysis. Only RCTs were included for final analysis. The search yielded 2571 records, 9 RCTs were identified for final analysis as per inclusion criteria.

Results: There were 265 patients in TIP Group and 265 in G-TIP group. Outcomes like UCF, glans dehiscence, stricture were comparable in both groups. Incidence of metal stenosis is found to be less in grafted group RR 0.29 CI 0.12-0.74.

Conclusion: There is good evidence to say that there is reduced incidence metal stenosis in G-TIP group. Our meta-analysis also reveals that required operative time for TIP is less as compare to G-TIP. As other outcomes like UCF, glans dehiscence, HOSE score, maximum flow rate, success rates are concerned there is no difference in both groups. Trial Sequential Analysis (TSA) has corroborated our meta-analysis finding of meatal stenosis. Further randomized studies are required to reach desired information size for outcome UCF.

Biography:

Sergey Suchkov was born in the City of Astrakhan, Russia, in a family of dynasty medical doctors. In 1980, graduated from Astrakhan State Medical University with MD. In 1985, maintained his PhD, and in 2001, his Doctor Degree at the National Institute of Immunology, Russia.

Abstract:

Abstract

A new systems approach to diseased states and wellness result in a new branch in the healthcare services, namely, personalized and precision medicine (PPM). To achieve the implementation of PPM concept, it is necessary to create a fundamentally new strategy based upon the recognition of biomarkers and thus the targets to secure the grand future of drug design and drug discovery.

Each decision-maker values the impact of their decision to use PPM on their own budget and well-being, which may not necessarily be optimal for society as a whole. It would be extremely useful to integrate data harvesting from different databanks for applications such as prediction and personalization of further treatment to thus provide more tailored measures for the patients resulting in improved patient outcomes, reduced adverse events, and more cost effective use of the latest health care resources including diagnostic (companion ones), preventive and therapeutic (targeted molecular and cellular) etc.

PPM and related areas are those of the most promising technologies for improving health care and health outcomes. The latter offers many advantages for PPM applications, including a size that matches the scale of the molecular substrates of PPM, an increased sensitivity in detecting and binding with target molecules, and flexibility in the design and function of therapeutics and diagnostics at the Nano scale.

The above-mentioned areas being an integral part of PPM are really an interdisciplinary research field that has the potential to significantly improve some canonical treatments, prevention, prophylaxis and rehabilitation. Specifically, in the field of PPM, it is expected to have a great impact in the near future due to its multiple advantages, namely its versatility to adapt a drug to cohorts of patients and/or persons-at-risk.

The initial efforts will be focused on providing answers to critically ill infants, and children with severe seizures and inborn conditions, i.e., persons-at-risk. The research into novel therapeutics will help enable children with previously debilitating and fatal genetic diseases, with clinical trials testing gene therapy treatments for rare, genetically pre-determined and inborn serious diseases.

But for children, who are still developing and have the most to gain, PPM is more than a bumper sticker. On the micro scale, early genetic testing - perhaps routinely, someday, in new-borns - can help guide medical care, targeted therapies and preventive strategies based on a child’s genetic makeup. On a macro scale, big data from the larger population becomes a predictive tool, guiding medical decisions that could be life-altering in a still-malleable child.

PPM expected would cover many potential and emerging applications of PPM including: (i) some subtypes of medulloblastoma having a genetic fingerprint predicting a milder course; (ii) orphane diseases having just one gene each at a time; (iii) autism being estimated to have more than 500 different genetic causes, with more still being discovered; (iv) chronic cardiovascular conditions; and (v) sore throat. For instance, multimodal genomic, theranostic, companion diagnostic and AI-driven approaches may indeed become a key driver in harmonizing the needs of the various stakeholders by allowing cost-effective delivery and monitoring of drug efficiency and safety, and close-meshed high-quality data collection.

For instance, enabling PPM for children. We will address what NanoPediatrics is meant. We will consider the implications of the Nano discipline for individual kids and the juvenile society as well. The nature of research, diagnosis, and screening in Nano Pediatrics will be illustrated in Nano diagnostics and Nano therapeutics via collaborative projects the combined use of diagnostics and therapeutics in a single Nano device referred to as theranostics.

PPM-related subareas are considered to be an emerging approach to be applied for pediatric cancer treatment as well that has recently taken giant steps in solid pediatric practice. Pediatric tumours have a different genetic make-up, with a fewer number of actionable targets than adult tumours. So, PPM-based oncologic medicine is an emerging approach for cancer treatment that has recently taken giant steps in solid pediatric practice. Recent advances in molecular diagnostics that can analyse the individual tumour’s variability in genes have provided greater understanding and additional strategies to treat cancers. Nevertheless, PPM-related oncology in the pediatric population has greatly improved the survival of patients with leukaemia and solid tumour. As you might understand we would need Centres for Personalized & Precision Pediatric (CPPP) designed to bring next-generation care to children by using advanced technologies to understand a child’s unique genetic makeup and offer tailored treatments and to be developing novel diagnostic and predictive tools as well as newest therapeutics that target specific diseases and improve health.

The promise of PPM is well understood and exists at the convergence of genomic sequencing, biomarker research, bioinformatics and big data analysis. One of the big challenges to bringing more lifesaving PPM-based treatments to children is that the vast networks of hospitals, foundations, and other organizations working toward new treatments and cures lack consensus on how to pursue their common goal. As a consequence, duplicative efforts and inefficiencies proliferate in this network including CPPP.

The aim of pediatric PPM, I do believe, is to uniquely combine genetic variation with developmental stage and environmental exposure to provide a tailored preventive, diagnostic, and therapeutic regimen. Current evidence suggests that the effect of genetic variation depends on the developmental stage of a child and environmental exposure such as infection or oncogene carrying during a specific stage. PPM is thus a new and exciting field with the potential to significantly improve medical care for children and young and smart communities.

Meanwhile, a lack of medical guidelines has been identified by responders as the predominant barrier for adoption, indicating a need for the development of best practices and guidelines to support the implementation of PPM-related pediatric services!

Several advances have been made in the last decade in the field of pediatric PPM heralding a new chapter in the fight against pediatric chronic disorders including cancer. The practical application of PPM in pediatric practice including cancers is expected to grow exponentially with time. So, the next-step generation Programs in pediatric PPM would sustain, strengthen and expand upon existing collaborative projects. The ultimate goals of the programs are to improve health care by promoting state-of-the-art translational research and applications, to drive scientific growth by facilitating improvements in the quality of scientific investigation, and thereby enhance future competitiveness for external funding so that we may continue to make improvements in healthcare. The latter is the reason for developing global scientific, clinical, social, and educational projects in the area of PPM and PPM-related pediatry to elicit the content of the new branch. In short, PPM will transform the way doctors practice and will shake up the entire pharmaceutical value chain.

Biography:

Charu Tiwari is currently working as Assistant Professor in Dept. of Pediatric Surgery at All India Institute of Medical Sciences, Raipur, CG, India. She completed her Super specialization (MCh Pediatric Surgery) in 2015 at TNMC & BYL Nair Hospital, Mumbai and has 8 years of experience post-super specialization. She is interested in Congenital Anomalies, Pediatric Gastrointestinal Surgery, Neonatal and Pediatric Emergencies of aero-digestive tract and Minimal Access Pediatric Surgery. She is interested in Research work and has more than 50 publications in indexed journals and has received Young Women Research Scientist Award in July 2021 awarded by VDGOOD, Mysore, India.

Abstract:

Abstract

Background: Accidental tracheobronchial foreign body aspiration is relatively common in children; especially in 1 – year age group. Vegetative or organic foreign bodies like ground nuts and peanuts account for about 75% of aspirated vegetable foreign bodies. We present two cases of whistle aspiration into the bronchus.

Case Summary:

Case 1: An eight-year-old boy was referred to Pediatric Emergency with diagnosis of foreign body in left main bronchus. History revealed that the boy had aspirated the whistle while playing with it one week back, followed by cough, fever and respiratory symptoms. HRCT thorax suggested foreign body in left bronchus with hyperinflation on ipsilateral side. At admission, he was afebrile, tachypneic, air entry was absent on left side. Sp02 was 96 % with 2 liters of oxygen. Bronchoscopy was done with 4.5 Fr rigid ventilating bronchoscope and a large foreign body was identified in left main bronchus. It was removed with help of Optical forceps. As the whistle has 3 different parts to make it; it was not possible to remove in assembled form. It was removed in 3 parts. Check bronchoscopy confirmed completeness of procedure. The post-operative recovery was uneventful.

Case 2: A seven-year boy was admitted with history of aspiration of whistle while playing 3 days back. At admission, his vitals were stable; and air entry was reduced on right side. Chest x-ray and HRCT thorax confirmed the foreign body in right main bronchus. The whistle was identified in the right main bronchus and all three parts removed by rigid bronchoscopy with 4.5 Fr ventilating bronchoscope. Check bronchoscopy ensured completeness. Post-operative recovery was uneventful.

Discussion and Conclusion: In pediatric patients, the usual history and classical symptoms of aspiration are mostly absent. Clinical examination suggesting absent or reduced unilateral respiratory sounds and tachypnoea point towards foreign body aspiration. An X-ray chest would suggest ipsilateral hyperinflation or collapse consolidation. An HRCT thorax in such patients helps in detection and localization of foreign body. The management is rigid bronchoscopy and removal of the foreign body. Whistle may be aspirated in slightly older kids while playing with it, as was the case in both our cases. The whistle is unique because it is made of three parts (one of which is transparent) assembled together. During bronchoscopic removal, care must be taken to remove all the three parts of the whistle separately; secondly, complete removal should be ensured by check bronchoscopy after removal.

Biography:

Abstract:

Abstract

Neurodevelopmental disabilities (NDDs) such as Autism Spectrum Disorder (ASD), Intellectual Disability (ID) and Global Developmental Delay (GDD) are on the rise. These occur early in the developmental period and may lead to impairments in areas of functioning such as overall cognitive, language, motor, academic, and social skills. According to The World Health Organization, one billion people, or 15% of the world’s population, experience some form of disability, and that 1 in 100 children now have ASD. Given the high incidence of NDDs, it is important that pediatricians are able to support identification and care of children with NDDs. This talk will provide an overview on the Diagnostic and Statistical Manual of Mental Disorders (DSM), 5^th edition criteria used in evaluation, medical needs including comorbid disorders and medical work up post-diagnosis and appropriate interventions for children and youth with ASD, GDD, and ID. Across countries, interventions may differ and as such, we will provide information regarding the core components of treatment and what is important for improving outcomes for patients and families.