7^th Annual Congress on Emergency Nursing & Case Reports April 17-18, 2023 Paris, France

Biography:

Dr.Azad A. Haleem Almezori is an assistant professor of pediatric and pediatric Endocrinologist M.B.Ch.B,DCH,FIBMS,MRCPCH, Iran
 

Abstract:

Case 1- A three-day-old boy with hyperglycemia:
Presentation: This boy was born at 32 weeks of gestation with a birth weight of 1.4 kg. He was in the neonatal intensive care unit on intravenous fluids. Blood sugar was high on routine monitoring (220 mg/dL, 12.2 mmol/L).Plan: Hyperglycemia in the neonatal period is usually due to high dextrose infusion. Neonatal diabetes should be considered only with persistent insulin-requiring hyperglycemia. Details regarding dextrose infusion rate, infection, and vasopressors should be obtained. Assessment: The child had no dehydration. He was on high dextrose infusion (9 mg/kg/minute). Sugar levels normalized after a reduction in dextrose infusion. Diagnosis: Transient hyperglycemia due to high dextrose infusion. Messages

Case 2- A 14-day-old girl with respiratory distress and hyperglycemia:
Presentation: This girl was admitted to the intensive care unit with respiratory distress. She had high blood glucose levels (270 mg/dL, 15 mmol/L).
Plan: An important consideration in a neonate with hyperglycemia includes the effect of stress and steroids.
Assessment: She girl was on steroids and beta-agonists. Glucose levels normalized with a decrease in steroid dose.
Diagnosis: Steroid-induced transient diabetes

Case 3- A 15-day-old girl with hyperglycemia and normal HbA1c:
Presentation: This girl presented with failure to thrive and dehydration. She had high blood glucose (320 mg/dL, 18.2 mmol/L) with normal HbA1C (5.6%).
Plan: High blood glucose, dehydration, and failure to thrive suggest neonatal diabetes; HbA1C may be falsely low in the period due to high fetal hemoglobin. Insulin should be considered in view of the clinical presentation.

Case 4- A five-day-old girl with diabetes and omphalocele:
Presentation: This girl presented with failure to thrive (current weight of 1600 qm as against a birth weight of 1800 qm) and dehydration. Investigations showed high blood glucose (425 mg/dL, 23.4 mmol/L) with no ketosis.
Plan: Early-onset hyperglycemia, low birth weight, and no ketosis suggest transient neonatal diabetes. Careful examination for pointers of TNDM (omphalocele and ear creases) should be done. Assessment The girl had omphalocele and ear creases suggesting TNDM1 due to a DMR defect.
Plan: Hypoglycemia after resolution of transient diabetes suggests increased beta-cell activity due to removal of the suppressive effect of ZAC 1 and HYMA1 genes. She should be started on diazoxide.

Biography:

Rabeya Akter Moni has completed his PhD at the age of 25 years from Andhra University and postdoctoral studies from Stanford University School of Medicine. A premier Bio-Soft service organization. He has published more than 25 papers in reputed journals and has been serving as an editorial board member of repute.

Abstract:

Encyclopedia of Bioanalytical Methods for Bioavailability and Bioequivalence Studies of Pharmaceuticals (E-BABE): It is a unique encyclopedia involving bioanalytical methods for bioavailability and bioequivalence (BA/BE) studies of pharmaceuticals for suitable method selection with thousands of combinations and searches against these methods. Most scrutinized literature was collected from different sources including PubMed. This database has been curetted using published methods for all most all pharmaceuticals. Required information for regular method development/validation such as IUPAC name, structure, solubility, chromatographic conditions, instrumentation information like HPLC, LCMS detection parameters, sample preparations, recovery details, limit of detection and limit of quantification, Tmax, Cmax etc., for routine application in BA/BE studies of pharmaceuticals was incorporated including official pharmacopeias information such as European Pharmacopeia, Japan Pharmacopeia and US Pharmacopeia. Database includes drug based bioanalytical methods covering most required fields and external database links of important drug portals such as drug bank, Rxlist, MEDLINE plus, KEGG Drug ID, KEGG Compound ID, Merck manual, PubChem compound ID, PubChem substance ID and USFDA. Searching/querying the database is through drug name, chemical formula or structural search by smiles format. Keen selections of bioanalytical methods for pharmaceutical analysis or regular quality control are also possible with E-BABE. E-BABE was built understanding the needs of pharmaceutical industry and laboratories including CROs working on BA/BE studies. Presently it has nearly of 5,000 methods and it will be updated regularly.

Biography:

Ahmed El Mohamady Mahfouz is affiliated to Department of Pediatrics, Faculty of Medicine, Menoufia University, Menoufia, Egypt.

Abstract:

Aim: To assess the role serum thrombomodulin in the diagnosis and prediction of mortality in pediatric septic cases.
Methods: This a prospective cohort study carried out at the Pediatric Intensive Care Unit (PICU) of Menoufia University Hospital. We included 70 critically ill patients admitted to PICU and 25 apparently healthy controls from October 2018 to September 2019. Clinical examination was performed including calculation of the Pediatric Risk of Mortality and Pediatric Index of Mortality II. Serum Thrombomodulin was performed for patients at admission and for the controls. Patients were followed up for 30 days.
Results: Serum Thrombomodulin level was significantly higher among the total patient cohort and those with systemic inflammatory response syndrome, sepsis and severe sepsis than among the controls (p<0.001), Furthermore, Serum Thrombomodulin was significantly elevated in non survivors compared with survivors (p=0. 005). Receiver-operating characteristic curve analysis exhibited an Area Under the Curve (AUC) of 0.915 for Thrombomodulin for prediction of sepsis, whereas C-reactive protein had AUC of 0.789. Regarding the prognosis, PIIINP had AUC of 0.711 for prediction of mortality, whereas the AUC for Pediatric Risk of Mortality and Pediatric Index of Mortality 2 were 0.918, 0.960 respectively.

Biography:

Dirk Wackernage is a neonatologist by heart, trying to improve treatment and outcome for our sick patients. Optimizing nutrition and growth in sick newborn term and preterm infants is my main research interest. One particular aspect is the postnatal glucose homeostasis following birth. In addition drug safety and patient safety is an other interest. He is an ultrasound enthusiast mainly of the newborn brain but even all other organ systems.

Abstract:

Aim: Postnatal hypoglycaemia in newborn infants remains an important clinical prob‐ lem where prolonged periods of hypoglycaemia are associated with poor neurode‐ velopmental outcome. The aim was to develop an evidence‐based national guideline with the purpose to optimise prevention, diagnosis and treatment of hypoglycaemia in newborn infants with a gestational age ≥35 + 0 weeks.
Methods: A PubMed search‐based literature review was used to find actual and ap‐ plicable evidence for all incorporated recommendations. The GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach was used for grading the evidence of the recommendations.
Results: Recommendations for the prevention of neonatal hypoglycaemia were extended and updated, focusing on promotion of breastfeeding as one prevention strategy. Oral dextrose gel as a novel supplemental therapy was incorporated in the treatment protocol. A new threshold‐based screening and treatment protocol pre‐ sented as a flow chart was developed.

Biography:

Alej-An Joyce Marie A. Gumpal-Te has done MD, RPh and is affiliated to University of Santo Tomas Hospital, Faculty of Medicine and Surgery, Philippines.

Abstract:

Methodology: This study utilized a meta-analysis design. Studies published up to September 30, 2022 were included in the analysis.
Data analysis: STATA MP Statistical Software, Version 13, College Station, TX: StataCorp LP was utilized for all statistical analyses. A p-value ≤ 0.05 was considered statistically significant. Since estimated heterogeneity is non-significant and not substantial, a fixed-effect model was utilized. Pooled risk ratio was utilized as the summary effect measure for the risk of neurodevelopmental delays and was estimated with their corresponding 95% confidence intervals. Heterogeneity was scrutinized using the following statistical tests: Q statistics test, I2 statistics and tau squared statistics. I2 values greater than 50% imply substantial heterogeneity, while a Q-statistics with a significant p-value denotes a statistically significant heterogeneity.
Results: Two studies with a total population of 7,848 patients met the eligibility criteria. Results indicated that all included studies have good quality of evidence in the areas of selection, comparability and exposure. Appraisal of the included studies in these areas of evaluation also showed that all studies were of good quality. The pooled risk of neurodevelopmental delays among infants born to COVID- 19 positive mother was 2.00% higher than those born from mothers who were negative for COVID-19 infection. However, this was not statistically significant. Graphical analysis of publication bias showed funnel symmetry, suggestive that publication bias was unlikely. This result was confirmed with formal statistical tests using Begg’s adjusted rank correlation test and Egger’s regression asymmetry test.
Conclusion: Although not statistically significant, infants born to mothers with COVID-19 infection during pregnancy have increased risk of neurodevelopmental delay. This may be attributed to the limited number of studies and articles available and in part because children born to women infected in the first wave of the pandemic are younger than two years of age. In addition, majority of developmental delay reflected developmental disorders of motor function or speech and language.