Biography:

Ashli Milling is a Lecturer in Orthoptics at The University of Liverpool, UK. She has graduated from the University of Liverpool in 2009 with a first class Honors. She has worked as a Clinical Orthoptist in Stepping Hill Hospital, Stockport, UK for five years.

Abstract:

The Kay Picture (KP) VA test is one of the UK’s leading tests for pre-literate children in clinical practice. The test has since been redesigned to modernise the optotypes. Phase-1: Resolution acuity for 25 pictures, 8 Landolt C’s and 5 ETDRS letters were assessed in adults. Phase-2: Recognition phase assessed children (<30 months). Phase-3: Resolution acuity of a reduced number of pictures and the Landolt C. Phase-4: Comparison of the KP test with LEA symbols and the ETDRS. Phase-5: Collection of age related norms. Mean (±SD) acuity with 25 pictures: -0.12±0.12 to -0.31±0.11 LogMAR, Landolt C’s: -0.06±0.12 and -0.13±0.10 for the ETDRS. Three pictures were removed at this point. Picture recognition was assessed in 420 children (<30 months). A further 10 pictures were removed based on recognition. Resolution acuity was assessed in 42 adults with the remaining 12 pictures. Based on individual recognition thresholds, the picture selection was reduced to six. A further 113 adults were assessed with the new KP test, the ETDRS and LEA symbol. The mean bias indicated similar results between tests. Phase-4 evaluated the repeatability of the KP test and the ETDRS in 100 adults, no significant difference was found between either test (p=0.1). Phase-5: Mean (±SD) acuity in children (<30 months): 0.10±0.07 LogMAR. The redesigned KP test has been shown to be highly comparable with current gold standard VA assessments. The new single crowded optotype enables clinicians to assess younger patients (<2 years), which potentially could detect amblyopia earlier than previously possible.

Biography:

Monika Kaushal has pursued MBBS, MD Pediatrics and DM Neonatology at All India Institute of Medical Sciences. She is currently pursuing MSC Neonatology from Southampton University, UK. She is working as a Consultant at Emirates Hospital Group

Abstract:

The aim is to reduce infection in unit by relearning infection control policies. Outcomes in neonatology have improved dramatically in the last three decades. Improved survival- associated with increasing short-term and long-term morbidity. Infections are important cause of morbidity and mortality. Majority of infections are potentially preventable. Early onset sepsis related to maternal and perinatal factors on which NICU professionals have little control. Late onset usually Healthcare-Associated Infections (HAI) and linked to infection control measures and are controllable and potentially preventable. Reported incidence of sepsis is 15-50% depending on location and gestation, 25% of VLBW in the NICHD network were having LOS. Incidence falling in developed economies, e.g. 15% in Canada (2010/11) and drop from 38/1000 admissions to 20/1000 admissions in the UK (2006-2014) and Gulf region (2013-15) it is 56/1000 admissions. Seasonal variations have been described to reduce the infection; we need to have policies in place. Some of which are hand hygiene policy, central line policy and bundles, isolation policies, antibiotic policies, cleaning and waste. We might have disjointed between policy and care delivery. The metrics being used were nor accurate/fit for purpose. If we look at hand hygiene policy, it may happen that there may be policy in place, IC team audits showing high compliance but fly on the wall observation revealed a different story, non-compliance widespread, accessibility of hand gel at bedside was an issue, Turnover of new staff e.g. residents who were poorly oriented. So, we need to work on the missing gap and improve the compliance. Similarly, for central line bundle it may have issues in any of the following: Bundles in place, IC team reporting high compliance, wrong metric being used was a tick box exercise with no empowerment of nurses, no standardization, application of antiseptic and adherence to aseptic technique suspect, type of antiseptic used, multiple breaks in to the line and indefinite line duration. When we do quality improvement then we can have infection free NICU.

Biography:

Bamini Devi has completed her PhD from Sri Ramachandra Faculty of Nursing, Sri Ramachandra University, Chennai, India. She has 14 years of experience in the field of teaching/research related to nursing. She is the Nursing Director for Venkateshwara Hospital and has published more than 14 papers in reputed journals.

Abstract:

The objectives of the study were to determine the effectiveness of Comprehensive Stroke Education Program (CSEP) on knowledge and quality of life among patients with stroke and to evaluate the effectiveness of CSEP on knowledge and burden among caregivers of patients with stroke. Randomized controlled trial research method was adopted. Patients who were diagnosed to have ischemic or hemorrhagic stroke based on CT-scan findings with mRS (modified Rankin Scale) grade 1-4 score, which indicates mild to moderate disability after stroke were considered as stroke victims and their caregivers who fulfill eligibility criteria were chosen. Sample size was 170 dyads in that 85 dyads in the study group and 85 dyads in the control group were recruited by lottery method. Pretest assessment was taken on demographic variables, clinical variables, knowledge on stroke, ADL and generic QoL for the patient and knowledge was assessed for the caregiver of both the groups. Following pretest, CSEP was implemented to the study group dyads apart from the routine care by laptop-assisted teaching by lecture cum demonstration method on one to one basis. Booklet on Life after stroke was issued to study group dyads on the day of discharge, which contained information on CSEP. The posttest assessments were taken on 30th day, 90th day and 180th day at neurology OPD for both the groups. Comparison of mean scores of knowledge on stroke between the study and control group showed the level of knowledge found to be high among study group patient at p<0.001. The mean scores of ADL in the study group and in the control group during posttest-I, II and III was statistically significant at p<0.05 level. The mean scores of PCS during posttest-I, II and III showed statistically significant at p<0.05. MCS mean score during posttest-I, II & III was statistically significant at p<0.05. Overall mean scores of SSQOL in the study group were found to be higher than that in the control group during posttest-I, II and III at p<0.01 between groups. The level of knowledge on stroke between the study and control group caregivers during posttest-I, II and III was statistically significant at p<0.01 level. The burden mean scores were higher in the control group caregiver than the study group caregiver during the posttests and were statistically significant at p<0.01 level during posttest-I and II and p<0.05 level during posttest-III. Based on the findings it is concluded that the combination of interventions like structured teaching, information booklet on Life after stroke and telephonic reminder and reinforcement are capable of increasing knowledge on stroke and thereby improving ADL and quality of life of patients with stroke and minimizing the caregiver burden. The Individual and Family Self-Management theory by Polly Ryan and Kathleen Sawin was chosen to incorporate the ideas of this study. Recovery after stroke is physically and mentally exhausting since stroke affects each person differently. Patients must be persistent enough to achieve favorable recovery following stroke.

Biography:

Lama Yousef Alsamnan has completed her Doctor of Optometry degree from King Saud University, Collage of Applied Medical Sciences, Optometry Doctor Program and Degree of Honor in 2018. Currently, she is working as an Optometry Doctor at Global Eye Care, Riyadh and has been serving as a Researcher at King Khaled Eye Specialist Hospital, Riyadh.

Abstract:

Introduction & Aim: The association of Vernal Keratoconjunctivitis (VKC) and keratoconus is well documented. The aim is to determine the characteristics of corneal topography among children with VKC compared to normal subjects and to determine the prevalence of subclinical keratoconus in patients with VKC. It is a cross sectional study.

Method: Forty (40) consecutive subjects (80 eyes) with VKC (VKC group) and 40 normal subjects (80 eyes) (control group) were included in this study. Clinical assessments included measurement of visual acuity with a LogMAR chart, cycloplegic refraction, complete slit lamp biomicroscopy and Goldman applanation tonometry. Pentacam (Oculus Optikgeräte GmbH, Wetzlar, Germany) derived corneal topography indices were recorded for both groups. Demographic data and topographic indices were analyzed and compared using the unpaired t-test between groups. Statistical significance was indicated by p<0.05.

Result: Thirty-three (82.5%) patients in the VKC group were males. The mean age at presentation was 10.43±1.99 years in the VKC group. Subclinical Keratoconus (KC) was found in in 48 eyes (60%). Compared to the control group, Maximum anterior elevation, Keratoconus Index, Central Keratoconus Index, Index of Surface Variance, Index of Vertical Asymmetry, Index of Height Decentration were significantly higher in the eyes with VKC with subclinical KC while Minimum Sagittal Curvature was significantly lower (p<0.05, all comparisons).

Conclusion: Compared to the normal control group, patients with VKC had a greater preponderance of myopic astigmatism that required correction. Sixty percent (60%) of patients with VKC had abnormal Pentacam indices compared to the control group.

Biography:

Vijay Dahiya has passed his MD Pediatrics from PGIMS Rohtak in 2004 as in Service Candidate. He is having experience of 15 Years in Pediatrics. He worked as a Medical Superintendent, as a Deputy Civil Surgeon and now he is a Civil Surgeon at Mukand Lal Civil hospital. He did many research works and attended many International, National  Conferences all around the world.

Abstract:

We made a research with the Preterm Infant mortality and morbidity at Mukand Lal District Civil Hospital from 2011. Till date 4867 number of newborn has been admitted in this secondary care level newborn unit. Out of these 3412 were treated and discharged from hospital, 1247 were referred to tertiary care centers and 208 newborn expired during treatment. It was observed that one important cause of neonatal mortality and referral to tertiary care centre was premature or preterm birth of newborn. As out of 208 deaths 129 were preterm babies. Preterm birth, defined as birth before 37 weeks of gestation is an important cause of neonatal deaths and ultimately a major contributor to overall infant and child mortality. So, it is important to address the determinants of poor outcomes related to preterm birth to achieve further reductions in infant and child mortality. Infant mortality and morbidity due to premature birth can be reduced through interventions delivered to the mother before or during pregnancy and during labor, and to the preterm infant after birth. Interventions can be directed to all women for primary prevention and reduction of the risk of preterm birth (e.g. smoking cessation programme) or aimed at minimizing the risk in women with known risk factors (e.g. progestational agents, cervical cerclage). However, the most beneficial set of maternal interventions are those that are aimed at improving outcomes for preterm infants when preterm birth is inevitable (e.g. antenatal corticosteroids, magnesium sulfate and antibiotic prophylaxis). It also need certain guidelines to provide evidence-based recommendations for interventions during pregnancy, labour and during the newborn period that are aimed at improving outcomes for preterm infants.

These guidelines are mandatory for health-care professionals responsible for developing national and local health-care protocols and policies, as well as managers of maternal and child health programmes and public health policy-makers in all settings.This guideline focuses on improving maternal and neonatal outcomes associated with preterm birth, and specifically includes both the care of pregnant women at imminent risk of preterm birth (birth < 37 weeks of gestation) and the care of preterm babies immediately after birth in all settings. Women at imminent risk of preterm birth are the pregnant women who are likely to deliver a preterm baby either as a result of onset of spontaneous preterm labour, preterm premature rupture of membranes or elective (or indicated) preterm birth.

Biography:

Titih Huriah has pursued his PhD from Faculty of Medicine, Universitas Gadjah Mada, Indonesia. She is a Nurse in Community Nursing who focused on children nutrition. She has published more than 20 papers in reputed journals and has been serving as an Editorial Board Member of Indonesian Journal of Nursing Practices

Abstract:

Stunting is still a problem in Indonesia. The highest prevalence of stunting in 2013 is in East Nusa Tenggara (51.7%), West Sulawesi (48.0%) and West Nusa Tenggara (45.3%). Stunting problems describe chronic nutritional problems, influenced by the condition of the mother or expectant mother, fetal period and infant or under-five years, including illness suffered during childhood. Like other nutritional problems, not only health issues, but also influenced by other conditions that indirectly affect health. The aim is to review the literature related to the events stunting determinant in Indonesia and identify the factors that have an impact on the incidence of stunting in children. Leading databases were searched electronically between the years 2013 and 2017. A database of relevant health including EBSCO, PubMed, BiomedCentral, ProQuest, DOAJ and Scholar in the search by using a combination of search terms: Determinants of stunting, malnutrition, risk factors stunting, Indonesia, Southeast Asia. Twelve (12) articles identified from 815 articles were included in the review. A few factors for the occurrence of stunting in Indonesia included: Factor of the child, family factors, sanitation and infectious diseases. This review literature review found out that the most dominant factors that causes stunting in children in Indonesia are children with Low Birth Weight (LBW), boys, not exclusively breastfed for six months, poorly educated parents, low social economics, parent with malnutrition and poor sanitation at home.

Biography:

Farhana Tabussum completed her BS Nursing at RMIT University, Australia at 1999, did her Diploma on Nursing at Aga Khan University at 1984. She worked in Pakistan Army at AFNS and also she is a head of EMS Faculty at Al Ghad College of Health Sciences, Jeddah. She represented the First “Nursing Now” Summit inaugurated by President of Pakistan at President House. She received the First Metropolitan Nursing Award by Karachi Mayor 2018. She has attended many National and International Conferences all around the world for about 15 years. Her Research work in the field of Nursing received many awards and Honors.

Abstract:

Background:

With advancements in medical & nursing fields it had been noticed that globally phenomenon of aging is going to be entirely an experience of attention. Health care providers including all stakeholders have to pay an extra ordinary interest to formulate a comprehensive and systematical elderly care. Geriatric care is now forecast as a vital need of the aging population especially in Pakistan where the development of health care system needs special consideration. Elderly care in Pakistan needs to be emphasized more vigorously as aging population is deprived of resources & a systemic framework with a comprehensive care designed especially for this vulnerable group.

Objective:

This study will recognize & classify the challenges & aspects of elderly care in Pakistan with a special focus on nursing staff and policy makers to develop a pathway to help this vulnerable population to receive the best possible.

Discussion:

The current health care system and the nursing education, training and services system in Pakistan is not well established and does not provide a comprehensive care system which may meet the needs of elderly population. The increasing number of older people worldwide is getting a considerable attention globally. The challenges & issues faced in Pakistan become more serious due to the limited resources, lack of focused care system and deficiency of awareness of the concerned issue

Biography:

Mohamad Miqdady is American Board certified in Pediatric Gastroenterology, Hepatology and Nutrition. He is the Division Chief, Ped. GI, Hepatology & Nutrition Division at Sheikh Khalifa Medical City in UAE. Program Director, Pediatric Gastroenterology Fellowship Training program, SKMC, Abu Dhabi, UAE. Also an Adjunct Staff at Cleveland Clinic, Ohio USA. He completed his Fellowship in Pediatric Gastroenterology at Baylor College of Medicine and Texas Children’s Hospital in Houston, TX, USA. He held the position of Assistant Professor at Jordan University of Science and Technology in Jordan for six years prior joining SKMC.

Abstract:

It is quite humbling to know that most of the cells in our bodies are bacterial cells. Moreover, “Bacterial System” is the largest organ in our body. There are more than a thousand different species in our body that lives in harmony with us. It is there for a good reason; that is helping us to stay healthy.

The science of probiotics is mounting exponentially. There is a huge amount of research being done all over the world to demystify this unique system. The role of probiotics in clinical practice is expanding very fast; it is indicated in various Gastrointestinal disorders, for example diarrheal illnesses whether that is infectious (Rota, C. Diff etc) or antibiotic induced or inflammatory in nature like Inflammatory bowel disease. Others may include irritable bowel syndrome, recurrent abdominal pain and several others.

Hostile environment like birth by cesarean section, formula fed, frequent use of antibiotics or severe chronic illness my affect the probiotic milieu negatively. These kinds of patients may benefit from restoring their bacterial system. Strong evidence based practice guidelines by International societies are limited; giving the huge number of different probiotics and the substantial differences in methodology of these studies. These guidelines and metanalysis studies will be presented and discussed in length during my presentation.