Day 1 :
- Plenary Tracks
Pediatric emergency department, Meir medical center , ISRAEL
Title: A short-term, simulation based FAST (focused abdominal sonography in trauma) training for pediatric residents
Time : 10:00-11:00
I have completed my MD training in Sackler school of Medicine in Tel Aviv University in 2014, and started my residency in Pediatric medicine on 2015. During my training I have completed a comprehensive point of care ultrasound course in Soroka University Medical Center affiliated to Ben Gurion University, which focused on FAST exam, cardiac, lung and vascular POCUS. As a future fellow in Pediatric emergency medicine, with the aim to improve and perfect this art of ER subspecialty, I designed with other experts in the field this short termed simulation based training in POCUS, which proved extremely efficient and productive. I truly believe this work will demonstrate the tremendous effect of POCUS training on the professional skills of residents in Pediatric medicine, and will encourage other hospitals around the world to initiate such programs.
BACKGROUND: FAST (focused abdominal sonography in trauma) examination has been integrated into the primary assessment of the Pediatric trauma patients in the ED.
Nowadays, most Pediatric patients are evaluated and treated primarily at the PED by PEM physicians or Pediatric residents. Thus, the ability to perform FAST is a required skill, although it is not included in the Pediatric residency curriculum.
The aim of this study is to assess the ability of Pediatric residents to acquire the skill of performing FAST following a short, simulation based training program.
METHODS: A total of 19 Pediatric residents were enrolled in this study, all without any previous experience with performing FAST. The training program consisted of a lecture, hands-on training, high fidelity simulator training, and 5 tests performed independently during the following month. Competence was evaluated a month later by a simulator based test.
Participants have also completed a questionnaire regarding their level of confidence in performing FAST examinations.
RESULTS - 56 of 57 tests performed were interpreted correctly (98.2%). The level of participants' confidence in FAST performance was increased following the training program, with a statistical significance.
CONCLUSIONS: A short simulation based training program is sufficient for obtaining the required proficiency in performing and interpreting the FAST examination among Pediatric residents.
University of Pisa, Italy
Title: Post-orchiectomy active surveillance in testicular germ cells tumors in pediatric age: which indications?
Time : 11:00-11:45
Aim of the Study: assessing the viability of post-orchiectomy active surveillance approach for testicular germ cells tumors.
Methods: we analyzed 52 patients who underwent surgery for testicular germ cell tumors from 2009 to 2014. The patients were divided by age in Group A (12 patients, age 0-14) and group B (40 patients, age 16-39). Inguinal orchiectomy was performed in all patients. Retroperitoneal lymphadenectomy was performed with orchiectomy in 4 patients (7.7%). Post-surgical management differed based on clinical stage and active surveillance or adjuvant therapy was carried out.
Main Results: After an average 7 year follow-up, the overall survival rate is 100% and, to date, all of our patients are still alive. 2 years after surgery we recorded a total of 11 relapses (21,1%). 3 (12%) of them occurred in patients followed with active surveillance, while 8 (29,6%) of them occurred in patients who underwent active treatment.
Conclusions: we observed an excellent prognosis in both age groups and this confirms that testicular germ cell tumors are curable. We believe that active surveillance is an optimal option for tumors at Stage I, because of their low risk of relapse. However, post-surgical treatment should be taken into consideration for germ cells tumors with risk factors.
The Odessa Regional Pediatric Hospital, Ukraine
Title: The case of successful treatment of newborn with extensive III degree thermal burn of the skin.
Time : 11:45-12:00
National University of Science and Tecnology, Oman
Title: Eff ectiveness of asthma educational intervention in improving asthma knowledge and attitudes of parents/ caregivers of asthmatic children.
Time : 12:00-12:45
Dr Chhaya Akshay Divecha has completed her Undergraduate as well as postgraduate (MD Pediatrics) from the reputed Seth G.S. Medical College & KEM Hospital at Mumbai , India.She has also obtained fellowships in Neonatal Intensive Care and Pediatric Intensive Care from the same reputed institution.She is currently assistant Professor in Pediatrics at College of Medicine, National University of Science and Technology (formerly Oman Medical College)at Sohar, Oman. She has more than 10 years of teaching experience and has published many papers in reputed journals as well as contributed to chapters in four textbooks.
Aims & Objectives:
Research shows positive effects of asthma education in improving parental knowledge, self-management skills and reduced health care costs. Such studies are lacking in developing countries. We studied effectiveness of educational intervention in improving knowledge and attitudes of parents/caregivers of asthmatic children.
Study was conducted in Pediatric chest clinic of tertiary hospital (India) over 21 months after ethics committee approval. Recruited parents were randomized into interventional group (A) receiving education module and control standard group (B). Parents’ asthma knowledge and attitudes were assessed at baseline and 5 months post-enrollment using 25-item questionnaire. Detailed demographic data, clinical data and exacerbations during study were noted.
75 parents/ guardians fulfilling inclusion criteria were analyzed (cases/Group A:37 and controls/ Group B:38). 8.3% parents/caregivers were illiterate. Around 36.9% had family history of allergy/asthma. Mean scores at baseline and follow up were 8.37 and 11.06 respectively. Parents did better on knowledge items related to chronicity, family history, chronic cough, home administration of steroids in acute severe asthma and maintaining records of clinical/medications for good control. Intervention group (A) showed significant improvement in most attitude based questions post-intervention as compared to non-intervention group (B), especially in improved quality of life after inhalation therapy and improved prognosis post-childhood. There was no statistically significance in asthma severity and control between groups at follow up.
Small group education on asthma in parents/ caregivers improves their knowledge and attitudes. Health care plans should invest in pediatric asthma education and identify key personnel and opportunities in routine care to impart the same.
Ayse Pervanlar has graduated as MD at the age of 25 years from Karadeniz Technical University Faculty of Medicine. She has worked in the Trabzon OF State Hospital Emergency Department as a general practitioner between November 2012 and September 2013 and in Istanbul Medeniyet University as a family medicine resident between September 2013 and April 2016. She has started Pediatric Residency in Maltepe University Faculty of Medicine in April 2016 and she is currently a pediatric resident in Maltepe University Faculty of Medicine.
Bartter’s syndrome (BS) is a rare autosomal recessive syndrome that is characterized by hypochalemic metabolic alkalosis, high renin and aldosterone plasma levels, and high levels of prostoglandines in blood and urine. In this case we present a 5 months old female child admitted to our hospital with the complaints of vomiting, diarrhea and failure to thrive. On admission to our hospital the patient was mildly dehydrated and weight gain was detected 250g/month for the last two months. Blood counts, urea, creatinine, LFT, serum calcium, magnesium, phosphorous and thyroid function tests levels were normal but blood gas revealed metabolic alkalosis with hyponatraemia, hypokalaemia and hypochloraemia. Cystic fibrosis(CF) was eliminated by negative sweat test. After the fluid and electrolyte correction the patient was discharged. During the control polyclinic examination no weight gain was detected and laboratory findings revealed metabolic alkalosis with hyponatraemia, hypokalaemia and hypochloraemia with increased renin levels. Based on the clinical picture and laboratory data she was diagnosed as BS and started on oral KCL supplementations. Gradually child showed improvement at weight gain.