12^th World Pediatric Congress July 22-23, 2019 Melbourne, Australia

Biography:

Liana Hill MSC, RN FNE, SANE-A SANE-P, Is the Forensic Nurse Examiner Program Director for Crisis Services of North Alabama. She provides direct services to victims of assault. She began the first Domestic Violence Nurse Examiner program in the state of Alabama.  Under her guidance and passion, the program now provides sexual assault, child physical abuse, domestic violence strangulation, elder abuse and suspect examinations to assist in civil and criminal cases and provide medical care to patients. She is 1 of 4 nurses in Alabama that holds both her SANE-A and SANE-P certifications.

Abstract:

This case study will follow the child abuse history of a 5 year old boy. In 2016 he was examined by a forensic nurse for physical abuse injuries, in 2017 he returns to school after his summer vacation looking gaunt with significant weight loss. What would you do as a teacher, social worker, child protective services worker or medical professional in seeing this child? Most would feed the child, most would do this due to concern and caring, not realising how serious this would become for the small boy.

He was again referred to the forensic nurse team for documentation of his injuries, where his condition was questioned further than the initial providers.

The now 6 year old boy was subsequently diagnosed with refeeding syndrome. First recorded during the second world war, when prisoners were released from concentration camps, after being starved, many ate too much often, quickly, and then died.

The presentation will discuss the sign and symptoms of this syndrome, including the metabolic abnormalities that occur when a malnourished person begins to feed again. It will include the treatment and recovery program for the child. The outcome of the case from a criminal disposition and education of the multi-disciplinary team, so that caring would not put another child at risk.

Biography:

Abstract:

Many youths from the slums have been engulfed by poverty and drug abuse. Many youths have been exploited to traffic drugs from one town to another. This program targets to address this issue through sports. Youths have been reached out with awareness on effects of drugs and victims being rescued and referred to rehabilitation centers. Advocacy messages have been passed to the communities through sports tournaments where boys and girls participate and later on drama with drug abuse messages are passed across.  The Project has been active in the community organizing tournaments and events. The Project has a national professional(currently coaching a national premier league football club) who engages the youths from our project twice a week. Sports is being used as tool to not only empower the youths both girls and boys with football skills but also to sensitize them of effects of drugs abuse and the need to be in school. In addition the coach facilitates a life skill curriculum with each team /group and uses the sessions to address issues such as self-esteem, being assertive, HIV/Aids, children trafficking

Biography:

Abstract:

Objectives: The present study intended to investigate effects of child sexual abuse faced at different age groups (before 18 years) on present sexual satisfaction of married women.

Method: Data was collected from 5 married women from Lahore, with age range of 21 to 35 years by conducting face to face in-depth interview using interview guide established after extensive literature review.

Results: Findings suggested that experience(s) of child sexual abuse has long term effects on the life of women survivors of child sexual abuse in terms of the sexual satisfaction. It was explored by the qualitative thematic analysis that women survivors of child sexual abuse may have issues in trusting their partners in terms of not being sincere with them along with a feeling of being betrayed by their partners. None of the male partners were aware that their female partners are survivors of child sexual abuse.

All the participants were re-victimized many times by different culprits but due to the fear of being rejected and stigmatized by the family and society, they were being suppressed by the person they shared the event with or by the culprit.

Women survivors of child sexual abuse reported feeling of depression, confusion in sexual relationship with regards to the sexual satisfaction of their husbands, and even after a long time, recalling that event was very discomforting for them.

One of the women survivors of child sexual abuse reported aggressiveness in her behaviour to cope with parental rejection along with guilt of being culprit. Personality issues like difference in real self and pretended self during sexual activity was also reported due to communication gap. They believe that refusal from sex may negatively affect their marital relationship.

They use pretended active participation during sexual activity to cope with the running thoughts of past traumatic sexual abuse, to show their involvement and to satisfy their partners.

Conclusion: Sexual satisfaction of married women survivors of child sexual abuse in Pakistani context (collectivistic cultures) declines even after having healthy sexual discussion on current sexual relationship with their partners.

Biography:

Dr Nankie Ramabu completed her PhD in Health and Community Studies from Leeds Beckett University. She is an independent researcher in Botswana communities focusing on designing interventions to address child abuse. She has published 6 papers in reputed journals and currently running a trust that sets up libraries in Botswana rural communities.

Abstract:

Neglected children in Botswana have received considerable attention in the past three decades owing to the HIV/AIDS epidemic in the country. The neglected children who received the most attention were the orphan and vulnerable children (OVC) which led to the child protection system being framed by the OVC thesis. This has led to neglect hardly studied among the general population of children. Leading to needs of neglected non OVC children been grossly overlooked. Additionally, neglect is usually studied with other forms of child maltreatment as it often co-occurs with them. This has led to neglect epidemic being unclear and difficult to mitigate. The main challenges facing Botswana include gathering accurate child neglect empirical data to aid child protection policy practice. Therefore, there is an urgent need for accurate data on child neglect to better inform child protection policy and practice. Using existing data, this study seeks to understand the extent of child neglect in Old Naledi, Gaborone.  

The study utilised secondary data sources from Botswana Social Services records in Old Naledi, Gaborone to establish the extent of child neglect and inform the prospective intervention study. The data was categories according to four types of child neglect namely; physical, emotional, educational and medical neglect and further characterised according to demographic data.

The findings show a number out of school children some of which have never being enrolled in school, a significant number of children who play on the streets at night until hours of the morning or when the police disperse them, children with no birth certificates, parents who have no identity cards and therefore their children cannot access government services, excessive alcohol use by some parents, low socioeconomic status of the residents, young mothers who have neglectful behaviour towards their children, alcohol and substance use by children, children left to self-care.

The findings from this study add to existing empirical data as well as have immediate implications for strengthening child protection system in Botswana.

Biography:

Dr Nankie Ramabu completed her PhD in Health and Community Studies from Leeds Beckett University. She is an independent researcher in Botswana communities focusing on designing interventions to address child abuse. She has published 6 papers in reputed journals and currently running a trust that sets up libraries in Botswana rural communities.

Abstract:

Neglected children in Botswana have received considerable attention in the past three decades owing to the HIV/AIDS epidemic in the country. The neglected children who received the most attention were the orphan and vulnerable children (OVC) which led to the child protection system being framed by the OVC thesis. This has led to neglect hardly studied among the general population of children. Leading to needs of neglected non OVC children been grossly overlooked. Additionally, neglect is usually studied with other forms of child maltreatment as it often co-occurs with them. This has led to neglect epidemic being unclear and difficult to mitigate. The main challenges facing Botswana include gathering accurate child neglect empirical data to aid child protection policy practice. Therefore, there is an urgent need for accurate data on child neglect to better inform child protection policy and practice. Using existing data, this study seeks to understand the extent of child neglect in Old Naledi, Gaborone.  

The study utilised secondary data sources from Botswana Social Services records in Old Naledi, Gaborone to establish the extent of child neglect and inform the prospective intervention study. The data was categories according to four types of child neglect namely; physical, emotional, educational and medical neglect and further characterised according to demographic data.

The findings show a number out of school children some of which have never being enrolled in school, a significant number of children who play on the streets at night until hours of the morning or when the police disperse them, children with no birth certificates, parents who have no identity cards and therefore their children cannot access government services, excessive alcohol use by some parents, low socioeconomic status of the residents, young mothers who have neglectful behaviour towards their children, alcohol and substance use by children, children left to self-care.

The findings from this study add to existing empirical data as well as have immediate implications for strengthening child protection system in Botswana.

Biography:

Abstract:

Pediatric patients have the potential to undergo a lifetime of treatments and procedures that can cause an increase in fear, anxiety, and long-term implications of negative medical experiences. Certified Child Life Specialists are trained medical professionals who work as part of the multidisciplinary team who focus on the psychosocial needs of patients and families in the hospital setting. Child life specialists are experts in child development with a Bachelor’s or Master’s degree in psychology, child development, or related field. Child life specialists train in children’s hospitals by completing practicums and clinical internships and are board certified by the Association of Child Life Professionals. We provide patient and family centered care to support children and caregivers overcoming the challenges of healthcare, injury and illness. A policy statement by The American Academy of Pediatrics states that child life

services are essential to provide the highest possible quality of care in hospitals. It is also stated in the policy that child life must adapt and grow with the changes of health care delivery (2014). Despite these recommendations, child life services are often not

adequately provided for many pediatric patients during their healthcare journey. This can be due to staffing, funding, understanding of role and/or perceived importance of psychosocial support.

As services and treatment for pediatric patients continue to grow, so does the need for psychosocial support for pediatric patients and families. This presentation offers ways in which child life specialists identify and assess psychosocial needs across the healthcare spectrum. Child life specialists support pediatric patients and families in reducing fear and anxiety during medical care while minimizing negative emotional effects and increasing positive coping and mastery. Child life practices apply psychoanalytic, psychosocial, cognitive, behaviorist, and information processing child

development theories to be responsive to individual patient needs. Interventions provided by child life specialists include developmentally appropriate procedure preparation and support, nonpharmacological pain management, distraction and coping techniques, behavioral interventions, support groups, medical play, and therapeutic activities. Services provided for families include facilitating adjustments to the child’s healthcare experience, supporting family members in understanding the child’s response to treatment, providing sibling support, advocating for family centered care, providing resources to empower and educate families, and educating caregivers on their roles and strategies for coping during medical procedures. Child life services improve patient and parent satisfaction with their overall healthcare experience and promote patient engagement and cooperation.

This presentation aims to equip attendees with the awareness of pediatric patient vulnerabilities and the tools that child life specialists use to support patients, siblings, caregivers, and staff. Attendees will learn how to integrate child life services in patient and family-centered models of care. Child life specialists can utilize their medical training to support pediatric patients and provide staff with the tools and information to incorporate developmentally appropriate and psychosocially supportive interventions into their treatments and healthcare goals. “The reality of child life is that it drives value, assures quality and safety, creates personalization and even has the

potential to reduce cost” (2018).

Biography:

Mamta Rajbanshi  has completed her  Master of science in Nursing (Child Health Nursing) from B. P. Koirala Institute of health sciences, Dharan, Nepal and has been contributing in the field of child health for more than 5 years. Some of the research work she has undergone are The Effect of bladder and lumbar stimulation technique for collection of urine in newborns. (2016), Nutritional status and intelligence quotient (IQ) of preschool children in Folkland, Dharan-17, Sunsari, Nepal. (2015), Substance use among the Nursing Staff of B.P. Koirala Institute of Health Sciences, Dharan, Nepal. (2010). The above paper is her original work during her postgraduate studies in B.P Koirala Institute of health sciences and was also presented  in conference organized by Core Group “Global Health Practitioner conference” 2018 Bethesda, Maryland, USA in 90 second science and in International conference in neonatology INCON - BPKIHS in collaboration with University of Tennessee on 8-10^th March 2015.

Abstract:

The primary objective of the study was to determine the effect of Bladder and Lumbar Stimulation Technique (BLST) for Collection of midstream Urine in Newborns and the secondary objective was to evaluate contamination rates of urine samples collected. An experimental research was conducted in BPKIHS, Dharan, Nepal including total of 54 term newborns. Urine culture was indicated for different reasons to the admitted newborns. They were randomly assigned either to the experimental group (n=27) or the control group(n=27). Twenty-five minutes after feeding, the genitals and perineal area of the babies were cleaned. The newborns were held under the armpits with legs dangling. Bladder and Lumbar stimulation technique was only applied to the newborns in the experimental group. Success was defined as collection of urine sample within 5 minutes (<300s) of starting the stimulation maneuver in the experimental group and of holding under the armpits in the control group.

Results: The success rate of urine collection was significantly higher in the experimental group (88.88%) than in the control group (25.92%) p<0.001. The median time for sample collection was 1.07 minutes (64.2s) [IQR=1.52minutes (91.2s)] in experimental group and 1.52minutes (91.2s) [IQR= 2.78 minutes (166.8s) for control group (p=0.069). Contamination was not found in urine samples collected in both the groups. The study suggests that the bladder and lumbar stimulation technique is safe, quick and effective way of collecting midstream clean catch urine in newborns.

Biography:

Mubashir has completed specialist training in Pediatrics from National Board of Examinations in India and is currently undergoing advanced trainee in Neonatal and Perinatal Medicine in India.

Abstract:

Despite a well-known entity, early diagnosis of Necrotizing enterocolitis (NEC) is difficult as no reliable standard imaging techniques are available. Highest risk of NEC is observed in very low birth weight babies. Literature mentions that diagnosis of intestinal ischemia which is the earliest sign before bowel necrosis can reduce the incidence of NEC [2]. We hypothesized that Superior Mesenteric Artery (SMA) Doppler may be a reliable, non-invasive, bedside tool to predict NEC in preterm neonates. We included consecutively born neonates weighing < 1500 grams at birth in this study. SMA Doppler indices (PSV, EDV, TAMV, PI and RI) on first day of life before initiation of enteral feeding were recorded. Attending neonatologist was blinded to Doppler results. Correlation of SMA Doppler indices with NEC was calculated among 2 groups (NEC versus No-NEC group). Comparison of SMA Doppler on day 1 between subgroups of appropriate for gestational age versus small for gestational age neonates was done to demonstrate any correlation with NEC. Further comparison between antenatal umbilical artery Doppler and postnatal day 1 SMA Doppler was done to identify the better predictor of NEC. Out of 114 eligible neonates, 11 (9.6%) developed NEC (≥ Bell’s stage IIA). Although neonates with NEC had lower SMA Doppler velocities; they were not statistically different in 2 groups (NEC vs No-NEC). No correlation was found between PI and RI to predict NEC in this cohort. However, absent or reverse end diastolic flow in umbilical artery continues to be a significant risk factor for NEC (RR=4.15, 95 %CI=1.32-12.97, P=0.01). This study didn’t observe any correlation between SMA Doppler on first day of life and NEC in VLBW neonates. India, being the global capital of preterm births with high incidence of NEC, should focus on high quality research for prevention and early diagnosis of NEC.

Biography:

Abstract:

Introduction:

Chemotherapy for acute lymphoblastic leukaemia consist of intensive phase which is the backbone for inducing haematological remission. However, this phase is complicated by increased susceptibility to infections. Increased susceptibility to infections is caused by neutropenia, deranged B cell and partly T cell function secondary to leukaemia and its therapy. This analysis was done to study the incidence of infection during first six months of curative chemotherapy for acute lymphoblastic leukaemia.

Methods:

This is a retrospective chart-based review of all patients <21 years of age who were treated for acute lymphoblastic leukemia in the department of Hematology CMC Vellore between 2006 and 2016. Data was collected from the electronic medical record available to the hospital.

Results:

A total of 834 children were diagnosed to have ALL between January 2006 to December 2016, out of which 247 (29.6%) were girls and 587 (70.4%) were boys. They were risk stratified into 3 groups, 125 (15%) formed standard risk, 675 (80.9%) formed intermediate risk and 34 (4.1%) formed high risk group.

Bacterial infections occurred in 117 (14%) patient, of which of which 78 (66.6%) were due to gram negative bacteria and 54 (47%) were due to gram positive bacteria. 7 (11%) patients had dual blood culture positivity. Of patient with gram negative bacterial infection the common organism detected was klebseilla 25 (32%) followed by pseudomonas 24 (30.7%), NFGNB 15 (19.2%), E coli 14 (17.9%).  

Sensitivity pattern showed pansensitive GNB growth in 23 (29.4) patient, extended spectrum beta lactamase GNB growth in 41 (52.5%) and carbapenem resistant GNB growth in 12 (15.3%).

Year 2005 to 2010 there were 53 (45.2%) patients with documented fungal infection as compare to 63 (54.7%) patients from 2011 to 2016.  There was no statistically significant increase in the infection rate (P = 0.3). Moratality rate due to bacterial infection was 17 (14.5%).

The Kaplan Mayer analysis showed poor overall survival who developed documented bacterial infection during the intensive phase of chemotherapy.

Conclusions:

Proven bacterial infections were documented in 14% of patients during induction. There was statistically significant difference noted between mortality in patient with proven infection and those without any infections. 

Biography:

Abstract:

Introduction:

Chemotherapy for acute lymphoblastic leukaemia consist of intensive phase which is the backbone for inducing haematological remission. However, this phase is complicated by increased susceptibility to infections. Increased susceptibility to infections is caused by neutropenia, deranged B cell and partly T cell function secondary to leukaemia and its therapy. This analysis was done to study the incidence of infection during first six months of curative chemotherapy for acute lymphoblastic leukaemia.

Methods:

This is a retrospective chart-based review of all patients <21 years of age who were treated for acute lymphoblastic leukemia in the department of Hematology CMC Vellore between 2006 and 2016. Data was collected from the electronic medical record available to the hospital.

Results:

A total of 834 children were diagnosed to have ALL between January 2006 to December 2016, out of which 247 (29.6%) were girls and 587 (70.4%) were boys. They were risk stratified into 3 groups, 125 (15%) formed standard risk, 675 (80.9%) formed intermediate risk and 34 (4.1%) formed high risk group.

Bacterial infections occurred in 117 (14%) patient, of which of which 78 (66.6%) were due to gram negative bacteria and 54 (47%) were due to gram positive bacteria. 7 (11%) patients had dual blood culture positivity. Of patient with gram negative bacterial infection the common organism detected was klebseilla 25 (32%) followed by pseudomonas 24 (30.7%), NFGNB 15 (19.2%), E coli 14 (17.9%).  

Sensitivity pattern showed pansensitive GNB growth in 23 (29.4) patient, extended spectrum beta lactamase GNB growth in 41 (52.5%) and carbapenem resistant GNB growth in 12 (15.3%).

Year 2005 to 2010 there were 53 (45.2%) patients with documented fungal infection as compare to 63 (54.7%) patients from 2011 to 2016.  There was no statistically significant increase in the infection rate (P = 0.3). Moratality rate due to bacterial infection was 17 (14.5%).

The Kaplan Mayer analysis showed poor overall survival who developed documented bacterial infection during the intensive phase of chemotherapy.

Conclusions:

Proven bacterial infections were documented in 14% of patients during induction. There was statistically significant difference noted between mortality in patient with proven infection and those without any infections. 

Biography:

Dr.Swati Srivastava has completed her Masters in Ocupational Therapy from Jamia Hamdard University,New Delhi, India. She is currently working as an Assistant Professor in the Department of Rehabilitation Sciences, Jamia Hamdard .Her expertise is to administer and persue professional excellence in the field of Occupatioanl Therapy.She has been associated with a number of reputed institutions and NGOs in India. She has published a number of research papers in peer reviewed journals of high repute.

Abstract:

Family and school both have a strong influence on a child's psychosocial development. This study assesses the prevalence of psychosocial problems and its association with different family and school-related stressors among school children. A cross-sectional survey design was used. The sample of 1024 children in the age group of 8-14 years was analysed for psychosocial issues in children and its association with school and family stressors. They were assessed using a researcher's assisted questionnaire and Strengths-Difficulty questionnaire (SDQ). The data was analysed using SPSS with a 95% confidence interval. SDQ scale was used for analysing the psychosocial factors and emotional wellbeing in the children. On a comparison between SDQ filled by the teachers and parents, a huge difference was found (p<0.0001). Among all children, 31.54 %( n=323) had psychosocial issues. Male students (64.08%) were more affected as compared to female students (35.92%). 12-14 years of age group had shown maximum issues (16.06%) as compared to the 8-10 age group (13%). Often family disputes, divorced parent, parent’s transferable jobs, financial problems in the family, less time for the children had shown a strong influence on the psychosocial issues of the children. Children going to the private schools were more affected (68.42%) as compared to government schools (31.57%).The findings indicate that many family stressors had a direct influence on the psychosocial issues of the children. There is a need to encourage the parents and the school settings to give special emphasis to this problem and to find the possible solutions for this.

Biography:

Abstract:

Background: Little is known about the genetic background of urinary tract infection (UTI) in children.

Methods: In this study, vitamin D receptor (VDR) gene polymorphisms were compared between 60 children with UTI (case group) and 60 healthy children (control group). DNA extraction, polymerase chain reaction, and the restriction fragment length polymorphism methods were used to perform the genetic analysis.

Results: There was a significant difference between the case and control groups for VDR gene, ApaI and Bsml, polymorphisms (P < 0.05). The frequency of VDR Bb, bb, Aa, and aa genotypes, and the b and a alleles in the case group was significantly higher than that in the control group (P < 0.05). A significant difference was also found between lower UTI and acute pyelonephritis groups for the VDR Apal and Bsml genotypes (P < 0.05). There was no significant difference between children with first UTI and those with more than one UTI for VDR gene polymorphisms (P > 0.05).

Conclusion: This study showed that there is a significant relationship between VDR gene, Apal and Bsml, polymorphisms and UTI in children. The results indicate that these polymorphisms may play a role in pathogenesis of UTI.

Biography:

Kasun Palihakkara is currently a third year nursing student following Advanced Diploma in General Nursing at International Institute of Health Sciences, Welisara, Sri Lanka. He’ll be completing his last year of Bachelors of Nursing at Deakin University, Geelong in 2020. He’s a member of the IIHS Scientific Committee which pioneers in research. Since his first year he has been interested in research & presented researches related to nursing at the BioInquirer research conferences & many other local conferences. Additionally he has volunteered at several medical service health camps at “Dewsiri Sevana” elderly home in Welisara, Sri Lanka. 

Abstract:

Although vaccine coverage in Sri Lanka is close to 100%, with the widely spreading vaccine rejection trend reaching South Asian regions, it is essential to catch on whether Sri Lankans are being misinformed from the common misconceptions regarding vaccines. As the rates of target diseases decrease, parents become less accepting of even minor common adverse events. It is essential to preserve the integrity of immunization programs and protect public health by finding out the prevalence of anti-immunization trends. The primary objective of this study was to assess the immunization practices & prevalence of trends related to anti-immunization among urban community in Sri Lanka A descriptive cross-sectional quantitative study on 323 participants using convenient sampling with 213 self-administered questionnaires. Additionally, 110 online questionnaires were distributed. 31% of the study population doesn’t maintain immunization records for their children. While majority seek information regarding immunization from reliable sources such as the family physician or specialist pediatricians, 30% also refer to unreliable sources such as online communities for their opinion. 31% of study population had not vaccinated for Japanese encephalitis. 73% of the study population had encountered with side effects of vaccination such as fever & 47% believed that such side effects are rare. 52% of the population had hostile attitude regarding the administration of several doses multiple vaccines within a child’s first year. Majority of the population were aware of the existing misconceptions regarding immunization. Disturbingly 22% of the study population believed that vaccines are useless in preventing diseases nowadays.

Biography:

Dr. Pradeep Kumar Gupta, a Nepalese citizen, currently working as a Pediatrician in Department of Pediatrics in a non-government non profitable hospital in Nepal. He completed his post-graduation (MD Pediatrics) from PGIMER, Chandigarh, India. He presented many papers in national and international conferences. I was awarded for best poster presentation on AOCCN Japan 2017. Currently I am doing research on septic markers in newborn and use of bubble CPAP in resource limited setting.

Abstract:

Introduction: Studies comparing the Demyelinating GBS (Dmy-GBS) and axonal GBS (Ax-GBS) subtype in children are lacking.

 Methods: In this hospital based, prospective and observational studies, consecutive children with GBS were studied to compare the clinical profile and outcome among the subtypes.

Results: Among 9847 children admitted to the emergency, 95 had acute flaccid paralysis, 57 of whom had GBS. Electrophysiologic studies were completed in 56, of whom 20 each had Dmy-GBS and Ax-GBS (19 motor axonal), 12 had non-reactive nerves, and 5 unclassifiable findings. Mean age of onset in Dmy-GBS was 55 months while Ax-GBS occurred later at 84 months. Mean time from onset of symptoms to hospital admission was more in Dmy-GBS 18 days to 8 days in Ax-GBS. Asymmetry of motor findings was more likely in Ax-GBS(10vs4 P=0.048).Respiratory muscle involvement (6 vs 3) and artificial ventilation (5 vs 2) was more in Ax-GBS. The average duration of hospital stay was more in Ax-GBS 16 days to 11 days in Dmy-GBS. Children with Ax-GBS less likely to be non-ambulant at discharge (12 vs 6, p=0.036). Mean disability scores at hospital discharge (4.9±1.2 vs 4±0.9, p=0.015) and at last follow up (0.7±1.01 vs 0.05±0.2, p=0.016) were higher in Ax-GBS. IVIg was the treatment modality and was tolerated well with no side effects reported with no relapse of symptoms after treatment.

Conclusion: Axonal and demyelinating subtypes of GBS are equally common in children of North India. Children with axonal GBS have severe clinical course and more short term morbidity and slower recovery.

Biography:

Shaila Ali has completed her Fellowship in 2012, in Pediatric Medicine from The Children’s Hospital & the Institute of Child Health, Lahore under College of Physician and Surgeons, Pakistan. She did her 2^nd Fellowship in Pediatric Neurology and completed it 2018, in same institution. She has special interest in pediatric stroke as well as neuromuscular problems in children. She is the In-Charge of Electrophysiology section of Pediatric Neurology. Currently she is at the Faculty Position and has published several papers in reputed journals.

Abstract:

Introduction: Acute Flaccid Paralysis (AFP) is a clinical syndrome characterized by rapid onset of weakness in a child aged less than 15 years due to any cause or any paralytic illness in a person of any age when polio is suspected. Exact cause of AFP with its incidence is needed for proper management.

Objective: To determine the spectrum of AFP cases in children.

Study Design: It is a retrospective, observational study.

Place & Duration of Study: Department of Neurology, Children Hospital & the Institute of Child Health, Lahore form January 2017 to October 2017.

Methods: Retrospectively, we extracted the data from multi centers of notified AFP cases. Causes of AFP were sorted out with their frequencies.

Results: Out of 376 cases of AFP, there was male predominance 59.57% (n=224) with male to female ratio 1.5:1 (age ranged 11-18 years). Highest number of patients falls in other categories (23.9%) including neuropathy, myopathy, spinal muscular atrophy, sepsis and TB spine, followed by GBS (18.88%), TN (12.76%), hypokalemic hypotonia (9.30%) and CNS infection (3.45%). Minor illnesses includes spinal muscular atrophy, cerebral palsy, cellulitis (0.53%) and rickets (0.26%),Wild polio cases declined because of intensive oral polio vaccine immunization and were found to be 1.59% (n=6) in 6 districts of Punjab having 4 cases in west and each in north and south region.

Conclusion: Non polio cases of AFP are more than polio. For global eradication of Poliovirus (PV), Pakistan should remain vigilant for effective surveillance of polio and non-polio cases.