Day 1 :
- Adolescent Pulmonology, Adolescent Oncology, Adolescent Neurology
Location: Webinar
Chair
Christopher F. Tirotta
Chief Department of Anesthesia Nicklaus Children’s Hospital
Session Introduction
Christopher F. Tirotta
Chief Department of Anesthesia Nicklaus Children’s Hospital
Title: Liposomal Bupivacaine: A novel long acting local anesthetic
Biography:
Dr. Tirotta has been an active member of Miami Children’s Hospital medical staff since 1991, practicing with the Department of Anesthesiology; he has served as the Director of Cardiac Anesthesia since 2002. He also has a clinical appointment with the Department of Anesthesiology at The University of Miami School of Medicine. Dr. Tirotta received his BA from Cornell University in 1982 and his MD from New York University School of Medicine in 1986. He also received an MBA degree from Columbia University in 1999. Dr. Tirotta completed his internship in Internal Medicine at SUNY at Stony Brook in 1987. He completed his residency training in anesthesiology at the University of Miami/Jackson Memorial Hospital in 1990; he sub-specialized in pediatric and cardiovascular anesthesia, including heart transplantation. He has been the Principal Investigator on a number of clinical drug/device trials, including on the ONQ Pain Buster, the muscle relaxant Zemuron, the procoagulant RiaSTAP, the Cardiotronic NICOM device and the AirPurge.
Abstract:
Post-operative pain control continues to be a problem in surgical patients. A novel formulation of an ultra-long acting local anesthetic is now available in the US: Exparel or liposomal bupivacaine. Liposomal bupivacaine is made up of microscopic polyhedral particles. The liposomes encapsulate the drug, bupivacaine hydrochloride, without altering molecular structure. This provides the reliable low dose release of the bupivacaine over time, providing long-lasting, post-surgical pain relief over the course of 2-3 days. This eliminates the need for titration of a single dose or the need for external devices or pumps to prolong analgesia. Plasma bupivacaine levels may persist for 96 hours after injection. Peak plasma concentrations are lower in magnitude and occur later in time than after a similar injection with bupivacaine HCl. Plasma bupivacaine concentrations are not correlated with local efficacy. Safety profile was evaluated in 10 clinical trials in patients undergoing a variety of surgical procedures. Most common adverse events were nausea, constipation and vomiting. Exparel demonstrated a favorable cardiac profile. There was no cardiac toxicity and no QTc prolongation, even a supra-therapeutic doses. Rate of absorption is dependent on total dose administered, route of administration and vascularity of the surgical site. Efficacy has been established. Multiple trials demonstrated a significant reduction if pain intensity scores and a reduction if overall opioid consumption compared to placebo. Liposomal bupivacaine is a safe and effective novel new drug to treat post-surgical pain.
Yu-Kai Du
Huazhong University of Science and Technology, China Wuhan
Title: The Role of Prenatal Tobacco Smoke Exposure in Modulating the Association of Genetic variants with Child Attention Deficit Hyperactivity Disorder
Biography:
Yu-Kai Du has expertise in maternal and child healthcare. He has worked in Department of Maternal and Child Health, Tongji Medical College, Huazhong University of science and Technology from 1983. He has undertaken a number of National Natural Science Funds projects on vertical transmission of hepatitis B virus in the Chinese population. He has also held a number of social positions, such as the Director of Chinese Society of Rural Health, the Director of Standing of Hubei Society of Family Education and Hubei Society of Comprehensive Development of Children Secretary-general, the committee of Chinese maternal and child experts’ committee. Committee and the expert group of prevention mother-to-child transmission of HIV, China’s Ministry of Health.
Abstract:
Objective: Many epidemiologic studies have consistently shown that cigarette smoking during pregnancy could increase the risk for children neurodevelopmental disorders and behavioral problems, but the gene-environment interaction of smoke exposure and gene influence is numbered. The purpose of our study was to test the hypothesis that prenatal tobacco smoke exposure(including maternal smoking and secondhand smoke exposure during pregnancy) could modify the association of genetic variants with diagnosed ADHD and ADHD co-occurring ODD (ADHD-ODD).Methodology: The simple effects of certain single nucleotide polymorphisms (SNPs) in the dopaminergic, serotonergic, and noradrenergic pathway and of prenatal tobacco smoke exposure in association with ADHD and ADHD-ODD were estimated, the joint effects, in addition, of SNPs and prenatal tobacco smoke exposure were measured using unconditional univariate logistic regression analysis adjusting by potential influences, such as preterm birth, low birth weight, lead. Findings: Prenatal tobacco smoke exposure was an important risk factor of children diagnosed ADHD even by adjusted other potential confounders. We found three SNPs in the ADRA2A, DRD2 and SLC6A4 genes were statistical associated with diagnosed ADHD, but the relationships were disappeared in some symptom domain. The risk of the genetic variants in the children ADHD symptom domains and ADHD-ODD were increased sharply when combined prenatal tobacco smoke exposure. Conclusion: The genetic variants and prenatal tobacco smoke exposure were in associated with astrong increased risk of ADHD and ADHD-ODD. These findings suggested that the genetic risk factors for ADHD could
Yonatan Menber
Bahir Dar University, Ethiopia
Title: Prevalence and associated factors of stunting among secondary school adolescents in Tehuledere district, Northeast Ethiopia, 2017
Biography:
Yonatan Menber has years of experience in treating and supporting patients, teaching and administration both in health and education institutions, and research. He acquired clinical and managerial skills by working in different technical and managerial positions and contributing his share for the development of a country.
Abstract:
Statement of the problem: Increased nutritional needs of adolescents relate to their fast growth fact that adolescents gain up much of their adult weight, height and skeletal mass during this period. The main nutritional problems affecting adolescent populations worldwide include both under nutrition and over nutrition. But, adolescents have been considered a low risk group and often receive little attention. The purpose of this study is to assess the prevalence and associated factors of stunting among secondary school adolescents in Tehuledere district, Northeast Ethiopia, 2017. Methodology: A school based cross sectional study was conducted among 535 secondary school adolescent age group students from 1st April to 20th April 2017 in Tehuledere district. Systematic random sampling technique was employed for selecting study subjects. A standardized, pre tested and structured self-administered questionnaire was used to collect the data. The outcome variable was measured with standardized anthropometric measurement. Data was entered using Epi info version 7 and analyzed using SPSS version 20 and WHO Anthro Plus soft wares. Crude and adjusted odds ratios with 95% level significance were used to measure the strength of association and statistical significance was declared at p-value less than 0.05. Findings: The overall prevalence of stunting among the adolescents (10-19 years) was 15.5%. After adjustment; being male (AOR=2.394 95% CI=1.425, 4.022), being in the age group 13-16 (AOR=2.106 95% CI=1.261, 3.516), using unsafe drinking water supply (AOR=3.721 95% CI=1.397, 9.913) and having no latrine facility (AOR=3.311 95%CI=1.569, 6.988) were found significantly associated with stunting at P value <0.05. Conclusion: The study revealed that prevalence of stunting was still high beside the surplus of food in the study area. Therefore, improving nutritional status of adolescents is imperative through providing comprehensive and routine nutritional assessment and counseling services for adolescents at community, school and health facility levels.
Radha Acharya Pandey
Institute of Medicine, Nepal
Title: Self-Esteem and Academic Stress among Nursing Students
Biography:
Radha Acharya Pandey has completed my Master degree in Adult Nursing at the age of 38 years from Institute of Medicine, Nepal. I am Associate Professor of Kathmandu University School of Medical Sciences. I have published more than 17 papers in reputed journals and I have served as a reviewer for a number of journals in my related field and earned certificate for quality review. I have presented paper at international and national conferences and organized conference, workshop in related areas.
Abstract:
Background: Stress and self-esteem are common issues that everyone has to cope with at some time in their lives and they could also affect other things going on in a persons’ life. Academic stress is psychological condition often experienced by college students as, to some extent, being multidimensional variables. Among others are self-esteem and psychological well-being which are considered to have influences in explaining why college students experience stress.
Objective: The aim of the study was to assess the self-esteem level and academic stress among the nursing students.
Methods: This is a cross-sectional study carried out in 2012. Total respondents were 190 nursing students selected randomly from Kathmandu University. Academic stress was assed using 30-item Scale for Assessing Academic Stress (SAAS) and Self-esteem was assessed using 10 item Rosenberg's Self-Esteem Scale. Information was collected through the self-administered questionnaire. The collected data was analyzed using SPSS version 16 software. Simple statistics measurement, percentage, means, correlation was used for the data analysis.
Results: This study shows mean age of the respondent’s was 20.44 (±2.67) years. Majority (88%) of students getting financial support of NRs less than 6000 ($60) per month and 64% have low perceived family support. This study found mean score of self-esteem and academic stress was 11.9 and 18.4 respectively. Further nearly 78% students have low self-esteem and 74% have high academic stress. Significant variable for high academic stress and low self-esteem were lower the age, lower the education and low perceived family support. Lower financial support has also has high academic stress.
Conclusion: Nepalese nursing students have low self-esteem and high academic stress. Intervention to lower the academic stress and increase the self-esteem should be carried out so that the learning of students will be efficient.
Keywords: Academic stress, Self-esteem, Nursing students.
Sushila Shrestha
University School of Medical Sciences. Dhulikhel, Nepal
Title: Institutional delivery and its associated factors: A cross sectional community based study in Kavre district, Nepal
Biography:
Mrs. Sushila Shrestha has her expertise in evaluation and passion in improving the health and wellbeing. He has working experience of 17 years in nursing. Four years in teaching hospital as a staff nurse, 7 years as a nursing instructor and 6 years as a Lecture in the Kathmandu University School of Medical Sciences. She has good experience in clinical area and competent in research. She has been supervised as an advisor for the more than 15 researches till now.
Abstract:
Health facility delivery is considered a critical strategy to improve maternal health. The Government of Nepal is promoting institutional delivery through different incentive programmes and the establishment of birthing centers. The purpose of this study was to identify utilization of institutional delivery and its associated factors. Methodology & Theoretical Orientation: A descriptive cross-sectional study was carried out among the mothers of under five children in Dhungkharka, Kavre District, Nepal. Pre-tested questionnaire was administered to 170 mothers between 15-45 years of age group. Household survey was done by using purposive sampling technique and face to face interview technique was used to collect the data from 1st July to 30th December 2014. Data was analyzed using simple descriptive statistic with SPSS version 16. Association with institutional delivery was assessed by using chi-square test. Findings: Among the total participants,90.0% of them had institutional delivery. The higher proportions of institutional delivery were found in both literate mothers (p=0.001), and literate husband (p=0.023).The proportion of institutional delivery among the mothers decided by their relatives(husband, father/mother-in-laws and other family members)for institutional delivery had higher portion (p=0.048) of institutional delivery than participants who decide themselves. But the study was not able to find out the significant association between institutional delivery and age of mothers, husband’s occupation and number of children, number of ANC visits and distance to nearest health facility for delivery. Conclusion & Significance: Utilization of institutional delivery was much higher than national figure. Institutional delivery was associate with both educational status of mothers and their husband. Decision made by husband, mother in-law, father in-law and other family members were also associated with institutional delivery. So, to increase institutional delivery, family members need to be encouraged for safe motherhood programme.