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INTERNATIONAL FACULTY
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Prof (Keith) Chee Yee Ooi
Australia
Prof (Keith) Chee Yee Ooi
University of New South Wales and Sydney Children's Hospitals Network
A/Professor Ooi (MBBS, Dip Paeds, FRACP, PhD, AGAF) is a Clinician Investigator with a tenured academic position at the University of New South Wales (UNSW) Medicine & Health and Senior Specialist Paediatric Gastroenterologist at Sydney Children’s Hospital Randwick, Sydney, Australia. He is recognized nationally and internationally for his research and clinical expertise in CF gastroenterology and nutrition as well as in pediatric pancreatic diseases. He completed a 3-year research fellowship in CF (2007-2010) at The Hospital for Sick Children and University of Toronto, Canada. He completed a PhD in CF at UNSW in December 2014 and received the UNSW Dean’s Rising Star Award in 2015. In 2021, he was awarded the Leadership Fellowship Award by the National Health and Medical Research Council (Australian equivalent to the National Institutes of Health [NIH]) and American Gastroenterology Association Fellowship.
He has published 120 journal articles, with 58% of these articles as first or senior author. He has written 16 textbook chapters, including multiple authoritative and international textbooks in CF, pediatrics, gastroenterology and pancreatology. He has a h-index of 30 (Scopus) and 32 (Dimensions).
Chronic and recurrent pancreatitis
Liver Symposium
13 October 2022 (1400-1530@Sipadan Hall 2)
Up until recently, our knowledge and understanding of paediatric pancreatitis have been extrapolated from the adult literature. This presentation will cover the spectrum of Dr Ooi's works in paediatric pancreatitis, including from his works as part of the INternational Study Group of Pediatric Pancreatitis: In search for a cuRE (INSPPIRE) project. INSPPIRE is the first multinational, multi-center effort to systematically characterize pediatric pancreatitis, particularly acute recurrent and chronic pancreatitis.
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Prof Aileen Wee
Singapore
Prof Aileen Wee
Emeritus Consultant Pathologist, dept of Pathology, National University Hospital
Professor Aileen Wee graduated from the University of Singapore in 1975 with MB,BS. She trained in Histopathology at the Department of Pathology, University of Singapore, and obtained her specialist degree in Histopathology from both the Royal Colleges of Pathologists in Australasia and the United Kingdom. She is a member of the American Association for the Study of Liver Diseases (AASLD), Laennec Liver Pathology Society, and International NAFLD Pathology Group (INPG).
Her research interests include fine needle aspiration (FNA) biopsy of liver and hepatobiliary pathology, and liver transplantation pathology. Dr Wee published extensively on FNA biopsy of the liver. She was involved in the development of qFibrosis - a computer-assisted image-based quantitative system employing second harmonic generation and two photon excitation fluorescence (SHG/TPEF) for the evaluation of fibrosis in liver biopsies.
Professor Wee is a reviewer and advisor on several regional/international journals, has published over 149 articles in peer-reviewed journals, and is co-author of several books. She was Director of Undergraduate Medical Education, Department of Pathology (1985 -2012), member of Medical Curriculum Review Committee and Phase II Co-ordinator for the medical undergraduate programme at YLLSoM (1995 - 2012). She was past Chair of the Specialist Training Committee (Pathology) in Singapore and was a member of the Specialist Accreditation Board, Singapore.
Currently, her work focuses on AI-assisted qualitative and quantitative digital pathology analysis of NAFLD/NASH; the establishment of qFIBS for the quantitation of Fibrosis, lobular Inflammation, Ballooning degeneration of hepatocytes, and Steatosis has potential application for enrollment and evaluation of efficacy endpoints in clinical trials for NASH patients.
As Course Director, Dr Wee has organized 9 consecutive Diagnostic Cytopathology Workshops for pathologists, cytopathologists, cytotechnologists and residents from Singapore and the region from 2004 to 2018. She has travelled extensively in the region and internationally to deliver invited lectures at scientific meetings and to conduct cytopathology, hepatobiliary pathology, and liver transplantation pathology workshops.
Clinicopathological approach to liver biopsy interpretation - How to make sense of a histopathology report
Histopathology Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
Pediatric NAFLD / NASH and liver fibrosis - Updates on histological criteria and assessment of liver fibrosis
Histopathology Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
Liver transplantation - Problem-oriented approach with tips to common clinical issues
Histopathology Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
Case studies (45 min) - A variety of cases with learning issues will be presented for discussion.
Histopathology Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
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Dr Andy Darma
Indonesia
Dr Andy Darma
Pediatric Gastroenterologist
Dr. Sutomo General Academic Hospital and Faculty of Medicine of UNIVERSITAS AIRLANGGA
Dr Andy Darma is the Pediatric Gastroenterologist of the Department of Child Health, Dr. Sutomo General Academic Hospital and Faculty of Medicine of UNIVERSITAS AIRLANGGA, Indonesia. He received his training as a medical doctor and subsequently a pediatrician and gastroenterologist at Dr Sutomo Hospital of Indonesia. He also underwent fellowship training in pediatric gastroenterology, hepatology and nutrition at Royal Children Hospital Melbourne – Australia from 2012 till 2014.
He is presently the full member of Indonesian Pediatric Society and Asia Pan-Pacific Society of Pediatric Gastroenterology, Hepatology and Nutrition (APPSPGHAN), Member of Scientific Subcommittee Endoscopy APPSPGHAN as well as Corresponding Member of European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN). He is also the secretary of Indonesian Scientific Society of Probiotic-Prebiotic, member of the Pediatric Gastrohepatology Working group of Indonesian Pediatric Society, committee of Institutional Review Board and Research Coordinator of Dr Sutomo General Academic Hospital.
Tips for OGDS- including simple foreign body removal
Endoscopy Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
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Prof Anshu Srivastava
India
Prof Anshu Srivastava
Professor, Department of Pediatric Gastroenterology Sanjay Gandhi Postgraduate
Institute of Medical Sciences
Qualification(s)
MD (Pediatrics), DM (Gastroenterology).
Fellowship Pediatric Gastroenterology and Hepatology at Royal Children’s Hospital, Melbourne, Australia and Alberta Children’s Hospital, Calgary, Canada
Area(s) of Interest
Autoimmune liver disease, Liver failure, Portal hypertension, Inflammatory bowel disease and motility disorders including achalasia
Publication(s)
~140 papers and 15 book chapters
Others
Section Editor (Gastroenterology) in Indian Journal of Pediatrics
Acute Viral Hepatitis: Experience From Asia
Liver Symposium (Day 2)
14 October 2022 (1500-1630@Sipadan Hall 2)
Acute viral hepatitis (AVH) is a common problem in the Asia Pacific region with hepatitis A virus (HAV) infection being the most common in children, followed by hepatitis B (HBV) and E (HEV). Uncommon causes include EBV, Parvo, dengue , HCV, CMV and adeno virus infection. In the vast majority of children, AVH starts with a prodrome followed by jaundice which subsides in 4-6 weeks. Nearly 18-20% children may have co-infection with 2 viruses, mostly HAV and HEV, but that has not been shown to increase the risk of complications or poor outcome. Complete liver function test and viral serology (IgM anti-HAV, IgM anti-HEV, HBsAg and IgM anti-HBc) is usually done to confirm the diagnosis. Most children with AVH need only symptomatic therapy and follow-up until complete clinical and biochemical recovery. However, the following subgroups of cases need special attention-
- Children at risk of developing acute liver failure (<1% of all AVH)- Patients with uncorrectable coagulopathy, shrinking liver span, irritability or altered sleep pattern etc. need to be identified early and hospitalized.
- Children with atypical manifestations like relapsing AVH, cholestatic hepatitis, extra intestinal manifestations like pancreatitis, hemolysis, arthralgia, thrombocytopenia etc. These subjects need to be recognized and diagnosed correctly so as to avoid unnecessary investigations.
- Children with underlying CLD- In nearly half of the cases of acute on chronic liver failure, the first clinical presentation is with acute onset jaundice due to AVH and the underlying CLD had been unrecognized. In all cases with suspected AVH, one should look for features of underlying CLD like early ascites, splenomegaly, growth failure, peripheral stigmata of CLD et. Appropriate evaluation, and prompt management of ACLF is required in them.
- Children with other infections resembling/ co-existing with AVH like enteric fever, leptospirosis, scrub typhus etc. Persistence of fever despite appearance of jaundice, systemic features (rash, eschar, lymphadenopathy etc.) and investigations help in correct diagnosis. Appropriate antimicrobial treatment is essential for a good outcome in these cases.
Specific antivirals are recommended only in select situations like HBV related ALF, severe EBV, persistent chronic HEV despite reduced immunosuppression etc. These cases should be managed by pediatric hepatologists. Adequate sanitation, safe water supply, feco-oral hygiene, educating about zoonotic transmission for HEV, adequate screening of blood products and safe injection practices are the important measures for prevention of AVH. Effective vaccination is available against Hepatitis A and B, while HEV vaccine is still not available for routine use. WHO has set a target of elimination of viral hepatitis by 2030 and we have to actively work to achieve this.
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Prof Anupam Sibal
India
Prof Anupam Sibal
Group Medical Director, Apollo Hospitals Group
- Group Medical Director, Apollo Hospitals Group since September 2005
- President, Global Association of Physicians of Indian Origin (GAPIO) in January 2020
- Member of the Regional Middle East International Advisory Board of Joint Commission International (JCI) since 2011
- Member of Institute Body, PGIMER Chandigarh (2009 – 2014)
- Honorary Clinical Professor at Macquarie University, Sydney in Australia
- Major Achievements:
- Helped set up the first successful liver transplant programme in India in 1998 at Apollo Hospitals.
- The Apollo Transplant Program is the busiest solid organ transplant program in the world since 2012.
- More than 3900 liver transplants have been performed of which 434 are pediatric.
- 124 publications,15 chapters, more than 401 National and International lectures
- Edited a Textbook in Pediatric Gastroenterology and Hepatology and Nutrition published in 2015.
- Author of the National best seller "Is Your Child Ready to face the World”?
- The Apollo Transplant Program is the busiest solid organ transplant program in the world since 2012.
Liver Transplant Program In Resource-Limited Setting: Current Issues And Challenges
Liver Symposium: Liver Transplantation in Asia
14 October 2022 (1330-1500@Sipadan Hall 2)
A sustainable pediatric liver transplant program requires a comprehensive approach – early diagnosis, timely referral, and coordination between the private and public healthcare sectors. Many countries in Asia and Africa with limited resources do not have these structures in place. The lack of economic development in developing countries is a crucial hurdle to access LT. Managing malnutrition and infectious diseases are given due precedence over transplantation and therefore, LT remains largely unavailable in the public sector. With the absence of universal insurance cover, the onus of funding is largely on the family. Need for regular follow- up and cost of immunosuppression add to the economic drain.
About 3 decades after its inception in the West, the first successful pediatric liver transplant in India was performed at Apollo Hospitals, New Delhi in November 1998. Overcoming the hurdles of financial constraints, reservations about organ donation and donor safety in a largely living related program, India is now amongst the leading centers for LT in Asia. Between 1500-2000 transplants a year are performed, 10% of which are pediatric. Survival rates surpassing 90% have been achieved. The Apollo Liver Transplant Program has now performed more than 4000 liver transplants in patients from 50 countries. Of these 456 are pediatric transplants. The recipient of the first successful pediatric liver transplant in India, Sanjay then a twenty two month old baby is now working as a doctor in Bangalore. Children from 20 countries have received a transplant in our center.
Over the years, indications and donor pool have expanded. Age, size and now cost is no longer a barrier for successful LT. Babies weighing as little as 3.5 kg have received a successful transplant, Combined liver kidney transplants and ABO incompatible liver transplants are routinely performed. The average cost is 30,000 USD which is about one-fifth to one-tenth the cost in the West. Crowd funding along with the support of some philanthropic organizations and individuals dedicated to funding LT has thus made transplantation possible for those with limited resources. With increasing acceptance of LT among the medical community and the public at large, LT is now well established.
About 3 decades after its inception in the West, the first successful pediatric liver transplant in India was performed at Apollo Hospitals, New Delhi in November 1998. Overcoming the hurdles of financial constraints, reservations about organ donation and donor safety in a largely living related program, India is now amongst the leading centers for LT in Asia. Between 1500-2000 transplants a year are performed, 10% of which are pediatric. Survival rates surpassing 90% have been achieved. The Apollo Liver Transplant Program has now performed more than 4000 liver transplants in patients from 50 countries. Of these 456 are pediatric transplants. The recipient of the first successful pediatric liver transplant in India, Sanjay then a twenty two month old baby is now working as a doctor in Bangalore. Children from 20 countries have received a transplant in our center.
Over the years, indications and donor pool have expanded. Age, size and now cost is no longer a barrier for successful LT. Babies weighing as little as 3.5 kg have received a successful transplant, Combined liver kidney transplants and ABO incompatible liver transplants are routinely performed. The average cost is 30,000 USD which is about one-fifth to one-tenth the cost in the West. Crowd funding along with the support of some philanthropic organizations and individuals dedicated to funding LT has thus made transplantation possible for those with limited resources. With increasing acceptance of LT among the medical community and the public at large, LT is now well established.
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Prof Chen Huey Ling
Taiwan
Prof Chen Huey Ling
Professor and Director, Department and Graduate Institute of Medical Education and Bioethics, Department of Pediatrics, College of Medicine, National Taiwan University
Professor Chen graduated from the College of Medicine (M.D.), and Graduate Institute of Clinical Medicine (Ph.D.) of National Taiwan University. She received pediatric residency and pediatric gastroenterology fellowship training in National Taiwan University, and has been a visiting scientist in British Columbia Cancer Research Centre, Vancouver. As a pediatric gastroenterologist, Dr. Chen’s clinical work is mainly in pediatric hepatology, gastroenterology, and nutrition. Her research interests center on pediatric liver diseases, prevention of hepatitis B virus (HBV) infection and mother-to-infant transmission of HBV, cholestatic liver diseases, genetic diagnosis of inherited liver diseases, and clinical pediatric GI diseases. She and colleagues have published papers in Gastroenterology, Hepatology, Journal of Hepatology, Journal of Pediatrics, Journal of Pediatric Gastroenterology and Nutrition, etc. She is currently the President of Taiwan’s Society of Pediatric Gastroenterology, Hepatology, and Nutrition, and chair of Hepatology subcommittee of Asian Pan-Pacific Society of Pediatric Gastroenterology, Hepatology, and Nutrition (APPSPGHAN) Scientific committee.
The use of IBAT inhibitors in paediatric liver disease
Liver Symposium : Neonatal cholestasis
13 October 2022 (1100-1300@Sipadan Hall 2)
Diagnostic approach in metabolic liver disease: perspective from Asia
Liver Symposium: Genetic and metabolic liver diseases
14 October 2022 (1030-1200@Sipadan Hall 2)
Management of Viral Hepatitis C In Children
Liver Symposium (Day 2)
14 October 2022 (1500-1630@Sipadan Hall 2)
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Prof Damayanti Rusli Sjarif
Indonesia
Prof Damayanti Rusli Sjarif
Dept of Pediatrics Faculty of Medicine Universita Indonesia & Dr Ciptomangunkusumo National Referral Hospital Jakarta
- Professor in Pediatrics Faculty of Medicine Universitas Indonesia, Jakarta, INDONESIA
- Pediatrician, Consultant in Pediatric Nutrition and Metabolic Diseases - Ciptomangunkusumo National Referal Hospital, Jakarta, INDONESIA
- Chair Human Genetic Research Cluster- IMERI Faculty of Medicine Universitas Indonesia, akarta, INDONESIA
- Chair of National Referral Center for Rare Diseases Indonesia - Dr Ciptomangunkusumo National Referral Hospital
- Scientific Reviewer for Food and Drug Administration Republic Indonesia 2006-now
- Member of Board Asian Society of Inborn Errors of Metabolism 2006- now
- Member of Board Asia Pacific Pediatrics Society of Gastro-Hepato-Nutrition
- Chair of Working Group on children and adolescent Anthropomethry Ministry of Health Indonesia
- Chair of Working Group on Foods for Special Medically Purposes Ministry of Health Indonesia
- Member of Society of Study Inborn Errors of Metabolism 1998-now
- Life time member of Asia Pacific Society of Human Genetics
- Chair of Stunting Task Force Indonesia Pediatric Society 2021-2024
Feeding The Undernourished Child: Experience From Indonesia
Nutrition Symposium: Nutrition and Micronutrients
15 October 2022 (0830-1000@Sipadan Hall 3)
Malnutrition refers to deficiencies or excesses in nutrient intake, imbalance of essential nutrients or impaired nutrient utilization. The double burden of malnutrition consists of both undernutrition and overnutrition, as well as diet-related noncommunicable diseases. Undernutrition manifests in four broad forms: wasting, stunting, underweight, and micronutrient deficiencies. In 2020 globally, stunting affected an estimated 22.0% or 149.2 million children under 5 , wasting continued to threaten the lives of an estimated 6.7 % or 45.4 million children under 5 and estimated 5.7 % or 38.9 million children under 5 were affected by overweight. and about 53% of stunting, 70% of wasting and 48% of overweight children under 5 live in Asia. Undernutrition always begin with undernourishment means that a person is not able to acquire enough food to meet the daily minimum dietary energy requirements. FAO defines hunger as being synonymous with chronic undernourishment. Poor weight gain, also called "weight faltering or " slow weight gain " refers to failure to gain weight appropriately is the first sign of undernourishment, without any intervention may be affected linear growth and head circumference also. The underlying cause of poor weight gain is "always insufficient usable nutrition," due to wide variety of insufficient nutrition consumption such as poverty, neglected and ignorancy or increased nutrition requirement such as recurrent infection or specific medical condition such as prematurity, food allergy, inborn errors of metabolism. etc. which need Food for Special Medically Purposes.
Principle treatment of undenutrition are nutritional treatment and early detection redflags and prompt treatment. Following the WHO guidelines 2007 for catch-up growth, the focus of dietary management during undernutrition has changed from supplementing only with energy to optimizing catch-up by providing adequate energy and protein. These guidelines suggest that 8.9–11.5% of energy should be supplied as protein, to provide optimal catch-up growth of lean and fat mass (from 10 g/kg/day, 8.9 PE% to 20 g/kg/day, 11.5 PE%; 73:27 lean:fat mass). The importance of a correct protein:energy ratio has also been highlighted by several recent studies investigating optimal oral/enteral feeds for catch-up growth. The protein requirement should content complete and sufficient essential aminoacids.
In Indonesia, stunting is the most prevalent children underfive malnutrition, it is suspected due to only 38% children 6-24 months who consumed animal sources protein, Pilot study in one village consist of dietary conselling to eat animal sources foods every meals minimal 1 egg per day plus referral system to GPs or Pediatrician for every malnourished children screened in community health post to interference with detection & prompt treatment redflags plus nutritional treatment, successfully reduced stunting prevalence about 8,4% in 6 months.
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Prof Felizardo Gatcheco
Philippines
Prof Felizardo Gatcheco
Pediatric Gastroenterologist/Clinical Epidemiologist
- Graduate of UST Faculty of Medicine and Surgery
- Pediatric residency at Manila Doctors Hospital
- Fellowship in pediatric gastroenterology and applied nutrition at UP-PGH
- Masters in Clinical Epidemiology at UP College of Medicine
- Fellow and Chair, Committee on Research of the Philippine Pediatric Society
- Fellow and Past President, Philippine Society for Pediatric Gastroenterology, Hepatology and Nutrition
- Consultant of Manila Central University Hospital, Jose R. Reyes Memorial Medical Center, Mandaluyong City Medical Center, Manila Adventist Medical Center
- Member, Asian Society for Pediatric Research, Asia Pan Pacific Society for Pediatric Gastroenterology, Hepatology and Nutrition, Global Health Network Inc, International Probiotic Association, Rome Foundation
Approach In Addressing Micronutrient Deficiency In Young Children?
Nutrition Symposium: Nutrition and Micronutrients
15 October 2022 (0830-1000@Sipadan Hall 3)
Micronutrient deficiency is one of the major problems affecting our children in the world, specifically in the Asian region. The deficiencies involving iron, zinc, Vitamin A, iodine and the like tend to be much higher nowadays than expected. Unfortunately, it can lead to a lot of clinical outcomes like reduced brain development, growth impairment, poor immunity, decreased working capacity and increased mortality. This presentation will provide us with some insights as to the etiology of such deficiencies, other possible outcomes and the different approached studied in the medical literature in terms of how to prevent micronutrient deficiencies involving supplementation, fortification, use of sprinkles or powders, biofortification and other strategies that might be helpful.
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Assoc. Prof George Alex
Australia
Assoc. Prof George Alex
Head of Department Department of Gastroenterology and Nutrition Royal Children's Hospital, Melbourne, Australia
Fellowships and Memberships
- Gastroenterology Society of Australia (GESA)
- North American Society of Paediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN)
- Australasian Society Paediatric Gastroenterology, Hepatology and Nutrition (AUSPGHAN)
- Fellow of the Royal Australian College of Physicians (RACP)
Advisory Boards
- Member of the Medical Advisory Board for the International Registry for Wilsons Disease 2021- Sponsored by Orphalan
- Abbvie Advisory Board – 2013 and 2017
- Remicade Advisory Board – 2010
National Committees
- National Paediatric Medicines Forum Medication Evaluation-Vedolizumab 2021
- CCA- Paediatric IBD Quality of Care Project Advisory Committee 2021
- IBD Patient Information Materials Working Group (GESA) 2020
- Executive Committee Member of Australian IBD Association – 2013 – 2017
- Member of National IBD Quality of Care Steering Committee – 2014 – 2016
- President of the Australasian Society Paediatric Gastroenterology, Hepatology and Nutrition (AUSPGHAN) – 2008 -2010 (renamed as GESA Paediatric network)
- Written Examination Committee of Royal Australasian College of Physicians (Paediatric Section) 2006-2011
Nutritional Management In Childhood IBD
Gastro Symposium (Day 2)
14 October 2022 (1500-1630@Sipadan Hall 1)
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Dr Gillian Greville Harris
United Kingdom
Dr Gillian Greville Harris
University of Birmingham, School of Psychology, UK,
Dr Gillian Harris has carried out research into infant and child feeding behaviour and appetite regulation at the University of Birmingham, School of Psychology, UK, for the past 38 years. She was also a Consultant Paediatric Clinical Psychologist for 30 years, and led a feeding clinic at The Children’s Hospital, Birmingham, UK, where she worked with infants and children who were food averse. She now runs a private clinical service for children and adults with Avoidant and Restrictive Food Intake Disorder(ARFID) many of whom have co-morbid ASD or ADHD. Her specific research and clinical interest is the development of food acceptance and rejection in early infancy and later childhood, and the effect of early experience on later food preferences. She has written around 100 published papers, articles and book chapters on these areas, and been awarded multiple research grants to support her research. She has also made many media appearances, both on television and radio. Her latest book, on Food Refusal and Avoidant Eating in Children, was published in 2018.
Managing picky eaters
Nutrition Symposium: Breastfeeding and complementary feeding
13 October 2022 (1600-1730@Sipadan Hall 3)
Managing Picky Eaters Gillian Greville Harris Picky or avoidant eating in children is usually due to one of two things: the onset of the neophobic stage of food refusal at around the age of 2 years, or sensory hyper-reactivity to the taste, smell, texture or appearance of both new and previously experienced foods. Children will eventually grow out of the neophobic response, but those children who are extremely sensory reactive will continue to show avoidant eating throughout childhood. The developmental trajectories of food refusal will be described and the management strategies that will enable good growth and eventual food acceptance in both neophobia and moderate avoidant eating will be discussed. The diagnostic criteria for a diagnosis of Avoidant and Restrictive Food Intake Disorder (DSM5) will also be addressed.
Understanding and Managing Parenting styles and its role in feeding disorders (Case Studies)
Nutrition and Growth Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
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Dr Helen Evans
New Zealand
Dr Helen Evans
Paediatric Hepatologist
Service Clinical Director, Starship Child Health, Te Toka Tumai
Dr Helen Evans is a Paediatric Hepatologist at Starship Child Health, Auckland, New Zealand. She is also the Service Clinical Director for Paediatric Medical Specialities and Honorary Senior Clinical Lecturer at the University of Auckland. Her main clinical and research interests include liver disease and transplantation, intestinal failure and quality improvement. She was involved in the creation of the New Zealand National Intestinal Failure and Rehabilitation Service, which she lead for many years. She is Associate Editor for Pediatric Transplantation and sits on several national and international committees relevant to her field.
Autoimmune liver disease
Liver Symposium
13 October 2022 (1400-1530@Sipadan Hall 2)
Nutrition in Chronic liver disease
Nutrition Symposium : Nutritional Issues in Children: Special Consideration
13 October 2022 (1100-1300@Sipadan Hall 3)
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Prof Huma Arshad Cheema
Pakistan
Prof Huma Arshad Cheema
Professor of Ped Gastroenterology-Hepatology (Emeritus) Children's Hospital & University of Child Health Lahore
Professional Achievements
- Pioneered the discipline of Pediatric Gastroenterology Hepatology in Pakistan.
- Established the first Fellowship program for Pediatric Gastroenterology and Hepatology in Pakistan .
- Developed the Only Genetic and Rare disease center in the department of Hepatology Children’s Hospital. Part of the team in establishing the Bone marrow transplant program at Children’s hospital along with the hematology oncology group .The program was started 6 years back and is now the most successful Pediatric Stem cell transplant program for Children in Pakistan
- Developed the first Inborn error of Metabolism diagnosis and treatment facility in the department with help of donors.
- Started the first prenatal screening of all genetic disorders free of cost with help of international collaborators. No other center in Pakistan does Prenatal screening for all genetic disorders.
Memberships / Positions in Societies
- Chairperson Pakistan Pediatric Association (PPA) GI group
- Council member APPSPGHAN (Asia Pan Pacific Society of Pediatric Gastroenterology Hepatology
- Council member CAPGAN
- Member FISPGHAN (Federation of international Societies of Pediatric Gastroenterology Hepatology and Nutrition)
- Member Task Force on Genetic diseases Government of Pakistan
- Member Pakistan Society of Gastroenterology & GI endoscopy
- Member Pakistan society of Hepatology
- Supervisor and Examiner for General Pediatrics Fellowship of College of Physicians and Surgeons (FCPS) Pakistan
- Supervisor and Examiner for Fellowship in Pediatric Gastroenterology and Hepatology of College of Physicians and Surgeons FCPS (Ped GI) Pakistan
Childhood Wilson’s disease: an Asian perspective
Liver Symposium: Genetic and metabolic liver diseases
14 October 2022 (1030-1200@Sipadan Hall 2)
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Prof Ichiro Nomura
Japan
Prof Ichiro Nomura
Chief, Division of Eosinophilic Gastrointestinal Disorders, National Research Institute for Child Health and Development
Major Research Interest:
- Eosinophilic Gastrointestinal Disorders
- Non-IgE-mediated gastrointestinal food allergy
- Hypereosinophilic syndrome
- Severe-protein-loss in atopic dermatitis
- Pediatric Allergy
Academy Memberships
- American Achademy of Asthma, Allergy and Immunology
- Japanese Allergology Society - 1993
- Japanese Pediatric Society - 1986
Honors and Awards
- Ichiro Nomura as a research representative, 2010-2022; Health and Labor Sciences Research Grants, Research on intractable diseases from Ministry of Health, Labor and Welfare in Japan
- Ichiro Nomura as one of “the Best Doctors in Japan” 2012-2022.
- The 2018 AAAAI/APFED (American partnership for Eosinophilic Disorders) Best Abstracts on EGIDs, Ichiro Nomura, MD PhD.
- Ichiro Nomura as a research representative, 2007-2009, Grant-in-Aid for Clinical Research from the National Hospital Organization in Japan
- Ichiro Nomura as a research representative, 2007, Grant-in-Aid for Clinical Research from the National Center Network for Child Health and Development in Japan
- 2003, American Achademy of Asthma, Allergy and Immunology, Sepracor Research Excellence Awards.
EGIDs in Asian children: Are they uncommon, or are we missing them?
Gastro Symposium : Potpourri of GI disorders
13 October 2022 (1100-1300@Sipadan Hall 1)
Eosinophilic gastrointestinal disorders (EGIDs) are chronic inflammatory gastrointestinal disorders characterized by marked accumulation of eosinophils in the GI mucosa. EGIDs can be divided into two main groups: eosinophilic esophagitis (EoE) and non-EoE-EGIDs. In EoE, inflammation is confined to the esophagus only, while in non-EoE-EGIDs, inflammation may be present anywhere in the stomach, small intestine, or colon. In Europe and the U.S., EoE patients are far more common than non-EoE-EGID patients, and some have severe disease. EoE is being studied in depth. For this reason, EoE is clearly perceived as a more important disease than non-EoE-EGIDs.
A few population-based studies have been conducted in Asia, but unlike in Europe and the U.S., most of them seem to be focused on non-EoE-EGIDs. We conducted a nationwide survey in Japan and found more non-EoE-EGID cases than EoE cases (Yamamoto M et al., J Allergy Clin Immunol Pract 2021). In terms of age of onset, EoE was concentrated in middle age and later, while childhood-onset EoE was very rare. On the other hand, non-EoE-EGIDs were common in children, and the decline in quality of life was more severe than in EoE patients.
We know that the various sections of the gastrointestinal tract have very different, specialized functions. The stomach and duodenum digest food and the small intestine then absorbs the important nutrients. Finally, the large intestine absorbs water. When those functions are compromised, the impact on the human body will be greater than when just the esophagus is compromised.
Treatment of childhood EoE in Japan is not very difficult. PPIs and oral budesonide are often sufficient. Non-EoE-EGIDs, on the other hand, require systemic steroids. Significant use of systemic steroids over several months often leads to short stature, Cushing's syndrome, diabetes, osteoporosis, and depression. Dietary therapy may help prevent or mitigate those undesirable outcomes.
Another important medical issue in Japan is non-IgE-mediated gastrointestinal allergies in newborns and infants. I really want to learn about the situation in Malaysia and the other Asia-Pacific Countries in regard to EoE and non-EoE-EGIDs and also non-IgE-mediated gastrointestinal allergies in neonates and infants.
A few population-based studies have been conducted in Asia, but unlike in Europe and the U.S., most of them seem to be focused on non-EoE-EGIDs. We conducted a nationwide survey in Japan and found more non-EoE-EGID cases than EoE cases (Yamamoto M et al., J Allergy Clin Immunol Pract 2021). In terms of age of onset, EoE was concentrated in middle age and later, while childhood-onset EoE was very rare. On the other hand, non-EoE-EGIDs were common in children, and the decline in quality of life was more severe than in EoE patients.
We know that the various sections of the gastrointestinal tract have very different, specialized functions. The stomach and duodenum digest food and the small intestine then absorbs the important nutrients. Finally, the large intestine absorbs water. When those functions are compromised, the impact on the human body will be greater than when just the esophagus is compromised.
Treatment of childhood EoE in Japan is not very difficult. PPIs and oral budesonide are often sufficient. Non-EoE-EGIDs, on the other hand, require systemic steroids. Significant use of systemic steroids over several months often leads to short stature, Cushing's syndrome, diabetes, osteoporosis, and depression. Dietary therapy may help prevent or mitigate those undesirable outcomes.
Another important medical issue in Japan is non-IgE-mediated gastrointestinal allergies in newborns and infants. I really want to learn about the situation in Malaysia and the other Asia-Pacific Countries in regard to EoE and non-EoE-EGIDs and also non-IgE-mediated gastrointestinal allergies in neonates and infants.
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Dr Itaru Iwama
Japan
Dr Itaru Iwama
Chief of the Division of Gastroenterology and Hepatology, Saitama Children's Medical Center, Saitama
Education
1996-2002 Saga Medical University: School of Medicine
Work Experience
- 2002-2005 Pediatric Residency at Okinawa Chubu Hospital
- 2005-2007 Pediatric Gastrointestinal and Hepatology Residency at Saitama Children’s Medical Center
- 2007-2011 Full-time pediatrician at Okinawa Chubu Hospital
- 2017- Chief of the Department of Gastroenterology and Hepatology at Saitama Children's Medical Center
Qualifications
- Qualified Medical Doctor (Ministry of Health, Japan, 2002)
- Qualified Pediatrician (Japanese Pediatric Society, 2006)
- Qualified Gatroenterologist (The Japanese Society of Gastroenterology, 2015)
- Qualified Gastroenterological Endoscopist (Japan Gastroenterological Endoscopy Society, 2017)
Typical OGDS findings for paediatric GI disease
Endoscopy Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
Endoscopic Findings of Upper Gastrointestinal Disease in Children
Pediatric upper gastrointestinal endoscopy is essentially performed on symptomatic patients, unlike in adults, where the primary purpose is to screen for malignant disease.
Typical indications for upper gastrointestinal endoscopy in children are acute epigastric or right upper quadrant pain, hematemesis or melena, dysphagia or odynophagia, caustic ingestion or foreign-body ingestion and recurrent vomiting.
On the day of the lecture, endoscopic findings will be explained with a focus on the following diseases
Esophageal diseases: reflux esophagitis, eosinophilic esophagitis, esophageal varices, esophageal achalasia, congenital esophageal stricture
Gastric diseases: gastric ulcer, chronic gastritis (H.pylori infection), gastric tumor, Menetrier's disease
Duodenal diseases: duodenal ulcer, Crohn's disease
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Prof Jae Sung Ko
Korea
Prof Jae Sung Ko
Professor, Department of Pediatrics, Division of Pediatric Gastroenterology and Nutrition
Seoul National University Children’s Hospital, Seoul National University College of Medicine
Memberships and Major Committee Assignments in Professional Societies :
- 2005-2009 Secretory General, Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition
- 2016-2018 Director of Scientific Committee, Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition
- 2021- President, Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition
- 2021- Vice Chairman, Korean Society of Gastroenterology
- Member of Council, Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition
- Korean Association for the Study of the Liver, Korean Society of Gastroenterology
Major research interests
Nonalcoholic fatty liver disease, Wilson disease, Neonatal cholestasis, Glycogen storage disease Genetics of pediatric liver disease
Epidemiology in Asia
Liver Symposium: Metabolic dysfunction-associated fatty liver disease: (NAFLD)
15 October 2022 (0830-1000@Sipadan Hall 2)
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in children. An international panel proposed to replace the terminology of NAFLD with metabolic dysfunction associated fatty liver disease (MAFLD) in children. The diagnostic criteria for pediatric MAFLD are based on the detection of steatosis along with the presence of one of three criteria, namely overweight or obesity, prediabetes or type 2 diabetes, or evidence of metabolic dysfunction. The incidence of MAFLD diagnosis significantly increased over 10 yrs. The global prevalence of pediatric MAFLD from general populations is 7.6% and no regional difference was found. Pooled global prevalence of MAFLD in obese children was 34%. Prevalence among obese children in Asia is 60% and higher compared with Europe and North America. Variants of PNPLA3 are more common in Asians. Risk factors for MAFLD are high fructose intake, maternal obesity, low or high birth weight, type 2 diabetes, dyslipidemia,and sarcopenia. Althogh genetic risks influence development of MAFLD, diet and lifestyles are critical determinants. Children with MAFLD have significantly higher rates of overall, cancer-, liver- and cardiometabolic-specific mortality and impose a heavy burden on health systems. Policy measures aimed at reducing social inequities and improving the food environment, prevention and screening of pediatric MAFLD are important.
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Dr James Huang
Singapore
Dr James Huang
Consultant Paediatric Gastroenterologist , National University Health System Singapore
Dr James Huang graduated with honours from National University Singapore in 2007 as the medical school class valedictorian and was awarded the Dean's List award for all 5 professional examinations. He was awarded the GlaxoSmithKline book prize, Tan Choon Kim book prize, Medical Class of 1975 Gold Medal in Pathology, Margaret Lee Ming Yee Memorial Medal and Albert Lim Liat Juay Silver Medal for being the top student in Microbiology and Immunology, Neuroscience and Pathology respectively. He was also awarded the Dean's Most Outstanding House Officer award for Housemanship Year 2007-2008. He was appointed membership of the Royal College of Paediatrics and Child Health (United Kingdom) and subsequently completed his advanced specialist training in Paediatrics. He is the first paediatrician in Singapore to receive formal double accreditation in Paediatric Medicine and Paediatric Gastroenterology, fulfilling clinical training and endoscopy accreditation criterion aligned with the European Society of Paediatric Gastroenterology Hepatology and Nutrition. He has also been awarded the Masters in Clinical Investigation coursework and currently is the principal investigator leading the study of the Microbiome and Metabolomics in Paediatric Inflammatory Bowel Disease. He was also awarded the NUHS Academic Medicine Development Award to complete an Advanced Paediatric Gastrointestinal Fellowship in Paediatric Inflammatory Bowel Disease at the Hospital for Sick Children, Toronto Canada.
Dr James Huang is a Consultant in the Division of Paediatric Gastroenterology, Nutrition, Hepatology and Liver Transplantation in National University Hospital. His main clinical interest is in Paediatric Inflammatory Bowel Disease and is the clinical lead for diagnostic and therapeutic Paediatric Endoscopy in the department. He is one of the pioneer members for the Asian Paediatric Inflammatory Bowel Disease network and has successfully inaugurated the use of a centralised registry to pool disease and therapeutic data across major paediatric gastroenterology centres in Asia. He is active in undergraduate and postgraduate education, and conducts regular educational lectures in Paediatric Gastroenterology for general paediatricians and medical students/nursing staff.
Imaging studies in IBD
Gastro Symposium: Paediatric IBD 1
13 October 2022 (1600-1730@Sipadan Hall 1)
In the diagnosis and management of paediatric inflammatory bowel disease, the appropriate use and interpretation of imaging studies complements the role of laboratory indices, gastrointestinal endoscopy and histopathology. I will discuss the utility and evolution of imaging modalities in paediatric inflammatory bowel disease through several interactive case-based scenarios from the perspective of a paediatric gastroenterologist.
Office Paediatrics in GI Disorders
Meet the expert session (Day 2)
14 October 2022 (0730-0820@Sipadan Hall 1)
Gastrointestinal complaints in the paediatric population account for a substantial proportion of consultation visits to both the general practitioner and subspecialist paediatrician alike. I will discuss the approaches one can take to common gastrointestinal complaints in a busy office ambulatory setting, through several case scenarios. Screening for red flags and alarm symptoms is paramount in ascertaining which child would need prompt tertiary evaluation, and which child can be safely managed in the ambulatory setting without the need for excessive specialised investigations.
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Assoc. Prof Jason Yap
Australia
Assoc. Prof Jason Yap
The Royal Children’s Hospital, Melbourne
Dr Jason Yap is currently appointed at The Royal Children’s Hospital, Melbourne as consultant Paediatric Gastroenterologist and Associate Professor, University of Melbourne.
He completed his medical school in Auckland, New Zealand and his gastroenterology training in New Zealand and Australia.
He furthered his training at The Hospital for Sick Children, Toronto, Canada. He worked in Canada for a decade as consultant Paediatric Gastroenterologist before returning down under. He currently leads the Children’s Intestinal Rehabilitation and clinical Nutrition Service (CIRNS) at The Royal Children’s Hospital.
His special interest include intestinal rehabilitation, clinical nutrition and liver/intestinal transplantation.
Management of IFALD In Children: A Multi-Disciplinary Approach
Nutrition Symposium: Intestinal failure/ Parenteral nutrition
14 October 2022 (1500-1630@Sipadan Hall 3)
The Nuts and Bolts of Home PN
Nutrition Symposium: Intestinal failure/ Parenteral nutrition
14 October 2022 (1500-1630@Sipadan Hall 3)
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Prof Jia-Feng Wu
Taiwan
Prof Jia-Feng Wu
Professor/National Taiwan University Hospital, Taipei, Taiwan
Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
Dr Wu’s research interests focus on the pediatric liver diseases, inflammatory bowel diseases, viral hepatitis, and gastrointestinal motility disorder. Dr Wu’s researches cover the natural course and genetic background of pediatric liver diseases, inflammatory bowel diseases, host factors and host-viral interactions on the natural course of chronic hepatitis infection from children to adults in HBV and signal analysis of high resolution manometry. He has been actively engaged in many global clinical trials on the anti-viral therapy of chronic hepatitis B infected children and biologics in inflammatory bowel diseases. He has served as a reviewer for more than 30 international scientific journals and internal medical congress, and published more than 120 peer-reviewed articles.
Advances In Paediatric Endoscopy: Expanding The Horizon
Endoscopy Symposium (Day 3)
15 October 2022 (0830-1000@Sipadan Hall 1)
Pediatric endoscopy is widely performed by pediatric gastroenterologists for a long time and is an essential modality to assist pediatric clinicians in the diagnosis and management of various kinds of pediatric gastrointestinal diseases. Most new endoscopic devices and technologies are developed from an adult endoscopy perspective at the beginning, and the major limitation of these new technologies for pediatric patients include the lack of large-scale pediatric trials, size of the devices, the indications of pediatric patients, the experience of pediatric gastroenterologists in performing these new technologies, and the economic consideration to develop these new technologies in the pediatric endoscopy unit. In developing these new technologies, adult gastroenterologists in Asia play an essential role in assisting the procedures and even the technology development in the pediatric endoscopy unit. With the maturation of these new technologies and the improvement of the size of these devices, pediatric gastroenterologists get the chance to perform these emerging technologies to benefit pediatric patients.
The recent advances in pediatric endoscopy include a decrease in invasiveness, improvement in lesion detection ability, functional assessment of gastrointestinal dysmotility, and therapeutic endoscopic technologies.
With the advanced diagnostic and therapeutic endoscopy technologies in the field of pediatric gastroenterology, we are equipped with more and more modalities to monitor and manage our pediatric patients with special clinical considerations delicately.
The recent advances in pediatric endoscopy include a decrease in invasiveness, improvement in lesion detection ability, functional assessment of gastrointestinal dysmotility, and therapeutic endoscopic technologies.
With the advanced diagnostic and therapeutic endoscopy technologies in the field of pediatric gastroenterology, we are equipped with more and more modalities to monitor and manage our pediatric patients with special clinical considerations delicately.
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Prof Jian-She Wang
China
Prof Jian-She Wang
Director, Center for Pediatric Liver Diseases, Children's Hospital of Fudan University
Dr. Jian-she Wang received his PhD degree in pediatrics and has been working on pediatric hepatitis B and inherited liver diseases since he started his PhD study. For hepatitis B, he provided important evidence for HBV-markers mother-to-babies transmission and the risk factors for mother-to-baby transmission of the virus. He is the pioneer in inherited liver diseases in China. He first diagnosed many inherited liver diseases in that population, such as Alagille syndrome, PFIC1-3, CTX, CBAS etc. As principal investigator, his group worldwidely first reported that MYO5B associated familiar intrahepatic cholestasis, ZFYVE19 associated high GGT cholestasis, ATP8B1 deficiency associated hypothyroidism, etc. He has been funded by The National Key Research and Development Program of China, and the Sino-Canada health cooperation project, and 6 regular projects from the Natural Science Foundation of China.
Inherited Intrahepatic cholestasis: molecular and clinical aspects
Liver Symposium : Neonatal cholestasis
13 October 2022 (1100-1300@Sipadan Hall 2)
Familiar intrahepatic cholestasis (FIC) is a group of autosomal recessive disorders with genetical and clinical heterogeneity. Three well known types of FICs, namely type I-III, are caused by mutation in genes ATP8B1, ABCB11 and ABCB4 accordingly. ATP8B1 and ABCB11 are linked with low/normal gamma-glutamyltransferase (GGT) cholestasis. ABCB4 is a cause of high GGT cholestasis. Along with the application of next generation sequencing, mutations in TJP2, NR1H4, MYO5B and USP53 are identified as the new cause of low-GGT cholestasis, while KIF12 and ZFYVE19 high-GGT cholestasis in recently years.
Low GGT FICs usually manifest as a spectrum with various severity. The most severe form is progressive familiar intrahepatic cholestasis (PFIC), while mild forms are benign recurrent intrahepatic cholestasis (BRIC) or transit neonatal cholestasis (TNC). Some PFICs may have extrahepatic manifestations, such as hearing loss in ATP8B1-, TJP2-, USP53- PFICs; hypothyroidism in ATP8B1-PFIC; diarrhea in ATP8B1- and MYO5B- PFICs. ABCB11- and TJP2- PFICs may develop hepatocellular carcinoma. The liver severity of ABCB11-, TJP2-, and MYO5B- PFICs are associated with the predicted consequence of mutations in corresponding genes, while lack of a correlation between the phenotype and genotype of ATP8B1-PFIC.
Mutation in MYO5B (encoding myosin-VB) was original associated with microvillus inclusion disease (MVID). In 2016, we identified MYO5B bi-allelic mutation is also associated with low-GGT cholestasis without obvious diarrhea. MVID usually occurs in patients with bi-allelic null mutations, while MYO5B-associated FICs occur in patients with at least one non-null (missense or non-canonical splicing) mutation. The missense mutation may gain-of-toxicity for the transportation of bile salt export pump (BSEP). A clear phenotype-genotype correlation in MYO5B-FICs was further demonstrated in 2021 by our group.
We demonstrated bi-allelic pathogenic variants in USP53 are associated with low-GGT cholestasis in 2020. Most of the pathogenic variants are null variants. The presenting symptoms and histologic & ultrastructure abnormality are some like TJP2-associated low-GGT cholestasis. However, most of the patients experienced a much milder liver manifestation - transit neonatal cholestasis, though liver transplantation has been reported in a case.
In 2019, we demonstrated bi-allelic mutations in ZFYVE19 are associated with high GGT cholestasis. Some of cases presented as neonatal cholestasis and resolved. Most of them presented as consequences of portal hypertension. Liver histological changes resemble congenital hepatic fibrosis and sclerosing cholangiopathy. Up to now, all the reported pathogenic variants were predicted or proved leading to null effects. ZFYVE19 is known involved in cell division. Cilia abnormality was observed in patients and cell lines.
In conclusion, inherited intrahepatic cholestasis is caused by mutations in variety of genes. Most FICs have a spectrum of disease with different severity. Clear genotype-phenotype correlation has been observed in most of them, that may facility the precision management of patients.
Low GGT FICs usually manifest as a spectrum with various severity. The most severe form is progressive familiar intrahepatic cholestasis (PFIC), while mild forms are benign recurrent intrahepatic cholestasis (BRIC) or transit neonatal cholestasis (TNC). Some PFICs may have extrahepatic manifestations, such as hearing loss in ATP8B1-, TJP2-, USP53- PFICs; hypothyroidism in ATP8B1-PFIC; diarrhea in ATP8B1- and MYO5B- PFICs. ABCB11- and TJP2- PFICs may develop hepatocellular carcinoma. The liver severity of ABCB11-, TJP2-, and MYO5B- PFICs are associated with the predicted consequence of mutations in corresponding genes, while lack of a correlation between the phenotype and genotype of ATP8B1-PFIC.
Mutation in MYO5B (encoding myosin-VB) was original associated with microvillus inclusion disease (MVID). In 2016, we identified MYO5B bi-allelic mutation is also associated with low-GGT cholestasis without obvious diarrhea. MVID usually occurs in patients with bi-allelic null mutations, while MYO5B-associated FICs occur in patients with at least one non-null (missense or non-canonical splicing) mutation. The missense mutation may gain-of-toxicity for the transportation of bile salt export pump (BSEP). A clear phenotype-genotype correlation in MYO5B-FICs was further demonstrated in 2021 by our group.
We demonstrated bi-allelic pathogenic variants in USP53 are associated with low-GGT cholestasis in 2020. Most of the pathogenic variants are null variants. The presenting symptoms and histologic & ultrastructure abnormality are some like TJP2-associated low-GGT cholestasis. However, most of the patients experienced a much milder liver manifestation - transit neonatal cholestasis, though liver transplantation has been reported in a case.
In 2019, we demonstrated bi-allelic mutations in ZFYVE19 are associated with high GGT cholestasis. Some of cases presented as neonatal cholestasis and resolved. Most of them presented as consequences of portal hypertension. Liver histological changes resemble congenital hepatic fibrosis and sclerosing cholangiopathy. Up to now, all the reported pathogenic variants were predicted or proved leading to null effects. ZFYVE19 is known involved in cell division. Cilia abnormality was observed in patients and cell lines.
In conclusion, inherited intrahepatic cholestasis is caused by mutations in variety of genes. Most FICs have a spectrum of disease with different severity. Clear genotype-phenotype correlation has been observed in most of them, that may facility the precision management of patients.
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Prof JIN SOO MOON
Korea
Prof JIN SOO MOON
Associate Professor, College of Medicine, Seoul National University
Membership
- 1995- Korean Medical Association
- 1997- Korean Pediatric Society
- 2001- Korean Society of Pediatric Gastroenterology and Nutrition (KSPGHAN)
- 2002- Korean Society of Gastrointestinal Endoscopy
- 2002- Korean Association for the Study of the Liver
- 2001- Korean Society of Gastrointestinal Motility
- 2007- The Korean Nutrition Society
- 2013- Korean Association for the Study of Intestinal Diseases
- 2018- Asian Panpacific Society of Pediatric Gastroenterology, Hepatology, and Nutrition (APPSPGHAN)
- 2020- European Society of Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN)
Education
- 1995 : M.D. degree, Seoul National University College of Medicine, Seoul, Korea
- 2000 : Master degree, Seoul National University Postgraduate School, Seoul, Korea
- 2007 : Doctoral degree, Seoul National University Postgraduate School, Seoul, Korea
Hospital Duties
- Former Chair of Department of Pediatrics, Inje University Ilsan Paik Hospital (Sep. 2010 - Feb. 2012)
- Former Chair of Institutional Review Board in Inje University Ilsan Paik Hospital (2nd session)
- Former Team Leader of Nutritional Support Team in Inje University Ilsan Paik Hospital
- Current staff of Nutritional Support Team in Seoul National University Children’s Hospital
- Vice Director, Office of Pediatric Operating and Medical Care, Seoul National University Children’s Hospital
Do we need regional growth charts in the era of World Health Organization Growth Standards?
Nutrition Symposium : Nutritional Issues in Children: Special Consideration
13 October 2022 (1100-1300@Sipadan Hall 3)
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Prof Katsuhiro Arai
Japan
Prof Katsuhiro Arai
Professional Memberships
- Japanese Society of Pediatric Gastroenterology, Hepatology and Nutrition
- Vice President
- Asian and Pan-Pacific Society for Pediatric Gastroenterology, Hepatology and Nutrition
- Council Member, Chair of Endoscopy Subcommittee of Scientific Committee, International Affair Committee Member
- Japan Pediatric Society
- Regional Representative
- European Society of Pediatric Gastroenterology, Hepatology and Nutrition
- Pediatric Inflammatory Bowel Disease Net
- Member of Operational Board
- Asian Organization for Crohn’s and Colitis
- Japanese Society for Inflammatory Bowel Disease
- Japan Gastroenterological Endoscopy Society
- Japanese Gastroenterological Association
- Cohn’s and Colitis Foundation of Japan
- Member of Board of Trustees
Board and Certification
- The American Board of Pediatrics (No. 076458, 2002-2009)
- The American Board of Pediatrics / Sub-board of Pediatric Gastroenterology (No. 878, 2007-2014)
- The Japanese Board of Pediatrics (No. 031226, 2009-)
Biologics
Gastro Symposium (Day 2)
14 October 2022 (1500-1630@Sipadan Hall 1)
Typical colonoscopy findings for paediatric GI disease
Endoscopy Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
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Prof Kazuhiko Bessho
Japan
Prof Kazuhiko Bessho
MEMBERSHIPS
American Association for the Study of Liver Diseases
Japanese Pediatric Society (Board Certified Supervisor of Pediatrics)
Japanese Society for Pediatric Gastroenterology, Hepatology and Nutrition (Board Certified Physician)
Japan Society of Hepatology (Board Certified Hepatologist)
Japan Society for Transplantation (Board Certified Transplant Physician)
Japanese Society of Emergency Pediatrics
Japanese Biochemical Society
Japanese Society for Regenerative Medicine
CLINICAL CAREER
2020- Associate Professor in Pediatrics, Graduate School of Medicine, Osaka University
2015-2020 Lecturer in Pediatrics, Graduate School of Medicine, Osaka University
2013-2015 Assistant professor in Pediatrics, Graduate School of Medicine, Osaka University
2007-2009 Assistant professor in Pediatrics, Osaka University Graduate School of Medicine
2005-2007 Staff in Pediatrics, Osaka University Hospital, Osaka, Japan
2005 Staff in Pediatrics, Sakai Municipal Hospital, Osaka, Japan
2004-2005 Staff in Pediatrics, Osaka University Hospital, Osaka, Japan
1998-1999 Resident in Pediatrics, Osaka-Minami Hospital, Osaka, Japan
1997-1998 Resident in Pediatrics, Osaka University Hospital, Osaka, Japan
RESEARCH CAREER
Oct. 2013-Apr. 2016 Adjunct Assistant Professor-Affiliated, Cincinnati Children's Hospital Medical Center, Division of Gastroenterology, Hepatology and Nutrition
Dec. 2009-June 2013 Staff Scientist, Cincinnati Children's Hospital Medical Center, Division of Gastroenterology, Hepatology and Nutrition (Group of Prof. Jorge A. Bezerra)
Jan. 2007-Sep. 2007 Post-doctoral Research Fellow, Department of Pediatrics, Osaka University Graduate School of Medicine
1999-2004 Graduate student, Division of Molecular Regenerative Medicine (Group of Prof. Toshikazu Nakamura), Osaka University, Osaka, Japan
Advances In Surgical and Medical Management of Biliary Atresia
Liver Symposium : Neonatal cholestasis
13 October 2022 (1100-1300@Sipadan Hall 2)
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Prof Kei Murayama
Japan
Prof Kei Murayama
Director, Department of Metabolism, Chiba Children's Hospital
Research Areas:
Inherited Metabolic Diseases: Mitochondrial Disease, Lysosomal Disorder, Urea Cycle Disorders, Fatty Acid Oxidation Defects etc.
Professional Societies:
Membership:
The Japan Pediatric Society
The Japanese Society of Inherited Metabolic Disease, Board member, Vice Chairman
The Japanese Society of Mitochondrial Research and Medicine, Director
The Japanese Society of Pediatric Gastroenterology, Hepatology, and Nutrition, councilor
The Japanese Society for Mass-screening, councilor
The Japan Society of Human Genetics, councilor
Appointments Held:
Currently:
President, Center for Medical Genetics, Chiba Children’s Hospital,
Director, Department of Metabolism, Chiba Children's Hospital,
Chief, Chiba Cancer Center Research Institute
Visiting Professor, Intractable Disease Research Center, Graduate School of Medicine, Juntendo University,
Visiting Professor, Department of Pediatrics, Graduate School of Medicine, Juntendo University,
Visiting Professor, Capital Medical University in Beijing and Beijing Children’s Hospital
Liver disease in mitochondrial disorders
Liver Symposium: Genetic and metabolic liver diseases
14 October 2022 (1030-1200@Sipadan Hall 2)
“Mitochondrial disease” is a collective term used for various clinical disorders that are characterized by failure of mitochondrial function and energy production. Mitochondria are intracellular organelles enveloped by double membrane; they play an essential role in cells in the biosynthesis of adenosine triphosphate (ATP) via oxidative phosphorylation (OXPHOS). ATP is produced by the ATP-synthase complex, which is driven by the proton motive force created by the respiratory chain complexes (I, III, and IV). Impairment of OXPHOS may lead to organ damage. This dysfunction is referred to as mitochondrial disease, which occurs at a frequency of 1 in 5000 births in Japan and western countries.
Mitochondrial hepatopathy is one of the phenotypes of mitochondrial disease in children. Furthermore, mitochondrial DNA depletion syndrome (MTDPS) may occur owing to defects in the proteins involved in mitochondrial DNA (mtDNA) maintenance. This condition results in quantitative and qualitative defects within the mtDNA and is therefore classified as mtDNA maintenance defects. MTDPS has three clinical phenotypes: myopathic, encephalomyopathic, and hepatocerebral. Hepatocerebral MTDPS is known to cause acute liver failure during infancy and is associated with mutations in genes such as, DGUOK, MPV17, POLG, SUCLG1, and TWNK.
Transfer RNA maturation disorders are a growing group of genetic diseases associated with tissue-specific, and mostly neurological, phenotypes. However, some of them, including IARS1, LARS1, and TRMU, are strongly associated with liver phenotypes. Therefore, rapid genetic diagnosis may become important in near future, for early detection of these defects.
In this symposium, I focus on the clinical and genetic features, including mitochondrial medicine, of mitochondrial hepatopathy in children
Mitochondrial hepatopathy is one of the phenotypes of mitochondrial disease in children. Furthermore, mitochondrial DNA depletion syndrome (MTDPS) may occur owing to defects in the proteins involved in mitochondrial DNA (mtDNA) maintenance. This condition results in quantitative and qualitative defects within the mtDNA and is therefore classified as mtDNA maintenance defects. MTDPS has three clinical phenotypes: myopathic, encephalomyopathic, and hepatocerebral. Hepatocerebral MTDPS is known to cause acute liver failure during infancy and is associated with mutations in genes such as, DGUOK, MPV17, POLG, SUCLG1, and TWNK.
Transfer RNA maturation disorders are a growing group of genetic diseases associated with tissue-specific, and mostly neurological, phenotypes. However, some of them, including IARS1, LARS1, and TRMU, are strongly associated with liver phenotypes. Therefore, rapid genetic diagnosis may become important in near future, for early detection of these defects.
In this symposium, I focus on the clinical and genetic features, including mitochondrial medicine, of mitochondrial hepatopathy in children
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Dr Kumudhini Rajasegaran
Singapore
Dr Kumudhini Rajasegaran
Senior Consultant, Adolescent Medicine Service, Department of Paediatrics, KK Women's and Children's Hospital
Dr. Kumudhini Rajasegaran, is a paediatrician, senior consultant and former head of the Adolescent Medicine Service, at KK Women’s & Children’s Hospital in Singapore for the last 12 years. Dr. Rajasegaran is also visiting consultant at the Eating Disorder Unit, at Singapore General Hospital and is an Adjunct Assistant Professor at Duke National University Singapore Medical School. She received her medical training at the University College Dublin, Ireland.
Dr Rajasegaran has been responsible for taking the lead in the further development of adolescent health, having been the joint recipient of a multi-million dollar health service development award. During this project she was successful at developing Adolescent Medicine as a distinct sub-speciality and multidisciplinary service. Under adolescent medicine, she has played a key role in the development of specialised obesity and eating disorder programmes within KKH. Specifically, she played a key role in the development of Family Based Treatment, in response to the large increase of referrals across the last few years. Furthermore, she was jointly responsible for the establishment of multidisciplinary service, SCAN, to manage suspected neglect and abuse of children, and has actively involved in projects aimed at facilitating better communication and collaborating between community resources, and different government sectors, for improved care of children and adolescents.
ARFID (Avoidant / Restrictive Food Intake Disorder)
Nutrition Symposium: Nutrition / Topics In Adolescent
14 October 2022 (1330-1500@Sipadan Hall 3)
ARFID is a new eating disorder diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM) fifth edition and essentially replaces “feeding disorders in infancy and childhood” that was described in DSM fourth edition, and which was restricted to children younger than 6 years. ARFID has no such age limitations and is distinct from eating disorders such as anorexia nervosa and bulimia nervosa with the absence of that drive for thinness and body image disturbances. However the failure to meet adequate nutritional needs results in both medical and psychological consequences. This talk will focus on treatment trends and developments thus far.
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Prof Kyung Mo Kim
Korea
Prof Kyung Mo Kim
Professor of Department of Pediatrics
Asan Medical Center Children's Hospital, University of Ulsan College of Medicine
Major Professional Experiences: (1996 ~ 2021)
Instructor in Pediatrics, University of Ulsan College of Medicine
Assistant Professor in Pediatrics, University of Ulsan College of Medicine
Associate Professor in Pediatrics, University of Ulsan College of Medicine
Professor in Pediatrics, University of Ulsan College of Medicine
Professional Societies:
President, Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (2015. 10~2017. 9)
Vice President of Korean Society of Gastroenterology (2016.11~2017.10)
Vice Dean of University of Ulsan College of Medicine (2010.3~2014.2)
Council and Execution Committee Member of APPSPGHAN (Asian-Pan-Pacific Society of Pediatric Gastroenterology, Hepatology and Nutrition)
President of APPSPGHAN 2023 Congress
Major Award:
Young Investigator Award of World Congress of Pediatric Gastroenterology, Hepatology and Nutrition (2000)
Professor of the Year of University of Ulsan College of Medicine 2008
Excellent Paper of The Korean Federation of Science and Technology Societies 2016
Paediatric IBD: How to make use of big data to predict incidence and outcome?
Gastro Symposium: Paediatric IBD 1
13 October 2022 (1600-1730@Sipadan Hall 1)
The development of IBD is known to be caused by environmental factors in hosts with a genetic predisposition. Changes in environmental factors are thought to be important factors in the development and prognosis of IBD compared to unchanging genetic factors. It has been reported that the incidence of IBD in Asian countries, including South Korea, is continuously increasing. The research of epidemiology in this region may be an important to find the factors of incidence and clinical outcomes of IBD in this region. As a source of bigdata, you can use the multi-hospital common data model or the public health data (PHD) provided by each country. PHD can provide the whole population depending on the supplied data from government and has the advantage of providing real world data in the study of such a rare disease as IBD. However, most of them are insurance claims data, which require an operational definition for accurate diagnosis, processing of data provided in code for anonymity, and statistical processing, which requires a multidisciplinary team approach. I would like to lecture on research using bigdata based on my personal research experience
ERCP In Children: Indications And Challenges
Endoscopy Symposium (Day 3)
15 October 2022 (0830-1000@Sipadan Hall 1)
To perform ERCP in children, there must first be data on the safety of the procedure. However, the current situation is that there is a lack of data on this topics. We expect the data from PEDI, a multi-center database comprised of 15 centers of patients less than 19 years old undergoing ERCP from May 2014 to May 2018, can provide answers to these questions partly in the future. The results of acute AE in pediatric ERCP to date have been reported similar to adults, according to meta analyses and a recent PEDI report. However, most ERCP procedures are accompanied by sphincterotomy, and there are no long-term reports of this. In our retrospective analysis, the incidence of gallstones, cholangitis, and biliary tract cancer was reported to be not high, demonstrating the long-term safety of the procedure. In children, the incidence of gallstones and hepatobiliary tract cancer is significantly lower than in adults, so number of ERCP in children is limited. However, due to the inability to diagnose with MRCP, the therapeutic aspect of being able to replace surgery, and the ability to perform biopsy, ERCP is an essential endoscopic procedure in children. In this lecture, based on the current data, I will lecture on the safety of pediatric ERCP and the indications for the procedure through the experience of the procedure.
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Prof Lau Yu Lung
Hong Kong
Prof Lau Yu Lung
Prof Yu Lung Lau graduated from the University of Glasgow in 1980. He is currently the Chair Professor of Paediatrics and Doris Zimmern Professor in Community Child Health of The University of Hong Kong (HKU). He has been Head of Paediatrics, Associate Dean of the Faculty of Medicine and Deputy Chief Executive of the Shenzhen Hospital of HKU, President of Hong Kong College of Paediatricians (HKCP) and Asia Society for Paediatric Research.
Prof Lau is a member of the WHO (WPRO) Technical Advisory Group for Immunisation and Vaccine Preventable Diseases. He is a member of the Advisory Panel on COVID-19 Vaccine for the HKSAR Government. He is the Chair of Scientific Committee on Vaccine Preventable Diseases and initiated universal childhood PCV vaccination as Chair of Working Group on Pneumococcal Vaccination. He helped introduce the universal screening for maternal HIV infection as Chair of the Scientific Committee on AIDS.
Prof Lau established the Asian Primary Immunodeficiencies Referral Network offering free genetic tests for over 2000 patients in Asia and Africa, and is the Founding President of the Asia Pacific Society for Immunodeficiency.
His research interests include genetics, infectious diseases and immunology. He has published over 400 original papers with h-index of 92 and supervised over 30 graduate students. He received the Outstanding Researcher Award, the Mrs Gordon Wu Exchange Professorship and the Faculty Knowledge Exchange Award, the Second Prize in Science and Technology of the Ministry of Education and the Outstanding Asian Pediatrician Award. He delivered the Guerrero Memorial Lecture, Inaugural Stuart Gan Memorial Lecture, Otto Wolff Lecture and Lata Kumar Lecture. He was awarded the Justice of Peace in 2020.
Primary Immunodeficiency In Gastrointestinal And Liver Diseases In Children
Plenary Lecture (Day 3)
15 October 2022 (1030-1200@Sipadan Hall 1)
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Prof Marc Benninga
Netherlands
Prof Marc Benninga
Professor Marc Benninga studied medicine at the University of Amsterdam, the Netherlands. After receiving his Medical degree he worked as a research fellow at the department of paediatric gastroenterology and nutrition at the Academic Medical Centre in Amsterdam with Jan Taminiau and Hans Büller.
He performed extensive research on constipation and faecal incontinence in childhood. Subsequently he was trained in paediatrics at the Wilhelmina Children’s Hospital in Utrecht, The Netherlands. After his paediatric training he performed research at The Women’s and Children’s Hospital, Adelaide, Australia with Geoff Davidson and Taher Omari. During his stay in Adelaide his research focussed on maturation of upper gastrointestinal motility in very young infants. In 1999 he became a staff member in the Academic Medical Centre in Amsterdam and currently he is the head of the department paediatric gastroenterology & Nutrition. Currently he is head of the department paediatric gastroenterology & Nutrition The focus of his current clinical and research work is gastro-oesophageal reflux disease, recurrent abdominal pain, constipation, functional non-retentive faecal incontinence and inflammatory bowel disease in childhood. He played in the Dutch National hockey team and competed at the Olympics in 1988, Seoul.
GERD: over diagnosis and over managed?
Gastro Symposium : Potpourri of GI disorders
13 October 2022 (1100-1300@Sipadan Hall 1)
Infantile colic: pathophysiology and management
Gastro Symposium : Potpourri of GI disorders
13 October 2022 (1100-1300@Sipadan Hall 1)
Intractable Functional Constipation: What Happens When Nothing Works?
Gastro Symposium: Constipation
14 October 2022 (1030-1200@Sipadan Hall 1)
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Assoc. Prof Marion Aw
Singapore
Assoc. Prof Marion Aw
A/Prof Marion Aw is a Senior Consultant in the Division of Paediatric Gastroenterology, Nutrition, Hepatology and Liver Transplantation, and the Paediatric Liver Transplantation Programme, National University Centre for Organ Transplantation at National University Hospital (NUH). She is also an Associate Professor at the Yong Loo Lin School of Medicine, National University of Singapore. She graduated from the National University of Singapore (NUS) and received her post-graduate paediatric training at the NUH. After completing her paediatric specialist training in Singapore, she spent 2 years with the Paediatric Liver Unit at King's College Hospital, London, United Kingdom. Her MD thesis (University of London) is based on clinical and research work done whilst she was there. A/Prof Aw’s area of clinical expertise is in paediatric gastrointestinal disease, hepatology and liver transplantation. She is a member of the National Liver Transplant Programme. A/Prof Aw also has an interest in nutrition and feeding issues in children. This led her to start the Interdisciplinary Feeding and Nutrition Clinic at NUH in 2013. In 2017, she set up the Paediatric Inflammatory Bowel Disease Regional Network and is the Chair of its EXCO. In addition to clinical practice, A/Prof Aw is also actively involved in the teaching and training of medical undergraduates and post-graduate paediatric doctors. At NUH, she is the Paediatric Department's Director of Postgraduate Training and Chair of the Graduate Medical Education Physician Wellbeing and Resilience Subcommittee. She is also the Vice Dean (Students) for the Yong Loo Lin School of Medical.
Paediatric Inflammatory Bowel Disease: The Next Epidemics In Asia?
Plenary Lecture (Day 3)
15 October 2022 (1030-1200@Sipadan Hall 1)
Breast Feeding & Oromotor Development
Nutrition and Growth Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
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Prof Mark Beattie
United Kingdom
Prof Mark Beattie
Professor R Mark Beattie is a Consultant Paediatric Gastroenterologist/Honorary Professor of Paediatric Gastroenterology and Nutrition in Southampton, UK and the lead for the Wessex Regional Paediatric Gastroenterology service. His main clinical and research interests include the Aetiology and Nutritional Management of Chronic Disease, particularly Inflammatory Bowel Disease. He is the clinical lead in the Southampton Paediatric IBD Genetics Research team. He has published widely in Paediatric Gastroenterology with more than 180 pubmed cited publications. He is the author of multiple clinical revision texts, and the Oxford Handbook of Paediatric Gastroenterology, Hepatology and Nutrition now in 2nd edition. He is Editor in Chief of Frontline Gastroenterology (2018 -) and Editor in Chief of BMJ Open Gastroenterology (2020 -). He was President of the British Society of Paediatric Gastroenterology, Hepatology and Nutrition from 2010-3 and Editor in Chief of Archives of Disease in Childhood, BMJ from 2012-7.
Optimising growth in the very preterm infants: Review the evidence
Nutrition Symposium : Nutritional Issues in Children: Special Consideration
13 October 2022 (1100-1300@Sipadan Hall 3)
Complicated Inflammatory Bowel Disease
Meet the expert session (Day 3)
15 October 2022 (0730-0830@Sipadan Hall 1)
Introduction to academic writing
Academic Writing Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
Presentation of current research work by participants (3 slides maximum each) followed by discussion
Academic Writing Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
Presentation of current research work by participants (3 slides maximum each) followed by discussion (Contd)
Academic Writing Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
Talk on publishing a paper
Academic Writing Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
Mock Editorial Committee (Selecting the best paper)
Academic Writing Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
Discussion/Conclusion
Academic Writing Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
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Dr Michelle Tan Li Nien
Singapore
Dr Michelle Tan Li Nien
National University Hospital
Dr. Michelle Tan graduated from the National University of Singapore in 2007 and received her postgraduate paediatric and neonatal training at the National University Hospital (NUH). She obtained her Membership of the Royal College of Paediatrics and Child Health (United Kingdom) and Masters of Medicine, Paediatrics (Singapore) in 2011, and completed her advanced specialist training in 2014.
In addition to general paediatric gastrointestinal diseases, Dr. Tan’s interests are in childhood nutrition, gut motility, gastro-esophageal reflux disease and feeding-related issues in children. She is also part of the multidisciplinary team running the Feeding Clinic in NUH.
She was awarded the TEAM Academic Medicine Development Award (AMDA) in 2014, for which she did an attachment in Cincinnati Children’s Hospital, specialising in children with aero-digestive issues. In 2016, she did an attachment in the gastroenterology unit at the Great Ormond Street Hospital and John Radcliffe Hospital in the United Kingdom under the AMDA scheme from the Ministry of Health.
Other than being involved in clinical work, Dr. Tan is a clinical tutor at the Yong Loo Lin School of Medicine (NUS). She is also part of the Faculty team (Paediatrics) of the NUHS Residency Programme involving education activities of residents
Nutrition in Special Populations-Eating and Nutritional Issues in Adolescents
Nutrition and Growth Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
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Prof Ni Yen Hsuen
Taiwan
Prof Ni Yen Hsuen
Dean, College of Medicine, Distinguished Professor of Pediatrics, National Taiwan University
Awards
Award for Excellence in Medical Service by National Taiwan University Hospital (2006, 2010)
Outstanding Research Award by National Taiwan University Hospital (2007, 2019)
Outstanding Research Award by Ministry of Science and Technology, Executive Yuan, Taiwan (2011, 2019)
Taiwan Pediatrics Association Award (2014)
Outstanding Teaching Award by National Taiwan University (2015, 2020)
Taiwan Pediatrics Association Medical Education Award (2020)
Research and Clinical Interests
Pediatric Liver Diseases: Viral Hepatitis, metabolic/genetic liver diseases, liver transplantation
Gut Microbiota
Pediatric Inflammatory Bowel Disease
Management of childhood Hepatitis B infection: State of the art approach
Plenary Lecture (Day 2)
14 October 2022 (0835-1005@Sipadan Hall 1)
Though different countries implement different HBV universal vaccination schedules, most programs consist of 3 doses of HBV vaccines and hepatitis B immunoglobulin (HBIG) in high risk groups. The first dose and the HBIG should be administered as early as possible after birth. Almost all the programs resulted in a good control of HBV infection.
Taiwan’s world’s first nationwide hepatitis B virus (HBV) universal vaccination program for infants is a good example of the successful vaccination to prevent chronic HBV infection and its subsequent cancer. The prevalence of hepatitis B surface antigen (HBsAg) carriers declined from 9.8% to 0.5% in children in Taipei City after 35 years of universal vaccination. In line with the decrease of chronic HBV infection, the incidence of pediatric hepatocellular carcinoma (HCC), which is related to chronic HBV infection and cirrhosis, also decreased. Up to 2000, the incidence of HCC per 100,000 children declined from 0.54 to 0.20 in Taiwan. We expect the universal vaccination program’s anti-cancer effect certainly will extend to adults.
Despite of the success of hepatitis B immunization, childhood chronic HBV infection and HCC have not been eliminated yet. Among those HBsAg carriers born after the vaccination program, nearly all of their mothers were positive for HBsAg. The importance of maternal transmission in the pathogenesis of chronic hepatitis B infection cannot be over-emphasized and should be intervened in the post-vaccination era. In addition to the primary prevention by vaccination, the efficacy of secondary and tertiary prevention of HBV-related complications by antiviral therapies was proven recently.
In conclusion, to eliminate HBV infection worldwide, we need to achieve the following three tasks: (1) to eradicate all of the infectious sources, (2) to interrupt every transmission route, (3) to immunize every individual. We need to screen out all the infectious pregnant mothers, minimize the risk of perinatal transmission, administer a universal immunization to the neonates, and adequately give the treatment to all vaccine failure cases.
Genetics of Metabolic Dysfunction-Associated Fatty Liver Disease: A New Perspective
Liver Symposium: Metabolic dysfunction-associated fatty liver disease: (NAFLD)
15 October 2022 (0830-1000@Sipadan Hall 2)
Obesity has already become a very important healthy issue worldwide. Nonalcoholic fatty liver disease (NAFLD) is a complex metabolic disease strongly associated with obesity and insulin resistance. It is not known why not every obese subjects develop NAFLD. Different ethnic/racial groups display differences in NAFLD prevalence, indicating genetic factor plays a role. The genetic approaches to dissect the genetic variations have been shown those genetic loci, including PNPLA3, TM6SF2, GCKR, MBOAT7, HSD17B13 may confer susceptibility to NAFLD in children and adults. PNPLA3 may be the most significant gene. Personalized prediction is required to guide risk stratification and treatment. Genetic variations provide novel insights into the NAFLD pathophysiology and may be incorporated into a predictive model for precision medicine in patients with NAFLD. High-throughput technologies, such as gene array and next generation sequencing, can facilitate the translation of genetic testing in the care of children with NAFLD. To date, genetic studies have successfully advanced our understanding in the pathogenesis of NAFLD, but there are still gaps in translating these genetic studies into clinical applications in the real world. Epigenetic alterations interacting with genetic variations further shape an individual’s susceptibility to NAFLD. A comprehensive analysis of personalized genetic and environmental factors may help assess the risk of children with NAFLD and adopt some early intervention by a precision medicine approach. We have shown the dysbiosisi of Desulfovibrio in NAFLD. Modulation of either genetic or microbiologic products can be the future targets of NAFLD treatment(s). Meanwhile, growing evidence indicates NAFLD could begin at birth or even in utero through a liver-specific programming mechanism. The early life period could be a critical window to prevent metabolic disorders in later life.
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Prof Nikhil Thapar
Australia
Prof Nikhil Thapar
Professor and Director of Gastroenterolog, Hepatology and Liver Transplant / Queesnland Children's Hospital, Brisbane
Professor Nikhil Thapar is Director of the Gastroenterology, Hepatology and Liver Transplant service at Queensland Children’s Hospital, Brisbane, Australia. He leads a specialist statewide multidisciplinary clinical service for children with gastrointestinal motility and functional disorders and was Academic Lead for Paediatric Gastroenterology and head of the Neurogastroenterology and Motility service at Great Ormond Street Hospital and University College London Great Ormond Street Institute of Child Health (London, UK). His research programme has focused on the pathogenesis and treatment of gut motility disorders including the potential of regenerative medicine as novel therapies for the most severe gastrointestinal neuromuscular disorders. Professor Thapar has published >100 original articles in these fields. He is co-editor of the textbook of Paediatric Neurogastroenterology, associate editor (Neurogastroenterology and Motility) for the Journal of Pediatric Gastroenterology and Nutrition and faculty lead for F1000 Prime. Professor Thapar sits on the Rome V committee (PaediatrIcs; lower GI) and chairs the Neurogastroenterology and Motility working group of the Asia Pan-Pacific Society of Paediatric Gastroenterology, Hepatology and Nutrition. He was previously chair of the Gastroenterology Committee of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition. He was a lead organizer of the 1st World Congress of Paediatric Neurogastroenterology and Motility held in Adelaide, Australia in April 2021.
How I Approach A Child With A Suspected GI Motility Disorder
Meet the expert session (Day 2)
14 October 2022 (0730-0820@Sipadan Hall 1)
Microbiota-Gut-Brain Axis and Childhood Functional Abdominal Disorders
Plenary Lecture (Day 2)
14 October 2022 (0835-1005@Sipadan Hall 1)
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Prof Oh Jean Yin
Singapore
Prof Oh Jean Yin
Dr Oh Jean Yin is a Senior Consultant with the Adolescent Medicine Service, in the Department of Paediatrics at KK Women’s & Children’s Hospital, Singapore. She completed her postgraduate training in Paediatrics with specialist training and experience in Adolescent Medicine from 2006 in KK Hospital and as a Fellow in the Division of Adolescent Medicine, Toronto Sick Children’s Hospital from 2008 to 2009. With support from the Ministry of Health for the promotion of Adolescent Health, the Adolescent Medicine Service initiated and developed services for young people with obesity and eating disorders, pregnant teens, and adolescents with chronic illness.
The work continues with KKH’s Child and Adolescent Weight Management Program with efforts to find effective interventions that are risk stratified and stage-based, within the continuum of care. Her team has studied a family-based program (Lifestyle Intervention for Everyone – LITE) which has shown promising results and continue to study novel approaches using digital platforms and in the community. She has spoken at various local and regional platforms on the stage-based approach for the management of Childhood Obesity. She is also currently a member of the Advisory Panel on Parenting (APOP) for the Ministry of Social and Family development (MSF) and was a member of the Healthy Youth Committee (HY-COM) for the Ministry of Education from 2009 – 2014. From her work in Adolescent Medicine with a focus on Childhood Obesity, she has developed an interest in inter-professional education and implementation science
Holistic Approach To Adolescent Obesity
Nutrition Symposium: Nutrition / Topics In Adolescent
14 October 2022 (1330-1500@Sipadan Hall 3)
The clinical approach and management of child and adolescent obesity has been outlined from screening to treatment plans including lifestyle intervention, behavioural modification and recommendations for weight management programs. While chronic disease model frameworks have detailed strategies that may help with successful approaches, the adolescent patient with obesity continues to have a fragmented journey that is fraught challenges.
A systems approach targeting the biopsychosocial aspects of adolescent obesity is important and providers will need to be aware of barriers and especially psycho-social co-morbidity which can made standard treatment challenging. More resources and care coordination is needed.
Dr Olakunle Oladehin
Director
Getting the Full Picture of Pneumococcal Vaccination
Sponsored Lunch Symposium by GlaxoSmithKline Pharmaceutical Sdn Bhd
13 October 2022 (@Sipadan Hall 1)
There are over 100 known serotypes of Streptococcus pneumoniae however only a minority of these serotypes cause the vast majority of the pneumococcal infections worldwide. Theserotypes that cause disease may be different from one country to another however pneumococcal conjugate vaccines have had a significant impact in reducing the overall burden of pneumococcal disease globally.
The effectiveness of pneumococcal conjugate vaccines should not be solely predicted based on its serotype content but on the net reduction of the burden of pneumococcal disease after its implementation. This net reduction is the sum of the vaccine type effectiveness (which is the serotypes included in the vaccine) and the cross protection, less by the replacement disease based on the natural history of disease progression.
Pneumococcal conjugate vaccines help to protect against pneumonia, severe and life threatening invasive pneumococcal disease (IPD) and the least life threatening but most frequently seen acute otitis media. It is estimated that almost 80% of children will have at least one episode of acute otitis media by the age of 3. Prevention through vaccination is key to reduce the direct and indirect costs of acute otitis media, pneumonia, and IPD. Paediatricians continue to play a pivotal role in advocating timely and complete vaccinations
to help reduce the burden pneumococcal diseases.
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Prof Robert Murray
United States of America
Prof Robert Murray
Professor of Pediatrics, Murray MD Nutrition LLC
Dr Robert Murray, MD, is an academic professor of Pediatrics in the College of Medicine at The Ohio State University. He completed his fellowship in Pediatric Gastroenterology at Children's Hospital, Columbus, Ohio in 1985. He spent more than 25 years in the Division of Pediatric Gastroenterology and Nutrition at Nationwide Children’s Hospital.
Prof. Murray’s primary areas of focus include biomedical nutrition and pediatric manifestations of malnutrition. He has published over 70 peer-reviewed articles, including most recently “A First Step Toward Eliminating Malnutrition: A Proposal for Universal Screening” in Pediatric Practice in Nutrition and Dietary Supplements. He has contributed to numerous books and public education projects, as well as to projects involving pediatric wasting, stunting, and obesity. Dr. Murray has served in many organisations; to say a few such as a member of the National Dairy Council Nutrition Advisory Committee, a member of the Children’s Hunger Alliance Governing Board, the vice-chair of the board of Action for Healthy Kids, and a collaborator with Abbott Nutrition International on nutrition education for pediatric practitioners.
Prof. Murray has received several awards. Most recently, he was a 2016 finalist for the Pathway to Populations Health Award for Columbus CEO Magazine. He was a recipient of the 2015 Child Advocate of the Year Award for Ohio Voices for Children. In 2008, he received a Special Achievement Award for obesity initiatives and Chairperson of the Year Award from the American Academy of Pediatrics (AAP).
Within the AAP, Dr Murray is currently their representative to the National Dairy Council Health Advisory Committee. He is the former chair of the AAP Council on School Health and is a past-president of the Ohio Chapter of the AAP
Bill Marshall Memorial Lecture : Malnutrition: the Child at Risk
Plenary Lecture (Day 1)
13 October 2022 (0830-0930@Sipadan Hall 1)
Traditionally, nutritional risk has been defined by growth failure, with clinical intervention indicated when a child falls below the 3rd-5th percentile on standardized growth charts. Although the rate of linear growth and weight gain are unparalleled during the first years, this period is also singularly unique for other reasons. Nutrition not only supports increased bone length, muscle mass, and tissue growth, but also the maturation of several highly metabolic organs, such as the gastrointestinal (GI) tract, the immune system, the cardio-respiratory system, and the central nervous system. Optimal growth depends on consistent nutrients, especially the brain, which consumes 60% of energy in the first year of life. Irrespective of weight status, the under-nourished child may exhibit compromised development and risk future cognitive performance. Establishing high diet quality during the months of complementary feeding is often challenging in early childhood. Pediatricians are uniquely positioned to identify the child with potential nutritional risk and design an appropriate intervention that preserves optimal growth and development.
Impact of Early Life Nutrition on Future Health
Nutrition and Growth Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
Nutrition and Growth: Monitoring growth and when to intervene
Nutrition and Growth Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
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Prof Sanja Kolacek
Croatia
Prof Sanja Kolacek
Sanja Kolaček is Professor of Paediatrics, Head of University Division of Paediatrics at the Children's Hospital Zagreb, Croatia. She is also chief of the Referral Center for Paediatric Gastroenterology and Nutrition in the Children's Hospital Zagreb
Prof. Kolaček is the current ESPGHAN President, and is/was also serving in different ruling and educational bodies of the ECCO, ESPEN, UEG and in various Croatian medical associations. Her editorial activities include being Associate Editor of the Journal of Pediatric Gastroenterology, Hepatology, and Nutrition (JPGN), and membership of the Advisory Board for the Journal of Crohn's and Colitis.
Her main clinical interests include chronic enteropathies and chronic intestinal failure, clinical nutrition and nutrition of healthy infants, while her present research activities are in the field of IBD, Coeliac disease, Probiotics and Disease-related malnutrition
How to feed a child with Neuromotor impairment
Nutrition Symposium : Nutritional Issues in Children: Special Consideration
13 October 2022 (1100-1300@Sipadan Hall 3)
Principles of Nutritional Support in Sick Children (cases studies) – Role of Nutrition support in critically ill or hospitalized child
Nutrition and Growth Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
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Dr Satoshi Nakano
Japan
Dr Satoshi Nakano
Assistant professor / Juntendo University
I have obtained M.D. degree in 2010 and Ph.D. degree in 2018. After the completion of training as general physician for 2 years, I have been working as a pediatrician with subspecialties in pediatric liver disease. I have joined to Dr. Hisamitsu Hayashi’s laboratory, The University of Tokyo, between 2015 to 2017 as a graduate student to conduct my doctoral program. The project results in his laboratory have been accepted by Scientific Reports (2019; 9: 17075). In 2020, I have started my carrier at Lund University, Cell Stem Center, Sweden, as a postdoctoral fellow. The topic of my research was ‘bile acid and oxysterol metabolism during ontogeny’. From April 2022, I began working as a pediatric hepatologist at Juntendo University.
Comprehensive and Informative Registry system for Childhood Liver Disease (CIRCLe): the Japanese experience
Liver Symposium : Neonatal cholestasis
13 October 2022 (1100-1300@Sipadan Hall 2)
Before CIRCLe - The environment surrounding pediatric cholestatic liver disease
There are many pediatric cholestatic diseases such as biliary atresia, Alagille syndrome, progressive familial intrahepatic cholestasis (PFIC)/ benign repetitive intrahepatic cholestasis (BRIC), citrin deficiency, Dubin-Johnson syndrome, Niemann-Pick disease type C, alpha 1-antitrypsin deficiency and bile acid metabolism disorder, which can lead to liver failure and death if not detected and treated early in childhood.
In Japan, registry studies existed only for biliary atresia, the most common of these diseases, but no registry system existed for the other diseases due to their rarity (1/10 to 1/100 of patients with biliary atresia).
The number of patients with pediatric cholestatic liver disease is small and scattered among various medical institutions, and the inability to consolidate patient information has delayed progress in elucidating the pathogenesis of the disease and in therapeutic research. In response to this situation, we established the Comprehensive and Informative Registry system for Childhood Liver disease (CIRCLe) in 2020.
CIRCLe has established a research website (https://www.circle-registry.org) to register and collect information on a wide range of pediatric cholestatic liver disease patients in various locations and to collect a large amount of clinical information and biological samples. CIRCLe also contributes to the diagnosis of patients by providing special tests (genetic analysis, bile acid analysis, and liver pathology; originally paid for by the patient) free of charge to patients with this disease group. CIRCLe aims to elucidate the natural history and prognostic factors of cholestatic liver disease in children and to develop and establish new diagnostic and therapeutic methods.
The number of participating medical institutions and registered cases has been steadily increasing since the start of full-scale operation in February 2021, with 38 prefectures and 70 medical institutions (all of which specialize in pediatric liver disease: covering 88% prefectures of Japan) participating and the cumulative number of cases reaching 100 (as of August 2022). The number of births in Japan in 2021 is 811,604, and considering that even biliary atresia, the most frequent cholestatic liver disease (1 in 10,000-15,000 births), theoretically only 54-81 births per year, CIRCLe (a registry system for pediatric cholestatic liver diseases excluding biliary atresia*) has performed well (*biliary atresia was excluded from the inaugural study because a dedicated registry study existed for this disease).
The introduction of CIRCLe has facilitated the treatment and research of pediatric patients with cholestatic liver disease, allowing many patients to undergo special tests through a simple procedure, and allowing valuable research materials to be stored in the registry and biorepository system.
The nickname "CIRCLe" is based on the idea of bringing together patients and their families, attending physicians and specialists, and researchers: creating a “circle”,"and is not intended to be a system that only benefits researchers and medical professionals. In order to realize this ideal, CIRCLe is currently developing a system that allows patients and their families to proactively participate in research. CIRCLe plans to expand the registry to other Asian countries in the future. We plans to use the CIRCLe system to provide special tests free of charge to people in Asia suffering from incurable diseases.
There are many pediatric cholestatic diseases such as biliary atresia, Alagille syndrome, progressive familial intrahepatic cholestasis (PFIC)/ benign repetitive intrahepatic cholestasis (BRIC), citrin deficiency, Dubin-Johnson syndrome, Niemann-Pick disease type C, alpha 1-antitrypsin deficiency and bile acid metabolism disorder, which can lead to liver failure and death if not detected and treated early in childhood.
In Japan, registry studies existed only for biliary atresia, the most common of these diseases, but no registry system existed for the other diseases due to their rarity (1/10 to 1/100 of patients with biliary atresia).
The number of patients with pediatric cholestatic liver disease is small and scattered among various medical institutions, and the inability to consolidate patient information has delayed progress in elucidating the pathogenesis of the disease and in therapeutic research. In response to this situation, we established the Comprehensive and Informative Registry system for Childhood Liver disease (CIRCLe) in 2020.
CIRCLe has established a research website (https://www.circle-registry.org) to register and collect information on a wide range of pediatric cholestatic liver disease patients in various locations and to collect a large amount of clinical information and biological samples. CIRCLe also contributes to the diagnosis of patients by providing special tests (genetic analysis, bile acid analysis, and liver pathology; originally paid for by the patient) free of charge to patients with this disease group. CIRCLe aims to elucidate the natural history and prognostic factors of cholestatic liver disease in children and to develop and establish new diagnostic and therapeutic methods.
The number of participating medical institutions and registered cases has been steadily increasing since the start of full-scale operation in February 2021, with 38 prefectures and 70 medical institutions (all of which specialize in pediatric liver disease: covering 88% prefectures of Japan) participating and the cumulative number of cases reaching 100 (as of August 2022). The number of births in Japan in 2021 is 811,604, and considering that even biliary atresia, the most frequent cholestatic liver disease (1 in 10,000-15,000 births), theoretically only 54-81 births per year, CIRCLe (a registry system for pediatric cholestatic liver diseases excluding biliary atresia*) has performed well (*biliary atresia was excluded from the inaugural study because a dedicated registry study existed for this disease).
The introduction of CIRCLe has facilitated the treatment and research of pediatric patients with cholestatic liver disease, allowing many patients to undergo special tests through a simple procedure, and allowing valuable research materials to be stored in the registry and biorepository system.
The nickname "CIRCLe" is based on the idea of bringing together patients and their families, attending physicians and specialists, and researchers: creating a “circle”,"and is not intended to be a system that only benefits researchers and medical professionals. In order to realize this ideal, CIRCLe is currently developing a system that allows patients and their families to proactively participate in research. CIRCLe plans to expand the registry to other Asian countries in the future. We plans to use the CIRCLe system to provide special tests free of charge to people in Asia suffering from incurable diseases.
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Prof Seak Hee Oh
Korea
Prof Seak Hee Oh
Professor
Educational Background
Graduate: College of Medicine, Kyung-Pook National University, Taegu, Korea 2003
PhD: Ulsan University of Ulsan College of Medicine, Seoul, Korea, 2018
Professional Career
Fellow of Pediatric Gastroenterology and Nutrition, Seoul Asan Medical Center 2010-2012
Post-fellowship doctor, Seoul Asan Medical Center 2012-2015
Assistant professor, Seoul Asan Medical Center 2016~2021
Associate professor, Seoul Asan Medical Center (current)
Research Field
Pediatric gastroenterology: very-early onset IBD, development of new biologics
Pediatric hepatology: acute liver failure, gene therapy for metabolic liver disease
Publications
ORCID ID: 0000-0002-9672-8877
Striving Towards Zero Mortality In Paediatric Liver Transplant: Importance Of Optimal Medical Care
Liver Symposium: Liver Transplantation in Asia
14 October 2022 (1330-1500@Sipadan Hall 2)
Liver transplantation is a treatment, used in children with end-stage liver disease. The ultimate goal of pediatric liver transplantation should be to achieve complete donor safety and zero recipient mortality. Fortunately, the outcomes of liver transplantation have been improved through advances in immunosuppression, surgical procedures, and the allocation system for liver donors. However, a salient fact that governs all in pediatric liver transplantation is that there are still post-operative mortalities despite our best attempts. Mortalities occur due to various causes; not only surgical issues but also post-operative medical issues. Herein, pediatric hepatologists must know perioperative issues in detail to optimize posttransplant survival. They include pretransplant conditions (candidate evaluation, waiting period, and nutrition), surgery (esp. immediate surgical complications), and early- and late- posttransplant courses (infection, immunosuppression). Guidelines from developed countries and experienced centers are truly important, but not enough to answer all real-world situations. Therefore, practitioner should gain his own deep insight into pediatric transplantation. I believe, based on generalized care guidelines and center-oriented experiences, comprehensive advances in meticulous management may eventually realize a zero-mortality rate in pediatric liver transplantation.
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Prof Seksit Osatakul
Thailand
Prof Seksit Osatakul
Seksit Osatakul, MD. Division of Gastroenterology, Department of Pediatrics, Faculty of Medicine
Prince of Songkla University, Songkla, Hat Yai
Dr. Seksit Osatakul is currently the Emeritus Professor of the Division of Pediatric Gastroenterology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Thailand. He received both M.D and the Thai Board of Pediatrics from the Faculty of Medicine, Ramathibodi Hospital, Mahidol University, then he trained in pediatric gastroenterology and hepatology at the Royal's Children Hospital, Brisbane, Australia.
His area of interest is functional GI disorders, particularly defecation disorders in children. He was the President of Thai Pediatric Society of Gastroenterology and Hepatology between 2014-2016. He has published about 40 articles.
Epidemiology of Constipation In Children
Gastro Symposium: Constipation
14 October 2022 (1030-1200@Sipadan Hall 1)
Functional constipation (FC) is a common health problem in children, as evidenced by data from a recent systematic review and meta-analysis on FC (Rome IV); which reported a pooled prevalence of 7 % (IQR; 3.5, 8) in infants, 18.5 % (IQR; 10, 26.5) in children aged 1-4 years, and 12 % (IQR; 4, 14) in children aged more than 4 years. In addition, a recent global survey study showed that FC accounts for overall 30% of patients attending pediatric gastroenterology clinics, worldwide. Epidemiological studies suggest that the prevalence of FC in Asia is significantly lower than other geographic regions. There have been studies demonstrating that, when using the same method of study, the prevalence of FC according to Rome III and Rome IV criteria in children aged > 4 years were comparable. There have been no conclusive evidence to support the association between FC with factors including gender, obesity, familial socioeconomic status, and exposure to stressful life events. However, it seems that history of FC in family, life style (diet and physical activity) are risk factors for childhood FC.
FC in children has a long clinical course. Only 50% of constipated children recover at one- year follow-up. About 20 % of children have persistence of FC into young adulthood. To date, studies concerning factors of influence on treatment outcomes of childhood FC have shown conflicting results. Therefore, it is needed that a good quality long term follow- up study, to determine predictive factors in regards to the clinical course of FC in children, takes place.
FC in children has a long clinical course. Only 50% of constipated children recover at one- year follow-up. About 20 % of children have persistence of FC into young adulthood. To date, studies concerning factors of influence on treatment outcomes of childhood FC have shown conflicting results. Therefore, it is needed that a good quality long term follow- up study, to determine predictive factors in regards to the clinical course of FC in children, takes place.
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Prof Shaman Rajindrajith
Sri Lanka
Prof Shaman Rajindrajith
Professor Shaman Rajindrajith graduated from the University of Ruhuna in 1996. He completed his postgraduate training in North Colombo Teaching Hospital, the Lady Ridgeway Hospital for Children in Colombo and in the John Radcliffe Hospital, University of Oxford, UK, where he was trained in paediatric gastroenterology during 2002-2004. He obtained his MD (paediatrics) in 1999 and MRCPCH (UK) in 2004, and FRCPCH (UK) in 2014.
He was appointed as the Chair professor of Paediatrics, University of Kelaniya in 2017, and currently serving as the Chair professor of Paediatrics, University of Colombo, since 2018. He is also a consultant paediatrician at the Lady Ridgeway Hospital for Children. He established and runs the only paediatric gastroenterology clinic of the country.
He is a keen researcher, especially in functional gastrointestinal disorders in children. In addition to that, he published widely on other paediatric gastrointestinal disorders including inflammatory bowel disease, and viral gastroenteritis as well. To date, he has 85 publications and a h-index of 32. He is the highest ranked paediatrician in the country in the AD Scientific Index in 2021.
He serves as a member of the editorial boards of several key journals including Journal of Neurogastroenterology and Motility, Indian Journal of Gastroenterology, World Journal of Gastroenterology, World Journal of Pediatrics, and Frontier Pediatrics. He is a member of the prestigious Rome V committee. Prof Rajindrajith is currently the President of Sri Lanka College of Paediatricians.
Pharmacological Management
Gastro Symposium: Constipation
14 October 2022 (1030-1200@Sipadan Hall 1)
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Dr Shin-Ichiro Hagiwara
Japan
Dr Shin-Ichiro Hagiwara
Dr Shin-Ichiro Hagiwara is Paediatric Gastroenterologist in Faculty in Dept. of Pediatric Gastroenterology, Nutrition and Endocrinology, Osaka Women’s and Children’s Hospital He was graduated from Jikei University School of Medicine (Tokyo in 2004 and obtained his PhD from Osaka University in 2022. Dr Shin-ichiro has published many papers in academic journals. He received young investigator and research awards in annual congress of the Japanese Society of Pediatric Gastroenterology, Hepatology and Nutrition. He is also involved in the guideline development of 2016 Japanese Pediatric endoscopy and he is youngest member among the guideline group.
Tips for Colonoscopy
Endoscopy Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
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Prof Suporn Treepongkaruna
Thailand
Prof Suporn Treepongkaruna
Division of Gastroenterology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University
Professor Dr. Suporn TREEPONGKARUNA was trained in Mahidol University, Bangkok, Thailand. Following that, she was trained in Pediatric Gastroenterology at Royal's Children Hospital, Melbourne, Australia. She is currently a Professor of Pediatrics in the Division of Pediatric Gastroenterology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand. She also serves as the assistant Dean for Academic Affairs of the same institution.
She has more than 75 scientific articles published mainly in the field of pediatric gastroenterology, hepatology and nutrition. She has also authored a total 80 book chapters in Thai language and is the editor/associate editor of 8 Thai Medical books. She is the current president of Asian Pan-Pacific Society for Pediatric Gastroenterology, Hepatology and Nutrition (APPSPGHAN) and the Secretary-Treasurer of FISPGHAN.
Mimics in Paediatric IBD: Special consideration in developing countries
Gastro Symposium: Paediatric IBD 1
13 October 2022 (1600-1730@Sipadan Hall 1)
Inflammatory bowel disease (IBD) comprises ulcerative colitis (UC), Crohn’s disease (CD), and IBD unclassified (IBD-U). IBD diagnoses require chronic inflammation in the GI tract and exclusion of other causes of inflammation, including infectious diseases, allergic diseases, vasculitis disorders, drugs, and primary immunodeficiency disorders. Accurate diagnosis of PIBD is based on a combination of history, physical examination, esophagogastroduodenoscopy, and ileocolonoscopy with histology and small bowel imaging. Investigations to exclude GI infections are mandatory. Diagnosis of PIBD in developing countries can be challenging due to limited facilities and a high prevalence of GI infections mimicking PIBD, including various bacteria, protozoa, fungi, and viruses. Initiation of immunosuppression and biologics for the treatment of presumptive diagnosis of IBD in individuals who are undiagnosed with infectious diseases could cause severe illness and dissemination of infection. In many developing countries, the prevalence of tuberculosis (TB) and intestinal amebiasis remains high, and both can mimic IBD. Investigations to exclude these two diseases are crucial for patients residing in the endemic area before diagnosing IBD.
Intestinal TB can mimic CD in both clinical presentations and endoscopic findings. Transverse ulcers, patulous IC valve, and isolated ileocecal involvement favor TB diagnosis, while longitudinal ulcers, cobblestoning, left-sided colonic lesions, luminal stricture, and fistula favor CD diagnosis. In a high endemic area, tuberculin skin test or interferon-gamma release assay, chest radiographs, and endoscopic biopsies for PCR for TB should be routinely performed in patients suspected of IBD. Histology of intestinal TB includes large and confluent granulomas, caseation necrosis, multinucleated giant cells, and absence of transmural crack and fissures (CD feature).
Intestinal amebiasis is caused by E. histolytica infection. Fulminant colitis and a liver abscess may develop after corticosteroid therapy. Stool antigen tests, stool PCR, or stool microscopy are typically used to diagnose intestinal amebiasis. Colonoscopic findings include discrete ulcerations, or flask-shaped ulcers, covered by exudate with skip area. Scrapings or biopsy specimens taken from the edge of ulcers may reveal cysts or trophozoites on microscopy.
In summary, many diseases mimic PIBD and should be excluded using careful clinical evaluation, relevant investigations, endoscopy, and histological examination.
References
Intestinal TB can mimic CD in both clinical presentations and endoscopic findings. Transverse ulcers, patulous IC valve, and isolated ileocecal involvement favor TB diagnosis, while longitudinal ulcers, cobblestoning, left-sided colonic lesions, luminal stricture, and fistula favor CD diagnosis. In a high endemic area, tuberculin skin test or interferon-gamma release assay, chest radiographs, and endoscopic biopsies for PCR for TB should be routinely performed in patients suspected of IBD. Histology of intestinal TB includes large and confluent granulomas, caseation necrosis, multinucleated giant cells, and absence of transmural crack and fissures (CD feature).
Intestinal amebiasis is caused by E. histolytica infection. Fulminant colitis and a liver abscess may develop after corticosteroid therapy. Stool antigen tests, stool PCR, or stool microscopy are typically used to diagnose intestinal amebiasis. Colonoscopic findings include discrete ulcerations, or flask-shaped ulcers, covered by exudate with skip area. Scrapings or biopsy specimens taken from the edge of ulcers may reveal cysts or trophozoites on microscopy.
In summary, many diseases mimic PIBD and should be excluded using careful clinical evaluation, relevant investigations, endoscopy, and histological examination.
References
- Levine A, Koletzko S, Turner D, et al. ESPGHAN revised Porto criteria for diagnosing inflammatory bowel disease in children and adolescents. J Pediatr Gastroenterol Nutr 2014;68:795-806.
- Shivashankar R, Lichtenstein GR. Mimics of inflammatory bowel disease. Inflamm Bowel Dis 2018;24:2315-21.
- Schofield JB, Haboubi N. Histopathological mimics of inflammatory bowel disease. Inflamm Bowel Dis 2020;26:994-1009.
- Limsrivilai J, Shreiner AB, Pongpaibul A, et al. Meta-analysis Bayesian model for differentiating intestinal tuberculosis from Crohn’s disease. Am J Gastroenterol 2017:112:415-27.
- Shirley DA, Moonah S. Fulminant amebic colitis after corticosteroid therapy: A systematic review. PLoS Negl Trop Dis 2016;10:e0004879.
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Prof Syed Asad Ali
Pakistan
Prof Syed Asad Ali
Associate Dean / Aga Khan University
Dr Syed Asad Ali is a Professor of Pediatrics in the Department of Pediatrics and Child Health, The Aga Khan University. He is the Associate Dean Research and The Noordin Noormahomed Sheriff Endowed Chair, AKU Medical College, Pakistan. He obtained his clinical training in Pediatrics at Duke University (USA), followed by a Fellowship in Pediatric Infectious Diseases and Masters in Public Health at the Vanderbilt University (USA) in 2009.
Dr. Ali maintains a broad clinical portfolio and participates actively in the advocacy of issues related to infectious disease and vaccines within Pakistan and in the region. He is a member of National COVID19 Vaccine Technical Committee of Pakistan and also the Chair of Adverse Events Following Immunization (AEFI) Review Committee, Ministry of National Health Services, Pakistan. He served as the general secretary of the Medical Microbiology and Infectious Diseases Society of Pakistan from 2013-2015. He currently serves as a Member of the International Pediatric Association (IPA) Strategic Advisory Group (SAG) on Environmental Health and as the President of AKU Medical College Alumni Association, Asia chapter.
Dr. Ali‘s research interests pertain broadly to pediatric public health challenges of developing countries, especially pneumonia, diarrhea and malnutrition. He has published over 110 peer-reviewed articles and contributes in numerous book chapters. He was the principal investigator of two PATH sponsored trials to study the factors responsible for lower immunogenecity of rotavirus vaccines in developing countries. He is the principal investigator of two Gates Foundation funded projects to better characterize environmental enteropathy, a key precursor of chronic malnutrition in children in developing countries. He is also the recipient of the Aga Khan University Award for Excellence in Research in 2022.
Environmental Enteropathy: Common Yet Underrecognised
Gastro Symposium: Diarrhoeal disorder in the developing countries
14 October 2022 (1330-1500@Sipadan Hall 1)
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Prof Tahmeed Ahmed
Bangladesh
Prof Tahmeed Ahmed
Executive Director icddr,b
Dr Tahmeed Ahmed is the current Executive Director of the International Centre for Diarrhoeal Disease Research, Bangladesh. He has been working for the last three decades in simplifying the treatment of maternal and childhood malnutrition, childhood tuberculosis, and diarrheal diseases. Together with Dr Jeffrey Gordon of Washington University in St. Louis he discovered microbiota directed complementary food (MDCF) - a novel intervention for childhood malnutrition. This discovery was highlighted by the prestigious journal Science as one of the scientific breakthroughs of 2019. He is continuing the research on MDCF in other countries in South Asia and Africa. He led the BEED (Bangladesh Environmental Enteric Dysfunction) study that validated non-invasive biomarkers of environmental enteric dysfunction, an important cause of stunting in children.
Dr Ahmed obtained his medical degree from Mymensingh Medical College and subsequently studied at the University of Tsukuba in Japan for his PhD. As a member of the Nutrition Guidance Expert Advisory Group of the WHO, Dr Ahmed revised the global guidelines for management of childhood acute malnutrition. Dr Ahmed was awarded the Bangladesh Academy of Science Gold Medal for outstanding achievement in Medical Science in 2003. He has more than 400 articles published in international journals and books. He is also Professor of Public Health Nutrition of James P. Grant School of Public Health, BRAC University, Dhaka as well as Affiliated Professor of School of Global Health, University of Washington, Seattle.
Microbiota-Directed Food Intervention in Undernourished children
Nutrition Symposium
13 October 2022 (1400-1530@Sipadan Hall 3)
Gut Microbiota and Childhood Undernutrition
Plenary Lecture (Day 3)
15 October 2022 (1030-1200@Sipadan Hall 1)
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Prof Takehisa Ueno
Japan
Prof Takehisa Ueno
Dr Takehisa UENO is the current director of Department of Transplantation Medicine at Osaka University Hospital, Osaka, Japan. He is also being appointed as an Associate professor in the Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Following his graduation from faculty of medicine, Osaka University, Japan in 1998, he received further training in The University of Tokyo Hospital, followed by Baylor University Medical Center, Texas, USA and University of Miami, Florida, USA as ASTS Transplant fellow. He published widely in the field of transplant medicine and pediatric surgery.
Short Bowel Syndrome and Small Bowel Transplantation
Nutrition Symposium: Intestinal failure/ Parenteral nutrition
14 October 2022 (1500-1630@Sipadan Hall 3)
The long-term prognosis of intestinal failure (IF), such as short gut syndrome, has been improved with the development of parenteral nutrition (PN). However, lack of central venous access or intestinal failure associated liver disease (IFALD) may make it difficult to continue. The ultimate treatment for IF is small bowel transplantation (SBT). However, SBT is not prevalent in all patients with SGS. In particular, the cases of SBT in Asia have been reported far behind that in Europe and the United States.
In recent years, multidisciplinary dietitians, nurses, pharmacists, and MSWs have collaborated on PN for medical treatment, surgical treatment, and SBT for IF, including SGS. Intestinal rehabilitation has become the standard treatment.
SBT has come to be positioned as one therapeutic option for intestinal rehabilitation. This will improve not only total care for IF, but also SBT for IF patients. Intestinal Transplant Association (ITA), which has long been a leader in small bowel transplantation internationally, changed its name to the Intestinal Rehabilitation and Transplantation Association (IRTA) in 2017. In this context, we will consider the treatment of SGS.
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Prof Toshiaki Shimizu
Japan
Prof Toshiaki Shimizu
Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine,
Professor Dr Toshiaki SHIMIZU is the current Professor and Chairman of the Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine. His area of expertise includes pediatric nutrition, Gastroenterology and neonatology.
His research interest is on the effects of n-3 PUFAs, pathophysiology of H.pylori infection, mucosal immunity of IBD, diagnosis and treatment of pancreatic diseases and the effects of probiotics. He was awarded the Lands Award by the Japan Society for Lipid Nutrition in 2011.
Effects of omega-3 fatty acids on health and disease in children
Nutrition Symposium
13 October 2022 (1400-1530@Sipadan Hall 3)
Omega-3 fatty acids are unsaturated fatty acids which have a double band at the third position from the terminal methyl group. In the body, they are synthesized from α-linolenic acid which is an essential fatty acid. However, the activity of enzymes turn this fatty acid into EPA and DHA is not enough, we must take foods which contain EPA or DHA in order to maintain the invivo levels of these ω-3 fatty acids. EPA and DHA are found abundantly in fish and shellfish, especially sardine, mackerel, saury and tuna. Human milk also contains ω-3 fatty acids which account for some two percent of the total lipid in the milk. Among the ω-3 fatty acids, DHA is thought to play some sighificant role in the development of the visual and brain functions through increase in the fluidity of nerve cell menbranes. On the other hand, EPA is considered to suppress inflammation, allergies, cancer and thrombosis by decreaing the production of inflammatory eicosanoids, such as PGE2, TXA2, LTB4, and LTC4. Moreover recent studies indicate some actions of DHA and EPA through intracellular signal transduction and gene expression. In this lecture, I’m going to introduce our clinical and animal studies concerning the usefulness of ω-3 fatty acids for neurological development, anti-inflammatory and anti-allergic functions, and gastrointestinal function. The results of recent studies about the effects of ω-3 fatty acids and fish oil on health and disease in children will be also added.
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Assoc. Prof Toshihiko Kakiuchi
Japan
Assoc. Prof Toshihiko Kakiuchi
Department of Pediatrics, Faculty of Medicine, Saga University
Dr. Toshihiko KAKIUCHI graduated from Jichi Medical School of medicine in year of 1999 and subsequently received further training in paediatrics gastroenterology and hepatology in The National Center for Child Health and Development, Tokyo, Japan, He is currently an associate professor of Paediatrics at Saga University, Japan.
Dr. KAKIUCHI research interests are in the field of Pediatric gastroenterology and Hepatology, Helicobacter pylori, New development of inspection equipment in the digestive field. He published widely in the field of pediatric gastroenterology and hepatology.
Strategies For Helicobacter Pylori Screening And Treatment In Junior High School Students To Eliminate Gastric Cancer
Endoscopy Symposium (Day 3)
15 October 2022 (0830-1000@Sipadan Hall 1)
Background and aim:
Helicobacter pylori (H. pylori) eradication therapy for children is thought to be effective for decreasing the risk of developing stomach cancer. We set up an administrative project of screening examination and treatment of H. pylori infection for those who got consent for third graders of all junior high schools and special support schools (108 schools) in Saga prefecture since 2016. Screening test, eradication treatment and eradication judgement for H. pylori were decided to start with the public expenditure grant.
Methods:
First, urinary anti-H. pylori antibody test using immune chromatography was implemented at the same time as school urinalysis performed every spring in Japan. Then, H. pylori stool antigen test was carried out in students who tested positive on the urinary test individually at home. If the two tests were positive, H. pylori eradication therapy was performed without upper GI endoscopy examination. After therapy, the sterilization judgment was carried out by using 13C-urea breath test.
Results:
After explaining about the project for the many related organizations such as the prefectural governor, prefectural board of education committee, municipal cancer counselor from each administrative side or the medical side, that was started. As a result of the six years from the starting of the project, the examination consent rates for children were 88.2% and the infection rates for H. pylori was 2.3% in PP analysis. Regarding the infection rate, it was somewhat higher in the mountain area, but correlation with the municipal population in the prefecture, three-generation cohabitation rate, water supply penetration rate, and stomach cancer incidence was not recognized. H. pylori eradication therapy was used of triple therapy with a potassium-competitive acid blocker (P-CAB), amoxicillin and clarithromycin. A total of 833 students received eradication therapy. Eradication rates were 85.0% in PP analysis. Adverse effects associated with eradication therapy were observed in 46 of 717 subjects (6.4%).
Conclusion:
We could have made this project possible in the prefecture unit for the first time in Japan for thanks to the multidisciplinary collaborators. First-line triple therapy with a P-CAB for H. pylori eradication in children was found to be safe.
Helicobacter pylori (H. pylori) eradication therapy for children is thought to be effective for decreasing the risk of developing stomach cancer. We set up an administrative project of screening examination and treatment of H. pylori infection for those who got consent for third graders of all junior high schools and special support schools (108 schools) in Saga prefecture since 2016. Screening test, eradication treatment and eradication judgement for H. pylori were decided to start with the public expenditure grant.
Methods:
First, urinary anti-H. pylori antibody test using immune chromatography was implemented at the same time as school urinalysis performed every spring in Japan. Then, H. pylori stool antigen test was carried out in students who tested positive on the urinary test individually at home. If the two tests were positive, H. pylori eradication therapy was performed without upper GI endoscopy examination. After therapy, the sterilization judgment was carried out by using 13C-urea breath test.
Results:
After explaining about the project for the many related organizations such as the prefectural governor, prefectural board of education committee, municipal cancer counselor from each administrative side or the medical side, that was started. As a result of the six years from the starting of the project, the examination consent rates for children were 88.2% and the infection rates for H. pylori was 2.3% in PP analysis. Regarding the infection rate, it was somewhat higher in the mountain area, but correlation with the municipal population in the prefecture, three-generation cohabitation rate, water supply penetration rate, and stomach cancer incidence was not recognized. H. pylori eradication therapy was used of triple therapy with a potassium-competitive acid blocker (P-CAB), amoxicillin and clarithromycin. A total of 833 students received eradication therapy. Eradication rates were 85.0% in PP analysis. Adverse effects associated with eradication therapy were observed in 46 of 717 subjects (6.4%).
Conclusion:
We could have made this project possible in the prefecture unit for the first time in Japan for thanks to the multidisciplinary collaborators. First-line triple therapy with a P-CAB for H. pylori eradication in children was found to be safe.
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Prof UJJAL PODDAR
India
Prof UJJAL PODDAR
Professor and Head, Department of Pediatric Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh
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Dr. Ujjal Poddar is presently the Professor and Head of the Department of Pediatric Gastroenterology at Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India. Dr. Poddar has graduated from North Bengal Medical College, West Bengal and received his postgraduate (MD) degree as well as doctorate in Gastroenterology (DM) from Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
He was actively involved in establishing the first academic super-specialty department of Pediatric Gastroenterology in India, in an awareness campaign about celiac disease in North India and neonatal cholestasis across India. He is the author of more than 180 publications, including original papers, reviews, and book chapters. His main research interest has been in the areas of celiac disease, portal hypertension, viral hepatitis B, neonatal cholestasis, and inflammatory bowel disease (IBD). He is the Section Editor (Gastroenterology) of Indian Pediatrics, the official journal of Indian Academy of Pediatrics and Associate Editor of Pediatric Gastroenterology, Hepatology, & Nutrition: Frontiers of Pediatrics.
Dr. Poddar received many National and International Awards, and also served as an active member of several International and National medical organizations, including European Society of Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN).He is the one of the two Pediatric Gastroenterologists from Asia featured in the World’s top 2% scientists in their respective field (Gastroenterology/ Hepatology).
Approach to Portal Hypertension in Children
Liver Symposium
13 October 2022 (1400-1530@Sipadan Hall 2)
Definitions:
Portal hypertension (PH) is defined as an increase in portal venous pressure of >5mm of Hg. The consequences of PH are the development of ascites, variceal bleeding, and hepatic encephalopathy. The etiology of PH is different in children than in adults. Non-cirrhotic portal hypertension such as extrahepatic portal venous obstruction (EHPVO) is found to be the commonest cause of PH in children in Asia. The most accurate way of assessing PH is hepatic venous pressure gradient (HVPG). Clinically significant portal hypertension (CSPH), is the state of PH when there is an increased risk of developing gastroesophageal varices, ascites, decompensation, and death, and is defined as HVPG>10mm of Hg. The presence of spider nevi, splenomegaly, and dilated tortuous abdominal wall veins are clinical findings that suggest the presence of CSPH. Esophageal varices develop when HVPG is ≥10mm of Hg and variceal bleeding happens when HVPG is >12mm of Hg. Hence, the presence of esophageal varices on endoscopy signifies CSPH. Since HVPG measurement is invasive, non-invasive tests (NIT) such as liver stiffness measurement (LSM) by transient elastography (FibroScan) with or without platelet counts have become popular in assessing the presence or absence of CSPH. As per Baveno VII (2022) guidelines on PH, CSPH is in when the FibroScan value is >25 kPa, and CSPH is out when it is <15 kPa. However, when the value is between 20-25 kPa then we need to add platelet counts (<150,000) to decide whether CSPH is there or not.
Diagnostic approach and primary prophylaxis:
As per Baveno VI (2015) recommendations, endoscopic variceal screening was recommended in all cases of chronic liver disease at the time of diagnosis and the subsequent management plan of PH was based on UGIE findings. However, in the latest Baveno VII guidelines, endoscopic variceal screening is done with, if there is no suspicion of CSPH. In such cases, yearly fibroscan and platelet counts are recommended. Endoscopic variceal screening is recommended when there is CSPH (LSM >20 kPa and platelet <150,000). Primary prophylaxis is recommended if there are large varices (>5mm) on endoscopy, presence of red-color signs (RCS), and the patient is in the Child-Pugh C stage of cirrhosis. Non-selective beta blockers (NSBBs) are the first choice and band ligation (EVL) is recommended if there is a contraindication or the patient is intolerant to NSBBs. Primary prophylaxis with NSBBs is recommended even in cases with low-risk varices if the patient has ascites.
Treatment options (secondary prophylaxis):
Acute variceal bleeding is managed with the combination of endotherapy (EVL or EST) plus vasoactive drugs (injection octreotide for 2-5 days followed with NSBBs). Refractory variceal bleeding in children can be controlled with balloon tamponade (Sengstaken Blakemore tube) followed by a transjugular intrahepatic portosystemic shunt (TIPS) in cirrhosis and portosystemic shunt surgery in EHPVO. Shunt surgery especially Meso-Rex shunt should be considered as a primary modality of treatment in cases with EHPVO with favorable anatomy (patent SMV and left branch of the portal vein).
Conclusions:
The etiology of portal hypertension in children is different than in adults and EHPVO is the commonest cause in Asia. The investigational approach to portal hypertension has been shifted from endoscopy to NIT such as liver stiffness measurement (LSM) with platelet counts. Non-selective beta blockers have become the preferred modality of treatment for primary prophylaxis against first variceal bleeding. Acute variceal bleeding is managed with EVL or EST with vasoactive drugs. Shunt surgery remains a preferred one-time treatment option in children with EHPVO.
Portal hypertension (PH) is defined as an increase in portal venous pressure of >5mm of Hg. The consequences of PH are the development of ascites, variceal bleeding, and hepatic encephalopathy. The etiology of PH is different in children than in adults. Non-cirrhotic portal hypertension such as extrahepatic portal venous obstruction (EHPVO) is found to be the commonest cause of PH in children in Asia. The most accurate way of assessing PH is hepatic venous pressure gradient (HVPG). Clinically significant portal hypertension (CSPH), is the state of PH when there is an increased risk of developing gastroesophageal varices, ascites, decompensation, and death, and is defined as HVPG>10mm of Hg. The presence of spider nevi, splenomegaly, and dilated tortuous abdominal wall veins are clinical findings that suggest the presence of CSPH. Esophageal varices develop when HVPG is ≥10mm of Hg and variceal bleeding happens when HVPG is >12mm of Hg. Hence, the presence of esophageal varices on endoscopy signifies CSPH. Since HVPG measurement is invasive, non-invasive tests (NIT) such as liver stiffness measurement (LSM) by transient elastography (FibroScan) with or without platelet counts have become popular in assessing the presence or absence of CSPH. As per Baveno VII (2022) guidelines on PH, CSPH is in when the FibroScan value is >25 kPa, and CSPH is out when it is <15 kPa. However, when the value is between 20-25 kPa then we need to add platelet counts (<150,000) to decide whether CSPH is there or not.
Diagnostic approach and primary prophylaxis:
As per Baveno VI (2015) recommendations, endoscopic variceal screening was recommended in all cases of chronic liver disease at the time of diagnosis and the subsequent management plan of PH was based on UGIE findings. However, in the latest Baveno VII guidelines, endoscopic variceal screening is done with, if there is no suspicion of CSPH. In such cases, yearly fibroscan and platelet counts are recommended. Endoscopic variceal screening is recommended when there is CSPH (LSM >20 kPa and platelet <150,000). Primary prophylaxis is recommended if there are large varices (>5mm) on endoscopy, presence of red-color signs (RCS), and the patient is in the Child-Pugh C stage of cirrhosis. Non-selective beta blockers (NSBBs) are the first choice and band ligation (EVL) is recommended if there is a contraindication or the patient is intolerant to NSBBs. Primary prophylaxis with NSBBs is recommended even in cases with low-risk varices if the patient has ascites.
Treatment options (secondary prophylaxis):
Acute variceal bleeding is managed with the combination of endotherapy (EVL or EST) plus vasoactive drugs (injection octreotide for 2-5 days followed with NSBBs). Refractory variceal bleeding in children can be controlled with balloon tamponade (Sengstaken Blakemore tube) followed by a transjugular intrahepatic portosystemic shunt (TIPS) in cirrhosis and portosystemic shunt surgery in EHPVO. Shunt surgery especially Meso-Rex shunt should be considered as a primary modality of treatment in cases with EHPVO with favorable anatomy (patent SMV and left branch of the portal vein).
Conclusions:
The etiology of portal hypertension in children is different than in adults and EHPVO is the commonest cause in Asia. The investigational approach to portal hypertension has been shifted from endoscopy to NIT such as liver stiffness measurement (LSM) with platelet counts. Non-selective beta blockers have become the preferred modality of treatment for primary prophylaxis against first variceal bleeding. Acute variceal bleeding is managed with EVL or EST with vasoactive drugs. Shunt surgery remains a preferred one-time treatment option in children with EHPVO.
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Prof Xia Qiang
China
Prof Xia Qiang
President of Renji Hospital, Shanghai Jiao Tong University School of Medicine
Professor Qiang XIA is the current President of Renji Hospital, Shanghai Jiao Tong University School of Medicine and the director of the Department of Liver Surgery and Transplantation. He is the leading expert in liver transplantation and liver surgery, including living donor and split liver transplantation. Over 6,000 cases of liver transplantation has been performed by his unit since 2004.
Professor XIA’s main research focused and publications are on ischemia/reperfusion injury, primary liver cancer and post-LT immune tolerance. He has conducted multi-centric clinical studies and published clinical guidelines on pediatric liver transplantation. He is the Chief Scientist for a National Key R&D Program of China and had received multiple grants in total 40 million RMB. He has received multiple awards in recognition of his contribution, notably the National Science and Technology Progress Award.
Paediatric Liver Transplant in Asia Pacific: Current Status and Expanding the Horizon
Plenary Lecture (Day 1)
13 October 2022 (0830-0930@Sipadan Hall 1)
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Prof Xue Feng
China
Prof Xue Feng
Director, Liver Surgery Dept. Paediatric Ward，Professor Doctor, Doctoral Supervisor，RenJi Hospital, SITU School of Medicine
Prof. Xue has been working in Paediatric liver transplantation for long time, she is responsible for intractable LT cases and MDT management, and is the core member of Ren Ji Hospital “Belt and Road” Project. She has publication over 80 papers, first /corresponding author over 60. She participated in compilation of 5 professional books, and patented 3 inventions.
Effect And Influencing Factors Of Vaccination Before And After Liver Transplant
Liver Symposium: Liver Transplantation in Asia
14 October 2022 (1330-1500@Sipadan Hall 2)
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Prof Yong Joo Kim
Korea
Prof Yong Joo Kim
Professor of Pediatrics, College of Medicine, Hanyang University
Professor Yong Joo KIM is a current Professor of Pediatrics, at the College of Medicine, Hanyang University, Korea. She was awarded a Ph.D. in 1994 from the Hanyang University, Korea. She has multiple academic publication in the field of Pediatric gastroenterology and nutrition. Professor KIM is active in multiple professional societies and was the past President of The Korean Society of Pediatric Gastroenterology and Nutrition.
The immunomodulatory properties of breastmilk
Nutrition Symposium: Breastfeeding and complementary feeding
13 October 2022 (1600-1730@Sipadan Hall 3)
Human neonates and infants are unable to develop a mature immune system promptly. Breast feeding at this stage of their lives is important as human milk contains bio-compound that can protect them against specific infections. The bioactive components of human milk are known to have antimicrobial, anti-inflammatory, and immunomodulatory effects and can therefore contribute to an infant’s immunity against allergies, asthma, autoimmune diseases, and inflammatory bowel disease. The bioactive factors are the nutritional components (macronutrients, lactoferrin, transferrin, vitamin B12-binding protein), hormones (erythropoietin, prolactin, insulin, gonadotropins, ovarian steroids, thyroid-releasing hormone, thyroid-stimulating hormone, etc.), growth factors (epithelial growth factor, insulin-like growth factor, etc.), neuropeptides (neurotensin, somatostatin, bombesin, etc.), cytokines (TNFα, IL-6, etc.), prebiotics, and nucleotides. The immunological factors in human milk are human milk leukocytes, lymphocytes, proinflammatory cytokines, immunoglobulins, etc. Human milk oligosaccharides is very important in immunomodulatory effects of human colostrum and milk, enhancing immune function, protecting and favoring gastrointestinal mucosa integrity and barrier function. The ingredients in human milk that contribute to its immunomodulatory effects are very diverse, and each bears characteristics that need to be individually well studied. Such knowledge can lead to effective education for breastfeeding mothers and ultimately help to augment the health of their babies. Key Words: Human milk; Immunomodulatory effect; Breastfeeding
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Prof Yoshiko NAKAYAMA
Japan
Prof Yoshiko NAKAYAMA
Shinshu University School of Medicine
Professor Dr. Yoshiko NAKAYAMA was awarded a Medical Degree in the year of 1992 from Shinshu University Graduate School of Medicine, Matsumoto, Japan. Subsequently,she was awarded Doctor of Philosophy in Medicine in 2004 from the same institution. She is the current chief of Pediatric Endoscopy Center of Shinshu University Hospital Matsumoto, Japan. Professor Nakayama also serves as the director of The Japanese Society for Pediatric Gastroenterology, Hepatology and Nutrition. She has published widely in the field of paediatric gastroenterology and has been awarded multiple grants to fund her research. She was appointed as an associate editor of Clinical Journal of Gastroenterology since the year of 2018.
Sedation and monitoring for endoscopy
Endoscopy Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
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Prof Yu-Cheng Lin
Taiwan
Prof Yu-Cheng Lin
Far Eastern Memorial Hospital
Dr. Yu-Cheng Lin is a pediatric gastroenterologist at Department of Pediatrics, Far Eastern Memorial Hospital, New Taipei City, Taiwan. He is the Vice Secretary General of the Taiwan Society of Pediatric Gastroenterology, Hepatology and Nutrition (TSPGHAN
Diagnosis and Management
Liver Symposium: Metabolic dysfunction-associated fatty liver disease: (NAFLD)
15 October 2022 (0830-1000@Sipadan Hall 2)
Nonalcoholic fatty liver disease (NAFLD), or the recently redefined metabolic-associated fatty liver disease (MAFLD), is a progressive liver disease that has become a public health problem in children. The pathogenesis of MAFLD is multifactorial; it is strongly associated with obesity and insulin resistance. However, not all obese children develop MAFLD, suggesting that genetic and environmental factors can modify an individual's susceptibility to MAFLD.
In recent years, important advances have been made in the diagnosis, etiology, genetics, and management of NAFLD. However, better care of children with MAFLD requires a greater understanding of the natural history and pathogenesis, with particular attention to the interplay of dietary, genetic, gut microbiome, and environmental factors. These advances can help determine which children will benefit most from intensive multidisciplinary care and specific treatment.
Clinically, serum alanine aminotransferase and liver ultrasonography are first-line tools for screening children with suspected MAFLD. Liver biopsy remains the gold standard for accurate assessment of the severity of MAFLD in children, but it is invasive. To better stratify high-risk patients and monitor patient response to therapy, the development and validation of non-invasive biomarkers and imaging modalities will be invaluable. However, serological tests, such as the Fibrosis-4 index (FIB-4), AST to platelet ratio (APRI), etc., are not as predictive in children as they are in adults. More studies are needed to establish serological scores specific for pediatric MAFLD. Likewise, validated cut-offs for controlled attenuation parameters and liver stiffness are lacking when using vibration-controlled transient elastography (VCTE) in children with MAFLD.
Currently, lifestyle interventions remain the cornerstone of obesity and MAFLD treatment. In clinical practice, however, it is uncommon to rely on lifestyle interventions to achieve meaningful and sustained weight loss in children. To date, no drug has been formally approved, although many pharmacological strategies have been tested in MAFLD clinical studies. In the future, a comprehensive analysis of individualized genetic and environmental factors will facilitate accurate assessment of risk and individualized treatment for children with MAFLD.
In recent years, important advances have been made in the diagnosis, etiology, genetics, and management of NAFLD. However, better care of children with MAFLD requires a greater understanding of the natural history and pathogenesis, with particular attention to the interplay of dietary, genetic, gut microbiome, and environmental factors. These advances can help determine which children will benefit most from intensive multidisciplinary care and specific treatment.
Clinically, serum alanine aminotransferase and liver ultrasonography are first-line tools for screening children with suspected MAFLD. Liver biopsy remains the gold standard for accurate assessment of the severity of MAFLD in children, but it is invasive. To better stratify high-risk patients and monitor patient response to therapy, the development and validation of non-invasive biomarkers and imaging modalities will be invaluable. However, serological tests, such as the Fibrosis-4 index (FIB-4), AST to platelet ratio (APRI), etc., are not as predictive in children as they are in adults. More studies are needed to establish serological scores specific for pediatric MAFLD. Likewise, validated cut-offs for controlled attenuation parameters and liver stiffness are lacking when using vibration-controlled transient elastography (VCTE) in children with MAFLD.
Currently, lifestyle interventions remain the cornerstone of obesity and MAFLD treatment. In clinical practice, however, it is uncommon to rely on lifestyle interventions to achieve meaningful and sustained weight loss in children. To date, no drug has been formally approved, although many pharmacological strategies have been tested in MAFLD clinical studies. In the future, a comprehensive analysis of individualized genetic and environmental factors will facilitate accurate assessment of risk and individualized treatment for children with MAFLD.
LOCAL FACULTY
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Dr Alvin Khoh
Dr Alvin Khoh
Consultant Paediatric Gastroenterologist and Hepatologist, Department of Paediatrics, Gleaneagles Hospital Kota Kinabalu, Sabah
Dr Alvin Khoh Kim Mun is a senior Paediatric Gastroenterologist and Hepatologist practising at Gleneagles Hospital Kota Kinabalu. He is also the visiting gastroenterologist at Women and Children’s Hospital of Likas, Sabah. He has very extensive experience in interventional paediatric endoscopy.
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Prof Azanna Ahmad Kamar
Prof Azanna Ahmad Kamar
Dr. Azanna Ahmad Kamar is an Associate Professor and Consultant Neonatologist at the Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. She trained in Paediatrics at the Paediatric Institute, Hospital Kuala Lumpur, and in the Republic of Ireland, where she worked at the Rotunda Hospital, Our Lady’s Hospital for Sick Children Crumlin, and the Coombe Women and Infants’ University Hospital. She is currently the head of the Neonatal Intensive Care Unit (NICU) the of University of Malaya Medical Centre (UMMC).
Her main interests include paediatric bioethics, infection control, ventilation, medical education, infant nutrition, neonatal transport & resources, quality improvement initiatives, systematic reviews, and neonatal innovations. She completed her certification in Paediatric Bioethics from Children’s Mercy Hospital, University of Missouri, Kansas City, USA in 2016, and teaches the Special Population course of Masters of Health in Research Ethics (MOHRE). Specific bioethics interests include neonatal end-of-life issues, medical innovations & their impact, technology dependence, shared-decisions, and sociocultural influences in decision making.
She is also the past President of the Perinatal Society of Malaysia (Council 2016/2017) and a current council member; a member of the Malaysian Bioethics Community (MBC) and Clinical Ethics Malaysia (CEM); a writing team member of the South East Asia Early Nutrition Academy (ENEA-SEA) e-learning infant nutrition platform under EU-Erasmus e-learning collaboration; the head of the Research and Publications committee of the Federation of Asia-Oceania Perinatal Societies (FAOPS); a steering committee member of the Malaysian National Neonatal Registry (MNNR); chairperson of the scientific committee of the FAOPS 2022 congress; a champion of the Malaysian Prematurity Awareness Programme; and was a past Organising/ Scientific Chair of the Kuala Lumpur International Neonatology Conference (KLINC).
The First 1000 Days: Challenges of The Preterm Infant
Nutrition Symposium: Breastfeeding and complementary feeding
13 October 2022 (1600-1730@Sipadan Hall 3)
The increasing prevalence of babies born preterm, especially those delivered at lower gestations, has caused significant neonatal management challenges to ensure their optimal long-term outcomes with an appropriately high health-related quality of life. Infants delivered preterm face unique challenges from the time that they are within the confines of the mother’s womb. The first 1000 days refers to the period most vulnerable to epigenetic modification or trauma, from the period of conception, right through to the embryonic, perinatal period, and subsequent lactation period, up until the infant reaches the age of 2 years. The initial adverse intrauterine exposure that predisposes preterm delivery, for example, chronic intrauterine hypoxia secondary to placental insufficiency may continue to exert significant effects on the physiologically immature infant until adulthood. The challenges faced during the preterm infant’s first 1000 days would therefore result in conditions unique to preterm infants who experience an initial nutrition phenomenon of failure to meet nutritional demands whilst being physiologically immature, within a hostile ex-utero environment that fails to support the period for occurrence of the most rapid neurodevelopmental growth. The difficulty in meeting these nutritional challenges can further worsen the medical outcomes of preterm infants. The morbidities associated with preterm delivery such as bronchopulmonary dysplasia, retinopathy of prematurity, and periventricular leukomalacia may further adversely affect the preterm infant’s gut microbiota, affecting their long-term growth and neurodevelopmental outcomes, including affecting their future risks of developing non-communicable diseases. This talk provides an overview of the evidence and research surrounding these challenges and summarises the support required for the period of the first 1000 days of the preterm infant to ensure their optimal outcomes, i.e., from the intrauterine period that the infant is determined to be at risk of fetal compromise, up until the age of 2 years.
Dr Chai Pei Fan
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Dr Cheang Hon Kit
Dr Cheang Hon Kit
Consultant Paediatrician & Neonatologist, Head Department of Paediatrics, Hospital Lam Wah Ee, Penang
- Member of Expert Panel of IMFeD for Growth Programme, MPA
- Member of Joint Ethics Committee, School of Pharmaceutical Science, USM-Hospital Lam Wah Ee
Dealing with Common Feeding Issues in Infants and Children (Cases to illustrate) Promoting Positive Eating Behaviours
Nutrition and Growth Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
Feeding difficulties are commonly reported by parents with normally developing children and it is even more frequently encountered among children with neurodevelopmental disabilities and chronic illnesses. There is no universally accepted definition or classification system on feeding difficulty, but these children typically have difficulty in consuming adequate quantity, quality, or variety of food. Etiological factors contributing to feeding difficulties are often multifactorial, including structural abnormalities, neurological conditions, medical illnesses, incorrect feeding practices and poor mealtime habits, as well as inappropriate feeding styles of caregivers.
Early recognition and management are important when dealing with children with feeding problems. A comprehensive clinical assessment, including parental report (parents’ perceptions of mealtime behaviours and food intake), review of the child’s health and developmental, feeding and growth history, thorough physical examination to detect signs of underlying organic diseases or malnutrition, as well as accurate anthropometric measurement, may help to identify the presence and severity of a feeding problem. Children who demonstrate red flag symptoms and signs will need prompt attention and may benefit from further laboratory investigation and referral to the appropriate specialists or multidisciplinary teams. A systematic and tailored approach, addressing both the children’s feeding behavior and the parents’ feeding practice, will ensure better outcome of
the affected children.
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Dr Chong Sze Yee
Dr Chong Sze Yee
Paediatric Gastroenterologist, Head of Paediatric Gastroenterology Service
Ministry of Health Malaysia Department of Paediatrics Hospital Raja Permaisuri Bainun, Ipoh, Perak
He received his basic paediatric training in Universiti Malaya. In 2010, he started his subspecialty training in the field of Paediatric Gastroenterology, Hepatology & Nutrition in various centres including Universiti Malaya, Hospital Selayang and Royal Children's Hospital Melbourne, Australia. Currently he serves as Paediatric Gastroenterologist in the Department of Paediatrics, Hospital Raja Permaisuri Bainun, Ipoh, Perak. He is the head of Paediatric Gastroenterology service for Ministry of Health Malaysia and sits in Subspecialty Committee of Paediatric Gastroenterology, National Specialist Registry. His main clinical interests are infant nutrition, food allergy, functional gastrointestinal disorders and inflammatory bowel disease. He is actively involved in medical education, research and publication.
Nutrition in Special Populations-The child with food allergies
Nutrition and Growth Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
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Prof Christopher Boey Chiong Meng
Prof Christopher Boey Chiong Meng
Dr Boey graduated in medicine from the University of London and underwent further training in paediatrics and gastroenterology in the United Kingdom, Australia, Japan and Singapore.
He was appointed a lecturer in the Department of Paediatrics at the Faculty of Medicine, University of Malaya on March 16th, 1992 and continues to serve the university to this day. In June 2005, he was appointed Vice-President of the Asian Pan-Pacific Society of Paediatric Gastroenterology, Hepatology and Nutrition and became its President in August 2008. He was also the Deputy Dean of Faculty of Medicine of University of Malaya from 2011 till 2019, then the Head of Paediatrics Department of University of Malaya Medical Centre from April 2021 till October 2022.
In 2013 Dr Boey received the award of Darjah Setia Pangkuan Negeri (DSPN) from the Governor of Penang , his hometown, which carries with it the title of Dato’.
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Prof Firdaus Binti Mamat @ Mukhtar
Prof Firdaus Binti Mamat @ Mukhtar
Hospital Pengajar UPM (HPUPM)
SCIENTIFIC EXPERIENCE AND SPECIALIZATION
- Deputy Dean, School of Graduate Studies, UPM
- Professor, Universiti Putra Malaysia (2019)
- Associate Professor, Department of Psychiatry, Psychology Program, Universiti Putra Malaysia
- Senior Lecturer, Department of Psychiatry, Universiti Putra Malaysia (6th July 2009- 2016)
- Guest Lecturer, Universiti Kebangsaan Malaysia for Master of Clinical Psychology Program
- Guest Lecturer, HELP University College for Master of Clinical Psychology Program (2011)
- Guest Lecturer, Universiti Sains Islam Malaysia for Year 5 Medical Program (2012)
- Guest Lecturer, Consultant Clinical Psychologist, Hospital Kajang & Hospital Kuala Lumpur
- Senior Lecturer, School of Allied Health Sciences, Universiti Sains Malaysia
- Lecturer, School of Medical Sciences, Universiti Sains Malaysia
Nutrition in Special Populations- Feeding the child on the spectrum
Nutrition and Growth Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
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Dr Foo Hee Wei
Dr Foo Hee Wei
General paediatrician and paediatric gastroenterologist and hepatologist, Hospital Selayang, Malaysia
Professional experience in Paediatric Gastroenterology and Hepatology
- Fellow in paediatric gastroenterology, hepatology and clinical nutrition, The Royal Melbourne Children’s Hospital, Melbourne
- Fellow in paediatric gastroenterology and hepatology, Hospital Selayang, Malaysia
- Fellow in paediatric gastroenterology and hepatology, University of Malaya Medical Centre
Professional experience in Paediatric Medicine
- General Paediatrician, Hospital Tengku Ampuan Afzan, Malaysia
- Specialist registrar in general paediatrics, Hospital Selayang, Malaysia
- Specialist registrar in general paediatrics, University of Malaya Medical Centre, Malaysia
- Specialist registrar in general paediatrics, Hospital Selayang, Malaysia
- Medical officer in Urology Department, Hospital Selayang, Malaysia
- Medical officer in community ambulatory clinics, Pahang, Malaysia
Professional Affiliations
- Life member, Malaysian Paediatric Association
- Member, Asian Pan -Pacific Society for Pediatric Gastroenterology Hepatology and Nutrition 3. Member, International Liver Transplantation
Dr Khoo Phaik Choo
Consultant Paediatrician
Subang Jaya Medical Centre (SJMC)
The Essentials of Prevention Through Hexavalent Vaccine
Sponsored Lunch Symposium by GlaxoSmithKline Pharmaceutical Sdn Bhd
13 October 2022 (@Sipadan Hall 1)
In her presentation, Dr Khoo highlights the sciences behind pertussis vaccines, with particular focus on the function of pertactin (PRN). PRN is a pertussis antigen which is expressed on the surface of Bordetella pertussis. Anti-PRN antibodies are able to effectively trigger the complement system and facilitate phagocytosis of the pathogen, leading to reduced bacterial load. Evidence shows that PRN-containing pertussis vaccines appear to have higher vaccine efficacy against pertussis, with up to 89% vaccine efficacy in one publication.
Safety is of the utmost importance when making an informed decision for their child's vaccines. A safety meta analysis on the hexavalent vaccine was published last year, and the publication highlights potential differences between vaccines when it comes to local and systemic adverse events.
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Prof Lee Way Seah
Prof Lee Way Seah
Professor Lee Way Seah is Senior Professor at Faculty of Medicine and Health Sciences, University Tunku Abdul Rahman (UTAR), Malaysia and Honorary Professor in Paediatrics, Department of Paediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur. He specializes in childhood GI and liver disease and nutritional issues. His main research interest is pediatric inflammatory bowel disease, neonatal and childhood liver disease, and childhood nutrition. He is a past President of College of Paediatrics, Academy of Medicine of Malaysia, as well as a Commonwealth Scholar and a Fulbright Scholar. He is currently a council member of Asian Pan-Pacific Society for Pediatric Gastroenterology, Hepatology and Nutrition (APPSPGHAN). Professor Lee has published more than 110 articles in academic journals as well as edited 4 textbooks in general paediatrics and paediatric gastroenterology/hepatology.
APPSPGHAN PIBD working group POSITION PAPER: Management and monitoring in Asia Pacific Region
Gastro Symposium (Day 2)
14 October 2022 (1500-1630@Sipadan Hall 1)
The incidence of pediatric inflammatory bowel disease (PIBD) is rising rapidly in many industrialised and affluent areas in the Asia Pacific region. There are obvious differences in disease characteristics of PIBD between Asian and Caucasian children. Current available guidelines, mainly from Europe and North America, may not be completely applicable to clinicians caring for children with PIBD in this region due to differences in disease characteristics and regional resources constraints. Many parts of Asia are endemic for tuberculosis, making diagnosis and management of pediatric Crohn’s disease a challenge. In some populations in Asia, the Nudix Hydrolase 15 (NUD15) gene is a better predictor of leukopenia induced by azathioprine than thiopurine-S-methyltransferase (TPMT). The main considerations in the use of biologics in the Asia Pacific region are high cost, ease of access, and potential infectious risk, especially tuberculosis. This Position Paper is an initiative from the APPSPGHAN with the aim of providing an up-to-date, evidence-based approach to PIBD in the Asia Pacific region. A group of pediatric gastroenterologists with special interest in PIBD performed an extensive literature search covering epidemiology, disease characteristics and natural history, management and monitoring. Attention was paid to publications from the region with special consideration to a resource-limited setting. This Position Paper concentrates on medical and surgical management, disease monitoring, complications, immunization, bone health and nutritional issues of PIBD in Asia. A special section on differentiating pediatric Crohn’s disease and management of tuberculosis in children with IBD is included. Conclusion: This Position Paper provides a useful guide to clinicians in the management of children with PIBD in the Asia Pacific region.
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Prof Muhammad Yazid Jalaludin
Prof Muhammad Yazid Jalaludin
Professor Dr Muhammad Yazid Jalaludin is currently The Deputy Dean (Undergraduate Studies) at the Faculty of Medicine, University Malaya, after serving as the Head of Department of Paediatrics UM from 2016 to 2021. He works as a Senior Consultant Paediatrician and Senior Consultant Paediatric Endocrinologist at the University Malaya Medical Centre (UMMC) and as Professor of Paediatrics at the Faculty of Medicine, Universiti Malaya. He completed his fellowship in Pediatric Endocrinology and Diabetes at Children’s Hospital of Philadelphia (CHOP), USA after obtaining his MBBS and Masters in Paediatrics, both from University Malaya.
He is currently the Chairman of the Malaysian Paediatric Endocrinology and Diabetes Group, Immediate Past President of the Asia Pacific Paediatric Endocrine Society (APPES 2020-2022) and a council member of the Malaysian Paediatric Association (MPA 2021-2023). He is also a member of The Endocrine Society USA, International Society for Paediatric and Adolescent Diabetes (ISPAD) and Malaysian Endocrine and Metabolic Society (MEMS).
Bone Health and Nutrition
Nutrition Symposium: Nutrition and Micronutrients
15 October 2022 (0830-1000@Sipadan Hall 3)
Nutritional Interventions to prevent & manage obesity – (Cases studies)
Nutrition and Growth Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
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Dr Nazrul Neezam
Dr Nazrul Neezam
Practising consultant paediatrician and paediatric gastroenterologist at Sunway Medical Centre. Previously completed my postgraduate training in paediatrics at University Malaya in 2006 before subspecialising in paediatric gastroenterology. Dr Nazrul completed his paediatric gastroenterology fellowship at local centres and spent a year at The Royal Children's Hospital Melbourne in 2010 before returning back to setup the service in Kuala Lumpur Hospital. In 2014, Dr Nazrul moved on to Sunway Medical Centre to start his private practice.
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Dr Neoh Siew Hong
Dr Neoh Siew Hong
Consultant Paediatrician and Neonatologist, Hospital Tunku Azizah
Dr Neoh Siew Hong graduated from University of Malaya in 1988 and obtained the MRCP(UK) in 1993. She did her Neonatal training at the Royal Prince Alfred Hospital Sydney in 2002-2003. She was elected to Fellowship of RCPCH in 2020.
She holds the position of senior consultant paediatrician and neonatologist in Hospital Tunku Azizah. She is the Head of Neonatal Unit in Hospital Tunku Azizah and Head of Neonatal Subspecialty, Ministry of Health Malaysia and plays an active role in several committees in the Ministry of Health Malaysia. Dr Neoh is a trainer for the Neonatal Subspecialty Program.
She was the treasurer of the Perinatal Society of Malaysia from 2008 – 2013. She is currently the treasurer of the Malaysian Resuscitation Association
Nutritional Issues In Neonatal Intensive Care: Recent Advances
Meet the expert session (Day 3)
15 October 2022 (0730-0830@Sipadan Hall 1)
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Assoc. Prof Ng Ruey Terng
Assoc. Prof Ng Ruey Terng
Consultant Paediatric Gastroenterologist and Hepatologist, University of Malaya Medical Centre, Kuala Lumpur
Assoc. Prof Dr Ng Ruey Terng is a Paediatric Gastroenterologist and Hepatologist practising at University of Malaya Medical Centre, Kuala Lumpur. He is one of the trainer for paediatric endoscopy in the country.
Acute Hepatitis of Unknown Origin in children-an update
Liver Symposium (Day 2)
14 October 2022 (1500-1630@Sipadan Hall 2)
There has been a sudden surged of acute hepatitis among children aged mainly below 5 since early 2022. The initial alarm came from Scotland and Alabama where children of below 5 years who was previously healthy presented with acute hepatitis of unknown origin and with significant morbidity and mortality, and it quickly spread to Europe and other part of the world. Human adenovirus (HAdV, predominant type 41) was isolated in more than 50% of the cases, and a small cohort of not more than 20% with evidence of SARS-CoV-2 infection. There was no liver histological evidence of direct infection of HAdV otherwise. About 5% of the patients worldwide needed a liver transplantation, and 2% has died. WHO has rated the risk of the disease as moderate and encouraged member regions to actively report and investigate all the newly diagnosed cases. Attention has been focuses on the hypothesis of post SARS-CoV-2 immune dysregulation as well as immunological naïve of children secondary to preventive strategies during pandemic.
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Datin Nik Raihan binti Nik Mustapha
Datin Nik Raihan binti Nik Mustapha
Retired (last place of practice - Hospital Sultanah Bahiyah, Alor Setar, Kedah)
Dr Nik Raihan Nik Mustapha was a senior consultant histopathologist at Hospital Sultanah Bahiyah, Kedah, Malaysia prior to her recent career break. She has special interest in liver and gastrointestinal pathology and has delivered many lectures on inflammatory bowel disease. She had also recently produced an IBD histopathology reporting guide for national use.
Pediatric IBD: Dissecting the histology
Histopathology Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
Inflammatory bowel disease (IBD) is a chronic relapsing-remitting inflammation of the bowel, variably associated with extraintestinal menifestations. The etio-pathogenesis of IBD is multifactorial, which includes genetic predisposition, dysregulated immune responses and environmental factors. IBD consists of two main entities i.e. ulcerative colitis (UC) and Crohn’s disease (CD). A temporary diagnosis of IBD unspecified (IBDU) is used when differentiation between UC and CD is not possible.
Pediatric IBD (i.e. presenting before the age of 18 years) comprises of up to 25% of IBD patients. CD is twice as common as UC in pediatric IBD. Compared to adults, pediatric IBD may differ phenotypically, in the form of clinical presentation (e.g. growth failure and delayed puberty, which may precede bowel symptoms), as well as in endoscopic and histologic appearances. Variable degrees of chronicity changes and disease activity may be appreciated on histology as a result of chronic inflammation and injury.
Assessment for IBD diagnosis on mucosal biopsy, including differentiating between UC and CD (both in pediatric and adult population) requires assessment of multiple histologic components, namely: mucosal architectural distortion, alteration in lamina propria lymphoplasmacytic cell gradient, epithelial abnormalities (e.g. surface erosion, ulceration and metaplasia), neutrophil granulocyte infiltration, distribution pattern of histologic changes, as well as presence/absence of epithelioid granulomas. Making an accurate histologic diagnosis also requires one to be familiar with normal gastrointestinal histology to avoid over/under- or misinterpretation of both abnormal and normal findings.
The histology in pediatric IBD may differ from that of adult’s, especially in younger patients (less than 10 years of age). In UC, patients may present with extensive colitis with less severe and less diffuse architectural distortion. There may be patchy inflammation and mucosa may even appear normal or just mildly inflamed at onset. Rectal sparing is seen in about 30% of cases. Some of these features may cause histologic confusion with CD. In Crohn’s disease, there tends to be more colitis (including rectal involvement) than ileitis in younger children. Granulomas and upper GI involvement are also more common as compared to adults.
Correct IBD diagnosis, as well as differentiation between CD and UC is pertinent for optimal treatment strategy, and in many instances, requires close correlation of clinical, endoscopic, histologic, and radiologic findings.
Case presentation (45 min)
Histopathology Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
Case presentation (30 min)
Histopathology Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
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Dr Pavitratha Puspanathan
Dr Pavitratha Puspanathan
Anatomic Pathologist, Hospital Pulau Pinang
Dr Pavitratha Puspanathan graduated from International Medical University in 2002 with Bachelor of Medicine and Surgery ( M.B.B.S). She completed her training in Masters in Pathology in National University of Malaysia in 2012 and further with subspeciality training with special interest in Gastrointestinal & Hepatobiliary Pathology at Royal Free Hospital London in 2022. She is currently working as Anatomic Pathologist in the Department of Pathology, Hospital Pulau Pinang and has set up and developed HPP as a referral centre for GI & HPB pathology.
Dr Pavitratha has published papers in academic journals as well as many poster presentations in regional and international conferences. Her interests include teaching and research, internal and external audit activities. She is committee member and life member of IAP Malaysian division and organizing committee member of APIAP Conference 2023
Case presentation (45 min)
Histopathology Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
A pottpourri of interesting and challenging cases diagnosed as chronic inflammatory bowel disease (IBD) in children and adolescents.
If it’s not IBD, what could it be? (45 min) - Discussion on clinicopathologic differentials for pediatric IBD
Histopathology Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
There is a wide variety of conditions and diseases that can closely mimic inflammatory bowel disease(IBD) in children and adolescents both clinically as well as on histology. This lecture addresses the more common and some uncommon differentials of IBD in the pediatric age group with emphasis on histology.
Case presentation (30 min)
Histopathology Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
A presentation and discussion of cases portraying various common mimickers of Inflammatory bowel disease(IBD) in children and adolescents.
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Datin Sheila Marimuthu
Datin Sheila Marimuthu
Consultant Adolescent Paediatrician, HTA
Dr Sheila MARIMUTHU is currently the Consultant Paediatrician and Adolescent Specialist of the Tunku Azizah Hospital Kuala Lumpur. She started her services at the Ministry Of Health Malaysia since 1992 and has served many Hospitals in Malaysia. She received her training in Adolescent Medicine in 2002 at the Childrens’ Hospital Westmead, Sydney Australia and also did an attachment at the Adolescent Unit, Royal Childrens’ Hospital, Melbourne in 2006.
Upon her return in 2003, the Adolescent Medicine Unit was established at the Paediatric Institute, Kuala Lumpur Hospital. The Adolescent Medicine Unit is also the local training centre for fellows training in this field. Apart from the clinical work at the hospital, Dr Sheila is involved in many activities related to Adolescent Health under the Ministry Of Health and other NGOs. This includes the planning for Adolescent Services in the MOH, training of primary care physicians in Adolescent Health, preparing the Sexual & Reproductive Health module with Division Of Family Health, preparation of Clinical Practice Guidelines, involvement with MyHealth initiatives especially in Adolescent Issues in the MOH. She is also an honorary lecture to undergraduate students in the Adolescent Health module as well as invited lecturer to post graduate lecture series.
Dr Sheila also engages in outreach programs for young people in collaboration with NGOs. Her areas of interest are psychosomatic illness in adolescents, reproductive health issues particularly in sexually abused teens as well as Eating Disorders and weight management in teenagers.
Anorexia Nervosa
Nutrition Symposium: Nutrition / Topics In Adolescent
14 October 2022 (1330-1500@Sipadan Hall 3)
In this symposium, classification of Eating Disorders will be discussed and in particular the detection of Anorexia Nervosa will be emphasized. Most cases with Anorexia or Bulimia are not picked up early enough by primary care givers and are referred relatively late with complications. We will also touch on the increase of cases since the Pandemic and talk about detection of complications and the management.
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Prof Shireen Anne Nah Han-Yien
Prof Shireen Anne Nah Han-Yien
Professor, Division of Paediatric & Neonatal Surgery, Faculty of Medicine, University of Malaya
Associate Professor Dr Shireen Anne NAH was trained in University Malaya. She previously served as staff consultant paediatric surgeon at KK Women’s & Children’s Hospital, Singapore and returned to Malaysia in 2019. She is currently an associate professor and Head of Pediatric Surgery in University Malaya Medical Centre, Kuala Lumpur, Malaysia. She is also the Head of National Conjoint Board, Paediatric Surgery Postgraduate Training Programme
Dr. Shireen was awarded the certificate of excellent service by University of Malaya in 2020 and had received the Team excellence award with her involvement in Liver Transplant services in University of Malaya Medical Centre. She is also the holder of several ongoing grants in the study of anorectal malformation & Hirschsprung's disease and paediatric bowel management programme. She also has ongoing collaboration with several international institution in Singapore, Netherlands and Texas. Dr. Nah has authored multiple publications in high-impact journals in the field of pediatric surgery.
Surgical Issues In Paediatric Gastroenterology
Meet the expert session (Day 2)
14 October 2022 (0730-0820@Sipadan Hall 1)
Holistic management of children with GI and liver diseases requires close and collaborative multidisciplinary care involving paediatricians, surgeons and other specialties.
Prof Shireen Nah will review common paediatric GI conditions in which surgical input is necessary to achieve good function and quality of life for patients. She will discuss the role of the paediatric surgeon, urgency and acuity of surgical referrals, and strategies to enhance communication with surgical and paediatric clinicians.
Prof Shireen Nah will review common paediatric GI conditions in which surgical input is necessary to achieve good function and quality of life for patients. She will discuss the role of the paediatric surgeon, urgency and acuity of surgical referrals, and strategies to enhance communication with surgical and paediatric clinicians.
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Ms Siti Hawa Mohd Taib
Ms Siti Hawa Mohd Taib
Clinical Dietititan
Ms. Siti Hawa Mohd Taib is a clinical dietitian working in University Malaya Medical Centre. She graduated with honors from Universiti Kebangsaan Malaysia and has 28years of working experience and currently specialising in medical nutrition therapy in pediatric gastroenterology and hepatology. She is actively involved as a facilitator in many postgraduate and undergraduate programs in University of Malaya and dietetic programs from other universities as well. Ms. Siti Hawa has also contributed in many publications and was awarded 4 times for the Excellence Service Award. She is currently an ordinary member of APPSPGHAN, PENSMA and Malaysian Dietitians Association.
Nutrition in Special Populations-Children with picky eating – to supplement or not to supplement?
Nutrition and Growth Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
Nutritional Interventions to prevent & manage obesity – (Cases studies)
Nutrition and Growth Workshop
12 October 2022 (0800-1700@Sipadan Hall 1)
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Dr Toh Teck Hock
Dr Toh Teck Hock
Professor Dr Teck Hock TOH is a Paediatrician and the Head of Clinical Research Centre (CRC) in Sibu Hospital. He worked in the Australia, United Kingdom and Singapore before returning in 2004 to work in Malaysia. He is the Professor for SEGi University and Sunway University, the Special Olympics Asia Pacific Regional Clinical Advisor in Health Promotion®, Vice President for the National Early Childhood Intervention Council, and the National Assessor for the Baby-Friendly Hospital Initiative. Besides general paediatrics, He also work in developmental-behavioural paediatrics and community child health and research one-health infectious diseases, vaccine trials.
Professor TOH have authored more than 70 peer-reviewed manuscripts and book chapters. Besides scientific papers, He has also published parent-teacher handbooks on ADHD, language development and breastfeeding, and children reading / colouring books and books on Chinese literary prose and short stories. He has been invited to speak at various scientific meetings/conferences and conducted training throughout Malaysia and internationally.
He received The Outstanding Young Malaysian Award in 2010 and Special Education Network in Asia Advocacy Award in 2018.
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Dr Yap Nan Jiun
Dr Yap Nan Jiun
Postdoctoral Research Fellow / Universiti Malaya
Dr. Yap Nan Jiun completed her PhD research at the Universiti Malaya (UM) on molecular characterisation of human and simian malaria species found primarily among the indigenous communities. She is currently a Post-Doctoral Research Fellow in Department of Parasitology, Faculty of Medicine, UM, working with collaborators from Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, NIH, USA to further analyse the microbiota and nutritional data for the project on “Interactions between helminth colonisation and the gut microbiota”. Her research interests include epidemiology and molecular characterisation of zoonotic malaria species, as well as the interaction between helminth infections and human gut microbiota profile.
Parasite-Related Diarrhoeal Disease
Gastro Symposium: Diarrhoeal disorder in the developing countries
14 October 2022 (1330-1500@Sipadan Hall 1)
Globally, diarrhoeal disease is among the leading cause of mortality and morbidity among children aged five years and below. In developing countries, children living in poor areas with unsafe water supplies and inadequate levels of hygiene and sanitation conditions are most at risk of developing persistent diarrhoea. Besides the enteric viruses and bacteria, intestinal protozoan parasites including Cryptosporidium spp. and Giardia spp. have also been recognised as the important causes of diarrhoeal disease. They can be transmitted by person to person via faecal-oral route or indirect route through contaminated food and drinking water with human or animal faeces. Most infections are self-limited but recurrences are common in endemic areas. However, chronic infection can lead to weight loss, malnutrition, cognitive impairment and potentially life-threatening in immunocompromised children. Given the importance of intestinal parasite as a cause of paediatric diarrhoeal disease, further studies targeting sociodemographic characteristics, behavioral and hygienic practice status are required. Adequate knowledge of the molecular diversity and geographical distribution of these parasites and the environmental and climatic variables that influence their prevalence will enable the implementation of multiple intervention strategies for children, households and their environments to combat preventable morbidity and mortality from diarrhoeal diseases.
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Prof YVONNE LIM AI LIAN
Prof YVONNE LIM AI LIAN
Department of Parasitology, Faculty of Medicine, Universiti Malaya
Dr. Yvonne Lim Ai Lian is a senior professor at the Department of Parasitology, Faculty of Medicine, Universiti Malaya (UM), Kuala Lumpur and a council member of the Academy of Sciences Malaysia (ASM). Her research focuses on host-parasite interactions and the epidemiology and control of neglected tropical diseases primarily among the indigenous communities. Her work has been funded by various national and international grants (eg. US NIH grant). Currently, together with researchers at the National Institutes of Health (NIH), USA, her team is further elucidating the role of gut microbiota-helminth association with nutritional status and inflammatory responses. She has published more than 225 scientific papers, 9 book chapters and 3 books. She has supervised more than 30 postgraduate students to completion. She was a visiting researcher at the Scottish Parasite Diagnostic and Reference Laboratory (formerly SPDL), Glasgow, Scotland; a visiting fellow at the Department of Veterinary Science, University of Melbourne, Australia and was appointed a visiting professor at the Department of Molecular Parasitology and Tropical Diseases, Taipei Medical University, Taiwan and the Massachusetts Institute of Technology (MIT). She was also one of the women leader mentors in the Association of Pacific Rim Universities (APRU) Asia-Pacific Women in Leadership (APWiL) Mentoring Programme. She has recently completed her Fulbright Scholar Program for an attachment at the Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), USA.
Gut worms and Gut Microbiota
Plenary Lecture (Day 2)
14 October 2022 (0835-1005@Sipadan Hall 1)
Gut worms especially the soil-transmitted helminths, namely Ascaris lumbricoides (roundworm), Trichuris trichiura (whipworm) and hookworm infections thrive in poor and disadvantaged communities in the tropics. They produce a wide range of symptoms including diarrhoea, abdominal pain, general malaise, whilst some cause blood loss. In severe cases, these infections can cause gut obstruction, rectal prolapse and severe anaemia. Chronic worm infections are common in children resulting in poor nutritional status, physical and cognitive development. Although these infections are responsible for significant morbidities, some studies have also shown that gut worms may promote beneficial effect to host, by modulating and supressing excessive inflammatory responses. The ability of worms to attenuate the severity of diseases could be related to its immunoregulatory effect which allow their longterm survival within the host. Besides these gut worms, a large number of commensal bacteria, collectively known as gut microbiota also resides in the gut. The prolonged cohabitation of gut worms and gut microbiota enables these organisms to influence each other, leaving significant effect on the host. This presentation will highlight the increasing interest in understanding the effect of gut worms on human health through the modulation of gut microbiota.
