Day 2 :
Dr. Mohamad Miqdady is American Board certified in Pediatric Gastroenterology, Hepatology and Nutrition. He is the Division Chief, Ped. GI, Hepatology & Nutrition Division at Sheikh Khalifa Medical City in UAE. Also an Adjunct Staff at Cleveland Clinic, Ohio USA. Member of the FISPGHAN Council (Federation of International Societies of Pediatric Gastruenterology Hepatology, and Nutrition) Expert member FISPGHAN Malnutrition/Obesity Expert team. Dr. Miqdady completed his Fellowship in Pediatric Gastroenterology at Baylor College of Medicine and Texas Children’s Hospital in Houston, TX, USA. He held the position of Assistant Professor at Jordan University of Science and Technology in Jordan for six years prior joining SKMC. Main research interests include feeding difficulties, picky eating, obesity, procedural sedation, allergic GI disorders and celiac disease. He has several publications and authored few book chapters including www.uptodate.com. On the Editorial Board of few journals including Gastroenterology & Hepatology.
It’s believed that the prevalence of atopic disorders is increasing worldwide. Gastrointestinal allergic disorders are no stranger to this phenomenon. Over the last two decades a new disease was described called eosinophilic esophagitis which simply means an allergic inflammatory reaction in the esophagus. This could be related to ingested or possibly inhaled allergens. Typically these young children present with difficulty in swallowing and dysphagia and frequently with food impaction with regular food. They have functional obstruction rather than at anatomical obstruction. During endoscopy an abnormal esophageal mucosa can be noted sometimes with some white spots indicated some eosinophilic abscesses, linear furrows and during formation of the esophagus. Biopsy should be taken to confirm the diagnosis which normally shows increased number of eosinophils. A cutoff point is described to be more than 15 eosinophils per high-power field. Typically these patients they don’t have eosinophilic infiltrates in other parts of the gastrointestinal system. The mainstay of treatment is elemental diet avoiding the commonest food allergies that includes milk, eggs, wheat, soy, nuts and seafood. In the Middle East allergy to sesame seems to be another common allergen. Also these patients that will require “swallowed topical steroid” in addition to a proton pump inhibitor. Unfortunately this is a chronic disorder and these patients need to be in diet for a long period of time with the above medications. Dilatation if required can be associated with higher increased risk of perforation.
Advanced Center for Daycare Surgery, UAE
Keynote: Prevalence, clinical characteristics and management of gastroenterology: An over view of the common and unusual GIT disease presentations with case studies from UAE
Time : 10:00-11:00
Makki Hummadi Fayadh is a senior consultant Physician & Gastroenterologist- Hepatologist & Endoscopist both in Iraq & UAE. He was graduated from the Medical College University of Baghdad and completed his Post graduate studies in Medicine & Gastroenterology in UK-London. Became a member of MRCP UK and worked in Saint Bartholomew’s hospital in London in the Gastroenterology department with Sir A.M.Dawson, during that time trained in endoscopic techniques and did research on malabsorption especially celiac disease, colitis, bile stone dissolution inflammatory bowel diseases & gastrointestinal lymphomas. He joined in Advanced Center for Day care surgery-ACDS as a consultant physician gastroenterologist & Medical director.
20% of people in the UAE are suffering from gastrointestinal problems because of obesity, poor diets and close marriage. Acid reflux, ulcerative colitis and irritable bowel syndrome are increasing in recent years. There are also a high number of sufferers of fatty liver, caused to a large extent by the excessive consumption of sugary drinks. Obesity is an issue that can affect the UAE’s development as a nation and needs to be managed immediately and effectively, vague discomfort is usually the only symptom of a fatty liver. Low fiber diets, lack of exercise and consuming large amounts of food and dairy products are responsible for the majority. Genetics combined with obesity are responsible for people suffering from many disorders. A case of fatty liver, if ignored, might escalate to an advanced liver problem later in life. During our practice in UAE we came across many rare and unusual disease presentations that were missed because of either lack of awareness or failure to check detailed history including family history and proper physical examination. These diseases included: IGG4 related diseases, Cowden disease, tylosis, hyper elasticity syndromes, Behcet disease, vascular compression syndromes, neuroendocrine tumors and mesenteric panniculitis. One fifth of the population in UAE suffers from gastrointestinal diseases including obesity, reflux disease and fatty liver. Rare and unusual disease presentations are frequently missed because of lack of detailed history taking including family history and failure to do full clinical examination.