Ocular morbidity and co-morbidities in children attending a nodal district early intervention center in Uttar Pradesh

Purpose: To obtain epidemiological data on children with ocular morbidity attending a nodal district early intervention center (DEIC). Methods: After parental consent, we recruited children with ocular morbidity. After detailed history and clinical evaluation, along with pediatric consultation and relevant neuro?radiological and ancillary investigation, information was entered in a pretested proforma: especially looking for perinatal morbidity, including developmental delay (DD). Visual acuity (VA) was assessed by age?appropriate means by an ophthalmic assistant trained to work with children with special needs. We diligently looked for strabismus and performed dilated ophthalmoscopy. Using JASP, we summarized data as means and proportions and reported 95% CIs. We explored the association of disability percentage with possible predictor variables using regression. Results: We enrolled 320 children, with a mean age of 34.43 ± 31.35 months; two?thirds were male; one?third belonged to lower socioeconomic status (36%), with most parents being illiterate. The mean presenting VA was 1.8 logMAR for both eyes, range: 0 to 3. Sixty?one percent were hyperopic and 27% were myopic. High refractive error, (>±6D) occurred in nine; anisometropia in one; strabismus in 149, mostly esotropia; congenital cataract in 25, whereas 63 had abnormal fundus. Seventy?six received a diagnosis of cerebral visual impairment (CVI). On multivariate linear regression (MLR), younger age, presence of DD, and CVI significantly predicted a higher disability percentage. Logistic regression revealed that statutory disability is likely associated with DD (odds ratio [OR]:13.43); whereas older age was protective (OR: 0.977). Conclusion: Our study suggests that in DEIC children with ocular morbidity, younger children, and the presence of DD significantly predict both greater disability and the likelihood of statutory levels

Factors Associated With Elevated Blood Lead Levels in Children

Objectives: To determine the prevalence and correlates of elevated blood lead level inchildren (6-144 months) of Aligarh. Methods: A hospital-based cross-sectional study wasconducted. Venous blood was obtained for lead estimation and a structured questionnairewas filled. Results: A total of 260 children were enrolled. The prevalence of elevated bloodlead level was 44.2%, seen mostly in children below 5 years of age. Old and deteriorating wallpaints at home was found to be significantly associated with elevated levels. Conclusions:Lead-based house paints are potential source of lead exposure. Meticulous renovation andpainting of the walls with safe paints is desirable

Spectrum of Cyanotic Heart Defects and Their Modes of Presentation at Cardiology Clinic in a Tertiary Care Hospital.

Background: Cyanotic Congenital heart defect (CHD) is the high risk group which requires prompt medical attention. Immediate management can drastically alter the natural history otherwise most of the children will succumb to their defect very early in infancy. It is thus important to have reliable information of the profile of various cyanotic CHDs as well as their mode of presentation for the early detection. Methods: The study was carried out in Department of Pediatrics and Center of Cardiology, Jawaharlal Nehru Medical College, Aligarh. All patients referred with complaints or clinical examination suggestive of congenital heart defects were further evaluated with echocardiography. On echocardiography patients having congenital heart defects were included as cases which were further divided into cyanotic and acyanotic heart defects, preterms having PDA and PFO and those with acquired heart defects were excluded. The profile and mode of presentation of various cyanotic CHDs was further described in detail. Results: Acyanotic heart defects were 290(72.50%) of the total heart defects, while the contribution of cyanotic heart defects was 110 (27.50%). Out of all CHDs, VSD was the most common lesion with contribution of 152 (38.00%) cases, while among the cyanotic heart defect, Tetralogy of Fallot (TOF) was the most common lesion (18% of total cases). Spectrum of various cyanotic lesions were TOF 65.45%, Single Ventricle 12.72%, TAPVC (Total Anomalous Pulmonary Venous Connection) 8.18%, TGA(Transposition of Great Arteries) 7.27%, Tricuspid Atresia 3.63%, Ebsteins malformation 1.81% and Truncus Arteriosus 0.90%. Conclusion: Profile of various cyanotic CHDs was similar to the previous studies, however spectrum of various CHDs was quite wide, a large number of cases were missed in infancy and presented late.

Profile of Acyanotic Congenital Heart Defects

Background: Acyanotic CHD constitute majority of heart defect with significant morbidity, Profile of various defects is essential for identifying children who need urgent intervention and who need to be medically followed. Methods: The study was carried out in Department of Pediatrics and Center of Cardiology, Jawaharlal Nehru Medical College, Aligarh. All patients referred with complaints or clinical examination suggestive of congenital heart defects were further evaluated with echocardiography. On echocardiography patients having congenital heart defects were included as cases which were further divided into cyanotic and acyanotic heart defects, preterms having PDA and PFO and those with acquired heart defects were excluded. The profile and mode of presentation of various acyanotic CHDs was further described in detail. Results: Acyanotic heart defects were 290(72.50%) of the total heart defects, while the contribution of cyanotic heart defects was 110 (27.50%). Out of all CHDs, VSD was the most common lesion with contribution of 152 (38.00%) cases, followed by ASD (20.34%) , PDA (13.10%), PS (6.90%), Subaortic Membrane (2.00%), AV Canal valve defect (1.00%), RSOV (1.00%), Bicuspid Aortic Valve (1.00%), PAPVC (0.66%), Cortriatriatum (0.33%), Coarctation of Aorta(0.33%), ALCAPA(0.33%) and Aortic stenosis (0.33%). Age of presentation for most of the children was between 1 to 5 years. Conclusions: The profile and mode of presentation of various acyanotic heart defects was similar to other studies but diagnosis was delayed in majority of cases. The prevelance of various obstructive lesions like AS, coarctation and bicuspid aortic valve was much lower.

Profile and Clinical Spectrum of Congenital Heart Defects in NICU

Introduction: Congenital heart defects are commonest birth defects and is an important cause of mortality and morbidity in newborns. The current study was done aiming at determining profile and clinical spectrum of various congenital heart diseases (CHD) in neonatal period. Methodology: An observational study was carried out in the NICU, Department of Pediatrics, Jawaharlal Nehru Medical College, Aligarh from Feb 2014 to Aug 2015 with the objective to determine profile of various congenital heart defects. All patients with clinical suspicion of congenital heart defect were further evaluated with echocardiography.  Patients who were preterm having PDA and PFO were excluded from cases. Prevalence of various congenital heart defects was calculated. Clinical Spectrum of various congenital heart defects was observed. Observations: Total newborns screened 238 and 52 congenital hearts defect were detected. Acyanotic heart defect contributed 67% while cyanotic heart defect contributed 23%. VSD was the most common lesion while TOF (11.5%) was commonest among cyanotic heart defects. Most of the cyanotic heart defects were detected on screening as murmur on auscultation while PDA of bigger size presented as fast breathing. In cyanotic heart, defect classical TOF presented with only murmur while TOF with PA presented as cyanosis. Conclusion: VSD was the most common congenital heart defect detected while Tetralogy of Fallot was commonest among the cyanotic heart defects.