ABSTRACT
Background: Cerebral palsy is a diagnostic term used to describe a group of motor syndromes resulting from disorder of early brain development. It describes a group of permanent disorders of the development of brain and posture causing activity limitation. The magnitude of cerebral palsy in our country is 2 to 2.5 per thousand live birth. The objective is to study co-morbidities associated in cerebral palsy patients.Methods: It was a hospital based cross sectional study carried out in KT Children Hospital, PDU Medical College, Rajkot for 1 year (April 2017-April 2018). Sample size: minimum 100 cases. Selection of subject: All the children suffering from cerebral palsy presenting at KT Children hospital, P.D.U. Medical college Rajkot, Gujarat. Cases were evaluated by history, clinical examination and necessary investigations.Results: From data collected in present study most common variety of Cerebral Palsy is spastic type (72.5%) followed by, dyskinetic (16%), ataxic (7%), and hypotonic (4.5%) type. Within spastic type; diplegic (48%) is the most common variety. Caesarean section delivered cases are more predisposed to Cerebral palsy in present study which might be due to other risk factors associated with it. Gender and consanguinity showed not major significance in association with CP child. Most of Cerebral palsy cases in present study were born full term (81.5%) and of normal birth weight (78.5%). The most common comorbidities in present study were cognitive impairment (77%) followed by epilepsy (38%), visual impairment (10%), hearing disability (9%) thyroid dysfunction (3%) and G.I. disturbances (2%). Perinatal asphyxia is the most common history finding in Cerebral palsy cases including in present study, followed by seizures during infancy, pathological jaundice, neonatal sepsis and history of NICU admission for any cause.Conclusions: Cerebral palsy in developing countries has a higher prevalence and different clinical profile regarding severity and associated disability. The perinatal and high-quality neonatal care together with physical therapy and rehabilitation programs have a significant role in preventing comorbidities in cerebral palsy cases, which is still lacking in developing countries.
ABSTRACT
As a presenting chief complaint, tall stature represents only ‘tip of iceberg’ of all the tall children. For a pediatrician, it is very important to distinguish familial or constitutional tall stature from other pathological forms of tall stature. For practicing pediatricians, availability of literature discussing clinical approach to a child presenting with tall stature is limited. This article presents clinically simple and rational approach to tall stature.
ABSTRACT
Introduction: Severe acute malnutrition is widely prevalent problem in developing countries and a major cause of morbidity and mortality in India. nutritional rehabilitation of such patients is very important aspects of management and often inadequate. This study was planned to understand catch up growth in severe acute malnourished patients admitted to rehabilitation ward for providing nutrition. Objectives: (1) To study the weight gain pattern of the patients with severe acute malnutrition admitted to hospital based nutritional rehabilitation center. (2) To study the factors associated with good or poor weight gain in the patients with severe acute malnutrition admitted to nutrition rehabilitation centre. Materials and methods: In this case record based retrospective study; records of severe acute malnourished patients admitted to nutritional. rehabilitation ward during the period of February 2012 to December 2012 were included. Results: A total of 98 patients were admitted during this period for nutrition rehabilitation. Mean baseline weight/ height z score (WHZ), Weight/age z score (HAZ) was - 1.67 (2.48), -4.19 (0.98) and -4.90 (2.50) respectively. 76 patients who stayed for more than 7 completed days were analysed for comparative statistics. Mean WHZ score of this 76 patients was-1.70 (2.25). Mean weight gain of these patients was 5.56 gm/kg/day. Patients age (p=0.03, OR=1.12, 95% CI: 1.040-1.211), educated mother (p=00.048, OR=1.29, 95% CI: 1.320-2.478) and recommended dietary intake of at least 80% (p=0.001, OR=7.94, 95%CI: 2.247-28.79) were the only statistically significant factors associated with good weight gain. Conclusion: Our study highlighted important role of nutritional rehabilitation of the severe acute malnourished children in hospital for early catct-up of the growth.