ABSTRACT
Background: Retinopathy of prematurity is a multifactorial vasoproliferative retinal disease that increases in incidence with decreasing gestational age and is one of the leading causes of preventable childhood blindness in India. Advances in neonatology have led to dramatic increase in survival of preterm neonates and in turn, to the risk of developing ROP. Since most of the risk factors associated with ROP mentioned above arise in the neonatal intensive care unit (NICU) itself and most of them are avoidable, cautious monitoring of the risk factors, early screening, follow up and surgical intervention have been shown to reduce the incidence and improve the outcome of ROP.Methods: This was a prospective observational study conducted for a period of 2 years. A total of 151 infants admitted in NICU /SNCU who satisfied the inclusion criteria were enrolled in this study. Initial and follow up screening was conducted in three phases the results were documented in proforma after ethical clearance.Results: Comparison of risk factors between eyes with and without ROP was done using Chi-square test. A p-value of<0.05 was considered to be statistically significant. Incidence of ROP in centre is found to be 33.8%. Among maternal risk factors, multiple gestation and PROM/PPROM is found to be significant in the development of ROP from this study. However, mode of delivery and gestational hypertension, were found to be not significant in ROP. Among neonatal risk factors, low birth weight, lower gestational age, prolonged oxygen exposure, blood transfusion, mechanical ventilation, sepsis, phototherapy was found to be significant in this study.Conclusions: ROP, being an emerging cause for potentially blinding visual disability, needs to be diagnosed early. Due to the advancements in neonatology and better survival of preterm babies, timely screening, regular follow up, early detection and intervention is mandatory. A multidisciplinary approach is required in diagnosis and treatment of the disease. Proper counselling and motivation for parents of preterm and low birth weight babies for regular follow up is also essential.
ABSTRACT
Introduction: Hypoparathyroidism is a rare endocrinedisorder characterized by low serum calcium and parathyroidhormone levels. The most common cause is iatrogenic surgicalremoval. However, idiopathic primary hypoparathyroidismis to be kept in mind especially in children as a cause ofhypoparathyroidism. Since PTH is important in calciumhomeostasis, this condition may cause ectopic calcifications,including intra cerebral calcifications, though rare.Case report: 11 year old MCH,with history of birth asphyxiaand global developmental delay was presented to emergencywith seizures. The child had seizures since the age of 5years,and wasn’t on regular treatment. The patient was admittedwith a provisional diagnosis of Cerebral Palsy with seizuredisorder with polymorphic seizures was made and treatedconservatively. Neuroimaging showed bilateral symmetriccalcification in basal ganglia,thalami and capsule. A completeworkup showed low serum calcium, high serum phosphorusand low parathormone. Calcium supplementation was givenand seizures was made under control.Conclusion: Idiopathic hypoparathroidism, though rarely, asit was in our case, may cause exuberant cerebral presentationswith extensive intracranial calcifications and extremehypocalcemia which may or may not correlate with severity ofsymptoms. Not only this is a treatable disorder that may havedangerous implications if untreated, but also its symptomsmay be completely reversed with prompt treatment.