ABSTRACT
Background: The pattern of obesity as decided by body fat distribution is an important predictor of adverse health effects such as diabetes, hypertension, hyperlipidaemia and coronary events. Waist hip ratio has been correlated with cardiovascular risk. Obesity is been known to cause restrictive respiratory impairment however; the effect of body fat distribution on the respiratory system is often underappreciated and limited evidence is available on spirometric pulmonary function in subjects with different body fat distribution. Hence here is a need to know weather pattern of obesity affects pulmonary function. Objectives: 1) To measure Waist Hip ratio (WHR) of subjects having BMI of more than 23 kg/m2 and based on this form two groups, one with apple and the other with pear shape fat distribution 2) To measure FVC and FEV1 in subjects of the above two groups.3) To compare FVC, FEV1 and %FEV1/FVC in above two groups. Methodology: In this comparative study a total of 182 subjects comprising of 91 subjects of Apple shaped and Pear shaped each were recruited in a period of 6 months. Study Settings: The study was conducted in the outpatient Physiotherapy department of a tertiary care hospital. The subjects in the study belonged to age group of 18-40 years. The mean age of the enrolled subjects was 29 years. Outcome measure: 1.FVC (L); 2. %FEV1 /FVC Results: The present study provides the evidence that FVC and %FEV1/FVC values are not statistically different in apple and pear shaped fat distribution individuals. Although both apple and pear shaped individuals showed %FEV1/FVC value more than 70% predicted, apple shaped individuals showed greater obstructive tendency i.e. reduced flow rates as compared to pear shaped individuals. Also more individuals of apple shaped showed restrictive pattern as compared to pear shaped. Conclusion: There was no statistically significant difference in the pulmonary function test in the two groups but there is a possibility of subclinical reduction in pulmonary function more in apple shaped than in pear shaped individuals
ABSTRACT
Cerebral palsy (CP) is a form chronic motor disability in children. It is a non-progressive disorder of posture and movement, often associated with epilepsy and abnormalities of speech, vision and intellect. It results from a defect or lesion of growing brain before or during birth or in postnatal period. The damage to brain is permanent and cannot be cured but the consequences can be minimized. Cerebral palsy (CP) is a disorder of development in which abnormalities of motor function are the main characteristic features. Severity varies from mild to severe. Cerebral palsy is a very challenging disability for parents and professionals. Cerebral palsy is a heterogeneous group of disorders caused by intrapartum asphyxia and exposure to maternal infection such as chorioamnionitis, sepsis, urinary tract infection, and prematurity. The incidence of Cerebral Palsy is 2 to 2.5 per 1000 live births. During the past twenty years, there have been increases in the incidence and prevalence of CP that may be associated to enhanced records of cases, advances in neonatal health care and other factors.METHODSThis cross-sectional study was conducted in the Department of Paediatrics, Darbhanga Medical College & Hospital, Laheriasarai, Darbhanga, Bihar, from October 2018 to September 2019. A total of 100 Cerebral Palsy cases coming from various districts to inpatient and outpatient department of hospital were selected.RESULTSIn this study a total 100 CP children up to 12 years of age was included. 60% were boys and 40% were girls. The causes of CP included birth asphyxia (47%), prematurity (22%), pyogenic meningitis (8%), genetic (7%), neonatal sepsis (6%), intracranial bleed (5%), and idiopathic (5%). Among these cases, spastic type (65%), ataxic (15%), dyskinetic (10%) and mixed (10%) varieties were found. Among spastic, quadriplegic subtype was seen in 69%, diplegia in 23%, and hemiplegia in 8%. Comorbidities associated with CP patients were speech problem (80%), pain (75%), cognitive disability (50%), hip displacement (30%), seizure (25%), behavioural disorders (25%), sleep disturbances (20%), visual impairment (19%) and hearing impairment (4%).CONCLUSIONSPerinatal asphyxia is a leading and preventable cause of cerebral palsy. Spastic type was the most common type and in spastic type, quadriplegic subtype was most common. Mental retardation, speech problems, pain, cognitive disability, hip displacement and seizure were the major co-morbidities in children with cerebral palsy. Early diagnosis and appropriate management are important in such children to limit morbidity.