Digit ratio (2D:4D) and performance in non-elite male badminton players

Background: The second to fourth digit ratio (2D:4D ratio) is derived by dividing the length of the index finger (2D) by the length of the ring finger (4D). It has been considered as an index of how much the fetus is exposed to testosterone in utero. Research has suggested that high levels of testosterone are associated with low 2D:4D ratio. The relationship between 2D:4D ratio and physical performance is still an unexplored field in badminton players. Aims and Objectives: This study intends to assess the digit ratio 2D:4D in non-elite male badminton players in comparison to their sedentary controls. Materials and Methods: The study included 30 male badminton players in the age group of 19–23 years who were practicing badminton for more than 3 years and 30 age, body mass index-matched sedentary controls. The second and fourth finger measurements were taken from scanned printouts using Vernier calipers. Results: The 2D:4D ratio was significantly lower in the left hand of badminton players when compared to their controls (P = 0.0001). There was no significant difference in 2D:4D ratios of the right hand and 2D:4D (? r–l) between badminton players and controls. Conclusion: There was significant difference in the ratio of 2nd–4th digit between badminton players and controls in the left hand but not in the right hand. The reason for no difference in 2D:4D ratio and controls in the right hand could be due to the fact that badminton is a moderate intensity sport, and also, the study participants were non-elite players.

Risk Factors for Scholastic Backwardness in Children.

Aim: To identify the risk factors for scholastic backwardness in children. Participants: Children in the 6-12 year age group attending regular schools and referred to the child guidance clinic for scholastic backwardness. Setting: Tertiary care hospital in South India. Methods: Participants were compared with an age-and sexmatched group of children with good academic performance, to ascertain risk factors for scholastic backwardness. Results: There were 75 boys and 35 girls in the study group. Among them 30 (27%) children had mental retardation, 39 (36%) had borderline intelligence and 12 (11%) had microcephaly. Undernutrition was noted in 36 (33%) children and 31 (28%) had stunted growth. 28 (26%) children had a history of chronic medical problems like epilepsy, bronchial asthma and congenital heart diseases. Visual, hearing and speech defects were present in 6 (6%), 5 (5%) and 12 (11%) children, respectively. Statistically significant differences were noted in the educational level and employment status of parents of children with scholastic backwardness and those with good academic performance. Conclusion: Social and family factors have a significant influence on the academic functioning of children.

Deliberate Self Harm in Children.

Objective: To study the nature of deliberate self-harm (DSH) in children and to identify the associated factors. Setting: Child Guidance Clinic attached to the Department of Pediatrics of a teaching hospital in South India. Subjects: Children with history of deliberate self harm who were referred to the CGC for psychological evaluation during a 10 year period. Methods: Children and parents were interviewed together and separately and details regarding age, sex, family and school environment, stresses and nature of self harm were documented. Psychiatric diagnosis was made based on DSM IV diagnostic criteria. Results: Among the 30 children included in the study, 21 were boys and 9 were girls. Majority of children were between the ages of 11 and 13 years, the youngest being 6 years old. 76% of children had history of acute stressful life events and 62% of them had chronic ongoing stress. 62 % of children had stress in the family and 41% had stress at school. Stress in the family included death of a parent, conflicts with parents or siblings, mental illness in the family, parental alcoholism and parental disharmony. Stress at school included conflicts with classmates, punishment or negative comments by teachers and learning problems. Psychiatric disorders were present in 52% of children, the commonest being depressive disorder. The commonest mode of DSH was self poisoning, and rat poison (zinc phosphide) was the commonest substance used. Conclusions: Deliberate self harm occurs in young children and the risk factors are comparable to those in adolescents.

Management of pain in leukemic children using the WHO analgesic ladder.

Objective. To ascertain the effectiveness of WHO analgesic ladder in pain management in children with leukemia. Methods. Children with leukemia who were referred to a pain and palliative care clinic attached to the Department of Pediatrics of a medical teaching hospital during a period of 6 months, were included in the study. Results. Thirty nine (39) children, who constituted 64% of children on treatment for leukemia, required referral to pain and palliative care services during the study period. Of these 92% had Acute Lymphocytic Leukemia (ALL) and 8% had Acute Non Lymphocytic Leukemia (ANLL). 95% of children had nociceptive pain and 5% had neuropathic pain. Step – 1 analgesia was effective in 12 (31%) children and 21 (54%) could be managed with Step – 2 analgesia. Step – 3 analgesia was required in only 6 (15%) children. Step 3 analgesia was required in children with neuropathic pain and bone pain. Conclusions. WHO analgesic ladder is effective in managing pain in children with leukemia. Majority of cases of cancer pain in children could be managed by the treating physician using non-opioids, weak opioids and adjuvants as per the WHO guidelines. Children with bone pain and neuropathic pain may require referral to specialist services and use of strong opioids like morphine. The study emphasizes the need for establishing specialist pain management services in all centres where children with cancer are treated.

Temperamental traits and psychological problems of children with bronchial asthma.

Children with persistent asthma were compared with an age and sex matched control group for psychological problems and temperamental traits. Childhood Psychopathology Measurement Schedule (CPMS) and Temperament Measurement Schedule were used to assess psychological problems and temperamental traits, respectively. 69% of children in the study group scored more than the cut-off score on the CPMS compared to 13% in the control group (P < 0.01). Children in the study group showed significantly more behavior problems, conduct symptoms, anxiety, depression and emotional problems compared to children in the control group. Children with asthma also received significantly low score on the temperament dimension of rhythmicity.

Intrathecal tetanus immunoglobulins in the management of tetanus.

OBJECTIVE: To study the clinical profile, treatment and outcome of tetanus in children treated with intrathecal tetanus immunoglobulin. (TIG) METHODS: Retrospective analysis of hospital records of tetaus cases admitted to the pediatric ICU during the five year period between 1999 to 2004 was done. RESULTS: There were 66 cases of tetanus treated with intrathecal TIG. Children below 5 years formed 53% of cases and 47% were above 5 years. Totally unimmunized children constituted 82% of cases and 18% partially immunized children. The portal of entry was otogenic in 58% of cases and injury in30% of cases. The common complications observed included thrombophlebitis, aspiration pneumonia, laryngospasm and autonomic system involvement. There were no complications specific to intrathecal administration of TIG. The mortality due to tetanus was 9%. DISCUSSION: Mortality and morbidity due to tetanus was less in the present study compared to other centers where TIG is given intramuscularly. CONCLUSION: Intrathecal TIG is effective in the treatment of mild and moderate tetanus. Randomized controlled clinical trials are needed to evaluate the efficacy of intrathecal TIG in the management of severe tetanus.

Temperamental traits associated with conversion disorder.

The aim of this study was to analyze the temperamental traits associated with conversion disorder in children. Thirty children with conversion disorder attending a child guidance clinic were compared with an age and sex matched control group of normal children for life stresses and temperament dimensions. The temperament measurement schedule (TMS) and the life event scale for Indian children (LESIC) were used for evaluating the temperament dimensions and life stresses respectively. Children with conversion disorder experienced significantly more stressful life events compared to the children in the control group. The stress factors included scholastic difficulties, examination failures, punishment by teacher, conflict with peers, parental disharmony and family problems and sibling rivalry. The characteristic temperamental traits associated with conversion disorder were low emotionality and low threshold of responsiveness.

Clinical profile of depressive disorder in children.

The aim of this retrospective study was to evaluate the risk factors, clinical features and co-morbid disorders of depressive disorder in children below the age of 12 years. Children who attended the child guidance clinic between January 2000 and December 2003 formed the subjects for the study. The diagnosis of depressive disorder was based on DSMIV diagnostic criteria for Major Depressive Disorder, Single episode. There were 26 boys and 19 girls. Stress at school and in the family was significantly associated with depressive disorder. Children with depressive disorder had significantly more family members affected with mental illnesses. The clinical features included diminished interest in play and activities, excessive tiredness, low self- esteem, problems with concentration, multiple somatic complaints, behavior symptoms like anger and aggression, recent deterioration in school performance and suicidal behavior. Majority of children had other associated psychiatric disorders which included dysthymic disorder, anxiety disorders, conduct disorder and conversion disorder.

Macroscopic T wave alternans in long QT syndrome.

A 6 year old girl was admitted with recurrent episodes of loss of consciousness. ECG showed prolonged QT interval and macroscopic T Wave alternans. Identification of this ECG pattern is important since it can lead to potentially lethal arrhythmias.

Effectiveness of individualized education program for slow learners.

OBJECTIVE: To evaluate the effectiveness of an individualized education program for children with scholastic backwardness. METHODS: Among the children attending a Child Guidance Clinic for scholastic backwardness, 12 of them who were diagnosed as slow learners based on current level of academic functioning and IQ and 6 children having mild mental retardation were given individualized education for a period of two months. Independent assessors evaluated the academic functioning at the beginning of the training and at the end. RESULTS: The results showed that the children had significant improvement in their academic functioning and self esteem after the training. CONCLUSION: The present experiment can be a model to set up a resource room in normal schools to provide individualized education to children who are slow learners.

Deliberate self-poisoning in children.

This prospective study was aimed to analyze the nature of and the factors associated with deliberate self-poisoning in children below the age of 12 years. Children referred to the Child Guidance Clinic for evaluation after recovery from the effects of poisoning during the five-year period between 1999 and 2003 formed the subjects of the study. The children were evaluated for stress factors, psychiatric disorders and the nature and mode of deliberate self-poisoning. Deliberate self-poisoning constituted 0.9% of total admissions due to poisoning. There were 10 boys and 2 girls between the ages of 9 and 12 years. Both acute and chronic stress in the family and school were associated with deliberate self-poisoning. Majority of them had psychiatric disorders. Rat poison (zinc phosphide) was the commonest poison used. Two children got the idea from watching TV serials.