Quality of life in children with cerebral palsy

Background: Cerebral palsy (CP) is the most common motor disability in childhood. Quality of life (QOL) has emerged as an important concept in childhood, especially for children with disabilities. CP has an impact on a child’s capacity to do activities of daily living thus affecting QOL of patients and their families. Aims and Objectives: The objective of present study was to assess the QOL in children with CP. Materials and Methods: In this study, 29 children with CP in the age group of 4–12 years were evaluated for QOL was assessed using CPQOL-Child Primary Caregiver Questionnaire (4–12 years). The questionnaire was completed by one of the parents or their caregiver. Scores for each domain of QOL were converted to a scale ranging from 0 to 100 and analyzed. Results: The scores as reported by the parents were low for each of the domains with maximum effect seen in functioning domain and least in pain domain. Girls had better QOL than boys. The QOL scores were negatively related to the severity of CP which was assessed by gross motor function classification system suggesting that severity of disability had negative impact on QOL. Conclusion: QOL of children with CP was found to be poor and was influenced by age, sex and motor functioning

Association of Anti N-methyl-D-aspartate (NMDA) Receptor Encephalitis with Chediak-Higashi Syndrome

Background: Neurological manifestations of Chediak-Higashi syndrome mainlyinclude peripheral neuropathy, ataxia, tremors, cranial nerve palsies, intellectual declineand seizures. Case Characteristics: A 2 years 10 month old girl with silvery hair syndromepresented with sub-acute onset behavioral issues, ataxia and multiple type abnormalmovements. Cerebrospinal fluid examination was positive for Anti NMDA receptorantibodies. Hair shaft examination and peripheral blood film findings were suggestive ofChediak Higashi syndrome. Message: Anti NMDA receptor encephalitis may beassociated with Chediak Higashi Syndrome.

Trends of transfusion transmittable infections among voluntary blood donors in a cardiac care hospital, Bengaluru, India

Introduction: Transmission of infectious diseases through donated blood is of concern to blood safety as transfusion forms an integral part of medical and surgical therapy. Blood transfusion carries the risk of transfusion-transmittable infections including HIV, hepatitis–B etc. Screening of voluntary donors who represent healthy population serves as a predictor for these dreadful diseases in healthy population. Materials and Methods: This retrospective study was conducted at the blood bank of Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru. Data were analyzed for a period of 7 years from January 2011 to December 2017. All voluntary donors including replacement donors of our blood bank were screened for Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) and Syphilis infection by using ELISA. Results: The most common infection was Hepatitis B (0.69%) followed by Syphilis (0.34%) and HIV (0.0736%) and least with HCV (0.04%) in our study. Conclusion: This study has shown a decrease in seroprevalence for HIV and increase in seroprevalence for HCV over 7 years study period.

Effectiveness of reminiscence therapy on health related quality of life among the old age people residing at a selected old age home, Bengaluru, India

Background and Objectives: The well being of oneself, happiness with one’s situation in life and ability to perform and control the different situation of life is HRQoL. Reminiscence therapy is a way for residents of assistant living facilities to become better acquainted with one another and strengthen the personal value and self esteem. The objective of this study was to assess the HRQoL while application of Reminiscence Therapy among the old age people who are residing at a selected old age home in Bengaluru, India. Materials and Methods: For this study quasi experimental research design was selected and convenient sampling technique was used to collect data from 60 samples staying at old age home by using the SF-36 scale. The samples in experimental group receive 10 sessions of reminiscence therapy each session last for 45 minutes to 1 hour. The experimental group was divided into 6 groups each group having five members for group discussion related to the topics like childhood memories, education pattern, first job and first salary, marriage, first child etc. Post test data was collected after a week of implementation of Reminiscence Therapy. Then the data was analyzed and interpreted. Results: The findings of the study with regard to pretest HRQoL reveals that 86.7% has poor HRQoL, 13.3 % moderate HRQoL and no one was having good HRQoL in experimental group. In control group 56.7% has poor HRQoL, 43.3% moderate HRQoL and no one was having good HRQoL. But in posttest, only in experimental group there was significant improvement in HRQoL as 83.3% has good HRQoL, 13.3% moderate HRQoL and 3% poor HRQoL.  Conclusion: This study concluded that with significant improvement in the SF-36 Scale score after administration of the reminiscence therapy and seen improvement in HRQoL.

Correlation Between Endocranial Capacity and Size of Foramen Magnum with Special Reference to Sex.

Background: Endocranial capacity is an important parameter in the study of human evolution, race and sex determination of skull. Diameters of foramen magnum are important because vital structures passing through it may endues compression and for sex determination of skulls. Correlation between endocranial capacity and area of foramen magnum was reported in mammals. This relation in human can be used to determine sex of damaged skulls. Methods: 150 dry skulls and 30 CT scan images of living subjects were studied. Endocranial capacity of skulls was measured by modified Breitinger’s method. Diameters of foramen magnum were measured by vernier calipers and its area was calculated by formula endocranial capacity of CT scan images measured by planimetry. Diameters and area of foramen were measured automatically. Results: The Mean endocranial capacity of male and female skulls were 1367.3ml and 1255.2ml respectively by modified Breitinger’smethod and by CT scan image planimetry method were 1347.1ml and 1130ml. The mean longitudinal diameter of foramen magnum in male was 33.4mm and female was 33.1mm and by CT Imaging method in male was 38.5mm and female was 35.2mm. The mean transverse diameter of foramen magnum in male was 28.5mm and female was 27.3mm and by CT Imaging method in male was 29.1mm and female was 27.6mm. Conclusion: Endocranial capacity, transverse diameter and area of foramen magnum of male skulls were greater than females. A significant positive correlation was observed between endocranial capacity and area of foramen magnum in male and female skulls, but highly significant positive correlation was observed when both sexes were considered together. Living subjects showed a significant positive correlation between endocranial capacity and area of foramen magnum when both sexes were considered together.

Morphometric Analysis of Foramen Magnum.

Background: Diameters of foramen magnum are important because vital structures passing through it and for sex determination of skulls. The dimensions of the foramen magnum are clinically important because vital structures passing through it may endure compression such as in cases of foramen magnum herniation, foramen magnum meningiomas and foramen magnum achondroplasia. The knowledge of foramen magnum diameters is needed to determine some malformations such as Arnold Chiari syndrome, which shows expansion of transverse diameter. Objectives: To study longitudinal diameter, transverse diameter and area of foramen magnum in relation to sex. Methods: 150 dry skulls and 30 CT scan images of living subjects were studied. Diameters of foramen magnum were measured by vernier calipers and its area was calculated by formula. Diameters and area of foramen were measured automatically. Results: The mean longitudinal diameter of foramen magnum in male was 33.4mm and female was 33.1mm and by CT Imaging method in male was 38.5mm and female was 35.2mm. The mean transverse diameter of foramen magnum in male was 28.5mm and female was 27.3mm and by CT Imaging method in male was 29.1mm and female was 27.6mm. Conclusion: longitudinal and transverse diameters and area of foramen magnum of male skulls were greater than females.

Morphometric Analysis of Endocranial Capacity.

Background: Endocranial capacity is an important parameter in the study of human evolution, race and sex determination of skull. Endocranial capacity is an important parameter in the study of racial differences and in clinical practice for the study of the abnormalities of cranial size, it is one of the most important variable in the study of the human evolution. The objective of present study is to measure endocranial capacity of skulls. Materials and Methods: 150 dry skulls and 30 CT scan images of living subjects were studied. Endocranial capacity of skulls was measured by modified Breitinger’s method and CT scan imaging by planimetry method. Results: The Mean endocranial capacity of male and female skulls were 1367.3ml and 1255.2ml respectively by modified Breitinger’smethod and by CT scan image planimetry method were 1347.1ml and 1130ml. Conclusion: Endocranial capacity of male skulls were greater than females. The knowledge of endocranial capacities were help in neurosurgical, anthropology and forensic practice.

Supracricoid laryngectomy with Cricohyoidopexy--a clinico oncological & functional experience.

Supracricoid laryngectomy with Cricohyoidopexy (CHP) is a procedure that is commonly practiced in France & Canada. Eight such procedures were carried out at Kidwai Memorial Institute of Oncology, Bangalore during the period from 1991 through 1996. Four Glottic, 3 transglottic & one supraglottic cancers were subjected to this procedure. The study comprised of 7 males & 1 female. The average age was 52 years. Two procedures were done as salvage procedures for radiotherapy (RT) failures. The patients have a follow-up ranging from one year to six years, except for one who died soon after discharge from hospital secondary to myocardial infarction. Median follow up was four years. The three year acturial disease free survival was 83%. Six out of 8 (75%) were decannulated, and physiologic deglutition without aspiration was established in all patients. Hospital stay ranged from 11 to 62 days averaging 29 days. The speech was analyzed together with other partial laryngectomies and was found to be qualitatively worse than speech after other partial laryngectomy procedures. In addition speech intensity levels after CHP were lower than in other partial laryngectomy procedures. The speech however allowed normal social interaction. This procedure certainly has distinct oncological advantage in encompassing circumferential horse-shoe lesions with minimal subglottic extension which in the past would have received total laryngectomy and needs to be included in the repertoire of speech restorative surgery in laryngeal cancers.

Surgical speech restoration by tracheo-oesophageal puncture--Kidwai experience.

This paper addresses our experience with primary (15 patients) and secondary (8 patients) tracheo-oesophageal puncture (TEP) in the laryngectomee. Despite a success rate of 93.3 percent in the primary TEP and 62.5 percent in secondary TEP, in a follow-up period of one month to eight years, prosthesis related problems like maintenance and recurring expenses emerged as significant deterrent factors in adopting prosthetic speech rehabilitation. Successful oesophageal speech training, increased practice of Pearson's near total laryngectomy, prior tracheostomy and advanced disease mandating post-operative radiotherapy in majority of patients are some of the factors in addition to prosthesis after-care maintenance that makes TEP a less practiced option at our center.

Vocal rehabilitation after gastric transposition. The critical overview.

Re-establishment of effective communication following laryngopharyngo esophagectomy and gastric transposition requires thorough knowledge and flexibility of introducing the entire range of communication options. This study describes our experience with eleven patients of gastric transposition who attended intensive speech therapy and developed gastric speech using different method of speech producing and attaining various levels of proficiency. Application of digital pressure is one of the most effective technique for production of satisfactory and intelligible voice in gastric transposition cases who fail to develop speech by inhalation method.

Post laryngectomy rehabilitation the case for planned early speech therapy.

This study reflects the efficacy of planned early speech therapy on post laryngectomy rehabilitation. Not only do a larger number of laryngectomees acquire intelligible esophageal speech where therapy is instituted early but also the pace of development and quality of the speech is far superior when compared to those laryngectomees in whom speech therapy was delayed. This paper unequivocally supports the institution of planned early speech therapy in the successful rehabilitation of the laryngectomee. Such therapy can proceed simultaneously with the post operative radiation therapy sans deleterious effects and without prolonging hospital stay with its attendant overheads.