ABSTRACT
Introduction: Paediatric medico-legal cases are important public health problems in the paediatric casualty in India. These cases are among the leading causes of paediatric disabilities and deaths. We conducted a study to evaluate the demographic features of the medico-legal cases who presented to our paediatric casualty. Methodology: In a total of two-year study period, 120 patients were presented in casualty as medico-legal cases. Information about the patients was obtained from hospital records and analysed by us from casualty. Results: 70 male (58.3%) and 50 female (41.6%) patients were included in our study. The majority of the patients were between 10- 14 years of age (n=30; 25.0%). Fall from height was the major complaint (n= 60; 50%) of our patients. Winter was the most common season (n= 37; 30.6%) and January (n=13; 11%) was the most common month for medico-legal admissions. The majority of the patients (n=42; 35%) presented to our emergency room between 18-24 hours. 78 cases (65%) had health risks at the time of presentation. Conclusion: Developing effective & preventive strategies is essential to prevent child injuries. Majority of cases were males and adolescents. There is an urgent need to focus more on this vulnerable age group i.e., adolescent age group. There should be increased awareness among paediatricians about these medico legal cases and improving counselling skills to handle relatives of patients
ABSTRACT
Cloverleaf deformity is an extremely rare skull deformity that happens when mutiple joints (sutures) between a baby's skull bones begin to fuse too premature. Also known as Kleeblattschädel syndrome, the cloverleaf deformity causes bossing at the front and sides of the skull, resembling a cloverleaf shape. Cloverleaf skull syndrome is an abnormal configuration of the calvaria classified as Craniosynostosis, consisting of premature ossification of cranial bones. It is a deformity characterized by a remarkable enlargement of the head, with a trilobed configuration of the frontal view, resembling a three leaved clover .The first report about such a syndrome in the literature occurred in 1973 and, over the years only some tens of cases have been documented worldwide. The present report describes a case of a severe craniofacial condition that is known as "cloverleaf skull syndrome". On Physical examination multiple malformations were observed, with altered craniofacial configuration, low set ear, hypertelorism, exopthalmos, syndactyly, closed anterior fontanelle, high arched palate, bilateral CTEV. The vast majority of patients with kleeblattschädel have mentalretardation and hydrocephalus. It is usually seen in thanatophoric dysplasia: classically type II only, severe Apert syndrome, severe Crouzon syndrome, Boston-type craniosynostosis & Carpenter syndrome. Craniosynostosis has an overall incidence of 1 in 2100 to 1 in 2500 live births with multi-suture craniosynostosis constituting about 5% of all the cases