ABSTRACT
Objective: To establish the normative blood pressure (BP) values in healthy Indian neonates using oscillometric method, and to develop BP percentile charts. Design: Prospective observational study. Setting: Neonatal unit of a teaching hospital in Eastern India. Participants: 1617 hemodynamically stable inborn neonates without birth asphyxia, major congenital anomaly, maternal complications (e.g. preeclampsia, hypertension, diabetes) or critical neonatal illness. Procedure: Quite state measurements of systolic BP (SBP), diastolic BP (DBP) and mean arterial pressure (MAP) were recorded by oscillometric method on day 4, 7 and 14 of postnatal life. The averages of three readings at 2-minute intervals were used. Results: Percentile charts (providing 5th, 10th, 25th, 50th, 75th, 95th, and 99th percentile values) have been developed. SBP, DBP and MAP showed a steady rise from day 4 to day 14, and were comparable between males and females, but were significantly lower in preterms than in term neonates Conclusions: Normative neonatal BP data along with gestational age-wise percentile charts shall be of help for decision-making and planning for sick newborns.
ABSTRACT
Keratoconus is a slowly progressive, noninflammatory ectatic corneal disease characterized by changes in corneal collagen structure and organization. Though the etiology remains unknown, novel techniques are continuously emerging for the diagnosis and management of the disease. Demographical parameters are known to affect the rate of progression of the disease. Common methods of vision correction for keratoconus range from spectacles and rigid gas‑permeable contact lenses to other specialized lenses such as piggyback, Rose‑K or Boston scleral lenses. Corneal collagen cross‑linking is effective in stabilizing the progression of the disease. Intra‑corneal ring segments can improve vision by flattening the cornea in patients with mild to moderate keratoconus. Topography‑guided custom ablation treatment betters the quality of vision by correcting the refractive error and improving the contact lens fit. In advanced keratoconus with corneal scarring, lamellar or full thickness penetrating keratoplasty will be the treatment of choice. With such a wide spectrum of alternatives available, it is necessary to choose the best possible treatment option for each patient. Based on a brief review of the literature and our own studies we have designed a five‑point management algorithm for the treatment of keratoconus.
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PURPOSE: To suggest a surgical normogram for lateral rectus recession in exotropia associated with unilateral or bilateral superior oblique muscle palsy (SOP). METHODS: We retrospectively reviewed the charts of 71 patients with exotropia who were successfully corrected over one year. Each patient had undergone unilateral or bilateral rectus recession associated with uni- or bilateral inferior oblique (IO) 14 mm recession, using a modified surgical normogram for lateral rectus (LR) recession, which resulted in 1 to 2 mm of reduction of LR recession. We divided all patients into 2 groups, the 34 patients who had undergone LR recession with unilateral IO (UIO) recession group and the remaining 37 patients who had undergone LR recession with bilateral IO (BIO) recession group. Lateral incomitancy was defined when the exoangle was reduced by more than 20% compared to the primary gaze angle. The surgical effects (prism diopters [PD]/mm) of LR recession were compared between the two groups using the previous surgical normogram as a reference (Parks' normogram). RESULTS: The mean preoperative exodeviation was 20.4 PD in the UIO group and 26.4 PD in the BIO group. The recession amount of the lateral rectus muscle ranged from 4 to 8.5 mm in the UIO group and 5 to 9 mm in the BIO group. Lateral incomitancy was noted as 36.4% and 70.3% in both groups, respectively (p = 0.02). The effect of LR recession was 3.23 +/- 0.84 PD/mm in the UIO group and 2.98 +/- 0.62 PD/mm in the BIO group and there was no statistically significant difference between two the groups (p = 0.15). CONCLUSIONS: Reduction of the LR recession by about 1 to 2 mm was successful and safe to prevent overcorrection when using on IO weakening procedure, irrespective of the laterality of SOP.
Subject(s)
Child , Female , Humans , Male , Exotropia/complications , Eye Movements , Follow-Up Studies , Nomograms , Oculomotor Muscles/physiopathology , Ophthalmologic Surgical Procedures/methods , Retrospective Studies , Treatment Outcome , Trochlear Nerve Diseases/complicationsABSTRACT
This observational study was conducted on 973 healthy children between 8 and 16 years to evaluate the relation between changes in foot length and pubertal maturation. The right foot length of study children was recorded and SMR staging was done. The difference in mean foot length was statistically significant between SMR 1 and 2 (P<0.0001). No significant difference in the mean foot lengths was found thereafter. Smoothed standard deviation curves were constructed for foot length as a function of SMR stage using the LMS method. Foot length was found to rise sharply in SMR 2, which coincides with the onset of puberty.
ABSTRACT
Background Body surface area (BSA) is used in clinical practice to prescribe medication, standardize measured parameters etc. Normogram has been the gold standard. However, there are several prediction equations in the published literature. A simple method giving an accurate estimation would help to assess BSA in day to day clinical practice efficiently. Objective To assess the accuracy of different equations for the estimation of BSA in a group of Sri Lankan children. Method Data collected in 3 different school surveys carried out between 2002 and 2005 were used. BSA estimated by 9 prediction equations described in the literature were compared with the BSA assessed by normogram. Results Two thousand three hundred and thirty eight girls and 639 boys, between the ages of 5-16 years, were assessed. The mean ages of the boys and girls were 10.3±1.47 years and 11.5±2.47 years respectively. The highest mean BSA estimation was given by Gehan & George equation (boys 1.14±0.20m2 and girls 1.2 ± 0.25m2) and lowest by Yu et al (boys 1.08±0.20m2 and girls 1.13±0.25m2). Estimates correlated highly with BSA assessed by normogram. When the estimates were compared with normogram, equation of Mattar gave the highest bias for both groups (females 0.0152m2 and males 0.0177m2). Mosteller equation gave relatively low bias (females 0.0077m2, and males 0.0072 m2). Conclusions All equations gave very good agreement between each other. Out of the equations, easiest to use in day to day clinical practice is the equation described by Mosteller. The maximum bias in estimation would lead to less than 5% error in determining drug doses which is negligible in day to day clinical practice. Mosteller equation is suitable for routine clinical use.
ABSTRACT
Pregunta de investigación. ¿Cual sera la validez del índice de masa corporal en embarazadas con relación al nomograma de Rosso y Mardones en los hospitales materno infantil, de la mujer y boliviano holandés de la ciudad de La Paz de enero a febrero gestión 2002?. Objetivo general. Determinar la sensibilidad, especificidad, valores predictivos positivos y negativo, además de los likelihood ratio del índice de masa corporal en embarazadas con relación al nomograma de Pedro Rosso y Mardones en los hospitales materno infantil, de la mujer y boliviano holandés de enero a febrero gestíon 2002. Diseño de estudio en la investigación. Test diagnóstico. Lugar. Hospital Materno Infantil, Hospital de la Mujer de la ciudad de La Paz y Hospital Boliviano Holandés de la Ciudad de El Alto. Población. Embarazadas, desde la décima semana a la semana 40 de gestación que asistieron al control prenatal de rutina de los hospitales señalados anteriormente. Métodos. Se evaluó el estado nutricional de la embarazada utilizando el Indice de Masa Corporal IMC (prueba a validarse) y el Nomograma de Rosso y Mardones (Gold Estandar). Para los cálculos de sensibilidad, especificidad, valores predictivos positivos y valores predictivos negativos se utilizó el paquete estadístico EPIDATA y para los cálculos estadísticos el paquete estadístico STATA 6.0. Se realizó el análisis descriptivo utilizando medidas de tendencia central y de dispersión como Promedio, Desviación Estandar, verificando a través del cálculo del intervalo de confianza 95 por ciento, porcentajes y frecuencia para las variables cualitativas. Resultados. El presente estudio se realizó en 479 embarazadas que asistieron al control prenatal de rutina en los meses de enero y febrero del 2002...
What is the validity of the Body Mass Index in pregnant women in relation to the Normogram of Rosso and Mardones in the Hospitals "Materno Infantil" " de la Mujer", and "Boliviano Holandés" in La Paz, from January to February 2002 ? General Objective o determine sensibility, specificity, positive and negative predictive values, in addition to likelihood ratio and Body Mass Index in pregnant women in relation to the Normogram of Pedro Rosso and Mardones in the Hospitals "Materno Infantil", "de la Mujer", and Boliviano Holandés" from January to February 2002. Research Design Diagnostic test SITE"Hospital Materno Infantil", "Hospital de la Mujer", "Hospital Boliviano Holandés" in La Paz. SAMPLE The sample consisted of 479 pregnant women, from the 10th week of gestation to 40 weeks of gestational age who came for routine prenatal control to the above mentioned hospitals. Methods We assessed the nutritional status of the pregnant woman using the Body Mass Index (the test to be validated), and the Normogram of Rosso and Mardones (Gold Standard).For the calculation of sensibility, specificity, negative and positive predictive values, we used the statistic package EPIDATA, and for the statistic calculus the statistic package STATA 6.0.For the descriptive analysis we used measures of central tendency and of dispersion like Mean, Standard Deviation, verifying by means of calculating the Confidence Interval 95%, percentages and frequency for the qualitative values. In order to establish the relationship between both tests we used the tests of Correlation and Chi2 .Result The present study was carried out in 479 pregnant women who came to the routine prenatal control in January and February 2002 in the Hospitals "Materno Infantil", "Boliviano Holandés", and "Hospital de la Mujer".The nutritional diagnose of the preThe results of the...