Etiology of short stature in east Azerbaijan, Iran

Short stature is a common problem encountered by pediatricians and is the most common cause for referral to pediatric endocrinologists. Although most children referred with short stature are normal and classified as normal variants of stature [constitutional growth delay and familial short stature], it may sometimes be the only obvious manifestation of an endocrine or systemic disease. The objective of this study was to assess the characteristics of patients referred to pediatric endocrinology clinic because of short stature and determination of the etiology. Three hundred-seventy nine children and adolescents were studied which referred with short stature to pediatric endocrinology clinic. After complete clinical and paraclinical evaluation and appropriate treatment [if needed], patients were followed for at least six months. From 379 studied patients with a mean age of 9.7 +/- 3.7 years, 192 [50.7%] were girls and 187 [49.3%] boys [P=0.066]; short stature in 132 [34.8%] of patients was not approved. Normal variants of Short stature [familial and constitutional] constituted 53.3% of etiology in short patients. In 11.5% of short patients, no obvious etiology was found, and 9.8% were born with intra uterine growth retardation. Other causes were growth hormone deficiency, hypothyroidism, skeletal dysphasia, Turner syndrome, and malnutrition. A great number of children and adolescents referred with short stature to pediatric endocrinology clinics are not really short. Greater than half of short patients are normal variants of Short stature

Intrauterine growth restriction: antenatal diagnosis and foetal outcome

The following study was conducted in the Department of Obstetrics and Gynecology Jinnah hospital Lahore to identify women with risk factors for IUGR [Intrauterine growth restriction: Antenatal diagnosis and foetal outcome.]on clinical assessment and ultrasound and to co -relate antenatal diagnosis with fetal outcome. Fifty [50] patients were picked on basis of risk factor. Fourteen [28%] had SFH less than expected for gestation. Eleven [22%] had hypertension, Nine [18%] had previous history of SGA babies. Other risk factors were diabetes mellitus, pre-pregnancy weight less than 50 kg and smoking. On ultrasound 18 [39.63%] of patients were diagnosed as IUGR while 28 [60.48%] were diagnosed as non IUGR. Among IUGR babies 66.24% had asymmetrical while 33.76% had symmetrical IUGR. 39.53% babies were suspected of IUGR on SFH, and 28% of IUGR babies were suspected on ultrasound, as outcome measure 25% of babies had birth weight less than 10th percentile after delivery. It was concluded that for antenatal diagn osis of IUGR sonographic assessment is more precise than clinical assessment

Modificación del dimorfismo sexual del peso durante la gestación en presencia de retardo de crecimiento intrauterino: relación con factores maternos adversos preconcepcionales, concepcionales y ambientales / Modification of sexual dimorphism of weight in intrauterine growth retardation

El dimorfismo sexual (DS) comprende, en sentido amplio, diferencias morfológicas y funcionales entre sexos. Refleja la relación entre el pool genético y las capacidades del ser humano para reaccionar ante diferentes condiciones ambientales. Ciertos aspectos del DS se inhiben ante factores ambientales adversos. Objetivo:Identificar si se modifica el DS del peso corporal frente a retardo de crecimiento intrauterino (RCIU). Pacientes y método: Se compararon 2 552 recién nacidos con (N = 250) y sin (N = 2 302) RCIU. Todos fueron de término (para Argentina > 37 semanas). La población se dividió en dos grupos de acuerdo a la condición de crecimiento fetal y la presencia de varios factores maternos adversos (preconcepcionales, concepcionales y ambientales). Resultados:No hubo diferencias estadísticas significativas entre sexos en el peso al nacer de neonatos con RCIU, siendo las niñas más pesadas que los varones. De forma contraria, los neonatos con crecimiento fetal normal evidenciaron diferencias significativas en el peso entre sexos siendo los varones más pesados que las niñas. Se concluye que la inhibición del DS está ya presente en etapas prenatales cuando ocurre una situación que afecte el crecimiento.

Neurobehavioral assessment of appropriate for gestational and small for gestational age babies.

he present study was conducted to evaluate the neurobehaviour of term appropriate for gestational aland small for gestational age babies during the first two weeks of life in a tertiary care hospital. Forty eight appropriate and thirty small for gestation age babies were evaluated using Brazelton Neurobehavioural Assessment Scale on 3rd, 7th and 14th day of life. The behaviour of AGA babies is characterized by optimal performance in habituation, range of state, regulation of state and autonomic stability. The behavior is at low to mid-range in orientation and in motor clusters. All the behavior clusters showed improvement over first 14 days except for regulation of state which showed a lower performance on day 7 and 14. The behavior performance of SGA babies on day 3, compared to AGA babies, was lower in all the clusters except orientation where they performed much better. The percentage improvement of scores in SGA babies is higher than in AGA babies and by day 14 SGA babies are scoring higher than AGA babies in orientation, autonomic stability and regulation of state. The difference in the neurobehavior pattern of babies in relation to their intrauterine growth suggests need for appropriate care.

Deciduous dentition and enamel defects.

Two hundred eighty children including wellnourished, malnourished and infants with intrauterine growth retardation (IUGR) were examined for dental eruption and enamel hypoplasia. In malnourished and IUGR children eruption of teeth was delayed. The prevalence of enamel hypoplsia in wellnourished children was 20% being significantly higher in females as compared to males in age group 1-2 years. Enamel hypoplasia was seen in 36.6% malnourished subjects. Breast-feeding was protective against enamel hypoplasia.

diagnostic ability of combined obstetric ultrasonography with clinical assessment for IUGR babies

IUGR [Intrauterine Growth Retardation] is the most common cause of morbidity and mortality in neonates in developing countries. Its early and correct diagnoses are probably the most important step in being able to decrease morbidity and mortality from this condition. In a retrospective analysis of 1947 deliveries conducted in the department of Obstetrics and Gynecology, Sheikh Zayed Hospital, Lahore for the year 1999 - 2000. The total incidence of singleton IUGR babies was found to be 6 percent [90], 4.34 percent [65] babies were correctly diagnosed for IUGR, while 1.67 percent [25] babies were missed for the diagnoses of IUGR. The combined method of obstetric USG and clinical assessment for the diagnosis of IUGR could yield a 72.22 percent sensitivity, 96.02 percent specificity, 53.70 percent positive predictive value and a 98.18 percent negative predictive value for the correct diagnoses of IUGR singleton babies prenatally

Inducción del parto con misoprostol: análogo de la prostaglandina E-1 / Induction of delivery with misoprostol: a prostaglandin E-1 analogue

Se estudian 64 pacientes embarazadas, hospitalizadas en la unidad de alto riesgo obstétrico del servicio de obstetricia y ginecología, en el período de julio a septiembre de 1997. Se induce el trabajo de parto con 50 mcg de misoprostol, intracervical o en el fórnix vaginal posterior, lográndose parto vaginal en 51 (79,9 por ciento) pacientes, con un período de latencia de 3,87 horas y un promedio de duración del trabajo de parto de 19,5 horas

Intrauterine growth restriction: a perspective for Pakistan

Intrauterine growth restriction [IUGR] is the second leading contributor to the prevailing perinatal mortality and morbidity. It affects 23.8% of newborns around the world and 75% of these affected infants are born in Asia. In Pakistan the incidence of IUGR is around 25%, more than the WHO criteria for triggering a public health action. IUGR is implicated with profound long-term impacts in adult life; like coronary heart disease, NIDDM and abnormal cortisol levels. The effects of the short and long term sequelae are reviewed. IUGR is associated with a wide variety of etiological factors. But the factor unique in its importance to Pakistan is maternal malnutrition. The fetal gene expression is under the influence of nutrition. Growth projection curves showing the interaction between the genetic and environmental factors are discussed. Identification of IUGR baby in a primary care setting and the options in diagnosis in secondary and tertiary care settings are overviewed. The roots of this problem, with multi factorial causes are in the socioeconomic infrastructure. This calls for a synergistic approach of reducing this public health issue. Women empowerment can help us to get out of this intergenerational cycle of growth failure. Availability of resources aside, it is also a matter of political will to change things for the better

Anomalias congénitas en población de bajo riesgo: screening con ultrasonido prenatal en un sistema público de salud / Congenital anomalies in low risk population: screening with prenatal ultrasound in a public health system

Conocer la prevalencia de anomalías congénitas, y la capacidad diagnóstica del ultrasonido en el segundo trimestre (18 a 28 semanas). Se evalúa la información sobre 41.294 partos (1995-1997), en el área sur-oriente de salud pública en Santiago, Chile. La prevalencia de anomalías congénitas mayores que son hospitalizadas en dicho período fue de 1,15 por ciento (475/41340). En el grupo estudiado, el 77 por ciento tuvo un examen de ultrasonido durante el trimestre medio. La sensibilidad del ultrasonido fue del 50 por ciento. La sensibilidad por sistemas fue de: 78,9 por ciento en genito-urinarias; 76,8 por ciento en anomalías del sistema nervioso central; 55,2 por ciento en gastro-intestinales; 56,6 por ciento en músculo-esqueléticas; 49 por ciento en trisomías (13, 18, 21); 44 por ciento en síndromes malformativos ; 36,2 por ciento para las anomalías cardiovasculares; 20 por ciento en faciales; y 28 por ciento para otras malformaciones. La mortalidad perinatal ampliada fue de 12,17/1000 (503/41340); el 24,1 por ciento de ésta (121/503) se asoció a anomalías congénitas. La evaluación con ultrasonido en el trimestre medio detecta una proporción significativa de las anomalías congénitas. Es importante aumentar la cobertura del examen de ultrasonido en el trimestre medio y mejorar la calidad del estudio ultrasonográfico cardiovascular y facial

Retardo do crescimento intra-útero: complicaçöes neonatais / Intrauterine growth retardation: neonatal complications

O autor descreve os tipos de desnutriçäo que ocorrem intra-útero e apresenta possíveis complicaçöes clínicas do processo no período neonatal. Também apresenta os resultados sobre o crescimento e o desenvolvimento desses recém-nascidos.

Retardo de crecimiento intrauterino: un desafío para la salud pública / Intrauterine growth retardation: challenge for the public health

Este artículo es una revisión de la literatura más reciente con respecto al Retardo de Crecimiento Intra-uterino. Este trabajo se propuso verificar los avances en relación al conocimiento de la etiología, prevención, diagnóstico y tratamiento del Retardo de Crecimiento Intra-uterino; así como, identificar los aspectos aún no estudiados.

Recien nacido de bajo peso, factores de riesgo

Durante un año se estudio en forma prospectiva factores de riesgo asociado con el bajo peso de nacimiento. Particparon 4 maternidades en La Paz y una en Tarija, todas ellas servian diferentes clases socio-economicas. De un total de 8876 recien nacidos, registramos 727 RNBP, de los cuales la mayor parte fue RNPT (430) y el resto niños con RCI. El porcentaje global de RNBP fue del 8.1 por ciento cifra que ha disminuido en relacion a estudios anteriores. Los factores de riesgo considerados mas importantes fueron: talla baja de los padres, estado nutritivo materno deficiente y poco aumento de peso durante la gestacion, cuidado prenatal inadecuado, nivel socioeconomico bajo, gesta 1, para 1, peso placentario inferior a 550 g. y presion arterial elevada. Un numero importante de factores de riesgo perinatal asociados al bajo peso de nacimiento peuden ser modificados en forma exitosa con la intervencion medica oportuna y adecuada y de esta forma disminuir el porcentaje y la morbimortalidad a sociada con el RNBP. Necesitamos trabajar en conjunto con todas las areas de salud diseñando programas nacionales para encarar el problema, al mismo tiempo es necesario mejorar las condiciones socioeconomicas de la poblacion.