Approaching a dysmorphic newborn

Dysmorphology combines concepts, knowledge and techniques from field of embryology, clinical genetics and pediatrics. It deals with people who have congenital abnormalities and their families. Clinical delineation of dysmorphism and dysmorphic syndromes is crucial for patient management and family counseling. Forty case mothers and neonates, 83 control mothers and neonates were recruited in the study. Face to face interviews were conducted with the mothers of both cases and controls. Case's mothers and neonates were subjected to certain investigations according to dysmorphic anomaly and when needed. The study showed that increased risk of having a dysmorphic child was associated with high consumption of legumes and the use of kerosene in cooking stoves. Their Odd Ratio [OR] and Confidence Interval [CI] respectively were [OR-15558.0; CI 137.0-17716.2] and [OR = 186.7; CI 42.3-824.5]. Maternal demographic risk factors were, medication intake [OR-29.62; CI 3.38-112.5], diseases during pregnancy [OR = 24.13; CI 5.92-114.18], maternal occupation [OR = 15.4; CI 1.78-132.8], and educational attainment [OR = 2.85; CI 1.19-6.86]. In rural areas the rate of having dysmorphic child is higher than that in urban areas [OR = 11.85; CI 3.60-38.99], [p-value-0.00]. Consanguinity [OR = 4.35; CI 1.927-9.796], was a key risk factor contributing to dysmorphology. Drinking water which is obtained by pumps was significant in this study [OR = 27.3; CI 3.4-222.7] as well as ghee consumption [OR = 6.3; CI 2.4-16.4]. In conclusion, the considerable challenge posed by dysmorphic abnormalities calls for the development of prevention programs through the establishment of community genetic services particularly those related to maternal education and environmental exposures. These primary prevention measures should be integrated into primary health care

Biological and cognitive aspects of somatoform disorders

A practical clinical subdivision of Psychosomatic Syndromes is proposed. Physiological and clinical features of both of them are discussed. The real and serious clinical problem that this entities represents is stated. Actual concepts about functional disorders of the Gl are being analyzed. Special focus is placed in the relation between the anatomical and physiological arrangement of the visceral afferent pathways, and the clinical presentations of these entities. The terms and concepts: hypersensitivity, hyperalgesia, pain thresholds, somatic reference of visceral pain, pain memory, receptive fields are studied.The mechanisms that allows and conduces to the hole expression of the syndrome are thought to have the special characters of the visceral sensorial modalities.It is proposed that many functional psychosomatic patients (Somatoform patients) have alterations in sensorial process at a peripheral level, with alterations in the pain and noxious memory of the Sensitive neurons of the dorsal horn. Cognitive process is being discussed, and an integrative point of view is proposed.It is concluded that the unique clinical, anatomical and physiological feature of visceral sensitive process: Ambiguity, and lack of accuracy, makes it more biased to distortions in the information process