Botulinum toxin treatment of hemifacial spasm and blepharospasm: objective response evaluation.

Twenty seven patients with hemifacial spasm (HFS) and sixteen patients with blepharospasm (BS) having mean Jankovic disability rating scale score of 2.56+0.58 SD and 2.81+0.54 SD, respectively, were treated with botulinum toxin A (BTX-A) injections. The total number of injection sessions were ninety one with relief response in 98.91%. The mean improvement in function scale score was 3.78+0.64 SD and 3.29+1.07 SD respectively, in HFS and BS groups. The clinical benefit induced by botulinum toxin lasted for a mean of 4.46+3.11 SD (range 2 to 13) months in HFS group and 2.66+1.37 SD (range 1 to 6) months, in BS groups. Transient ptosis was seen in 4.39% of total ninety one injection sessions. These findings show that local botulinum toxin treatment provides effective, safe and long lasting relief of spasms.

Neonatal screening by mid-arm circumference.

One hundred and ninety-seven neonates were screened within 24 hours after birth by a tricolored mid-arm circumference (MAC) measuring tape with a borderline yellow-zone between 7.5 cm and 8.5 cm and two peripheral zones, red and green beyond 7.5 cm and 8.5 cm respectively. All of the neonates identified by red-zone had birth weight less than 1500 g. Majority (89.7%) of neonates identified by yellow-zone had birth weight between 1500 g and 2000 g, but only a small (10.3%) number of neonates had birth weight more than 2000 g. A very large proportion of neonates identified by green-zone had birth weight more than 2000 g (98.8% vs 1.2% weighed less than 2000 g at birth). The sensitivity and specificity of MAC critical limit 8.5 cm identifying neonate below 2000 g were 93.7% and 98.2% respectively. It was not worthy in this study to calculate the sensitivity and specificity of the critical limit of 7.5 cm for MAC to identify neonates below 1500 g because of the very small sample size. But, this simple MAC measuring tape can be used by field worker for easy assessment of low birth weight neonates.