RESUMO
Background: Developmental and childhood neuropsychiatric disorders have a large burden throughout the world, including the developing countries. Many children with clinically identifiable developmental problems present late for medical help due to lack of simple measures for their early recognition. These missed opportunities increase the level of dependence and disability of an individual and decrease the productivity of the community at large. So simple measures are needed to determine NDIs at an early age where professional expertise is sparse. Authors objective was to estimate the proportion of children having NDIs in a tertiary care hospital, and to estimate the specific types of NDIs, and their grades of severity, within the study population.Methods: It was a cross sectional study conducted at the Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh and the duration of the study was six months. Children aged 0-2 years who were attending Pediatric OPD were included in the study. Sample was collected by lottery method and who fulfilled the inclusion criteria. A two-stage design was followed for detection of NDIs. Stage I was consisted of screening of all children in the sample by Development Screening Questionnaire (DSQ). Stage II consisted of neurodevelopmental assessment using a validated RNDA method of evaluation of all children with DSQ positive screening result.Results: 7.26% children were found to have DSQ positive for NDIs. Cognition and speech was the mostly affected domain. By RNDA, NDIs were found in all DSQ positive cases. Severe impairment was 35.29% of the affected children in speech by RNDA. Detection of NDIs was more in gross motor (52.94% vs 35.29%), fine motor (94.18% vs 17.65%), speech (76.47% vs 64.71%), cognition (94.18% vs 64.71%), behavior (58.82% vs 5.89%) respectively by RNDA than the DSQ.Conclusions: The frequency of NDIs is 7.26% of all children. In certain developmental domain (i.e. gross motor, fine motor, cognition, speech, behavior) RNDA is more effective than DSQ as found in the small-scale study.
RESUMO
A ossificação pulmonar difusa é uma condição rara, de etiologia desconhecida, na qual osso maduro é encontrado no parênquima pulmonar. É quase sempre descoberta como um achado incidental de autópsias. Freqüentemente afeta homens de meia-idade e é assintomática. Relata-se o caso de um paciente de 75 anos, que apresentou uma radiografia torácica com comprometimento pulmonar difuso e cujo diagnóstico foi baseado no exame histopatológico de fragmento pulmonar obtido através da biópsia a céu aberto, o qual demonstrou fibrose intersticial acentuada com ossificação do parênquima pulmonar.
Diffuse pulmonary ossification is a rare condition of unknown pathogenesis in which mature bone is found in the pulmonary parenchyma. It is almost invariably discovered as an incidental finding at autopsy. Most commonly, it affects middle-aged men and is asymptomatic. We present the case of a 75-year-old man in which the chest X-ray showed diffuse interstitial infiltrate. Diagnosis was based on histopathological examination by open-lung biopsy, which revealed interstitial fibrosis with pulmonary ossification.