ABSTRACT
INTRODUCTION: Measurement of birth weight, crown-heel length, head circumference and chest circumference used to assess the intrauterine growth of a baby vary with altitude, race, gender, socioeconomic status, maternal size, and maternal diseases. The study aimed to construct centile charts for birth weight, crown-heel length and head circumference for new born at different gestational ages in Western Nepal. METHODS: This was a descriptive cross-sectional study done over a period of 15 months in a tertiary care hospital of Western Nepal. Birth weight, length, head circumference and chest circumference were measured within 12-24 hours of birth. Gestational age was estimated from the first day of last menstrual period and New Ballard's scoring system. Microsoft 2007 Excel and SPSS-16 was used for data analysis. Cole's Lambda Mu Sigma method was used for constructing centile curves. RESULTS: Out of 2000 babies analysed, 1910 samples were used to construct smoothed intrauterine growth curve of birth weight, crown-heel length, and head circumference from 33-42 weeks of gestation. Among all, 1147 (57.35%) were male and 853 (42.65%) were female, mean gestational age was 38.13±2.44 weeks. The means of birth weight, crown-heel length, head and chest circumference were 2744.78 gm, 47.80 cm, 33.18 cm, and 30.20 cm with standard deviations of 528.29, 3.124, 1.78, and 2.35 respectively. CONCLUSIONS: This necessitates the update in the existing growth charts and development in different geographical regions of a country.
Subject(s)
Altitude , Birth Weight , Body Height , Fetal Development , Gestational Age , Growth Charts , Head/anatomy & histology , Thorax/anatomy & histology , Adult , Anthropometry , Cephalometry , Cross-Sectional Studies , Female , Humans , Infant , Infant, Newborn , Longitudinal Studies , Male , Nepal , Pregnancy , Reference Values , Tertiary Care Centers , Ultrasonography, Prenatal , Young AdultABSTRACT
BACKGROUND: Phenytoin, mainly metabolized by cytochrome P450 enzyme system, has a narrow therapeutic index and may have adverse effects due to inter-individual variation in the dose requirement and genetic polymorphisms. This cross-sectional study was done to study the prevalence of cytochrome P450 CYP2C9 polymorphisms in Indian epileptic children and to see the effect of polymorphisms on serum levels in epileptic children on phenytoin monotherapy. METHODS: We studied 89 epileptic children of North Indian population, randomly selected, to see the genotypic and allelic frequency of CYP2C9 and its association with drug levels on phenytoin monotherapy. Analysis was done using STATA 9 Software. The results were analyzed as prevalence at 95 % C.I. (Confidence Interval). The difference in mean phenytoin serum levels between wild and mutant alleles was tested using Student`s T test for independent samples. P value less than 0.05 was considered statistically significant. RESULTS: CYP2C9*1, *2 & *3 allelic frequencies were 85.4, 4.5 and 10.1 % respectively. CYP2C9*3 allelic group showed significantly higher serum phenytoin levels compared to the wild variants (P = 0.009). There was no statistically significant difference in the dose received (P = 0.12) and side effects of CYP2C9*2 and CYP2C9*3 genotypes (P = 0.442 and 0.597 respectively) when compared with wild variant. CONCLUSION: CYP2C9*3 is more common than *2 in the present study. All the polymorphisms demonstrated in our study were heterozygous with no homozygosity. Serum phenytoin levels are higher in polymorphic groups (*3) which suggest their poor metabolizing nature. Genotyping may help to avoid toxicity and concentration-dependent adverse effects.
Subject(s)
Anticonvulsants/pharmacokinetics , Cytochrome P-450 CYP2C9/genetics , Epilepsy/drug therapy , Phenytoin/pharmacokinetics , Polymorphism, Genetic , Anticonvulsants/blood , Anticonvulsants/therapeutic use , Child , Child, Preschool , Cross-Sectional Studies , Epilepsy/blood , Epilepsy/genetics , Female , Gene Frequency , Genetic Markers , Genotype , Genotyping Techniques , Humans , India , Male , Phenytoin/blood , Phenytoin/therapeutic useABSTRACT
The clinical profile, commonly involved precipitating factors, comorbid conditions, treatment options and outcome of conversion disorder in 40 children in a tertiary level hospital in North India were studied, retrospectively. Majority of the patients were from rural India. Most common presenting symptom was psychogenic non-epileptic seizures; depression and anxiety were among the commonest comorbid conditions. Precipitating factors were predominantly scholastic problems. Treatment option included either psychotherapy only or combination of psychotherapy and pharmacotherapy. No significant difference was found in terms of outcome between the in-patient and out-patient treatment groups. This observation could be cost effective for developing countries like India, where the resources are very limited.
