Evaluation of the change in the tongue posture and in the hyoid bone position after twin block appliance therapy in skeletal class II subjects

BACKGROUND: The tongue is posteriorly postured in a retrognathic mandible, and Twin Block appliance (TBA) therapy places the tongue and the hyoid bone in a favorable position to eliminate the risk of causing respiratory obstruction. OBJECTIVES: The aim of this study was to evaluate the change in the tongue posture and in the hyoid bone position after TBA therapy. MATERIAL AND METHODS: This cross-sectional study was conducted using the pre-functional (PF1), postfunctional (PF2) and post-treatment (PT) cephalograms of 30 growing subjects. The tongue posture at 6 distances and the hyoid bone position with 4 parameters were digitally measured using the Rogan-Delft View Pro-X® software. A digital vernier caliper was used to determine the inter-canine and inter-molar widths on the dental casts. The Wilcoxon signed-rank test was used to compare the PF1 and PF2 values, and the PF1 and PT values. RESULTS: The comparison of the PF1 and PF2 values showed significant differences in the tongue posture at distances 1-5. In the case of the hyoid bone, only the linear distance from the sella (S) to the most anterior point on the hyoid bone (H) - the SH distance - revealed a significant difference (p \u3c 0.01). The change in the tongue posture and in the hyoid bone position achieved at the PF2 stage remained stable at the PT stage. Significant differences occurred in the PF1 and PF2 maxillary and mandibular inter-canine and inter-molar widths (p = 0.01 and p = 0.04, and p \u3c 0.01 and p = 0.02), respectively. CONCLUSIONS: Twin Block appliance therapy resulted in the advancement of the mandible with a lowered posturing of the tongue. The hyoid bone was displaced inferiorly after TBA therapy, whereas the angular position of the hyoid bone remained unchanged

Frequency of Thyroid Dysfunction and Congenital Heart Defects in Subjects with Down Syndrome

ABSTRACT: Background: Down syndrome (DS) is the most common chromosomal abnormality with prevalence of 1 in 700-1500 live births. Its manifestations may include congenital heart defects(CHD), thyroid dysfunctions, hematopoietic disorders, early-onset Alzheimer disease, gastrointestinal disorders, neuromuscular weakness, hearing and visual problems, characteristic facial and physical features. The prevalence of thyroid disorders and congenital heart diseases are higher in DS patients than in general population. Objective:To explore the frequency, and types of congenital heart defects (CHD) and Thyroid disorders in children with Down syndrome (DS) in the children hospital and the institute of child health (CHICH) Multan. Study design:  Descriptive cross sectional Setting: Outpatient department (OPD) of CHICH Multan Method:A total of 158 down syndrome (DS) patients of 0 to 15 years of age, of both genders were included in this study from October 2019 to October 2020. DS was diagnosed by specific clinical features and karyotyping. Age, sex and mother’s age was noted. Blood samples of all the patients were sent for karyotyping and serum T4 and Thyroid stimulation hormone (TSH). For patients more than 36 months, blood samples were also sent for Antithyroglobulin and antithyroid peroxidase antibodies. Echocardiography of all the patients was done. Data was collected and analyzed by using SPSS version 16.0. Results:Out of 158 DS children most presented below 6months of age, with male to female ratio of 1:1.4. Mostly mothers were between 20 to 40 years of age. Karyotyping revealed non disjunction in 97% of cases. Cardiac abnormalities were found in 48% of DS children. Most common Type was VSD (10.9%), Thyroid abnormalities were detected in 24% of DS patients, subclinical hypothyroidism (13.9%) was most common. Conclusion: CHD and Thyroid disorders must be ruled out in all DS patients,to start early management.  Keywords: Down syndrome, Congenital heart disease, hypothyroidism

Impact of Body Weight on Self-Esteem among Undergraduate Young Adult Students of Doctor of Physiotherapy, Karachi

Objectives: To determine the recurrence of body disappointment, loss of control and self- related wellbeing in interpose the relationship among body weight and impairments in self-esteem among students of Doctor of Physiotherapy (DPT) Material and Methods: The research was among youthful understudies of the two sexes (boys and girls) of Doctor of Physiotherapy in both campuses—removed for blind review---. Concluded an overview through the questionnaire (Rosenberg Self-Esteem Scale according to the sample size of 298 computed through online programming Open Epi. The survey was acknowledged globally and it was standardized questionnaire. The data was assembled by figuring the BMI among body weight understudies of (DPT) and to check the level of self-esteem by Rosenberg Self-Esteem Scale. The survey conducted from January 2019 to February 2019. Results: Normal weight was adjusted to 18.50 till 24.90 – a total of 81 respondents, Overweight was adjusted to 25.00 till 29.90 of 35 respondents, obese category was adjusted to 30.00 or more a total of 17 respondents were adjudged to be in this category as per weigh ranges BMI. After analyzing the Chi-Square tabulation, it was found that the highest self-esteem was found in the normal weight BMI category respondents followed by the overweight category and the lowest self-esteem was found in obese category. As the table shows that girls have more self-esteem as compared to the boys, although the girl’s respondents are more so than boys are. Conclusion: It has been conclude that the proportion of the highest self-esteem were found in the normal weight BMI category respondents followed by the overweight category and the lowest self-esteem was found in obese category. Keywords: Body Mass Index, Stress, Obesity, Body image, Depression and Self-esteem

Impact of Body Weight on Self-Esteem among Undergraduate Young Adult Students of Doctor of Physiotherapy, Karachi

Objectives: To determine the recurrence of body disappointment, loss of control and self- related wellbeing in interpose the relationship among body weight and impairments in self-esteem among students of Doctor of Physiotherapy (DPT) Material and Methods: The research was among youthful understudies of the two sexes (boys and girls) of Doctor of Physiotherapy in both campuses—removed for blind review---. Concluded an overview through the questionnaire (Rosenberg Self-Esteem Scale according to the sample size of 298 computed through online programming Open Epi. The survey was acknowledged globally and it was standardized questionnaire. The data was assembled by figuring the BMI among body weight understudies of (DPT) and to check the level of self-esteem by Rosenberg Self-Esteem Scale. The survey conducted from January 2019 to February 2019. Results: Normal weight was adjusted to 18.50 till 24.90 – a total of 81 respondents, Overweight was adjusted to 25.00 till 29.90 of 35 respondents, obese category was adjusted to 30.00 or more a total of 17 respondents were adjudged to be in this category as per weigh ranges BMI. After analyzing the Chi-Square tabulation, it was found that the highest self-esteem was found in the normal weight BMI category respondents followed by the overweight category and the lowest self-esteem was found in obese category. As the table shows that girls have more self-esteem as compared to the boys, although the girl’s respondents are more so than boys are. Conclusion: It has been conclude that the proportion of the highest self-esteem were found in the normal weight BMI category respondents followed by the overweight category and the lowest self-esteem was found in obese category. Keywords: Body Mass Index, Stress, Obesity, Body image, Depression and Self-esteem

OUTCOME OF DEVELOPMENTAL THERAPY IN CHILDREN WITH CEREBRAL PALSY CHILDREN: A PROSPECTIVE COHORT

Introduction: Cerebral palsy (CP) is the non-progressive disorder of motor and posture with associated delayed development in areas of cognition, perception, behavior and sensation, due to insult to immature brain. Improvement in all developmental domains of CP patients depends upon early institution of rehabilitation programs involving all multidisciplinary approach. The portage early education program (PEEP) is a worldwide, effective and early interventional method, for developmentally delayed children.   Objective: To determine the outcome of developmental therapy in children with CP by using PEEP.  Study Design: Experimental research design (within group)  Settings: The children hospital and the institute of child health Multan.  Methodology: 156 patients of 2 to 10 years of age, both gender from January 2020 to December 2020, diagnosed as CP were enrolled for this study. All children were assessed by using PEEP and GMFM (Gross Motor Function Measure) twice 6 months apart. A trained clinical psychologist administered PEEP to all the children. All the Patients were advised regular weekly sessions at hospital by multidisciplinary team and at least 2 hours per day for continuation of these therapies at home. At the end of 6 months we found that all families had not followed this. The patient who visited >2times/month were considered compliant and those visited <2times/month were considered non-compliant. Data was analyzed by using SSPS version 16. Paired t test was used to compare the developmental outcome of compliant and non-compliant groups.  Results: Out of 156 participants, 58(37%) were in compliant and 98(63%) non-compliant. Male subjects were prominent 42(72.41%) and 67(68.37%) respectively. Most of the participants belonged to 3-6 years of age in both groups28(48.29%) and 51(52.04%) respectively. Spastic quadriplegia (26(44.83%), 57 (58.16%)), and level 5 on GMFM  24(42.86) and 52(53.06%) respectively was commonly presents in both patient groups. The mean comparison of DQ of Compliant CP Children at initial stage and after six months in areas of GM, C, SH, S, L and GMFM was found statistically significant.   Conclusion: CP children should be on regular follow up for developmental therapy for long time for better outcome. PEEP is an excellent system for the assessment, training and rehabilitation of children with delayed development. 

Sturge Weber Syndrome (SWS): A case report in an infant

Introduction: Sturge Weber Syndrome (SWS), known as encephalotrigeminal angiomatosis, is a rare neurocutaneous disorder and is having a prevalence of 1/20-50,000, live births. The syndrome consists of leptomeningeal angiomas and the angiomas of the face, characteristically in the ophthalmic and maxillary divisions of the trigeminal nerve. The neurological presentations include fits, deficits in cognition, glaucoma, and visual field abnormalities. The overgrowth of the soft tissues and extracranial angiomas can also occur in SWS. Case presentation: We are presenting a rare case of Sturge Weber Syndrome in an infant who presented at an early stage of this disorder. The index case presented to us with a large port-wine stain and right-sided focal fits. The CT scan brain showed subtle gyriform tram-track calcification of the left cerebral cortex and the left-sided cerebral atrophy. Ophthalmological examination showed glaucoma of the left eye. The clinical and radiological criteria were used to make the final diagnosis of SWS. Conclusion: The case is being reported in order to increase awareness among medical professionals