Associated Impairments among Children with Cerebral Palsy in Rural Bangladesh—Findings from the Bangladesh Cerebral Palsy Register

Background: We aimed to describe the burden, severity, and underlying factors of associated impairments among children with cerebral palsy (CP) in rural Bangladesh. Methods: This study reports findings from the Bangladesh Cerebral Palsy Register—the first population-based surveillance of children with CP in any LMIC, where children with confirmed CP aged < 18 years are registered by a multidisciplinary team following a standard protocol. Associated impairments were documented based on clinical assessment, available medical records, and a detailed clinical history provided by the primary caregivers. Descriptive analysis, as well as unadjusted and adjusted logistic regression, were completed using R. Results: Between January 2015 and February 2022, 3820 children with CP were registered (mean (SD) age at assessment: 7.6 (5.0) y; 39% female). Overall, 81% of children had ≥1 associated impairment; hearing: 18%, speech: 74%, intellectual: 40%, visual: 14%, epilepsy: 33%. The presence of a history of CP acquired post-neonatally and having a gross motor function classification system levels III–V significantly increased the odds of different types of associated impairments in these children. Most of the children had never received any rehabilitation services and were not enrolled in any mainstream or special education system. Conclusions: The burden of associated impairments was high among children with CP, with comparatively low receipt of rehabilitation and educational services in rural Bangladesh. Comprehensive intervention could improve their functional outcome, participation, and quality of life

Novel weight estimation equation for children with cerebral palsy in low-resource settings: Validation in a population-based cohort

Aim: To validate a novel equation to estimate weight from mid-upper arm circumference (MUAC) among children with cerebral palsy (CP) in rural Bangladesh. Method: Children with CP aged 2 to 18 years registered in the Bangladesh CP Register were randomly selected. Data on sociodemographics, Gross Motor Function Classification System level, and anthropometric measurements were extracted. Bland–Altman plots with a 95% agreement limit and Lin's concordance correlation coefficient with 95% confidence intervals (CI) were reported to measure agreement between observed and estimated weight. Percentage error was used to determinate the method's accuracy. Results: There were 497 participants with a mean age at assessment of 9 years (SD 4 years 11 months) (47.7% female). Lin's concordance correlation coefficient between the observed and estimated weights was 0.90 (95% CI 0.89–0.92). Bland–Altman plots showed a reasonable accuracy of the equation in the study cohort. The mean percentage error of the equation was 5.04%. The average difference between observed and estimated weights was −1.02 kg (SD 5.1). The differences between observed and estimated weights were significantly greater among children with weight-for-age, height-for-age, or BMI-for-age z-scores less than or equal to −4. Interpretation: It is possible to predict the weight of children with CP from MUAC with sufficient accuracy. The equation can be used for populations in low-resources and low- and middle-income countries. What this paper adds: The equations predict the weight of children with cerebral palsy from their mid-upper arm circumference reasonably accurately. The difference between observed and estimated weights ranged between 0 kg and ± 5 kg in 81.5% of children. Sex and Gross Motor Function Classification System level did not affect the accuracy of the equations. The equations were less accurate for estimating the weight of severely undernourished children.Fil: Jahan, Israt. University of South Asia; Bangladesh. Central Queensland Universit; AustraliaFil: Ruiz Brunner, María de Las Mercedes. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; ArgentinaFil: Muhit, Mohammad. University of South Asia; BangladeshFil: Hossain, Iskander. Universidad Nacional de Córdoba. Facultad de Medicina; ArgentinaFil: Cuestas, Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; ArgentinaFil: Cieri, Maria Elisabeth. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; ArgentinaFil: Condinanzi, Ana Laura. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; ArgentinaFil: Escobar Zuluaga, L. Johana. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; ArgentinaFil: Badawi, Nadia. University of Sydney; Australia. University of South Asia; BangladeshFil: Khandaker, Gulam. University of Sydney; Australia. University of South Asia; Bangladesh. Central Queensland University; Australi

Targeted Preventive Care May Be Needed for Adults with Congenital Spine Anomalies

To compare hospitalizations caused by spina bifida-sensitive conditions, ambulatory care-sensitive conditions in adults with spina bifida and in the general population, our aim was to provide information about whether preventive health efforts already underway in the hospitalized general population are adequate for preventive care in spina bifida and congenital spine anomalies. Design: Retrospective secondary data analysis. Patients (or Participants): Records of hospitalized individuals who were 18 years of age and older. Methods: Comparison between individuals hospitalized with spina bifida and the general population using data from the California State Inpatient Database from the Healthcare Cost and Utilization Project for 2004 of adults. Main Outcome Measurements: Prevalence of spina bifida-sensitive conditions and ambulatory care-sensitive conditions as reason for hospitalization and 30-day readmission. Results: As compared with the general population, persons with spina bifida who were hospitalized in 2004 had a significantly greater number of hospitalizations, number of hospitalizations associated with both spina bifida-sensitive conditions and ambulatory care-sensitive conditions, and number of 30-day readmissions. Stratification by age shows that the admissions for spina bifida sensitive conditions were greater in persons with spina bifida than in the general population for all age groups. In contrast, only in the youngest age group did those with spina bifida experience greater hospitalizations for ambulatory care-sensitive conditions. Conclusions: This study provides further evidence that persons with spina bifida have hospitalizations that are beyond what the general population experiences. These conditions may be potentially preventable with appropriate ambulatory care. This group also had a greater risk for readmission within 30 days of discharge from their last hospitalization. More research is needed on the efficacy of programs aimed at prevention of these conditions. © 2011 American Academy of Physical Medicine and Rehabilitation

Octahedral Cu-II and Ni-II complexes manifesting with N'-[1-(pyridin-2-yl)ethylidene] acetohydrazide: structural outlooks and spectral characteristics

A tridentate hydrazone precursor, N′-[1-(pyridin-2-yl)ethylidene] acetohydrazide (L) (1:1 refluxed product of acetichydrazide and 2-acetylpyridine), produced two octahedral Cu and Ni derivatives, [CuL ]·NO (1) and [NiL ]·ClO ·H O (2). Both are subjected to X-ray diffraction system, and structural investigation shows that the central metal atom (Cu or Ni ) adopts a distorted octahedral geometry with N O donor sets by coordination of a pair of independent hydrazone precursors. Besides X-ray study, IR and UV-vis spectra, thermal analysis and room temperature magnetic moments are utilized for establishing significant characteristics of both complexes. It is apparent that the M-N bonds are slightly longer than the M-N bonds, Cu1-N1 and Cu1-N4 [2.300(2) and 2.038(2) Å] for 1 and Ni1-N1 and Ni1-N4 [2.075(2) and 2.084(1) Å] for 2, Cu1-N2 and Cu1-N5 [2.062(1) and 1.932(1) Å] for 1 and Ni1-N2 and Ni1-N5 [2.008(2) and 1.975(2) Å] for 2, respectively. As per our observation, the effective magnetic moment value (μ ) is found to be 1.77 B.M. for 1 and 3.06 BM for 2, respectively