A study to assess the factors associated with developmental delay and nutritional status among the children with cleft lip and/or cleft palate

Background: Cleft lip with or without cleft palate is one of the most common congenital anomalies. Development is often affected in these children. It may be due to other associated defects, syndromic status, or malnutrition. Objective: The objective of this study was to assess the factors associated with developmental delay and nutritional status among the children with cleft lip and/or cleft palate. Materials and Methods: A cross-sectional study was conducted at the Department of Pediatrics of a Medical College in Sawangi (Meghe), Wardha, for 2 years from August 2010 to March 2012. All children below 15 years with cleft lip and/or palate admitted in the pediatric ward, the neonatal intensive care unit, or postnatal ward were included in the study. A total of 200 children were included in the study and were analyzed for developmental delay and growth lag. Results: Cleft clip was seen in 51 (25.5%) of the children, 25 (12.5%) had cleft palate, and 124 (62%) had both cleft lip and palate. Developmental delay was more common in cleft palate category; however, it was not statistically significant (χ2=0.90, p=0.34). Unilateral form of defects had more number of delays as compared to bilateral defects, and it was statistically significant (χ2=7.32, p=0.006). Delay was more common when both the defects were present together as compared to isolated defects; however, it was not statistically significant. Gross motor and language delay were the most common type followed by global and personal social. 12.5% of children were syndromic. Most of the syndromic children (64%) had global developmental delay (χ2=7.84, significant). 69.6% of children below the age group of 5 years were malnourished (χ2=16, significant). Faulty feeding (73.5%), recurrent respiratory infections (21.4%), and repeated hospitalization (17.1%) were the statistically significant factors for poor growth. Conclusion: Global developmental delay was more common in syndromic children. Overall, delay was more commonly seen in children with unilateral defect. Factors, which contributed to growth lag, were faulty feeding, recurrent respiratory infections, and repeated hospitalization

Sonographic Screening for Abdominal Organ Involvement in Sickle Cell AnemiaA Step towards Better Patient Care

Background: Sickle cell disease is characterized by repeated crisis and need for frequent transfusions. Abdominal crisis are common and potentially can damage any abdominal organ. Screening for organ involvement will lead to early detection and better patient care. Aim and Objectives: To see whether ultrasound can be a better noninvasive technique for early detection of organ involvement. Material and Methods: Prospective cross sectional observational study done on patients admitted in pediatric ward of a medical college. Total of 150 patients, already diagnosed to have sickle cell anemia (homozygous 110 and heterozygous 40) was included in the study. All the patients were in steady state. Demographic, clinical biochemical details were noted and were subjected to ultrasonography. Renal artery, Being end artery, Doppler study was also done. All the modalities were compared for early detection. Results: Majority of patients (77%) were between 1 to 30 years with male female ratio of 2:1. Recurrent fever (64%) and recurrent abdominal pain (47%) were most common symptoms and anemia (66%), hepatomegaly (62%), splenomegaly (21%) were most common signs. When clinical examination, biochemical tests and ultrasonography were compared for organ detection, ultrasound significantly detected more patients (p=<0.05). Ultrasonography of kidney included renal doppler also. Renal involvement by microalbuminuria measurement was of same as ultrasonography. Organ involvement increased with age. Conclusion: Ultrasonography was good noninvasive technique for organ detection but kidneysyield was better with Doppler study. Most common organ found to be affected was liver. Involvement increased with age. Early detection helps clinicians to avoid drugs toxic to involved organs

Traumatic dural sinus thrombosis Causing persistent headache in a child

Dural venous sinus thrombosis following a mild head injury is increasingly recognized. We report case of a 9-year-old male child presented with progressive headache and vomiting following a minor fall. A diagnosis of sinus venous thrombosis was suspected on nonenhancing computed tomography, and that was confirmed with magnetic resonance venography. The child was managed with intravenous fluids, anticoagulation (injection heparin followed by oral anticoagulants–tab coumarin), antiedema measures (mannitol), and antiepileptics (phenytoin) with good outcome

Rare case of neonate with meconium peritonitis

It's unusual to find a meconium cyst in a premature newborn. Meconium pseudo cyst is a consequence of meconium peritonitis, a sterile chemical peritonitis caused by a perforation of the uterine tract. When a puncture in the intestine does not heal and communication with the cyst continues after birth, the cyst can expand, the cyst can get infected, and the pseudo cyst can rupture. This is a case report of a newborn who developed perforated peritonitis due to the rupture of a meconium pseudo cyst [1]. Our patient was born prematurely at 34 weeks and had a caesarean procedure. She had a large abdominal distention that was later confirmed as a meconium cyst