Prediction of cognitive and intellectual competence in kindergarten schools associated with general measures of health: a study on children with age ranges between 4 to 7 years

BACKGROUND Stunting refers to the low “height-for-age” measurement. Literature suggests that it is associated with delayed or diminished physical development, cognition and intellectual abilities. OBJECTIVES: This study aimed to estimate the physical growth measures among children under 4 to 7 years of age and to determine its relationship with cognitive deficits & intellectual performances

Long-term clinical and functional outcomes of distally based sural artery flap: A retrospective case series

Background: Reconstruction of soft tissue defects around the lower leg, foot and ankle is a challenge for orthopedic surgeons. These defects commonly occur as a result of trauma, infection and tumor excision. Sural artery neurovascular island flap is a relatively thin, pliable and insensate flap with minimum donor-site morbidity and acceptable aesthetic outcome.Methods: A retrospective analysis of a case series was conducted, all operated by a single surgeon over a period of 25 years from July 1996 to February 2020. Data were collected through a structured proforma; the variables included were as follows: demographic data, mechanism of injury, defect site and size, size of flap, hospital stay, complications, outcome of flap and functional status of limb. Data analysis was performed by using SPSS version 25.0.Results: We included 89 patients out of 106, with 92 distally based sural artery flaps. The flap coverage was divided in two groups: group I for leg (n=41) and group II for foot (n=51). The mean flap dimension in leg was 9.98 ± 2.2 cm and 12.15 ± 3 cm in foot. Postoperatively functional outcomes were assessed using a self-designed tool and graded as excellent in 79 cases (leg=38; foot=41), good in 10 cases (leg=2; foot=8), fair in 3 cases (leg=1; foot=2) and poor in zero cases. All flaps survived uneventfully.Conclusion: The reverse sural artery flap is versatile and reliable, and can be performed easily with good knowledge and using a microsurgical technique. It is useful for the reconstruction of soft tissue defects around the lower third of the leg, dorsum of the foot, malleoli and hind foot. The functional range of motion of the ankle is not compromised because of the flap\u27s supple and pliable nature. The reverse sural artery flap is ideal for the coverage of the foot, ankle and lower one third of the leg. This flap is insensate and not suitable for the weight-bearing area of the heel

Long term clinical and functional outcome of lateral supramalleolar flap for soft tissue coverage of foot and ankle defects: Largest case series at a tertiary care hospital

Background: Reconstruction of defects around foot and ankle is challenging issue. We wanted to assess the clinical and functional outcome of lateral supramalleolar flap for coverage soft tissue defects around the foot and ankle. Methods: This analytic case series was conducted at Aga Khan University Hospital, Karachi. The data was collected from medical records and patient interviewing. Patients with soft tissue defects around foot and ankle and coverage with supramalleolar flaps were included. The various parameters of interest (causes, flaps dimensions, vascular variations, and outcome) were included in the prestructured proforma the data was analyzed with SPSS version 25. Results: Forty-seven patients were included in the study from May 1999 to December 2019. The male to female ratio was 35:12. The mechanism of injury was varied. Eighteen cases were pedicle island flaps whereas two were peninsular rotation flaps. The maximum flap size harvested was 20 cm × 8 cm distal flap necrosis occurred in one patient requiring split thickness skin graft. In eight patients’ flap was rotated as ‘delay flap’. In 12 cases the peroneal artery perforator was absent, the flap being based on inferolateral collateral artery from anterior tibial artery. Majority of the patients fall in excellent category based on self-designed assessment tool. Conclusion: The lateral supramalleolar flap provided coverage to almost all regions of the foot and ankle with a cosmetically acceptable donor and recipient site. There were no problems with shoe wear, only two patients requiring defattening for cosmetic reasons. Microvascular expertise was required for a predictable outcome