Analyzing Referral Trends in a Child Guidance Clinic: Insights from a Tertiary Care Hospital in Central Maharashtra, India |Chapter 8 | Medicine and Medical Research: New Perspectives Vol. 6

Background: About 52.9 million children under the age of five have developmental disabilities, with 95% living in low and middle-income countries. The lack of data regarding the burden and risk factors slows the programs and policymaking actions for these highly prevalent conditions in developing countries. The early detection of risk factors and developmental problems can provide faster intervention and, thus, enable a better prognosis.

 

Objectives: This study seeks to analyse the referral profile of developmental disabilities presented to the Child Guidance Clinic (CGC) of a Government Tertiary Care Hospital.

 

Methods: This is a descriptive retrospective study based on medical records of Children presenting with developmental disabilities, irrespective of the cause, between the ages of 1 month and 12 years from November 2016 to December 2018 to a government tertiary care CGC of Maharashtra, India. The patients were enrolled using a convenient sampling method, and data was collected in a pre-designed, validated, structured questionnaire format. Data obtained was compiled on an MS Office Excel sheet and analyzed using SPSS v 26.0 (IBM). Descriptive results of categorical variables are described as frequency (%) and continuous variables as mean ± standard deviation (SD).

 

Results: In this study, 264 cases referred to the CGC were Included and enrolled. The mean age of referral was 2.54 years (±1.00) with an M: F ratio was 1.4:1. Hindu predominance (56.4%) was found in religion. In the record, 76.5% hailed from urban areas; 39% of all cases showed Consanguinity, 37% belonged to Class IV(Upper Lower), and 89% had chronic malnutrition. Additionally, 46.2% of cases had NICU stay, of which perinatal asphyxia (PA) was found in 40%. The majority of children (45.7%) had Global developmental delay (GDD)/Mental Retardation (MR), 37.7% had various forms of CP, Attention Deficit Hyperactivity Disorder (ADHD) was seen in 13%, 3.4% had Autism, 4.5% had specific language disorder, learning disability was seen in 2.7%, and only 2.7% had Isolated motor delay.

 

Conclusions: Early intervention services for children lag in developing countries, and the proportion of children referred to CGC with severe disabling conditions is high. This study's findings highlight a considerable burden and an increasing trend of children being referred for suspected developmental disabilities. This study provides baseline data for further planning services and interventions for these children in Maharashtra.

 

Author (s) Details

Smita M. Mundada
Department of Pediatrics, Government Medical College, Aurangabad, Panchakki Road, Aurangabad, Maharashtra, India.

 

Shilpa Y. Pawar
Department of Pediatrics, Government Medical College, Aurangabad, Panchakki Road, Aurangabad, Maharashtra, India.

 

Prabha Khaire
Department of Pediatrics, Government Medical College, Aurangabad, Panchakki Road, Aurangabad, Maharashtra, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v6/2219

 

Shedding Light on Respiratory Problems in Children with Cerebral Palsy | Chapter 5 | Medical Science: Recent Advances and Applications Vol. 2

Respiratory issues pose significant challenges for children with cerebral palsy (CP). Children with CP often experience complex health challenges that extend beyond their primary condition. Notably, respiratory problems are very common and serious, and even with improvements in healthcare, they are still the main cause of high morbidity and mortality among these children. The purpose of this review is to examine and summarize the most common pulmonary problems in CP children or when CP is a part of another syndrome and to analyze the most common predisposing risk factors for them. This review focuses on the complex factors that affect the breathing of individuals with CP. Repeated lung infections are a major source of problems for this population, highlighting the need to improve their airway health to boost their well-being and lifespan. This review adopted a systematic approach to identify and synthesize recent research on respiratory or pulmonary problems in children, specifically focusing on those with CP. Following the PRISMA guideline, a comprehensive search was conducted across two major scientific databases, PubMed and Scopus, between September 2023 and December 2024. The search utilized combinations of the keywords “cerebral palsy”, “CP”, “pulmonary problems”, “respiratory problems“ “lung problems“ or “pulmonary infections”. No restrictions were imposed regarding the publication date. Eligible studies were required to be original research exploring risk factors influencing respiratory problems in this population, or involving CP children as part of conditions affecting respiratory health. Identifying respiratory illnesses in CP patients can be difficult because their symptoms might be unusual, they may communicate indirectly, testing options can be limited, and getting medical evaluations can be hard. Common risk factors for lung infections include intermittent aspiration, compromised airway clearance, and spinal or chest wall deformities. In addition, nutritive status plays a major role in the results for CP children, with malnutrition being widespread and affecting both their respiratory system and overall well-being. Therefore, an interdisciplinary approach is pivotal to managing these multifaceted issues, challenging the collaboration of specialists and interventions targeting colorful aspects of CP-related respiratory problems. This review emphasizes the significance of early identification, comprehensive evaluation, and acclimatized interventions to improve the respiratory health of CP children. In conclusion, cerebral palsy‘s impact on childhood disability is underscored by its significant influence on respiratory health. Respiratory issues, ranging from aspiration to deformities and compromised function, play a pivotal role in morbidity and mortality. Through collaboration and expertise, this intricate respiratory landscape with precision, empathy, and dedication can be navigated.

 

Author (s) Details

Pavlina Peneva
First Department of Internal Disease, Faculty of Medicine, Medical University, Varna, Bulgaria.

 

Rouzha Pancheva
Department of Hygiene and Epidemiology, Faculty of Public Health, Medical University, Varna, Bulgaria.

 

Silviya P. Nikolova
Department of Social Medicine and Healthcare Organization, Faculty of Public Health, Medical University, Varna, Bulgaria.

 

Please see the book here:- https://doi.org/10.9734/bpi/msraa/v2/5046

Integrated Neurorehabilitation (INRA) for Children with Cerebral Palsy: Protocol and Case Report on Promoting Neuroplasticity | Chapter 5 | Achievements and Challenges of Medicine and Medical Science Vol. 2

Cerebral palsy (CP) is the commonest cause of physical disability in children, but optimal rehabilitative protocols have yet to be determined, and progress in developing novel interventions has been slow. Neuroplasticity is no longer thought to be fixed in childhood, but instead develops throughout life; however, the best way to exploit the remodeling brain has yet to be determined. The management of CP must, therefore, be multidisciplinary to achieve the best outcomes. The use of nutraceuticals (a food or product with health benefits, or a dietary supplement) in the management of cerebral palsy is less well documented, but there are a few examples of studies examining the use of vitamin supplementation in children with CP,18,19 and children with CP are known to suffer from micronutrient deficiencies and anti-oxidant imbalances. This study presents a novel multimodal integrative medicine protocol for the management of children and adolescents with CP termed Integrated Neurorehabilitation (INRA). The basic INRA protocol combines physical therapy, magnetostimulation, and a nutraceutical regimen to provide endogenous and exogenous neurorestorative stimuli to damaged corticospinal pathways on a background of an optimized neuronal microenvironment. A 13-year-old boy with cerebral palsy was referred to the clinic with severe motor, intellectual, and speech deficits.  This study illustrates the protocol with the case of a 13-year-old boy showing marked improvements in gross motor function (GMFM-88 score 82% from 59%), speech (TOM score 3 from 0), and cognition (TOEM score 3 from 1) after four years of therapy. There was also a slight increase in his IQ and a decrease in epileptiform activity on EEG. Epileptiform activity on EEG was reduced. This study describe the protocol in full and the scientific rationale for its implementation. IRNA can be used alongside existing medical and rehabilitative regimens to promote neuroplasticity and synaptogenesis. Further testing of the protocol is required in a prospective clinical trial.

 

Author (s) Details

 

Maja Roje Novak
Neurologija-dr.Maja Roje Novak d.o.o., Private Clinic, Pavla Hatza 27, 10000 Zagreb, Croatia.

 

Please see the book here:- https://doi.org/10.9734/bpi/acmms/v2/2685

Hypoxic – Ishemic Spinal Cord Lesions in Cerebral Palsy: A Case Report | Chapter 11 | Current Practice in Medical Science Vol. 11

 Objective: To investigate the alternative theory that perinatal hypoxia - ischemia affects brain circulation to the same amount as it affects spinal circulation, which challenges the prevalent view of cerebral palsy as a condition restricted by the brain.

Case Presentation: We discuss a 4-year-old boy who has lower paraplegia and delayed speech in this example. A clinical examination demonstrated enhanced bilateral muscular tone in the thigh adductors and gastrocnemius. Bilaterally, the iliopsoas muscle tone was decreased. According to electrophysiological analysis, motoneurons in the L 2–S 2 level are less excitable. MRI results at that level also showed spinal cord lesions in addition to brain abnormalities. MRI spinal angiography was used to identify a convoluted anterior spinal artery. The lower thoracic and first lumbar vertebrae of the patient underwent theophyllinum electrophoresis, which helped to improve his leg motor function. Discussion and Verdict Dr. Little, the first investigator of cerebral palsy, based his theory on a comprehensive postmortem study that he and his colleagues carried out. He reported that the cerebral palsy was brought on by a neonatal lesion to the brain or spinal cord, based on the information gathered during the section. However, the subsequent researcher on this disorder, Dr. Freud, focused exclusively on brain cuts for his pathlogoanatomic research, ignoring the spinal cord. However, our presentation illustrates how the spinal cord is involved in the development of cerebral palsy and the advantages of spinal therapy, supporting Little's theory.

Author(s) Details:

Belenky Vadim,
Arsvita Clinic, Krasnoputilovskaya Street 125, St. Petersburg, Russia.

Kozireva Elena,
Custom Clinic, Moskovskii Avenue 141, St. Petersburg, Russia.

Plakhotina Nadezhda,
Dr. Berezin Medical Institute, 6th Sovetskaya Street, 24-26, St. Petersburg, Russia.

Skoromets Alexander,
Department of Neurology, Pavlov Medical University, Lev Tolstoy Street, 6-8, St. Petersburg, Russia.

Dugaev Pavel,
Dr. Berezin Medical Institute, 6th Sovetskaya Street, 24-26, St. Petersburg, Russia.

Leontiev Oleg,
Nikiforov Centre of Urgent and Radiologic Medicine, Lebedev Street 4/2. St. Petersburg, Russia.

Please see the link here: https://stm.bookpi.org/CPMS-V11/article/view/8035

A Brief Study about Cerebral Palsy: Comorbidities and Second hidden Side| Chapter 6 | Current Overview on Disease and Health Research Vol. 4

 The review planned to evaluate the comorbidities in youngsters experiencing Cerebral paralysis (CP) in Kolhapur locale, India.

The cross-sectional review was led among kids experiencing cerebral paralysis and introducing to Department of Pediatrics (n=250), D. Y. Patil Medical College, between October 2018 to October 2019. Nitty gritty history with clinical assessment were kept in a pre-planned performa. The patients were ordered in light of physiological and geographical elements.

Normal type of cerebral paralysis was spasti Of the complete members (n=250), male prevalence was noticed (n=140); with age scope of 1c kind (n=140; 56%). Most normal sort among spastic CP was diplegia - 18 years.

(n=96; 38%). In spastic CP cases (n=65), kids had discourse anomalies. Every one of the youngsters with spastic hemiplegia (n=3) had scholarly inabilities.

Obviously the basic co-morbidities really cause the inability; the engine impedance is just the first class side effect.

Author(s) Details:

Jinela Desouza,
Department of Paediatrics, Dr. D. Y. Patil Hospital, Kolhapur, Maharashtra, India.

Mohan Patil,
Department of Paediatrics, Dr. D. Y. Patil Hospital, Kolhapur, Maharashtra, India.

Please see the link here: https://stm.bookpi.org/CODHR-V4/article/view/8004

Overview of Cerebral Palsy in Children| Chapter 14 | Current Practice in Medical Science Vol. 7

 

 Cerebral paralysis is a gathering of long-lasting problems of the improvement of development and stance, causing movement impediments that are credited to non moderate aggravations that happened in the creating fetal or newborn child cerebrum .The gamble factors incorporate antenatal, perinatal, post pregnancy causes like maternal infection,eclampsia, toxoplasmosis ,rubella, twin birth, low birth weight, troublesome conveyance and head injury during the initial not many long stretches of life. Around 2% of cases are accepted to be because of an acquired hereditary reason. As indicated by European information, the typical recurrence of Cerebral paralysis is 2.08 per 1000 live births.

The various kinds of subtypes have been depicted on the particular issues present as spastic, dyskinetic, ataxic structures. The order is additionally finished as spastic diplegia, monoplegia, hemiplegia, twofold hemiplegia in view of body parts included. The coordinated methodology is proposed in administration of cerebral paralysis which includes extraordinarily physiotherapy word related treatment, language training. The treatment procedures should be utilitarian objective situated. Muscle tone enhancement, anticipation of contractures, improvement in situating and cleanliness and give great dealing with to decrease strange development designs, is the way to work on personal satisfaction in cerebral paralysis. The multidisciplinary group including the youngster and relatives ought to be advised with respect to benefits if sequential assessment, early intercession and urged to follow treatment arranging.

Author(s) Details:

Edwin Dias,
SIMS&RC, India and  Srinivas University, India.

S. Sonali,
Department of Physiotherapy, SSIMS, Srinivas University, Mangalore, India.

Akshay Dias,
Department of Medicine, Father Muller Medical College, Mangalore, India.

Please see the link here: https://stm.bookpi.org/CPMS-V7/article/view/7845

Mirror Therapy Effect on Hand Functions in Cerebral Palsy | Chapter 18 | Current Practice in Medical Science Vol. 5

 

This study's goal is to ascertain how mirror treatment affects the hand functions (fine and gross motor activity) in kids with hemiplegic cerebral palsy. Cerebral palsy (CP) is a term used to describe a range of movement and postural abnormalities that limit activity and are thought to be the result of non-progressive disruptions in the developing fetus or infant brain. On a female patient with hemiplegic cerebral palsy aged 5 years old, the QUEST and Box and Block tests were administered. For three weeks, mirror treatment was used for 30 minutes a day, six days a week. The right hand's tasks comprised grasps in the cylindrical, spherical, and hook patterns, gripping exercises with a green therapeutic gripping gel, peg board arrangement, peg link exercises, and item transfer. Significant variations between pre- and post-treatment scores showed that mirror therapy affected how often the injured hand was used for daily tasks.

Author(s) Details:

S. D. Shahanawaz,
Department of Physiotherapy, College of Applied Medical Sciences, University of Hail, Kingdom of Saudi Arabia.

Sayali Joshi,
Department of Physiotherapy, College of Applied Medical Sciences, University of Hail, Kingdom of Saudi Arabia.

Please see the link here: https://stm.bookpi.org/CPMS-V5/article/view/7667