scholarly journals Rapid Neurodevelopmental Assessment (RNDA) : An Important Tool for Assessment of Psychomotor Development in Children with Perinatal Events

2021 ◽  
Vol 20 (1) ◽  
pp. 16-21
Author(s):  
Dhananjoy Das ◽  
Kawsar Sultana ◽  
Golam Mohammed Tayeb Ali ◽  
Tanuka Barua ◽  
Mahmood A Chowdhury Arzu
Keyword(s):  
High Risk ◽  
Neonatal Jaundice ◽  
Perinatal Asphyxia ◽  
Psychomotor Development ◽  
Fine Motor ◽  
Speech Impairment ◽  
Neurodevelopmental Outcomes ◽  
Gross Motor ◽  
History Of

Background: Infants with various perinatal events are at risks for long term neurodevelopmental impairments. Neurodevelopmental assessment at early life has been considered as a valuable tool for prediction of neurodevelopmental outcomes in this population. This present study aimed to identify the neurodevelopmental impairments in high risk children by Rapid Neurodevelopment Assessment (RNDA) Materials and methods : This was a cross sectional study conducted in the Autism and Child Development Centre of Chattogram Maa Shishu-O-General Hospital during the period of 0ctober to December 2018. Babies aged 0 -2 years with different perinatal events like prematurity, birth asphyxia, neonatal jaundice, and without any adverse event; that attended RNDA clinic underwent Rapid Neurodevelopmental Assessment (RNDA) to find at risk children for long term neurodevelopmental impairments. Results: Among the 50 study subjects,Perinatal asphyxia was found in 41(82%). 26(52%) had history of IUGR, 22(44%) had Preterm delivery and 25(50%) had history of Neonatal convulsion. History of neonatal jaundice was found in 14(28%) cases. 5(10%) children did not have any perinatal event. The Mean ± SD age of study subjects was 7.38±7.31month. Severe impairment in gross motor and fine motor function were found in 25(50%) and 24(48%) respondents respectively. Vision was severely impaired in 10(20%) cases. Severe cognition and behavior impairment were found in 8(16%) and 3(6%) cases accordingly. Severe hearing and speech impairment were found in 2(4%) & 10(20%) cases respectively. Severe seizure was found in 19(39%) cases. Study subjects with the history of delayed cry or Perinatal asphyxia had significantly decreased fine motor skills. Children born with IUGR had significant gross motor and fine motor skill impairment. Significant speech & cognitive impairment were observed in children with neonatal jaundice. Seizure was found significant in study subjects with a history of neonatal convulsion. Conclusion: Rapid Neurodevelopment Assessment (RNDA) plays an important role for early identification of neurodevelopmental impairments of high-risk infants and thus screening for these can promote early therapeutic intervention and subsequent follow up, leading to better outcome. Chatt Maa Shi Hosp Med Coll J; Vol.20 (1); January 2021; Page 16-21

scholarly journals Association of clinical features of acute viral encephalitis with mortality and neurodevelopmental outcomes

2015 ◽  
Vol 6 (2) ◽  
pp. 50-52
Author(s):  
Khadija Rahman ◽  
MS Khaled ◽  
Marium Begum ◽  
Nasreen Begum ◽  
Azmeri Sultana ◽  
...  
Keyword(s):  
High Risk ◽  
Hospital Stay ◽  
Clinical Features ◽  
Low Income ◽  
Glasgow Coma Score ◽  
Viral Encephalitis ◽  
Fine Motor ◽  
Neurodevelopmental Outcomes ◽  
Gross Motor ◽  
Duration Of Hospital Stay

Background : Acute viral encephalitis is a world-wide health problem with severe morbidity, significant mortality and a high incidence of residual sequelae in survivors.Objective : To identify the association of clinical features of acute viral encephalitis with mortality and neurodevelopment outcomes.Methodology : It is a hospital based comparative observational prospective study done in Dhaka Shishu Hospital during the period of October 2005 to March 2006. Children with 1 month to 12 years of both sex presenting with specific clinical features and laboratory evidences suggestive of acute viral encephalitis (seizures, altered consciousness, features of raised intracranial pressure, cerebrospinal fluid evidences of viral encephalitis) were included. 44 children were enrolled according to inclusion criteria. Data were collected on clinical and socio demographic status. SPSS 16 version program was used for data analysis.Result : Among the 44 cases, the mean age bellow 2 years was 14 months and above 2 years was 66 months. The incidence of acute viral encephalitis was highest within first 3 years of age. Most of the mortality 8(72.73%) occurred in low income group (P=0.003). 29(66 %) patients had Glasgow Coma Score <8 on admission, low Glasgow Coma Score at presentation had significant association with outcome, 11(100%) patients who died had Glasgow Coma Score <8(P=0.003). 28(68 %) patients stayed in hospital for >7 days, indicating more time taking for improvement from acute illness. There was significant association of duration of hospital stay and outcome (P=0.008). In Neurodevelopmental assessment domains were Gross motor, Fine motor, Vision, Hearing and Cognition and impairments were different in different patients. Impairments persisting in different domain at follow up comparing with admission showed satisfactory improvement. Improvement was significant in case of Gross motor (P=.005), Fine motor (P=.08) and Cognition (P=.09).Conclusion : It was observed from this study that children with acute viral encephalitis are at high risk of mortality and morbidity. Lower age at presentation, low socio-economic status, low Glasgow Coma Score on admission and short duration of hospital stay were associated with high mortality and were at high risk of future neurodevelopmental impairmentsNorthern International Medical College Journal Vol.6(2) 2015: 50-52

scholarly journals Adverse effects of hyperbilirubinemia on the development of healthy term infants

2016 ◽  
Vol 46 (2) ◽  
pp. 51
Author(s):  
I Made Arimbawa ◽  
Soetjiningsih Soetjiningsih ◽  
I K Kari
Keyword(s):  
Adverse Effects ◽  
Fine Motor ◽  
Term Infants ◽  
Gross Motor ◽  
Regression Test ◽  
History Of ◽  
Scale Test ◽  
The Relationship ◽  
Logistic Regression Test

Background Indirect hyperbilirubinemia is a common problem dur-ing the neonatal period and may cause long-term abnormality ordevelopmental delay.Objective To evaluate the adverse effects of hyperbilirubinemiaon the development of healthy term infants.Methods This was a prospective cohort study on healthy terminfants born in Sanglah Hospital, Denpasar. Mullen Scale Testswere performed at the ages of 3 and 6 months to assess subjects’development. Bivariate and multivariate analyses were conductedto examine the relationship between several dependent variablesand developmental outcomes.Results One hundred and twelve infants were enrolled in this study[56 with hyperbilirubinemia, 56 without hyperbilirubinemia; 58 (52%)male, 54 (48%) female]. Mean birth weight was 318.3 grams (SD342.26) vs 3162.5 grams (SD 338.61). At the age of 3 months,below average category according to Mullen Scale Test was higherin infants with history of hyperbilirubinemia compared to those with-out hyperbilirubinemia, which was statistically significant for finemotor scale (17.9% vs 5.4%; respectively; P=0.039; RR 1.66; 95%CI 1.15;2.39). At 6 months of age, it was higher in infants withhistory of hyperbilirubinemia compared to those without hyperbi-lirubinemia and this was statistically significant for gross motor scale(19.6% vs 3.6%, respectively; RR 1.86; 95%CI 1.36; 2.56; P=0.008)and fine motor scale (17.9% vs 5.4%, respectively; RR 1.66; 95%CI1.15; 2.39; P=0.039). Multivariate logistic regression test showedthat only hyperbilirubinemia was correlated with gross motor scaledelay at the age of 6 months (P=0.027; OR 5.97; 95%CI 1.22;29.12).Conclusion Healthy term infants with history of hiperbilirubinemiawere associated with increased gross motor scale delay at theage of 6 months

scholarly journals Neurodevelopmental Assessment in Preterm Neonates at Early Ages: Screening of at-risk Infants for Long Term Sequlae

2017 ◽  
Vol 40 (1) ◽  
pp. 5-11
Author(s):  
Mirza Md Ziaul Islam ◽  
M Monir Hossain ◽  
Sheikh Anisul Haque ◽  
Naila Zaman Khan
Keyword(s):  
At Risk ◽  
Preterm Infants ◽  
Neonatal Period ◽  
Fine Motor ◽  
Preterm Neonates ◽  
Neurodevelopmental Outcomes ◽  
Cross Sectional ◽  
Gross Motor ◽  
Developmental Domains

Background: Preterm infants are at risk for long term neurodevelopmental impairements. Neurodevelopmental assessment at early months of infancy has been proposed as a valuable tool for prediction of neurodevelopmental outcomes in this population.Objective: The present study attempted to find the neurodevelopmental impairments in preterm infants and thus to identify the at risk infants for follow up and subsequent therapeutic intervention.Methodology: This prospective cross-sectional observational study was conducted in Dhaka Shishu (Children) Hospital from October 2011 to March, 2012. A total 103 preterm neonates who met the inclusion criteria underwent rapid neurodevelopmental assessment (RNDA) at neonatal period and again at their 3 months of age to find the at risk infants for long term neurodevelopmental impairments.Results: Among the enrolled 103 preterm infants during RNDA at neonatal period, abnormal domains found in primitive reflexes 41(39.7%), gross motor 42(40.7%), fine motor 32(31%), vision 40(38.7%), hearing 32 (31%), speech 40(38.7%), cognition 3(2.8%), behavior 3 (2.8%) and 3(2.8%) had seizure. Again in RNDA at 3 months of age, the no. of preterm infants having abnormal developmental domains are: gross motor 49(47.5%), fine motor 19(18.3), vision 9(8.6%), hearing 16(15.4%), speech 15 (14.5%), cognition 6(5.7%), speech 15 (14.5%), cognition 6(5.7%), behavior 11(10.6%) and 3 (2.9%) had seizure.Conclusion: The identification of neurodevelopmental impairments in early months of preterm infants should offer a valuable complement to tools for identification of at risk infants for long term sequlae (in neurodevelopmental impairment).Bangladesh J Child Health 2016; VOL 40 (1) :5-11

scholarly journals Long-Term Outcome after Asphyxia and Therapeutic Hypothermia in Late Preterm Infants: A Pilot Study

Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 994
Author(s):  
Hanne Lademann ◽  
Karl Abshagen ◽  
Anna Janning ◽  
Jan Däbritz ◽  
Dirk Olbertz
Keyword(s):  
Pilot Study ◽  
Preterm Infants ◽  
Perinatal Asphyxia ◽  
Psychomotor Development ◽  
Long Term Outcomes ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Developmental Index ◽  
Mental Developmental Index

Therapeutic hypothermia (THT) is the recommended treatment for neuroprotection in (near) term newborns that experience perinatal asphyxia with hypoxic-ischemic encephalopathy. The benefit of THT in preterm newborns is unknown. This pilot study aims to investigate long-term outcomes of late preterm asphyctic infants with and without THT compared to term infants. The single-center, retrospective analysis examined medical charts of infants with perinatal asphyxia born between 2008 and 2015. Long-term outcome was assessed using the Bayley Scales of Infant Development 2 at the age of (corrected) 24 months. Term (n = 31) and preterm (n = 8) infants with THT showed no differences regarding their long-term outcomes of psychomotor development (Psychomotor Developmental Index 101 ± 16 vs. 105 ± 11, p = 0.570), whereas preterm infants had a better mental outcome (Mental Developmental Index 105 ± 13 vs. 93 ± 18, p = 0.048). Preterm infants with and without (n = 69) THT showed a similar mental and psychomotor development (Mental Developmental Index 105 ± 13 vs. 96 ± 20, p = 0.527; Psychomotor Developmental Index 105 ± 11 vs. 105 ± 15, p = 0.927). The study highlights the importance of studying THT in asphyctic preterm infants. However, this study shows limitations and should not be used as a basis for decision-making in the clinical context. Results of a multicenter trial of THT for preterm infants (ID No.: CN-01540535) have to be awaited.

Dementia screening in elderly high-risk patients following heart failure decompensation may predict unfavorable long-term clinical outcomes

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Stepien ◽  
P Furczynska ◽  
M Zalewska ◽  
K Nowak ◽  
A Wlodarczyk ◽  
...  
Keyword(s):  
Heart Failure ◽  
High Risk ◽  
Clinical Outcomes ◽  
Mmse Score ◽  
Coronary Revascularization ◽  
High Risk Population ◽  
Risk Population ◽  
History Of

Abstract Background Recently heart failure (HF) has been found to be a new dementia risk factor, nevertheless their relations in patients following HF decompensation remain unknown. Purpose We sought to investigate whether a screening diagnosis for dementia (SDD) in this high-risk population may predict unfavorable long-term clinical outcomes. Methods 142 patients following HF decompensation requiring hospitalization were enrolled. Within a median time of 55 months all patients were screened for dementia with ALFI-MMSE scale whereas their compliance was assessed with the Morisky Medication Adherence Scale. Any incidents of myocardial infarction, coronary revascularization, stroke or transient ischemic attack (TIA), revascularization, HF hospitalization and bleedings during follow-up were collected. Results SDD was established in 37 patients (26%) based on the result of an ALFI-MMSE score of &lt;17 points. By multivariate analysis the lower results of the ALFI-MMSE score were associated with a history of stroke/TIA (β=−0.29, P&lt;0.001), peripheral arterial disease (PAD) (β=−0.20, P=0.011) and lower glomerular filtration rate (β=0.24, P=0.009). During the follow-up, patients with SDD were more often rehospitalized following HF decompensation (48.7% vs 28.6%, P=0.014) than patients without SDD, despite a similar level of compliance (P=0.25). Irrespective of stroke/TIA history, SDD independently increased the risk of rehospitalization due to HF decompensation (HR 2.22, 95% CI 1.23–4.01, P=0.007). Conclusions As shown for the first time in literature patients following decompensated HF, a history of stroke/TIA, PAD and impaired renal function independently influenced SDD. In this high-risk population, SDD was not associated with patients' compliance but irrespective of the stroke/TIA history it increased the risk of recurrent HF hospitalization. The survival free of rehospitalization Funding Acknowledgement Type of funding source: None

Abstract 12153: Impact of a Hybrid Nurse-Led Intervention for the Prevention of Progressive Cardiac Dysfunction in High Risk Individuals: Results From a Pragmatic, Randomized Trial (the NIL-CHF Study)

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Simon Stewart ◽  
Melinda Carrington ◽  
Yih Kai Chan ◽  
Garry Jennings ◽  
Chiew Wong ◽  
...  
Keyword(s):  
High Risk ◽  
Cardiac Function ◽  
Diastolic Dysfunction ◽  
Cardiac Dysfunction ◽  
Systolic Dysfunction ◽  
Cardiac Abnormality ◽  
Coronary Syndrome ◽  
History Of ◽  
Hybrid Program

Background: The natural history of chronic heart failure (CHF) is characterized by initial cardiac insult and/or stressors over time that leaves affected individuals at high risk for progressive cardiac dysfunction and eventual development of the syndrome. Methods: Of a total of 624 subjects at high risk of developing CHF randomized into the NIL-CHF Study comparing a hybrid program of home and clinic-based follow-up (NIL-CHF group) to Standard Care, 454 (73%) underwent serial echocardiography at 1 month post index cardiac hospitalization and at 3 years. At both time points (nil signs/symptoms of CHF at baseline), these were blindly classified as follows: 1) no cardiac abnormality, 2) systolic dysfunction/HFrEF - LVEF ≤ 45% ), 3) diastolic dysfunction/HFpEF as defined by any moderate diastolic dysfunction (with pseudonormalization pattern) or E/E prime ratio ≥ 15, 4) combination of 2 & 3 and 5) other cardiac abnormality (including LVH). Pre-specified criteria were used to determine - i) no change, ii) improvement or iii) deterioration in cardiac function from baseline to 3 years. Results: Mean age was 66±11 years, 71% were male, 70% were hospitalized with an acute coronary syndrome and 62% and 26%, respectively, were being treated for hypertension and diabetes. At baseline 25.2% vs. 28.4% (p=ns), 15.1% vs. 9.1% (p<0.05), 35.1% vs. 32.4% (p=ns) and 34.3% vs. 39.6% had normal cardiac function, HFrEF, HFpEF (13% both HFrEF and HFpEF overall) and LVH (the predominant “other” cardiac abnormality), respectively. At 3 years the proportion of subjects with reversal of pre-existing HFrEF or HFpEF was lower in the NIL-CHF group (23% vs. 16%; p=0.063). Moreover, significantly more NIL-CHF subjects demonstrated any form of cardiac recovery/reversal on echocardiography (39% vs. 25%, p=0.011, 95% CI 1.35, 95% CI 1.04, 1.76). They also demonstrated significantly greater regression to normal LV structure (36% vs. 25%; p=0.047) among those with LVH at baseline. Conclusions: These pre-specified analyses (secondary endpoint) of the recently completed NIL-CHF Study suggests a cardio-protective effect conferred by a long-term, nurse-led, home and clinic-based intervention targeting hospitalized individuals at high risk for developing CHF.

scholarly journals Association between maternal shift work and infant neurodevelopmental outcomes: results from the Taiwan Birth Cohort Study with propensity-score-matching analysis

2019 ◽  
Vol 48 (5) ◽  
pp. 1545-1555
Author(s):  
Chih-Fu Wei ◽  
Mei-Huei Chen ◽  
Ching-Chun Lin ◽  
Yueliang Leon Guo ◽  
Shio-Jean Lin ◽  
...  
Keyword(s):  
Cohort Study ◽  
Propensity Score ◽  
Birth Cohort ◽  
Shift Work ◽  
Fine Motor ◽  
Birth Cohort Study ◽  
Work Status ◽  
Neurodevelopmental Outcomes ◽  
Gross Motor ◽  
Taiwan Birth Cohort Study

Abstract Background Maternal shift work is associated with preterm delivery, small-for-gestational-age new-borns, childhood obesity and future behavioural problems. However, the adverse effects on and interactions of maternal shift work with infant neurodevelopment remain uncertain. Therefore, we examined the associations between maternal-shift-work status and infant neurodevelopmental parameters. Methods The Taiwan Birth Cohort Study is a nationwide birth cohort study following representatively sampled mother–infant pairs in 2005. The participants’ development and exposure conditions were assessed by home interviews with structured questionnaires at 6 and 18 months of age. Propensity scores were calculated with predefined covariates for 1:1 matching. Multivariate conditional logistic regression and the Cox proportional-hazards model were used to examine the association between maternal-shift-work status and infant neurodevelopmental-milestone-achievement status. Results In this study, 5637 term singletons were included, with 2098 cases selected in the propensity-score-matched subpopulation. Persistent maternal shift work was associated with increased risks of delays in gross-motor neurodevelopmental milestones [aOR = 1.36, 95% confidence interval (CI) = 1.06–1.76 for walking steadily], fine-motor neurodevelopmental milestones (aOR = 1.39, 95% CI = 1.07–1.80 for scribbling) and social neurodevelopmental milestones (aOR = 1.35, 95% CI = 1.03–1.76 for coming when called upon). Moreover, delayed gross-motor and social development were identified in the propensity-score-matched sub-cohort. Conclusions This study shows negative associations between maternal shift work and delayed neurodevelopmental-milestone achievement in the gross-motor, fine-motor and social domains at 18 months. Future research is necessary to elucidate the possible underlying mechanisms and long-term health effects.

scholarly journals The Natural History of Infantile Neuroaxonal Dystrophy

2020 ◽  
Author(s):  
Fadie D Altuame ◽  
Gretchen Foskett ◽  
Paldeep Atwal ◽  
Sarah Endemann ◽  
Mark Midei ◽  
...  
Keyword(s):  
Natural History ◽  
Neurodegenerative Disorder ◽  
Gastrointestinal Disease ◽  
Cerebellar Atrophy ◽  
Neuroaxonal Dystrophy ◽  
Fine Motor ◽  
Speech Impairment ◽  
Infantile Neuroaxonal Dystrophy ◽  
Significant Difference ◽  
History Of

Abstract Background: Infantile neuroaxonal dystrophy (INAD) is a rapidly progressive neurodegenerative disorder of early onset causing premature death. It results from biallelic pathogenic variants in PLA2G6, which encodes a calcium‐independent phospholipase A2. Objective: We aim to outline the natural history of INAD and provide a comprehensive description of its clinical, radiological, laboratory, and molecular findings. Materials and Methods: We comprehensively analyzed the charts of 28 patients: 16 patients from Riyadh, Saudi Arabia, 8 patients from North and South America and 4 patients from Europe with a molecularly confirmed diagnosis of PLA2G6‐associated neurodegeneration (PLAN) and a clinical history consistent with INAD.Results: In our cohort, speech impairment and loss of gross motor milestones were the earliest signs of the disease. As the disease progressed, loss of fine motor milestones and bulbar dysfunction were observed. Temporo-frontal function was among the last of the milestones to be lost. Appendicular spastic hypertonia, axial hypotonia, and hyperreflexia were common neurological findings. Other common clinical findings include nystagmus (60.7%), seizures (42.9%), gastrointestinal disease (42.9%), skeletal deformities (35.7%), and strabismus (28.6%). Cerebellar atrophy and elevations in serum AST and LDH levels were consistent features of INAD. There was a statistically significant difference when comparing patients with non-sense/truncating variants compared with missense/in-frame deletions in the time of initial concern (p = 0.04), initial loss of language (p = 0.001), initial loss of fine motor skills (p = 0.009), and initial loss of bulbar skills (p = 0.007).Conclusion: INAD is an ultra-rare neurodegenerative disorder that presents in early childhood, with a relentlessly progressive clinical course. Knowledge of the natural history of INAD may serve as a resource for healthcare providers to develop a targeted care plan and may facilitate the design of clinical trials to treat this disease.

scholarly journals Long-term neurodevelopmental outcomes of significant neonatal jaundice in Taiwan from 2000–2003: a nationwide, population-based cohort study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Pei-Chen Tsao ◽  
Hsin-Ling Yeh ◽  
Yu-Shih Shiau ◽  
Yen-Chen Chang ◽  
Szu-Hui Chiang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Neonatal Jaundice ◽  
Population Based ◽  
Neurodevelopmental Outcomes

scholarly journals Role of Topiramete in Moderate to Severe Perinatal Asphyxia - A Randomized Controlled Clinical Trial

2020 ◽  
Vol 35 (2) ◽  
pp. 135-140
Author(s):  
Naznin Akther ◽  
M Monir Hossain ◽  
Ahmed Ferdous Jahangir ◽  
Shayla Imam Kanta ◽  
Sayeeda Mehnaz Masud
Keyword(s):  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Intervention Group ◽  
Treatment Protocol ◽  
Fine Motor ◽  
Control Group ◽  
Neurodevelopmental Outcomes ◽  
Randomized Controlled ◽  
And Control

Background: Topiramate is an anticonvulsant drugs that has multiple mode of mechanism of action. Topiramate appears to be effective as both an anti-seizure and neuroprotective agent in animal models of newborn brain injury. Objectives: To determine the neurological outcome of oral topiramate with moderate to severe hypoxic ischemic encephalopathy. Methods: This one year randomized controlled trial was carried out in the Neonatal ward and ICU of a tertiary care specialized hospital. A total of 64 neonate were enrolled in this study and were randomly assigned intervention group (Group-A, n=32) and control group (Group B=32). In case group oral topiramate 10mg/kg was given for 3 consecutive days along with standard treatment protocol. And control was given only standard protocol. Finally outcomes are compared. Results: Baseline clinical characteristics, age, sex, mode of delivery, arterial pH, residence, basic status of HIE cases were matched in both groups. This study has shown significant reduction of neurological impairment in all domain (gross motor, fine motor, vision hearing, speech) at 1 and 3 months in case than control. There is also early seizure control, early initiation of feeding, short duration of hospital stay in case (treatment) than control without any side effects. Conclusion: Early administration of topiramate to infants with moderate and severe HIE in perinatal asphyxia was very effective in controlling seizures, improving USG findings, and producing favorable neurodevelopmental outcomes at1 and 3 months of age. DS (Child) H J 2019; 35(2) : 135-140

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