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 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 Prevalence and associated factors of neurodevelopmental disability among infants in eastern Uganda: a population based study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Gertrude Namazzi ◽  
Helena Hildenwall ◽  
Paul Mubiri ◽  
Claudia Hanson ◽  
Christine Nalwadda ◽  
...  
Keyword(s):  
Low Income ◽  
Social Behaviour ◽  
Assessment Tool ◽  
Statistical Significance ◽  
Low Income Countries ◽  
Fine Motor ◽  
Neurodevelopmental Outcomes ◽  
Factors Associated ◽  
Neurodevelopmental Disability ◽  
Eastern Uganda

Abstract Background Neurodevelopmental disability (NDD) is increasingly acknowledged as one of the important causes of disease burden in low income countries. None the less, there is a dearth of data on the burden of NDD and its determinants in these settings. We aimed to establish the prevalence and factors associated with NDD among infants in Eastern Uganda. Methods We assessed 487 infants aged 9–12 months within Iganga-Mayuge Health Demographic Surveillance Site in Eastern Uganda using the Malawi Developmental Assessment Tool. The tool has four domains: gross motor, fine motor, language and social domains. An infant failed a domain if she/he failed more than two parameters of the expected at his/her age. We interviewed mothers on factors that could influence the infants’ neurodevelopmental outcomes. Data were analysed using STATA version 14. We used odds ratios and 95% confidence intervals to assess statistical significance of associations. Results Of the 487 infants, 62(12.7%) had an NDD in at least one of the domains. The most affected was social behaviour where 52(10.7%) infants had an NDD. Severe impairment was seen among 9(1.8%) infants with NDD in either three or four domains. Factors associated with NDD at multivariate logistic regression included: parity of more than three children (aOR = 1.8, 95% CI: 1.02–3.18); failure to cry at birth (aOR = 3.6, 95% CI: 1.46–9.17) and post-neonatal complications (aOR = 4.15, 95% CI: 1.22–14.10). Low birth weight, immediate and exclusive breast feeding were not significantly associated with NDD. Conclusion We found a high NDD burden among infants particularly in the social behaviour domain. To optimise the socio-neural development of infants, programs are needed to educate and work with families on how to engage and stimulate infants. Existing immunisation clinics and community health worker strategies provide an excellent opportunity for stemming this burden.

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 Effect of play-based family-centered psychomotor/psychosocial stimulation on the development of severely acutely malnourished children under six in a low-income setting: a randomized controlled trial

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Teklu Gemechu Abessa ◽  
Berhanu Nigussie Worku ◽  
Mekitie Wondafrash ◽  
Tsinuel Girma ◽  
Johan Valy ◽  
...  
Keyword(s):  
Low Income ◽  
Effect Size ◽  
Linear Growth ◽  
Intervention Group ◽  
Fine Motor ◽  
Social Emotional ◽  
Gross Motor ◽  
Psychosocial Stimulation ◽  
Low Income Setting

Abstract Background The World Health Organization (WHO) recommends incorporating psychosocial stimulation into the management of severe acute malnutrition (SAM). However, there is little evidence about the effectiveness of these interventions for SAM children, particularly when serious food shortages and lack of a balanced diet prevail. The objective of this study was to examine whether family-based psychomotor/psychosocial stimulation in a low-income setting improves the development, linear growth, and nutritional outcomes in children with SAM. Method Children with SAM (N = 339) admitted for treatment to the Jimma University Specialized Hospital, Ethiopia, were randomized to a control (n = 170) or intervention (n = 169) group. Both groups received routine medical care and nutritional treatment at the hospital. The intervention group additionally received play-based psychomotor/psychosocial stimulation during their hospital stay, and at home for 6 months after being discharged from hospital. The fine motor (FM) and gross motor (GM) functions, language (LA) and personal-social (PS) skills of the children were assessed using adapted Denver II, the social-emotional (SE) behavior was assessed using adapted Ages and Stages Questionnaires: Social-Emotional, and the linear growth and nutritional status were determined through anthropometric assessments. All outcomes were assessed before the intervention, upon discharge from hospital, and 6 months after discharge (as end-line). The overtime changes of these outcomes measured in both groups were compared using Generalized Estimating Equations. Results The intervention group improved significantly on GM during hospital follow-up by 0.88 points (p < 0.001, effect size = 0.26 SD), and on FM functions during the home follow-up by 1.09 points (p = 0.001, effect size = 0.22 SD). Both young and older children benefited similarly from the treatment. The intervention did not contribute significantly to linear growth and nutritional outcomes. Conclusion Psychomotor/psychosocial stimulation of SAM children enhances improvement in gross motor functions when combined with standard nutrient-rich diets, but it can enhance the fine motor functions even when such standard dietary care is not available. Trial registration The trial was retrospectively registered on 30 January 2017 at the US National Institute of Health (ClinicalTrials.gov) # NCT03036176.

scholarly journals Triaging patients with upper gastrointestinal bleeding: the utility of Glasgow-Blatchford score

2019 ◽  
Vol 8 (1) ◽  
pp. 42
Author(s):  
Namita Mohanty ◽  
Arjun Nataraj Kannan
Keyword(s):  
High Risk ◽  
Blood Transfusion ◽  
Gastrointestinal Bleeding ◽  
Hospital Stay ◽  
Upper Gastrointestinal Bleeding ◽  
Positive Likelihood Ratio ◽  
Low Risk ◽  
P Value ◽  
Duration Of Hospital Stay ◽  
Upper Gastrointestinal

Background: Glasgow-Blatchford bleeding score (GBS), was developed to predict the need for hospital-based intervention (transfusion, endoscopic therapy or surgery) or death following upper gastrointestinal bleeding. Study evaluated the Glasgow Blatchford score’s (GBS) ability to identify high risk patients who needed blood transfusion in patients with UGI haemorrhage.Methods: A total of 270 cases admitted with upper gastrointestinal bleeding in the Medical ICU/Wards of MKCG Medical College were put on Blatchford scoring system and classified as those requiring (high risk = GBS >1) and not requiring blood transfusion (low risk) based on the score assigned on admission and a correlation between initial scoring and requirement of blood transfusion was done.Results: Units of blood transfusion required, the GBS and duration of hospital stay were significantly lower among the low risk group, all with p value <0.001. No blood transfusion was required in patients with GBS <3. There was significant correlation between GB score and requirement of blood transfusion (p <0.001) and duration of hospital stay (p <0.001). GBS had 100% sensitivity, negative predictive value and positive likelihood ratio, when a cut off of > 16 was used in predicting mortality.Conclusions: Patients presenting with Upper GI bleeding can be triaged in casualty with Glasgow Blatchford scoring. Patients with a low score of less than or equal to 3 can be safely discharged and reviewed on follow up thereby reducing admission, allowing more efficient use of hospital resources.

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 Prelabour caesarean section and neurodevelopmental outcome at 4 and 12 months of age: an observational study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mehreen Zaigham ◽  
Lena Hellström-Westas ◽  
Magnus Domellöf ◽  
Ola Andersson
Keyword(s):  
Caesarean Section ◽  
Observational Study ◽  
Neurodevelopmental Outcome ◽  
Indirect Evidence ◽  
Mean Difference ◽  
Cognitive Outcomes ◽  
Fine Motor ◽  
Neurodevelopmental Outcomes ◽  
Gross Motor ◽  
Ages And Stages Questionnaire

Abstract Background With prelabour caesarean section rates growing globally, there is direct and indirect evidence of negative cognitive outcomes in childhood. The objective of this study was to assess the short-term neurodevelopmental outcomes after prelabour caesarean section as compared to vaginally born infants. Methods We conducted a prospective, observational study of infants delivered by prelabour caesarean section at the Hospital of Halland, Halmstad, Sweden and compared their development with an historical group of infants born by non-instrumental vaginal delivery. Results Infants born by prelabour caesarean section were compared with a group of vaginally born infants. Follow-up assessments were performed at 4 and 12 months. Prelabour caesarean infants (n = 66) had significantly lower Ages and Stages Questionnaire, second edition (ASQ-II) scores in all domains (communication, gross motor, fine motor, problem solving and personal-social) at 4 months of age with an adjusted mean difference (95% CI) of − 20.7 (− 28.7 to − 12.6) in ASQ-II total score as compared to vaginally born infants (n = 352). These differences remained for gross-motor skills at the 12 month assessment, adjusted mean difference (95% CI) -4.7 (− 8.8 to − 0.7), n = 62 and 336. Conclusions Adverse neurodevelopmental outcomes in infants born by prelabour caesarean section may be apparent already a few months after birth. Additional studies are warranted to explore this relationship further.

Effect of cerebrolysin on neurodevelopmental outcome of high risk preterm infants: A randomized controlled trial

2021 ◽  
pp. 1-9
Author(s):  
A. Samir ◽  
N. Nasef ◽  
K. Fathy ◽  
A-H. El-Gilany ◽  
S. Yahia
Keyword(s):  
High Risk ◽  
Preterm Infants ◽  
Motor Development ◽  
Intervention Program ◽  
Controlled Trial ◽  
Intervention Group ◽  
Fine Motor ◽  
Early Intervention Program ◽  
Gross Motor ◽  
Gross Motor Development

BACKGROUND: A significant proportion of preterm infants experience developmental delay despite receiving a post discharge early interventional care. Cerebrolysin is a peptide mixture which acts similar to endogenous neurotrophic factors through promoting neurogenesis and enhancing neuronal plasticity. OBJECTIVE: To compare the effect of Cerebrolysin plus routine intervention program versus routine intervention program alone on the outcome of preterm infants at high risk for neurodevelopmental delay. METHODS: In a randomized controlled trial, high-risk preterm infants <  32 weeks’ gestation who have abnormal neurological assessment at two months corrected post-natal age were randomized at 6 months corrected post natal age to receive either early intervention program or early intervention program plus Cerebrolysin injection of 0.1 mL/kg body weight every week for 3 months as an adjuvant therapy. The primary outcome was the rate of failure of the gross motor assessment at 12 months of corrected age and secondary outcomes included fine motor, language, and personal social development at 12 months corrected post-natal age as assessed by Denver Developmental Screening Test II. RESULTS: Cerebrolysin group had a significant lower number of infants diagnosed with failed gross motor development compared to infants in the routine intervention group [10 (33%) versus 21 (70%), p = 0.009]. Cerebrolysin group had a significant lower number of infants diagnosed with failed fine motor, language and personal social development compared to infants in the routine intervention group. CONCLUSION: Cerebrolysin, as an adjuvant therapy to routine early interventional care, may improve gross motor development of high-risk preterm infants at 12 months corrected post-natal age.

scholarly journals Validation of the Malawi Developmental Assessment Tool for Children in the Dominican Republic

2018 ◽  
Author(s):  
Laura V. Sanchez-Vincitore ◽  
Paul Schaettle ◽  
Arachu Castro
Keyword(s):  
Child Development ◽  
Dominican Republic ◽  
Internal Consistency ◽  
Low Income ◽  
Interrater Reliability ◽  
Assessment Tool ◽  
Fine Motor ◽  
Developmental Assessment ◽  
Validation Process ◽  
Gross Motor

Background: This study initiated the validation process of a translated and adapted version of the Malawi Developmental Assessment Tool (MDAT) for children in the Dominican Republic (DR). Like Malawi before the development of the MDAT, the DR did not have early childhood development (ECD) tools explicitly designed for low-resource areas that are also valid assessments of child development. We chose MDAT because it underwent a rigorous validation process and retained measurements of test items that were culturally adaptable from the Denver Developmental Screening Test II. We aimed to test the internal consistency and inter-rater reliability of the psychometric properties of the MDAT in children under the age of two years living in low-income neighborhoods in Santo Domingo in 2017. Methods and Findings: Forty-two children from 2 to 24 months of age (mean = 11.26, SD = 6.37, boys = 22, girls = 20) and their corresponding caregiver participated in the study. We conducted a cross-sectional, pre-experimental study. The primary outcome measure was an index of ECD, as assessed by the Dominican adaptation of the MDAT. The tool evaluates children in four domains: social, fine motor, language, and gross motor. To determine internal consistency, we obtained Cronbach's alpha for each sub-scale. The results ranged from 0.89 to 0.94, indicating good consistency. Second, to test the interrater reliability, we conducted a Kendall's Taub test of independence for both the general scale and each sub-scale. Significant Cronbach's alpha scores ranged from .923 to .966, indicating appropriate interrater reliability. Third, we correlated the age variable with each subscale to determine if the development scale followed a progression of abilities that are expected to increase with maturation. The age variable correlated positively with all the subscales (social r=.887, p < .001; fine motor r = .799, p < .001; language r = .834, p < .001; gross motor r = .805, p < .001), indicating that the older the child, the better scores in the development measurements, as expected. There were no adverse events. This study, however, has multiple limitations. We did not gather information about socioeconomic position, which is an important variable when assessing child development; however, all participants lived in a low-income neighborhood. Given that this is the first ECD tool specific to the Dominican Republic, norm-referenced scores for the Dominican population do not yet exist. This study sample size is insufficient to make inferences about the national population. Conclusions: This study represents the first attempt to obtain a valid tool to screen for development milestones in children living in poverty in the DR. More research is needed to refine the instrument. The availability of the tool will enable impact evaluations of ECD intervention programs and the development of evidence-based public policies in the DR.

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