Explanatory factors of the psychomotor development of infants aged 1-24 months in N'Djamena (Chad)

Introduction: Psychomotor development (PMD) reflects the cerebral maturation through sensory, motor and psychological acquisitions of an individual. Its evaluation allows an early diagnosis of delays in order to take care of them. The objective of this study was to determine the profile and explanatory factors of PMD of infants in N'Djamena. Methods: This was a cross-sectional study conducted at the “Notre Dame des Apôtres” Hospital in N'Djamena. It involved 428 infants aged 1 to 24 months received in preventive consultation between October 2017 and June 2018. The Denver II scale was used for the assessment of PMD. Data were analyzed with SPSS 21.0 software. Results: the sex ratio was 1.06. The most represented age group was under 3 months (35.5%). The items of gross motor skills were 95% completed, fine motor skills 93.8%, language 84.6% and sociability 68.8% at the 90th percentile. Development was advanced in 56.8% normal in 32.1% and delayed in 2.1%. Statistically significant differences in PMD were observed according to age group (p= 0.000), vaccination status (p= 0.002), feeding mode (p= 0.000), maternal exchange (p= 0.000) and pregnancy follow-up (p= 0.03). Conclusion: The psychomotor development of N'Djamenese infants is similar to that of other African children, although some variations are noted. It is influenced by certain factors related to the infant and the mother.

Administration of Antenatal Corticosteroids: Current State of Knowledge

The administration of a single course of corticosteroids before week 34 + 0 of gestation in cases with impending preterm birth is now standard procedure in obstetric care and firmly established in the guidelines of different countries. But despite the apparently convincing data, numerous aspects of this intervention have not yet been properly studied. It is still not clear which corticosteroid achieves the best results. There are very few studies on what constitutes an appropriate dose, circadian rhythms, the time frame in which corticosteroids are effective, and the balance between the risks and benefits of repeat administration. As the existing studies have rarely included patients before week 24 + 0 of gestation, we have very little information on the possible benefits of administering corticosteroids before this timepoint. If corticosteroids are administered antenatally after week 34 + 0 of gestation, the short-term benefit may be offset by the long-term adverse effect on psychomotor development. This present study summarizes the current state of knowledge regarding these issues.

Iodine supplementation: compliance and association with adverse obstetric and neonatal outcomes

Objectives Over 1.9 billion people worldwide are living in areas estimated to be iodine insufficient. Strategies for iodine supplementation include campaigns targeting vulnerable groups, such as women in pre-conception, pregnancy and lactation. Portuguese women of childbearing age and pregnant women were shown to be mildly-to-moderately iodine deficient. As a response, in 2013, the National Health Authority (NHA) issued a recommendation that all women considering pregnancy, pregnant or breastfeeding, take a daily supplement of 150–200 μg iodine. This study explored how the iodine supplementation recommendation has been fulfilled among pregnant and lactating women in Portugal, and whether the reported iodine supplements intake impacted on adverse obstetric and neonatal outcomes. Design and methods Observational retrospective study on pregnant women who delivered or had a fetal loss in the Braga Hospital and had their pregnancies followed in Family Health Units. Results The use of iodine supplements increased from 25% before the recommendation to 81% after the recommendation. This was mostly due to an increase in the use of supplements containing iodine only. Iodine supplementation was protective for the number of adverse obstetric outcomes (odds ratio (OR) = 0.791, P = 0.018) and for neonatal morbidities (OR = 0.528, P = 0.024) after controlling for relevant confounding variables. Conclusion The recommendation seems to have succeeded in implementing iodine supplementation during pregnancy. National prospective studies are now needed to evaluate the impact of iodine supplementation on maternal thyroid homeostasis and offspring psychomotor development and on whether the time of the beginning of iodine supplementation (how early during preconception or pregnancy) is relevant to consider.

Plasma vitamin B12 concentration is positively associated with cognitive development in healthy Danish 3-year-old children; the SKOT cohort studies

Adequate vitamin B12 and folate concentrations are essential for neural development in early childhood but studies in well-nourished children are lacking. We investigated the relation between plasma vitamin B12 and folate at 9 and 36 months and psychomotor development at 36 months in well-nourished Danish children. Subjects from the SKOT cohorts with vitamin B12 measurement and completed Ages and Stages Questionnaire (ASQ-3) at 36 months were included (n=280). Dietary intake, vitamin B12- and folate concentrations were collected at 9 and 36 months, and ASQ-3 was assessed at 36 months. Associations between vitamin B12 and folate at 9 and 36 months and ASQ-3 were analyzed using regression models. Associations between diet and vitamin B12 were also investigated. No children had insufficient vitamin B12(<148pmol/L) at 36 months. Vitamin B12 at 36 month was positively associated with total ASQ-3 corresponding to an increase of 100 pmol/L vitamin B12 per 1.5 increase in total ASQ-3 score; p=0.019) which remained significant after adjustment for potential confounders including 9 months values. Vitamin B12 at 9 months or folate at any time point was not associated with total ASQ-3. Intake of milk products was associated with vitamin B12 at 36 months (p=0.003) and showed a trend at 9 months (p=0.069). Intake of meat products was not associated with vitamin B12. In conclusion, vitamin B12 was positively related to psychomotor development at 3 years in well-nourished children, indicating that the impact of having marginally low vitamin B12 status on psychomotor development in well-nourished children should be examined further.

MEDICAL AND PSYCHOLOGICAL SUPPORT OF WOMEN WITH THE THREAT OF PRETERM BIRTH IN THE LAST TRIMESTER OF PREGNANCY AND AFTER DELIVERY

Introduction. Throughout life, everyone faces a variety of emotionally complex situations. Pregnancy is one of such situations for a woman. It’s a very strong level of experience and a specific set of sensations in life, the study of which has recently received close attention. Circumstances that have developed in Ukraine in connection with environmental disadvantages mainly determine the low health index of pregnant women, and create preconditions for the increasing frequency of premature pregnancies in future generations. This problem is of great medical and social importance. More than a third of babies born prematurely lag behind in physical and psychomotor development. Considering the above mentioned, it can be argued that the creation of a system of medical and psychological support for pregnant women with a risk of preterm birth in the last trimester of pregnancy is relevant, necessary and timely. The purpose of the study is to develop a set of measures for medical and psychological support of women at risk of preterm birth in the last trimester of pregnancy and after childbirth based on a systematic approach to the study of individual psychological, pathopsychological and psychosocial characteristics. Material and methods. During 2016-2019 the study was conducted based on Storozhynets Central District Hospital in the Chernivtsi region. 150 pregnant women in the third trimester of pregnancy (23-37 weeks) and their husbands were examined. The main group (MG) included 120 women with the risk of premature birth in the last trimester of pregnancy. The comparison group (CP) included 30 women with a physiological course of pregnancy. The main therapeutic group (MTG) consisted of 42 women with a risk of preterm birth in the last trimester of pregnancy with maladaptive (MTG1) and destructive (MTG2) types of interaction in the triad "mother-child-father", who agreed to participate in medical and psychological care. The correctional group (CG) included 12 women with a risk of preterm birth in the last trimester of pregnancy with maladaptive and destructive types of interaction in the triad "mother-child-father", who refused to participate in the proposed measures. Results. Analysis of the evaluation of the developed system of medical and psychological support of the family during pregnancy showed the following (p <0.001): a) improvement of psycho-emotional state, well-being and overcoming emotional stress demonstrated by MTG1 women (up to 43.7 ± 0.8 and 42.5 ± 1.5, respectively, and after 20.8 ± 1.5 and 22.1 ± 1.2, respectively), the level of depression and anxiety on the Hamilton scale (up to HDRS 11.4 ± 1.2 and HARS 12.5 ± 1.2 after HDRS 4.2 ± 0.4 and HARS 5.7 ± 0.4) and female MTG2 indicators of RA and PA on the Spielberger-Khanin scale (up to 51.7 ± 0.8 and 50.7 ± 1.5, respectively, and after 21.4 ± 1.8 and 23.1 ± 1.5, respectively), the level of depression and anxiety on the Hamilton scale (up to HDRS 16.3 ± 1.2 and HARS 18.3 ± 1.2 after HDRS 7.6 ± 0.7 and HARS 6.9 ± 0.6). Among CG women indicators RA and PA on the Spielberger-Khanin scale (up to 47.7 ± 0.8 and 46.6 ± 1.5, respectively; after 45.8 ± 1.5 and 42.1 ± 1.2, respectively), the level of depression and anxiety on the Hamilton scale (before HDRS 13.8 ± 1.2 and HARS 15.4 ± 1.2; after HDRS 12.2 ± 0.4 and HARS 14.7 ± 0.4) were higher. b) there was an increased level of social support on the last two scales - "support of colleagues" and "support of public organizations" among MTG1 and MTG2 women (up to 25.3%, after 55.2% / up to 14.8%, after 45, 2%, respectively) compared with CG women (up to 18.5%, after 24.5%). c) there was a complete reduction of the deformation of marital relations in the majority of MTG1 (83.3%) and MTG2 (75%) women in contrast to the examined CG. Conclusions. The implementation of the system of medical and psychological support for women with a risk of preterm birth in the last trimester of pregnancy and after childbirth allowed to optimize the choice of adequate behavioral strategies in a family, improve emotional state and well-being, optimize women's attitudes to pregnancy and harmonize family interaction (72.5%) ˂0.001), to harmonize the relationship in the triad "mother - child - father" in the postpartum period (66.4%) (p˂0.001).

Results of osteopathic treatment of infants with psychomotor developmental disorders

Aim. To compare the effectiveness of osteopathic treatment of infants with psychomotor development disorders with standard treatment in terms of functional status. Methods. The study was conducted at the Yaroslav-the-Wise Novgorod State University and the Institute of Osteopathic Medicine named after V.L. Andrianov, between 2020 and 2021. The study included 49 children with delayed psychomotor development, of which: the main group consisted of 26 children receiving osteopathic treatment; the control group consisted of 23 children treated with standard therapies. Data gathered included the indicators of the functional health state, complaints of parents, assessed neurological, vegetative, and osteopathic statuses, the psychomotor development in the children according to the ZhurbaMastyukova scale, performed neurosonography. The results were processed using descriptive statistics followed by checking for the significance of the difference by using the Student's t-criterion for related samples. Results. A comparison of the effectiveness of osteopathic and standard treatment of infants with a delay in psychomotor development by indicators of the functional status was carried out. The need for an integrated approach to therapeutic and diagnostic procedures was substantiated. The number of subjective complaints about the health of children from parents in the main group decreased, while in the control group, it remained the same. Neurological status in children of both groups improved, but the changes are more pronounced in the main group (p 0.05). The outcomes of the treatments indicate for improving psychomotor development of the children in the main group, in the control group, such an increase was only 13.0% (p 0.001). Conclusion. The results of the study showed that osteopathic treatment of infants with psychomotor development disorders is more effective than standard complex treatment, which is reflected in the improvement of functional health indicators.

Long-term follow-up of a patient with syndromic diarrhea (tricho-hepato-enteral syndrome) with Crohn's-like syndrome

Objective. To describe a long-term follow-up of a patient with a rare genetic disease – syndromic diarrhea, or trichohepatoenteric syndrome.Results. From the first months of life, the child was diagnosed with incurable diarrhea syndrome, which led to the development of malabsorption syndrome, retardation of physical and psychomotor development. Long-term follow-up revealed the progression of malabsorption syndrome, metabolic and endocrine disorders against the background of increasing morphological changes in the intestine. Only a genetic study of the patient and his parents made it possible to formulate the final diagnosis: «Syndromic diarrhea (trichohepatoenteric syndrome, nucleotide variant g.31929071C> T homozygous in the SKIV2L gene) with crown-like syndrome».Conclusion. The combination of incurable chronic diarrhea syndrome with facial dysmorphism, skin and hair abnormalities is important for this diagnosis.

Penerapan Terapi Bermain Lego Terhadap Perkembangan Motorik Halus Pada Anak Usia Prasekolah Dengan Resiko Gangguan Perkembangan

Psychomotor skills are one of the developing chilg’s abilities that involve certain organs and muscles and requre well coordination. The purpose of this study is to describe the application of lego play therapy in improving psychomotor development in preschool-aged children who are at risk of developmental disorders participated in this study. The Developmenta Pre-Screening Questionnaire (KPSP) was used to assessthe psychomotor skills. The result show that KPSP value before the intervetion in both participant were 5 and 7. After the intervetion the values were increase to be 10 and 12. These result proved that lego play therapy can improve psychomotor development among preschool-aged chilidren who are at risk of devolpmenental disorders. Moreover nurses are strongly suggest to implement legp play therapy as an alternative intrvetion to improve psychomotor developmental in preschool-aged children.Keywords: Lego Play Therapy, Preschool Age, Psychomotor Development AbstrakMotorik halus merupakan salah satu kemampuan anak yang sedang berkembang yang melibatkan bagian-bagian tubuh tertentu dan otot-otot kecil dan memerlukan koordinasi yang cermat. Tujuan penulisan ini menggambarkan penerapan terapi bermain lego dalam meningkatkan perkembangan motorik halus pada anak usia prasekolah. Metode yang digunakan dalam studi kasus ini adalah metode deskriptif dengan subyek dua pasien anak usia prasekolah yang mengalami resiko gangguan perkembangan. Alat ukur menggunakan lembar observasi yang mengacu pada Kuisioner PraSkrining Perkembangan (KPSP). Hasil menunjukkan sebelum intervensi nilai observasi perkembangan motorik halus pada kasus satu yaitu 5 dan pada kasus dua yaitu 7. Setelah dilakukan intervensi nilai observasi kasus satu meningkat menjadi 10, sedangkan pada kasus dua meningkat menjadi 12. Kesimpulan bahwa terapi bermain lego membantu meningkatkan perkembangan motorik halus anak usia prasekolah yang mengalami resiko gangguan perkembangan. Diharapkan perawat menjadikan terapi bermain lego sebagai salah satu alternative tindakan untuk meningkatkan perkembangan motorik halus pada anak prasekolah.Kata kunci : TerapiBermain Lego; Motorikhalus; UsiaPrasekolah