Growth and sexual maturation of low birth weight children: a 14 year follow up

OBJECTIVE

To evaluate the physical growth and sexual maturation of children born with low birth weight (< 2000 g). (LBW).

DESIGN

Longitudinal follow up.

SETTING

Hospital born urban cohort.

METHODS

Weight, height, head circumference and pubertal changes were recorded till 14 years at specified intervals in 252 LBW and 176 control (term neonates with birth weights > or = 2500 g) children. Effect of prematurity and fetal growth retardation (SFD) was studied in 79 preterm appropriate for gestation and 45 term SFD children.

RESULTS

LBW boys significantly lagged behind their controls for all physical growth parameters till 14 years, while the LBW girls had a physical growth comparable to controls after 11 years. Preterms had comparable weight, height and head circumference with their controls after 11 years. The SFDs, however, remained significantly handicapped in their overall physical growth even at 14 years. In comparison to controls, menarche occured 6 months earlier in preterms and 12 months earlier in SFD girls. However, there was no change in the sequence of pubertal changes in either preterms or SFDs.

CONCLUSIONS

Fetal growth retardation has a lasting adverse effect on later physical growth, while most preterms catch up with their peers by adolescence.

Roentgenographic evaluation of erosive changes in early cases of rheumatoid arthritis: using magnified view

The diagnosis of typical cases of rheumatoid arthritis can be done on clinical grounds but problem arises in equivocal cases and radiological changes suggestive of rheumatoid arthritis help in confirmation or overweight the clinical diagnosis. Radiological changes viz, osteoporosis and soft tissue swelling can be assessed by conventional projections but problem arises in early detection of minute erosive changes of the articular surfaces. These lesions have been very well demonstrated by using magnification radiography and hence may be recommended for early diagnosis of rheumatoid arthritis.

Abnormal pattern of lung functions in rubber factory workers

The influence of suspended particulate matter, benzo(e) pyrene, benzo(e) pyrene and benzo(a) anthracene concentration on pulmonary lung functions ie, residual volume, total lung capacity, residual volume/total lung capacity, forced residual capacity were studied in 667 rubber factory workers during 1990-91. The respirable fraction of the particulate size (< 0.5 micron) showed high mean concentration of suspended particulate matter, benzo(a) pyrene, benzo(e) pyrene and benzo(a) anthracene in the compounding section (group III), when compared with vulcanising (group II) and packing loading (group I) units. While comparing the lung functions amongst these groups, the higher results of residual volume, residual volume/total lung capacity ratio, forced respiratory capacity and lower values of total lung capacity were observed in group III workers as compared with other two groups. And also these results seem to be correlated with the high pollutant concentrations to which group III workers were exposed, and reflect a clear combination of obstructive and restrictive pattern of lung functions in them.

A study of extra-auditory effects of noise

Paper mill workers (106) exposed to noise ranging from 80 to 96 dBA were assessed for alteration in clinical status. Neurobehavioral functions were examined with the help of a questionnaire. The study did not reveal any changes attributable to noise in subjects exposed to 86-90 dBA and > 90 DBA noise in course of their occupations.

Broken tracheostomy introducer--an unusual tracheobronchial foreign body

We present a rare case where the introducer of a metal tracheostomy tube became lodged in the tracheobronchial tree. This may be the only reported case. The literature is reviewed to study the possible cause of tracheostomy tube component fracture and to suggest methods for preventing this complication.

Peri renal extravasation in a case of urethral valves

A case is described urinary ascites and a perinephric urinoma due to obstruction of the urinary tract by posterior urethral valves.

Leiomyosarcoma of gallbladder: a case report

A case of leiomyosarcoma of gallbladder, a rare tumor in hepatobiliary region, is reported. The present case differs from previously reported cases in its presentation with empyema of gallbladder and multiple intrahepatic cholangiolytic abscesses. Curative surgery could not be undertaken on account of poor condition of patient, and invasion of tumor into liver and adjacent organs.

Kerosene oil poisoning--a childhood menace

This study documents 3-year retrospective analysis of accidental kerosene oil poisoning in 70 children with regard to clinical profile, radiological changes and outcome. About 77% of cases were between 1 and 3 years old. Fifty children (71.4%) developed significant symptoms, with onset soon after to within 10 hours of ingestion. These included breathlessness (55.7%), fever (47.1%), cough (31.4%), restlessness (25.7%) and abdominal distension (15.7%). Chest X-rays were obtained in 65 children. Abnormal radiographs were seen in 45 (69.2%) children with right basal infiltrates being the commonest picture (21.4%). Ingestion of more than one ounce of kerosene oil adversely affected the clinical and radiological profile. Severely malnourished children had extensive radiological changes and poorer clinical outcome. One case developed myocarditis, a complication which has not been reported to the best of our knowledge. Mortality rate was 4.3%. All deaths occurred within 48 hours of admission.

Chest radiographs in neonatal septicemia

Chest radiographs of 63 culture proven cases of neonatal septicemia were evaluated in this prospective study. Gram negative septicemia was responsible for 76.2% cases. Radiological abnormalities were observed in 27 cases (42.8%). Seven of these had no respiratory distress. The findings were right sided infiltrates (27%); hyperinflation (7.9%), bronchopneumonia (6.3%) and pneumothorax (1.6%). Increasing gestational age, late onset of illness (greater than 3 days) and presence of respiratory signs of distress had a positive correlation with presence of X-ray findings. Term newborns with respiratory distress of late onset sepsis (greater than 3 days) had significantly higher number (p less than 0.05) of abnormal radiographs. Presence of radiological abnormality neither influenced the clinical outcome nor was affected by the causative organisms. The practice of doing a chest radiograph routinely in cases of neonatal septicemia is justified irrespective of presence of respiratory signs of distress.

Malignant carcinoid tumor of the gallbladder: a case report and review of literature

Carcinoid of the gallbladder and bile ducts is a rare tumor. Till date 20 cases have been reported. Here we report one more case and review all 21 cases collectively. The tumor affects elderly patients of either sex equally. Surgical obstructive jaundice (SOJ), followed by abdominal symptoms were the commonest presenting complaints. None of the patients presented with carcinoid syndrome. Bile duct carcinoids presented significantly earlier than gallbladder carcinoids because of strategic location causing SOJ. Gallstones were present only in 3 cases. Fifty per cent of these tumors were malignant, with liver followed by bone as the commonest site of metastasis. Surgery has been the mainstay of the treatment of these lesions. Old age, jaundice and metastasis at presentation and location of carcinoid in bile duct were found to be bad prognostic factors. In the absence of these features overall survival after surgical procedures like radical cholecystectomy was encouraging enough to undertake the surgical challenge.

Acute osteomyelitis: early diagnosis by ultrasonography

A prospective study was carried out to evaluate the role of ultrasound in early detection of infections of bone. Presence of a hypoechoic collection adjacent to bone was considered highly suggestive of osteomyelitis whereas a hypoechoic collection away from the bone implied a soft tissue abscess. Cellulitis presented as increased subcutaneous thickness. Of the 31 patients clinically suspected to have osteomyelitis, and subjected to ultrasound, 25 were proven to be osteomyelitis at surgery or by subsequent radiological changes, 4 had soft tissue abscesses and the remaining 2 had cellulitis. Co-existent hip joint effusion was seen in 2 patients. It is felt that ultrasound is simple and non-invasive investigation, capable of detecting bone and soft tissue infections.

Carcinoma oesophagus--an unusual cause of hypertrophic osteoarthropathy

A rare case of Hypertrophic Osteoarthropathy in association with carcinoma of the oesophagus has been reported from Indian subcontinent. In addition to long bones short tubular bones are also involved in our case. Neurogenic theory is the most feasible pathogenesis for hypertrophic osteoarthropathy in the present case.