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Vashisht RG, Dasaratha V, Santahanakrishna R. Awareness of Periconceptional Folic Acid in Parents of Children Affected by Spina Bifida - A Pilot Study. Afr J Paediatr Surg 2024; 21:107-110. [PMID: 38546248 PMCID: PMC11003567 DOI: 10.4103/ajps.ajps_102_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 11/16/2022] [Accepted: 12/09/2022] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Spina bifida is a congenital malformation involving an open vertebral column resulting from failure in neural tube closure. It is among the most frequently occurring birth defects, observed in 1-3 cases per 1,000 live births worldwide. Conventionally requiring surgical repair, it can cause severe neurologic and musculoskeletal complications. However, consumption of prophylactic folic acid in mothers, at least 3 months before to 12 weeks after conception (periconceptional) has been shown to reduce the incidence of spina bifida by approximately 75%. This makes ascertaining parental understanding of such benefits critical. Therefore, this study provides baseline information on the awareness of periconceptional folic acid among parents whose children previously underwent surgical repair of spina bifida defects. MATERIALS AND METHODS The study subjects constituted 80 parents whose biological children had undergone surgical repair of spina bifida defects from 2014 to 2021 at a large paediatric tertiary care centre in South India. Upon providing informed consent, the subjects answered a cross-sectional telephonic survey containing 21 questions aimed at exposing their understanding of folic acid and its association with spina bifida. RESULTS None of the mothers had consumed folic acid before conception. However, 75% of them had consumed it as prescribed by their obstetrician during the first trimester of pregnancy. Finally, only 35% of them were aware of its role in preventing spina bifida. CONCLUSION The awareness of periconceptional folic acid and its preventive role in spina bifida was low amongst parents whose children were once treated for same congenital abnormality.
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Affiliation(s)
- Rohan Giridhar Vashisht
- Department of Paediatric Surgery in Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India
| | - Vinupriya Dasaratha
- Department of Paediatric Surgery in Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India
| | - Ramesh Santahanakrishna
- Department of Paediatric Surgery in Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India
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Chawla A, Patil MC, Reddy SJ, Pillai S, N SSB. Global Differences in Management of Neurogenic Bladder: Indian Perspective. CURRENT BLADDER DYSFUNCTION REPORTS 2023. [DOI: 10.1007/s11884-023-00692-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
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Faleiros F, Santos LM, Bimbatti K, Käppler C. Bowel Emptying Methods Used by German Residents Living With Spina Bifida. J Wound Ostomy Continence Nurs 2021; 48:149-152. [PMID: 33605711 DOI: 10.1097/won.0000000000000741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE The purpose of this study was to describe and analyze methods of bowel emptying among Germans living with spina bifida. We also analyzed relationships between age, sex, level of spinal bifida anomaly, and methods of bowel elimination. DESIGN A quantitative, descriptive study. SUBJECTS AND SETTING The sample comprised 88 persons (56 women and 32 men) residing anywhere in the Federal Republic of Germany. Their mean age was 17.5 years (SD 13.64 years), range 0 to 55 years. METHODS Data were collected through an online survey questionnaire developed for the urological follow-up protocol for patients with spina bifida. Parents completed the questionnaire for participants younger than 18 years. RESULTS Twenty participants (22.7%) reported normal defecation and 68 (77.3%) reported neurogenic bowel dysfunction requiring regular bowel management. Participants requiring bowel management predominately used rectal irrigation (40.9%) and digital rectal stimulation (27.3%) to enhance bowel evacuation. Age emerged as the only factor related to the bowel management techniques. Younger participants (≤20 years) were more likely to use rectal irrigation for bowel evacuation (P = .001, Fisher's exact test), whereas older respondents (≥21 years) were more likely to use digital rectal stimulation (P = .015, Fisher's exact test). Analysis revealed no differences in methods of bowel evacuation based on sex or level of spina bifida anomaly (cervical, thoracic, lumbar, or sacral). CONCLUSIONS Rectal irrigation was the most common method for bowel evacuation. Participants were less likely to employ potentially effective and more conservative measures for intestinal emptying, such as toilet training/timed evacuation associated with Valsalva maneuvers, abdominal press, abdominal massage, and digital rectal stimulation. Additional comparative studies with more participants and other countries with intestinal emptying methods are needed to better understand the needs of individuals with spina bifida and their families and to improve the health-related quality of life of these people.
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Affiliation(s)
- Fabiana Faleiros
- Fabiana Faleiros, PhD, Nursing School of Ribeirão Preto, University of São Paulo, Ribeirão Preto (SP), Brazil
- Lilka Marques Santos, Nursing School of Ribeirão Preto, University of São Paulo, Ribeirão Preto (SP), Brazil
- Karina Bimbatti, Nursing School of Ribeirão Preto, University of São Paulo, Ribeirão Preto (SP), Brazil
- Christoph Käppler , PhD, Faculty of Rehabilitation Sciences, University of Dortmund, Germany
| | - Lilka Marques Santos
- Fabiana Faleiros, PhD, Nursing School of Ribeirão Preto, University of São Paulo, Ribeirão Preto (SP), Brazil
- Lilka Marques Santos, Nursing School of Ribeirão Preto, University of São Paulo, Ribeirão Preto (SP), Brazil
- Karina Bimbatti, Nursing School of Ribeirão Preto, University of São Paulo, Ribeirão Preto (SP), Brazil
- Christoph Käppler , PhD, Faculty of Rehabilitation Sciences, University of Dortmund, Germany
| | - Karina Bimbatti
- Fabiana Faleiros, PhD, Nursing School of Ribeirão Preto, University of São Paulo, Ribeirão Preto (SP), Brazil
- Lilka Marques Santos, Nursing School of Ribeirão Preto, University of São Paulo, Ribeirão Preto (SP), Brazil
- Karina Bimbatti, Nursing School of Ribeirão Preto, University of São Paulo, Ribeirão Preto (SP), Brazil
- Christoph Käppler , PhD, Faculty of Rehabilitation Sciences, University of Dortmund, Germany
| | - Christoph Käppler
- Fabiana Faleiros, PhD, Nursing School of Ribeirão Preto, University of São Paulo, Ribeirão Preto (SP), Brazil
- Lilka Marques Santos, Nursing School of Ribeirão Preto, University of São Paulo, Ribeirão Preto (SP), Brazil
- Karina Bimbatti, Nursing School of Ribeirão Preto, University of São Paulo, Ribeirão Preto (SP), Brazil
- Christoph Käppler , PhD, Faculty of Rehabilitation Sciences, University of Dortmund, Germany
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Pediatric Neurogenic Bladder and Bowel Dysfunction: Will My Child Ever Be out of Diapers? Eur Urol Focus 2020; 6:838-867. [PMID: 31982364 DOI: 10.1016/j.euf.2020.01.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 12/02/2019] [Accepted: 01/13/2020] [Indexed: 02/07/2023]
Abstract
CONTEXT Managing patient and parent expectations regarding urinary and fecal continence is important with congenital conditions that produce neurogenic bladder and bowel dysfunction. Physicians need to be aware of common treatment algorithms and expected outcomes to best counsel these families. OBJECTIVE To systematically evaluate evidence regarding the utilization and success of various modalities in achieving continence, as well as related outcomes, in children with neurogenic bladder and bowel dysfunction. EVIDENCE ACQUISITION We performed a systematic review of the literature in PubMed/Medline in August 2019. A total of 114 publications were included in the analysis, including 49 for bladder management and 65 for bowel management. EVIDENCE SYNTHESIS Children with neurogenic bladder conditions achieved urinary continence 50% of the time, including 44% of children treated with nonsurgical methods and 64% with surgical interventions. Patients with neurogenic bowel problems achieved fecal continence 75% of the time, including 78% of patients treated with nonsurgical methods and 73% with surgical treatment. Surgical complications and need for revisions were high in both categories. CONCLUSIONS Approximately half of children with neurogenic bladder dysfunction will achieve urinary continence and about three-quarters of children with neurogenic bowel dysfunction will become fecally continent. Surgical intervention can be successful in patients refractory to nonsurgical management, but the high complication and revision rates support their use as second-line therapy. This is consistent with guidelines issued by the International Children's Continence Society. PATIENT SUMMARY Approximately half of children with neurogenic bladder dysfunction will achieve urinary continence, and about three-quarters of children with neurogenic bowel dysfunction will become fecally continent. Most children can be managed without surgery. Patients who do not achieve continence with nonsurgical methods frequently have success with operative procedures, but complications and requirements for additional procedures must be expected.
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