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Ailmemts & Remedies Pediatric

Microcephaly

Definition:
Microcephaly (my-kroh-SEF-uh-lee) is a rare  neurodevelopmental disorder in which the circumference of the head is more than two standard deviations smaller than average for the person’s age and sex. Microcephaly may be congenital or it may develop in the first few years of life. The disorder may stem from a wide variety of conditions that cause abnormal growth of the brain, or from syndromes associated with chromosomal abnormalities. Two copies of a loss-of-function mutation in one of the microcephalin genes causes primary microcephaly.

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Sometimes detected at birth, microcephaly usually is the result of the brain developing abnormally in the womb or not growing as it should after birth.

Microcephaly can be caused by a variety of genetic and environmental factors. Children with microcephaly often have developmental issues. Generally there’s no treatment for microcephaly, but early intervention may help enhance your child’s development and improve quality of life.

Symptoms:
The primary sign of microcephaly is:

*A head size significantly smaller than that of other children of the same age and sex.

Head size is measured as the distance around the top of the child’s head (circumference). Using standardized growth charts, the measurement is compared with other children’s measurements in percentiles. Some children just have small heads, which may measure in the third, second or even first percentiles. In children with microcephaly, head size measures significantly below the first percentile.

These characteristics may accompany severe microcephaly:

*Backward sloping forehead
*Large ears
*Visual impairment


Depending on the severity of the accompanying syndrome, children with microcephaly may have:

*mental retardation,
*delayed motor functions and speech,
*facial distortions,
*dwarfism or short stature,
*hyperactivity,
*seizures,
*difficulties with coordination and balance, and
*other brain or neurological abnormalities.

Some children with microcephaly will have normal intelligence and a head that will grow bigger, but they will track below the normal growth curves for head circumference.


Causes:

It is most often caused by genetic abnormalities that interfere with the growth of the cerebral cortex during the early months of fetal development. It is associated with Down’s syndrome, chromosomal syndromes, and neurometabolic syndromes. :

Babies born with microcephaly will have a smaller than normal head that will fail to grow as they progress through infancy.

Microcephaly usually is the result of abnormal brain development, which can occur in the womb (congenital) or in infancy. Microcephaly may be genetic. Other causes may include:

*Craniosynostosis.
The premature fusing of the joints (sutures) between the bony plates that form an infant’s skull keeps the brain from growing. Treating craniosynostosis usually means your infant needs surgery to separate the fused bones. If there’s no underlying brain abnormality, the surgery allows the brain adequate space to grow and develop.

*Chromosomal abnormalities.
Down syndrome and other conditions may result in microcephaly.

*Decreased oxygen to the fetal brain (cerebral anoxia).
Certain complications of pregnancy or delivery can impair oxygen delivery to the fetal brain.

*Infections of the fetus during pregnancy. These include toxoplasmosis, cytomegalovirus, German measles (rubella) and chickenpox (varicella).

*Exposure to drugs, alcohol or certain toxic chemicals in the womb.
Any of these put your baby at risk of brain abnormalities.

*Severe malnutrition
. Not getting adequate nutrition during pregnancy can affect your baby’s development.

*Uncontrolled phenylketonuria (fen-ul-kee-toe-NU-ree-uh), also known as PKU, in the mother. PKU is a birth defect that hampers the body’s ability to break down the amino acid phenylalanine.

Complecations & Risk Factoirs:

Some children with microcephaly will be of normal intelligence and development, even though their heads will always be small for their age and sex. But depending on the cause and severity of the microcephaly, complications may include:

*Developmental delays, such as in speech and movement
*Difficulties with coordination and balance
*Dwarfism or short stature
*Facial distortions
*Hyperactivity
*Mental retardation
*Seizures

In general, life expectancy for individuals with microcephaly is reduced and the prognosis for normal brain function is poor. The prognosis varies depending on the presence of associated abnormalities.

Diagnosis:
To determine whether your child has microcephaly, your doctor likely will take a thorough prenatal, birth and family history and do a physical exam. He or she will measure the circumference of your child’s head, compare it with a growth chart, and remeasure and plot the growth at subsequent visits. Parents’ head sizes also may be measured to determine whether small heads run in the family.

In some cases, particularly if your child’s development is delayed, your doctor may request tests such as a head CT or MRI and blood tests to help determine the underlying cause of the delay.

Treatment :

Generally, there’s no treatment that will enlarge your child’s head or reverse complications of microcephaly.  Early childhood intervention programs that include speech, physical and occupational therapy may help your child strengthen abilities.

Treatment focuses on ways to decrease the impact of the associated deformities and neurological disabilities. Children with microcephaly and developmental delays are usually evaluated by a pediatric neurologist and followed by a medical management team. Early childhood intervention programs that involve physical, speech, and occupational therapists help to maximize abilities and minimize dysfunction. Medications are often used to control seizures, hyperactivity, and neuromuscular symptoms. Genetic counseling may help families understand the risk for microcephaly in subsequent pregnancies.

Certain complications of microcephaly, such as seizures or hyperactivity, may be treated with medication.

Prognosis:

Some children will only have mild disability. Others, especially if they are otherwise growing and developing normally, will have normal intelligence and continue to develop and meet regular age-appropriate milestones.

When you learn your child has microcephaly, you may experience a range of emotions, including anger, fear, worry, sorrow and guilt. You may not know what to expect, and you may worry about your child’s future. The best antidote for fear and worry is information and support. Prepare yourself:

*Find a team of trusted professionals. You’ll need to make important decisions about your child’s education and treatment. Seek a team of doctors, teachers and therapists you trust. These professionals can help evaluate the resources in your area and help explain state and federal programs for children with disabilities.

*Seek out other families who are dealing with the same issues. Your community may have support groups for parents of children with developmental disabilities. You may also find Internet support groups.

Prevention:
Learning your child has microcephaly may raise questions about future pregnancies. Work with your doctor to determine the cause of the microcephaly. If the cause is genetic, you and your spouse may want to talk to a genetic counselor about risks for future pregnancies.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.medicinenet.com/microcephaly/page2.htm
http://www.mayoclinic.com/health/microcephaly/DS01169
http://en.wikipedia.org/wiki/Microcephaly

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The Unromantic Truth About Why You Kiss

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The kiss may have evolved for reasons that are far more practical – and less alluring – than prevously thought.British scientists believe it developed to spread germs.

They say that the uniquely human habit allows a bug that is dangerous in pregnancy to be passed from man to woman to give her time to build up immunity.

Cytomegalovirus, which lurks in saliva, normally causes no problems. But it can be extremely dangerous if caught while pregnant and can kill unborn babies or cause birth defects. These can include problems ranging from deafness to cerebral palsy.

Writing in the journal Medical Hypotheses, researcher Dr Colin Hendrie from the University of Leeds said: “Female inoculation with a specific male’s cytomegalovirus is most efficiently achieved through mouth-to-mouth contact and saliva exchange, particularly where the flow of saliva is from the male to the typically shorter female.”

Kissing the same person for about six months provides optimum protection, he added. As the relationships progresses and the kisses become more passionate, her immunity builds up.

Previously scientists have claimed that kissing acts as a form of evolutionary quality control, with saliva holding clues to fertility, health and genes.

Resources:
Mail Online November 1, 2009
Medical Hypotheses October 12, 2009

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‘Brushing Teeth Prevents Preterm Birth’

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Preterm births are easier prevented than thought. Researchers in the United States have found that brushing your teeth properly and maintaining  proper oral hygiene reduces the chance of early labour by a large extent.

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Researchers from Case Western Reserve and Yale Universities Previously undiscovered bacteria usually found in the mouth could be responsible for up to 80% of early preterm labours.

The research could help doctors prevent preterm births by encouraging oral hygiene or stop early labour from developing by prescribing targeted antibiotics, Discovery News reported on its website on Wednesday.

“The earlier the woman goes into preterm labor, the higher the chance that she will be infected,” said Yiping Han, a doctor at Case Western University and the first author on the study.

Most human pregnancies last about 40 weeks. A birth prior to 37 weeks is classified as preterm. Babies born preterm can face many hurdles: vision and hearing loss, cerebral palsy, mental retardation, even death.

Labour itself is still somewhat of a mystery to science, which makes puzzling out preterm labour even more difficult. Anything from socioeconomic status and race to bacterial infection and genetics have been linked to preterm births, but a definitive cause is still elusive.

Han and her colleagues think they have found a major cause, at least in mice. By infecting the rodents with Bergeyella, a previously unknown bacteria found in the mice, the researchers caused preterm births.

In humans, the scientists showed a strong correlation between infection and preterm births. Doctors removed amniotic fluid from 46 different women with potentially higher risk pregnancies. Of that group, 21 delivered an early preterm baby (32 weeks or earlier). Nineteen of those women, or about 85%, were positive for previously undetected bacteria.

The bacteria normally live in the mouth, but if a cut, cavity or other wound allows the bacteria to enter the blood stream, they can travel and eventually colonize the uterus. That triggers an immune response, which can inflame the uterus and eventually cause a mother to go into labour prematurely.

To identify bacteria behind preterm labour, doctors used polymerase chain reaction (PCR). Using PCR, the scientists identified the Bergeyella bacterium, as well as DNA belonging to 10 or 11 different strains of newly identified bacteria. Now that doctors know about another link to preterm labour, the next step is to treat it. Antibiotics that specifically target these new bacteria are currently being tested.

Sources: The Telegraph (Kolkata, India)

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Infections May Cause Premature Births

Undiagnosed infections may be causing a significant number of premature births, researchers reported on Monday after finding bacteria or fungi in 15 per cent of the amniotic fluid samples taken from women in pre-term labor.

….

The heavier the infection, the more likely the women were to deliver younger, sicker infants, the team at Stanford University in California found.

“If we could prevent these infections in the first place, or detect them sooner, we might one day be able to prevent some of these premature births,” Dr. Dan DiGiulio, who worked on the study, said in a statement.

More and more children are being born prematurely in the United States, with 12 per cent percent of births coming before the 37th week of gestation. Premature babies are vulnerable to breathing problems, underdeveloped organs, infections and cerebral palsy.

DiGiulio’s team looked for the DNA of germs in amniotic fluid samples collected from 166 women in pre-term labor at the Detroit Medical Center between October 1998 and December 2002. They used this method and standard laboratory cultures to determine that 25 of the 166 samples were infected with either bacteria or fungi. They also found at least one unknown organism that could be a new species.

All 25 of the women with infected amniotic fluid went on to deliver their babies pre-term, while 53 of the women with no infections were able to stop their labor. Now the team is working to see if infections can be detected before pre-term labor starts, which could lead to new prevention or treatment approaches.

Sources: The Times Of India

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