QUALITY OF LIFE OF CHILDREN WITH RICKETS IN YOUNG AGE IN ARMENIA.

Quality of Life (QL) currently is one of the most important criteria for evaluating a child's function. The main characteristics of QL in pediatrics are the psychological, physical and social functioning of the body. Integral characteristics of QOL based on the subjective perception of the components of the child and his parents. As a result of the official statistics and our research it turned out that children in this age-group more often suffer from intestinal infections, anemia, hypertrophy, rickets, skin and subcutaneous fiber disease, deficiencies occurring in prenatal period. The aim of the research is to evaluate the peculiarities of QL criteria change in case of rickets. So far in Armenia there were no tools of QL assessment of children of an early age, thereby the most acceptable questionnaire of QUALIN was used to create Armenian version on its basis. We cooperated with MAPI institute and the authors of QUALIN(Qualite de vie du Nourisson) questionnaire (Manificat S., Dazord A,) and got MAPI's permission to apply the questionnaire in the Republic of Armenia. The questionnaire QUALIN was selected for studying children's QL. The results show that the QL of children with rickets is lower than the QL of the ones who are healthy. The difference is more vividly expressed in the following parameters of QL: neuropsychological development and physical health, the ability to stay alone. In this case the pediatricians have given lower mark of QL than parents. We think that one of the possible motives of such diversity is the professional approach of doctors who estimated the QL more strictly than parents did. So QUALIN international questionnaire can be applied to estimate the peculiarities of QL criteria change of children with rickets at an early age.

Description and evaluation of operative deformity correction in calcium-deficiency rickets in Kaduna, northern Nigeria.

PURPOSE: Rickets is a recurrent disease worldwide, especially in countries with limited resources (Nield et al Am Fam Physician 74(4):619-626, 2006; Thacher et al Ann Trop Paediatr 26(1):1-16, 2006). Medical therapy including orally administered calcium substitution is shown to improve a patients clinical symptoms and positively impact bone deformities, especially in the lower extremity. Even though orthopaedic intervention is necessary in a significant percentage of patients, few reports exist about operative deformity correction in patients wtih rickets. METHODS: We describe our concept of operative treatment by single-stage, three-dimensional closing-wedge osteotomies on 45 deformed legs in 27 patients from the rural area of Kaduna, North Nigeria, with calcium-deficiency rickets and evaluate the early results in a 1.5-year follow-up. RESULTS: We found a significant improvement in parameters of quality of life, functionality, clinical and radiological angulation and angles following the definition of Paley et al., with a complication rate of 4 % under 88 osteotomies (Paley et al Orthop Clin North Am 25(3):425-65, 1994). CONCLUSION: The described operative therapy shows to be sufficient and with satisfactory results in correcting rickets-related leg deformities under rural circumstances with low availability of medical resources.

Complications of ichthyosis beyond the skin.

Although ichthyoses are noted for their skin features, like many dermatologic conditions, patients are often impacted in ways beyond the skin. Much has been described in recent years regarding quality of life and skin disorders. This is certainly the case for ichthyosis. For neonates or others with diffuse involvement of their skin, nutritional needs are often exceeding normal requirements. These can often result in growth abnormalities. Lastly, with specific subtypes of ichthyosis, compromise of tissues around the eyes and ears can be of concern to some patients. Certainly, some forms of ichthyosis are routinely complicated by such findings. It is important for practitioners caring for individuals with ichthyosis to have these issues in mind.

The medicalization of sunlight in the early twentieth century.

This paper traces the emergence of the therapeutic use of sunlight in medicine during the first half of the twentieth century. This was a period of considerable flux in medicine with various strands of practice and theory competing. Drawing on two case studies of sunlight therapy, both artificial (actinotherapy) and natural (heliotherapy), in the treatment of rickets and tuberculosis this paper will explore how medicine was constituted within these regimes. The paper will argue that therapeutic and clinical applications of sunlight helped establish an association between sunlight and health but also defined a particular and specific performance of medicine.

Symptomatic vitamin A and D deficiencies in an eight-year-old with autism.

An 8-year-old boy with autism developed a limp and periorbital swelling. He was found to have hypocalcemia and radiographic evidence of rickets. Ophthalmologic examination revealed xerophthalmia and corneal erosions. Serum vitamin A was undetectable and serum 25-hydroxyvitamin D was decreased. Dietary history revealed a markedly altered intake consisting of only french fried potatoes and water for several years. All biochemical and physical abnormalities reversed with appropriate supplementation. The nutritional content of french fries is reviewed. Feeding dysfunction is an integral part of autism and closer attention should be paid to potential nutritional deficiencies.