Subject(s)
Calcitriol/administration & dosage , Calcium/administration & dosage , Hypocalcemia , Tachycardia, Supraventricular , Calcium Channel Agonists/administration & dosage , Humans , Hypocalcemia/diagnosis , Hypocalcemia/drug therapy , Hypocalcemia/etiology , Hypocalcemia/physiopathology , Infant , Male , Rickets/complications , Rickets/diagnosis , Rickets/drug therapy , Tachycardia, Supraventricular/diagnosis , Tachycardia, Supraventricular/drug therapy , Tachycardia, Supraventricular/etiology , Tachycardia, Supraventricular/physiopathology , Treatment Outcome , Vitamin D Deficiency/diagnosis , Vitamin D Deficiency/drug therapyABSTRACT
INTRODUCTION: Measuring head circumference and plotting it in centile charts is a routine practice in paediatrics. However if wrong charts are used, serious misinterpretations can ensue. OBJECTIVES: This study was carried out to ascertain the appropriateness of charts used in Sri Lanka. Out of a birth cohort of 2215 children, 250 from each sex were invited for a follow up study. Head circumference was measured at 2, 4, 6, 9 and 12 months. Statistical characteristics of head circumference for each sex, at each age were calculated. RESULTS: At the first follow up 244 boys and 241 girls were assessed. Out of this, 85% of boys and 86% of girls completed the follow up. CONCLUSIONS: Head circumference of both sexes deviated significantly at all ages from the charts available in the Child Health Developmental Record (CHDR). Head circumference charts available in the CHDR are inappropriate for use in Sri Lankan children.
Subject(s)
Cephalometry/standards , Growth Charts , Cephalometry/statistics & numerical data , Female , Follow-Up Studies , Head/growth & development , Humans , Infant , Infant, Newborn , Male , Reference Values , Sri LankaABSTRACT
INTRODUCTION: Assessing the anterior fontanelle size is an important component of routine neonatal examination. For meaningful interpretation of fontanelle size, normal reference values are essential. Normal values for the fontanelle size in Sri Lankan newborns are not available. OBJECTIVES: To investigate characteristics of anterior fontanelle size at birth in Sri Lankan babies. METHODS: A descriptive cross sectional study was carried out between October and November 2010. Horizontal and vertical dimensions of the anterior fontanelle were measured in 2215 normal term babies, between 12 to 24 hours after birth. A practical and simple method was used to measure fontanelle size. Average fontanelle size was calculated by adding horizontal and vertical dimensions and dividing by two. RESULTS: Mean of the average fontanelle size for the total sample was 2.55 cm (for males 2.57 cm and for females 2.52 cm). Longitudinal dimension was significantly higher than the horizontal in both sexes (p<0.001). Frequency distribution curves of fontanelle size followed a normal distribution in both sexes. The ninety seventh centile and third centile for the average fontanelle size were 4.5 cm and 0.9 cm respectively. CONCLUSIONS: Babies with an average anterior fontanelle size more than 4.5 cm or less than 0.9 cm need further follow up. Further studies are needed to evaluate the accuracy of these cut off values.
Subject(s)
Cranial Fontanelles/anatomy & histology , Cross-Sectional Studies , Female , Humans , Infant, Newborn , Male , Reference Values , Sex Factors , Sri LankaABSTRACT
INTRODUCTION: Salt is the main source of iodine in areas with high rainfall and iodine deficiency is the main cause of preventable hypothyroidism. Iodisation of salt increases iodine intake, but will depend on how salt is handled. This study was carried out to assess the pattern of salt consumption in the estate population and to ascertain the relationship between household salt iodine concentration and TSH levels in children. METHODS: A descriptive cross sectional study was carried out in 20 randomly selected estates in the Ratnapura district of Sri Lanka, from August to November 2009. 1683 households with at least one child between 5-9 years were surveyed to determine patterns of salt usage. A salt sample from each household was tested for adequacy of iodine (concentration ≥ 30 ppm). In phase two, 519 children were randomly selected from these households and serum TSH levels were assayed. RESULTS: Salt powder (54.5%) was preferred to salt crystals. Salt crystals were washed before use in 20% households. Salt was kept away from the fire-place in 90.4% of households. Salt samples of 88.7% households had an adequate iodine concentration. Salt iodine concentration was significantly lower when salt was stored near a fire-place and washed before use (p<0.001). The median TSH level of children from households with adequate salt iodine concentrations was significantly lower than that of children from households with inadequate salt iodine concentration (p<0.001). CONCLUSIONS: A significant number of households did not have adequate iodine in salt samples probably due to inappropriate handling and storage. Consumption of salt low in iodine is associated with high serum TSH levels.