Exploring the association between haematological markers of iron and general movements in 4-month-old infants exposed to anaemia in-utero.

BACKGROUND: Iron is a vital micronutrient for brain development, influencing myelination, neurotransmitter balance, and the maturation of specific brain cells. Hence iron insufficiency in the foetal, neonatal and infancy period has the potential to influence the neuromotor development. AIMS: We aimed to describe haematological markers of iron at 4 months of age in infants exposed to prenatal anaemia and explore the association with their quality of general movements. STUDY DESIGN: Cross sectional study nested within the RAPIDIRON-KIDS trial. SUBJECTS: All infants whose mothers were part of RAPIDIRON-KIDS trial, were eligible to participate in this study when the infants were 4 months old. Children suffering from fever or acute illness on the day of assessment, or with a history of either surgery, or admission to hospital in the first month were excluded. OUTCOME MEASURES: Haematological markers of iron (Haemoglobin and Ferritin level) and quality of general movements in infants at 4 months of age. RESULTS: 120 infants were assessed with mean birth weight of 2685.5 g (±384.5) and median gestational age of 39 weeks [Q1, Q3:38,40]. There was no significant association between haemoglobin or ferritin levels with fidgety movements (p = 0.18 and p = 0.27, respectively). The combined effect of haemoglobin and ferritin estimates also did not show any significant association with the study groups (p = 0.21). CONCLUSION: A majority of infants still had low iron indices at 4 months of age and this was not associated with the quality of general movements. A prospective longitudinal study needs to be considered in infants exposed to prenatal anaemia rather than assessing the outcomes at a single time point.

Effectiveness of a smartphone-based virtual reality intervention on balance and functional mobility in children with acute lymphoblastic leukemia: A pre-post experimental study.

BACKGROUND: The odds of survival of children with acute lymphoblastic leukemia (ALL) has increased markedly owing to a better understanding of pathogenesis, adoption of risk stratification therapy, and availability of newer therapeutic agents. These drugs, however, may affect balance and functional mobility, leading to activity restrictions. Virtual reality (VR) is a promising rehabilitation program for motor difficulties. The study, therefore, aimed to determine the effect of a smartphone-based VR intervention on balance and functional mobility in children with ALL. METHODS: The pre-post experimental study included 32 children with ALL between 4 and 18 years of age. They received smartphone-based VR intervention every day for a period of 2 weeks, with each session lasting for 30 minutes. Each session included five VR games that were played by the child for 5 minutes each, with 1 minute rest between the games. Pre- and post-intervention, balance and functional mobility were evaluated using the balance subset of Bruininks Oseretsky Test of Motor Proficiency, second edition (BOT-2) and the Timed Up and Go (TUG) test, respectively. RESULTS: Children with ALL demonstrated a significant improvement in balance post-intervention, with a mean difference of 2.22 ± 1.75 (P < 0.0001). Functional mobility improved with a mean difference of 1.12 ± 1.09 (P < 0.0001). There was an improvement of 8.04% and 11.04% in balance and functional mobility, respectively. CONCLUSION: The study concluded that a 2-week smartphone-based VR intervention is effective in improving balance and functional mobility in children with ALL.

Impact of a Brief Healthcare-based Intervention to Support Early Childhood Development in India: A Pilot Randomized Controlled Trial.

OBJECTIVES: To study the impact of a brief early childhood develop-ment (ECD) intervention, Sit Down and Play (SDP), integrated within routine healthcare visits on parent and child outcomes. METHODS: Between April, 2018 and March, 2019, caregivers and their infants aged 5-6 months attending a well-baby clinic were enrolled and randomized to intervention (n=26) or control (n=26) groups. Intervention families received SDP at recruitment and two subsequent immunization visits (8 months and 10 months). Control families received usual care. ECD outcomes were assessed through in-person assessments at the age of 12 months using the Stim Q subscales to assess parenting behaviors, and the Developmental Assessment Scale for Indian Infants (DASII) for neurodevelopment. RESULTS: There was a significant improvement in parent-child stimulation activities and verbal interactions in the intervention group compared with the control group [6.1(1.4) vs 4.9 (1.3); P=0.002]. Infants in the intervention group had significantly higher DASII scores in multivariable analyses [108.0 (103.0-111.3) vs 102.0 (96.8-108.0); P=0.04]. CONCLUSION: Our findings suggest a brief healthcare intervention supports opportunities for early learning among caregivers and neurodevelopmental outcomes in their infants.