Dataset Information

Is the same brace fit for all? The length of abduction bar in Steenbeek foot abduction brace for Indian children-A pilot study.

ABSTRACT: Purpose:We measured the foot size and shoulder width in North Indian children with idiopathic clubfoot and calculated the corresponding metal rod length for abduction brace. The differences in the foot length in unaffected, unilateral and bilateral clubfeet were also measured. Patient and methods:Two sets of measurements were taken on each child: feet size and shoulder width. Using statistical analysis, the following were compared: Differences in the manual prescribed and our calculated SFAB bar length, foot size in unilateral clubfoot and unaffected foot and both feet in bilateral clubfoot. Results:There were 156 patients with 76 unilateral (37 left + 39 right) and 80 bilateral feet. The mean prescribed bar length for foot sizes 8-14 in the Steenbeek manual is 30.18 cm. The mean predicted bar length worked out to be 22.33 cm in our series (p < 0.001). In unilateral clubfoot, the mean foot length (11.9 cm) when matched with unaffected foot (12.6 cm) was comparable (p = 0.08). Bilateral clubfeet lengths (12.29 cm versus 12.3 cm) were also comparable (p = 0.978). Conclusions:There was significant difference between the prescribed and the predicted bar length in foot sizes 8-14 with a smaller bar length measurement of Indian children. The Ponseti treated unilateral club foot length matched the unaffected foot. The foot lengths in bilateral feet disease were also similar.

SUBMITTER: Agarwal A

PROVIDER: S-EPMC6349614 | biostudies-literature | 2019 Jan-Feb

REPOSITORIES: biostudies-literature

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Is the same brace fit for all? The length of abduction bar in Steenbeek foot abduction brace for Indian children-A pilot study.

Agarwal Anil A Agrawal Nargesh N Dubey Anurajan A Gupta Neeraj N

Journal of clinical orthopaedics and trauma 20171028 1

<h4>Purpose</h4>We measured the foot size and shoulder width in North Indian children with idiopathic clubfoot and calculated the corresponding metal rod length for abduction brace. The differences in the foot length in unaffected, unilateral and bilateral clubfeet were also measured.<h4>Patient and methods</h4>Two sets of measurements were taken on each child: feet size and shoulder width. Using statistical analysis, the following were compared: Differences in the manual prescribed and our calc ...[more]

PMID: 30705561

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Project description:BackgroundThe Ponseti method is the gold standard for clubfoot treatment. However, relapse and residual gait deviations are common, and follow-up until 7 years of age is recommended. We evaluated the reliability of the foot drawing method, a new instrument for the follow-up of clubfoot. The method uses drawings of the foot in the neutral position and external rotation to measure foot length and outward rotation.MethodsNineteen children aged 2.5-7 years who were treated with the Ponseti method for congenital clubfoot were included. Two raters made the drawings twice (D1 and D2). Each rater measured foot length, foot rotation, and foot-tibial rotation independently (D1). Later, the raters repeated the measurements (D2). Interrater reliability was assessed using the D1 from each rater. Intrarater reliability was assessed using the measurements from each rater's D1 and D2. Bland-Altman plots were used to visualize the limits of agreement (LoA). The mean, 95% confidence interval, and one standard deviation of the differences in all measurements were calculated.ResultsThe mean differences between and within raters were: foot length < 1 mm, foot rotation < 1°, and foot-tibia rotation < 2°, which indicated no systematic differences. The LoA for foot length were: 4.5 mm and 5.9 mm between raters for D1, - 4.8 mm and 5.9 mm for rater 1 (D1-D2), and - 5.1 mm and 5 mm for rater 2 (D1-D2). The LoA for foot rotation: were - 12° and 10.6° between raters (D1), - 8.4° and 6.6° for rater 1 (D1-D2), and - 14° and 14.1° for rater 2 (D1-D2). The LoA for foot-tibia rotation were: - 17.8° and 14.3° between raters (D1), - 12° and 12.2° for rater 1 (D1-D2), and - 12.7° and 13.6° for rater 2 (D1- D2).ConclusionsThe absence of systematic differences between and within raters, and LoA observed indicate that the foot drawing method is applicable in clinical practice and research. However, the results of the foot and foot-tibia rotation analyses imply that caution is needed when interpreting changes in foot rotation in feet with higher degrees of rotation.

Project description:PurposeChildhood malnutrition is a multifactorial disease, responsible for nearly half of all deaths in children under five. Lately, the probable association of a dysbiotic gut to malnutrition is also being eagerly investigated. The current study is an attempt to investigate this purported association through assessing the abundance of major gut bacterial phyla (Firmicutes, Bacteroidetes, Actinobacteria and Proteobacteria), probionts (Bifidobacteria and Lactobacillus), butyrogens (Faecalibacterium and Roseburia) and pathogens (Escherichia and Klebsiella).MethodsThe study was conducted in the suburbs of Chandigarh, India in the year 2017. The children enrolled in the study were part of Anganwadis (Rural Child Care Centres) set up under Integrated Child Development Scheme (ICDS) of Government of India where community-based management approach is being widely used for treatment of malnutrition. We used qPCR based absolute quantification as well as the 16S rRNA amplicon sequencing approach for our study. The study population included 30 children in the age group of 2-5 years who were categorized into three groups Healthy, Moderate Acute Malnutrition (MAM) and Severe Acute Malnutrition (SAM), with 10 children in each group. The selection of participants was made based on Z scores. Further, statistical tools like the One-way ANOVA, PCA and PLSDA were employed to analyze and compare the gut bacterial profile.ResultsOur investigation through the qPCR (Absolute quantification) approach revealed a significantly higher abundance of Actinobacteria in healthy, in comparison to children suffering from Severe Acute Malnutrition (SAM). Consequently, the same trend was also reflected with respect to Bifidobacterium, a prominent member of the Actinobacteria phylum. Conversely, a significant higher abundance of Lactobacillus with the diminishing nutritional status was recorded. Escherichia showed a significant higher abundance in healthy subjects compared to the malnourished; however, no such difference in abundance of Klebsiella was observed. The other target phyla [Bacteroidetes, Firmicutes and Proteobacteria] and genera (Faecalibacterium and Roseburia) showed differences in abundance; however, these were non-significant. Similarly, the bacterial taxonomy analysis of 16S rRNA gene amplicon sequencing data revealed the higher abundance of phylum Actinobacteria and its member Bifidobacterium with lower prevalence of Lactobacillus in healthy children.ConclusionThe pattern of gut microbiota profile in malnourished subjects suggests a dysbiotic gut depleted in Bifidobacteria, a core member of the consortia of beneficial anaerobes of the healthy child gut.

Project description:Background:Human height is a classic polygenic trait and currently available data explains only 10% of the phenotypic variation in height. Almost 60%-80% of the children coming to pediatric and endocrinology outpatient department for the evaluation of short stature are still labeled as idiopathic. Objectives:The aim of this study is to identify various chromosomal alterations causing idiopathic short stature (ISS) and short stature with dysmorphic features not pertaining to known genetic syndromes. Materials and Methods:After exclusion of all nutritional, systemic, endocrine, and syndromic causes of short stature, 19 patients with height <2 standard deviation scores were subjected to chromosomal microarray (CMA) study using Affymetrix CytoScan 750K array and CMA Scanner 3000 platform. Results:We identified total 61 copy-number variant (CNV) and polymorphs (33 gains, 11 loss, and 17 gain-mosaics) not described as normal variants in database of genomic variations. We identified SHOX haploinsufficiency as a cause of short stature in two patients, whereas one patient was gain-mosaic for SHOX. All three had normal conventional karyotype. One of these patients also had deletion of PAX3, which could be the cause of both short stature and associated mild intellectual impairment in this patient. We also found a long noncoding RNA, namely, KIAA0125 and a pseudogene ADAM6 in 18 out of our 19 patients which might have a regulatory role. Conclusion:This study shows that CMA is a very promising tool for the identification of pathogenic CNVs in patients with ISS. It can also help to identify novel genes controlling height and can open up new insight into pathophysiologic mechanisms underlying ISS, and thus may help to unfold new therapeutic targets for treatment of this condition. The association of CNV having genes for long noncoding RNAs, such as KIAA0125 and pseudogene such as ADAM6 with ISS suggest that they may play a role in controlling the expression of height-related genes and it needs further investigations.

Dataset Information

Is the same brace fit for all? The length of abduction bar in Steenbeek foot abduction brace for Indian children-A pilot study.

Publications

Is the same brace fit for all? The length of abduction bar in Steenbeek foot abduction brace for Indian children-A pilot study.

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