Indications for GH therapy:
A] GH- deficiency
B] Non- GH-deficient conditions:
1. SGA (small for gestational age)
2. Ch renal failure
3. Turner syndrome, Prader- Willi
4. Idiopathic short stature: most controversial
Side effects of GH:
1. Pseudo-tumor cerebri
2. arthralgia, myalgia
3. rash
4. Hypothyroidism
5. SCFE (slipped capital femoral epiphysis)
The two pointers towards possible growth hormone (GH) deficiency in neonatal period are:
1. Hypoglycemia: in persistent hypoglycemia, GH deficiency should be ruled out.
2. Micro-phallus: always do accu-checks and this can lead to further investigations.
Yesterday in the clinic, I saw a one year boy-on a follow up visit- who was born with Congenital Below Elbow Amputation (BEA). It was an isolated abnormality and genetic consult revealed no syndromic association.
Osgood-Schlatter disease (OSD) is one of the most common causes of knee pain in the adolescent. In the US, exact incidence is not known, but it is quite common.
Consisting of pain and edema of the tibial tubercle (and hence this is an extra-articular disease), OS disease is generally a benign, self-limited knee condition associated with ‘traction apophysitis’ in adolescent boys and girls.
Despite hygienic food, regular exercizes one will not know as to whether his heart is developing coronary artery disease or not. No more! You can get the status of your coronaries to assess whether they are developing plaques (which lead to narrowing and hence ischemic heart disease). Dr Sanjay Gupta in the Time magazine (January 22, 2007) suggests that use of CT Angiography (a kind of CAT scan)- which is non invasive- will tell you of any developing plaque. Thus before you attain the age of 40, get one such scan and then at least you know the exact status of your heart. And the old mantra of being a vegetarian is now fast catching up. Be vegetarian and be more healthy!
The link to this article: http://www.time.com/time/magazine/article/0,9171,1576846,00.html
Today we counselled a mother at a Manhasset facility (New York) whose 18 months female kid’s chromosomal studies have confirmed Angelman Syndrome (happy puppet syndrome, thus use of this term is not encouraged now). Her face was not really dysmorphic, though striking features are: maxillary hypoplasia, deep set eyes, wide mouth with prognathism.
Initailly described by Dr Harry Angelman in 1965, this is a syndrome with deletion defect (15 p- and this is maternally contributed. Paternal contribution results in Prader Willi syndrome).
Other features:
Developmental delay, particularly speech (none or minimal words), movements: ataxia or tremulous gait.
Seizures with high probability around 4 years of age, resolve by 10 years.
Sleep disturbances, strabismus.
For more details about this syndrome, log onto: www.angelman.org
Infant Mortality Rate (IMR) denotes number of kids dying in first year of their lives per 1000 alive kids in a year. In USA, the IMR is roughly 7/1000 kids, whereas it was 3.1 in HongKong in 1999. In January,07 The Tribune (published from Chandihgarh, India) reports that IMR has come down to 42/1000 alive kids in the state of Haryana.