Academic literature on the topic 'Keywords: spina bifida'

Neural tube defects (NTD) are one of the birth defects or congenital abnormalities that occur in the brain and spine, and commonly find in newborns worldwide. Anencephaly and spina bifida are the two prevalent forms of NTD. The incidence of spina bifida happen on average 1 in 1000 cases of birth worldwide and there are 140,000 cases per year worldwide. Source searches were carried out on the online portal of journal publications as many as 20 sources from MedScape, Google Scholar and the Nation Center for Biotechnology Information / NCBI with the keywords “Neural tube defects (NTD), prevention, and spina bifida”. Spina bifida is a congenital abnormality that occurs in the womb due to a failure of closing process the neural tube during the first few weeks of embryonic development which causes the spine not completely close around the developing spinal cord nerves. NTD can ensue multifactorial conditions such as genetic, environmental, and folate deficiency. The use of folic acid supplementation starting at least 3 months before pregnancy, those are 400 mcg (0.4 mg) per day and 800 mcg per day during pregnancy can reduce the risk of developing neural tube defects such as spina bifida. Generally, spina bifida is undertaking by surgery and the regulation of patients comorbid. Public can find out prevention to avoid or reduce the risk of spina bifida so that the incidence of spina bifida can decrease along with the increasing awareness of the community regarding this disease.

Spina bifida is a neural tube defect in which incomplete closing of the spine membrane that occurs in the lumbar and sacral. The defect of spina bifida can be motoric defect or sensoric defect. Clinical manifestation of spina bifida can be appear as limb anaesthesia, total paralysis, incontinensia urine and alvi that can cause recurrent uronary tract infection, renal insufficiency, and nephropathy reflux. Spina bifida can cause hindbrain herniation and hydrocephalus. Diagnosis of spina bifida can use 2D ultrasonography, 3D ultrasonography, and MRI. Procedure surgery of spina bifida can be done with postnatal surgery, prenatal surgery, or percutaneous minimally invasive fetoscopic surgery. Percutaneous minimally invasive fetoscopic surgery is a procedure to close the defect of fetus while intrauterine using minimal access with three or four trocar and using partial amniotic carbon dioxide insufflation (PACI) without laparotomy or hysterectomy. The adventage of percutaneous minimally invasive fetoscopic surgery compare with postnatal surgery and prenatal surgery is improve baby’s motoric function, decrease risk of ventriculoperitoneal (VP) shunt, decrease hindbrain herniation, decrease fluid in hydrocephalus, decrease risk of preterm birth, decrease risk of spontaneous membrane rupture, oligohydramnione, uterine dehiscence, uterine rupture, less pain in two days, and mother can go home from the hospital in a weeks. Keywords: Spina bifida, percutaneous minimally invasive fetoscopic surgery, partial amniotic carbon dioxide insufflation (PACI)

Introduction: Antenatal ultrasound has been reported to be an effective tool for detecting neural tube defects including spina bifida. Moreover, major structural abnormalities can be detected by ultrasound examination, depending on the time of ultrasound scan. Objectives: To determine the diagnostic accuracy of ultrasound in detection of spina bifida in the first and second trimester using post-natal MRI as gold standard. Study Design: Descriptive, Cross-sectional study Study duration: 11th February 2019 to 10th August 2019 Settings: Department of Radiology, Jinnah Hospital, Lahore. Materials & Methods: A total of 125 pregnant patients/Gravida presenting in first trimester (11 to 13 weeks) & second trimester (14 to 22 weeks) assessed on dating scan, at risk for spina bifida were included. Women with pre-eclempsia and eclempsia determined on systolic BP > 140 and protein urea and history of congenital heart defects were excluded. A standard ultrasound scan was performed by the same Radiologist on the same ultrasound machine and any findings associated with the spina bifida would be noted & recorded on a predesigned Performa (Attached). Patients were followed till delivery and post-natal MRI was done to evaluate spina bifida. Presence of absence of spina bifida on USG & MRI was noted. Results: All the patients were subjected to first ultrasonography and then MRI. USG supported the diagnosis of spina bifida in 62 patients. MRI confirmed spina bifida in 63 cases. In USG positive cases, 58 were true positive and 04 were false positive. While in USG negative patients, 58 were true negative and 05 were false negative. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of ultrasound in detection of spina bifida in the first and second trimester using post-natal MRI as gold standard is 92.06%, 93.55%, 93.55%, 92.06% and 92.80% respectively. Conclusion: This study concludes that ultrasonography is a highly sensitive and accurate modality for diagnosing spina bifida, and has not only dramatically improved our ability of diagnosing spina bifida but also be a simple, economical and readily available alternative to MRI. Keywords: Spina Bifida, Ultrasonography, Sensitivity

Aim: To see central nervous system anomaly during pregnancy (anencephaly, hydrocephalus and spina bifida) by ultrasonography associated with folic acid deficiency/ low intake. Study design: cross sectional Site and duration: one year from Jan 2021 to Dec 2021 at Pak Red Crescent Medical & Dental College and teaching Hospital Dina Nath Multan Road Kasur. Method: There was convenient sampling. Written Consent was taken from mothers for participation in study. Pregnant mothers were examined by ultrasonography and color Doppler Machine. Designated proforma was filled by taking history of pregnant mother. Results: The mean age of mothers was 25.oo + 5.00. Most of mothers were in 3rd trimester and Gravida 2. In eleven percent cases CNS anomalies were seen among these 6% were anencephaly and 5% were Spina bifida and hydrocephalus. Conclusion: Central nervous system anomalies were found associated with folic acid low intake by mothers during pregnancy. Keywords: Anencephaly, Hydrocephalus, Spina bifida, Folic acid intake, Ultrasonography.

Myelomeningocele results from failure of the neural tube to close in the developing fetus and is associated with neurological impairment (Incidence 1:1000 births). The level of the anatomic lesion generally correlates with the neurological deficit and ranges from complete paralysis to minimal or in some cases no motor involvement. Myelomeningocele or Spina bifida can lead to health problems, physical disabilities, and learning problems. Most commonly, associated with paralysis of the lower extremities and neurogenic bladder. Treatment requires multidisciplinary participation. The functional classification that concerns us in this review includes three types and were obtained through gait analysis. Keywords: Spina bifida; instrumental; gait analysis; kinematics and kinetics; orthotics

Objective: To determine the outcome of Ponseti’s method among children with spina bifida related non-idiopathic clubfoot at a leading pediatric tertiary care children hospital of South Punjab, Pakistan. Study Design: A retrospective cohort. Place and Duration of the Study:Department of Pediatric Orthopedic Surgery, The Children’s Hospital and Institute of Child Health, Multan Pakistan from 1st January 2016 to 31st March 2022. Material and Methods: A total of 24 children (41 feet)of both genders aged up to 3 months presenting with non-idiopathic clubfoot related to spina bifida who underwent Ponseti’s method for treatment of clubfoot, with a minimum post-treatment follow up of 3 years were included. Demographic data, severity of clubfoot disease along outcomes in terms of successful correction, unsuccessful correction, relapse were noted during the study period. Results: In a total of 24 children, 15 (62.5%) were boys. Overall, mean age was calculated to be 2.6±2.2 weeks while 14 (58.3%) children were aged between 0-2 weeks. Bilateral feet were involved in 17 (70.8%) children while unilateral feet involvement was noted in 7 (29.2%) cases so total number of feet were 41. Out of these 41 feet, 38 (92.7%) had severity of clubfoot as per Pirani Score as 6. Number of casts performed were 8 or below in 39 (95.1%). Mean duration of follow up was 3.8±0.6 years. Correction of clubfoot was achieved in 36/41 (87.8%) feet. During the follow-ups, recurrence occurred in 11 (26.8%) feet. Conclusion:Initial clubfeet correction in the spina bifida cases achieved good correction rates. Rate of recurrence was considerably high with a minimum follow up period of 3 years among spina bifida associated clubfeet. Keywords: Achilles tendon, clubfoot, Pensoti’s method, spina bifida.

Objective: To find out the incidence of hydrocephalus after excision and repair in infants presenting with Spina Bifida Aperta. Materials & Methods: This prospective cohort study was conducted at the Pediatric Neurosurgery Department, Children Hospital & The Institute of Child Health, Lahore, Pakistan, from January 2021 to October 2021. A total of 62 infants of both genders presenting with spina bifida Aperta undergoing repair were included. Data of the patients, i.e., name, age, gender, head circumference, location, and width of the defect, accompanying bladder, limb anomalies, radiological, laboratory findings, and diagnosis (meningocele or meningomyelocele) were noted. Patients were followed postoperatively for 1-month, and the incidence of post-surgery hydrocephalus was noted. Results: Out of 62 children, 36 (58.1%) were male and 24 (41.9%) female. The mean age was noted to be 138.82 days. Most children, 36 (58.1%), were found to have meningocele. The most frequent local meningocele/meningomyelocele was noted to be lumbosacral, 22 (35.5%). Post-surgery hydrocephalus was noted among 11 (17.1%) cases. No significant association of gender, age, head circumference, defect size, the maximum dimension, diagnosis (meningocele or meningomyelocele), or location was noted with post-surgery hydrocephalus among study cases (p > 0.05). No mortality was reported. Conclusion: Meningomyelocele and lumbosacral location of the defect were among the prominent factors affecting the incidence of post-surgery hydrocephalus. Keywords: Spina Bifida Aperta, Meningiocele, Myelomeningocele, hydrocephalus, lumbosacral

Current health guidelines aim to increase the responsibility of people with chronic conditions to self-care. Literature studies highlight educational programmes for self-management of chronic conditions as a holistic approach, involving special health needs and emotional, psychological and social needs. Lorig and Holman (with adults and the elderly population) and Malheiro (with adolescent’s with spina bifida) have proposed self-management educational programmes, using ‘Lay-leds’, as mentors on programmes. These programmes have proven effective, with positive health outcomes, such as improvement on adherence to therapy, functionality and decrease of use of emergency services and hospitalisations and reducing health costs. Thus, we propose to adapt and implement this education programme for self-management of adolescents with diabetes type 1, using Lay-leds as educators, and evaluate their effectiveness on self-management competences, quality of life, self-efficacy, physical activity motivation, self-concept, HbA1c, variability in heart rate, blood pressure, body mass index and anthropometric profile. Keywords: Self-management programme, adolescents, chronic conditions, Lay-leds.

Background: One of the large trilateral bones present at the base of the vertebral column is named as sacrum. The body weight transfers from trunk to pelvis and lower extremities. Different studies considering sacral morphological variations are conducted in the western world. The scope and knowledge of these studies in the eastern world is limited. Different sacral anatomies are reported by the scientists. Objective: The purpose of the study was to investigate and measure thoroughly the variable morphologies of sacrum. Study design: It is an investigational and cross-sectional study facilitated by statistical approach. Material and Methods: The study was conducted on 223 skeleton samples. These samples were preserved in the anatomy department of Mufti Mehmood Teaching Hospital Dera Ismail Khan and Bacha Khan Medical Complex Swabi during the period from October 2021 to June 2022. The human research ethical committee of the hospital approved the study. The vernier caliper was used to measure the correlation parameters of variability. The morphological features were calculated. The study also calculated the sacral variation incidence. The sacra with any kind of bony defects were excluded from the study. Results: The anatomical differences reported in the 223 samples were observed to be 59%. Out of the 223 patients the 81 were females and 142 were males. The five variations were reported in the sacral regions, while two samples have the rare sacral variations. The mean age of the included sample was observed to be 44 years. The age of the people whose sacral samples were included in the study was between 21-72 years. The percentage incidence of accessory auricular faces was observed to be 12.5%. The sacral skewness was observed in 24% cases. The 17% showed the transitional vertebra, while sacral spina bifida occulta was seen in 28% samples. Conclusion: This large scale anatomical study provides information about the apparent changes in the morphology of different sacral variables. This study provides comprehensive data about the different sacral variations. The detailed information about the human sacrum is provided. The apparent identification methods by western medical officers are also considered in this work which may help our medical staff to identify the sacral variations. Keywords: Sacrum variations, Sacrum morphology, Accessory auricular faces, Transitional vertebra and Sacral spina bifida occulta

Resumo- A mielomeningocele configura um defeito primário do tubo neural mais comum, tal defeito constitui uma das malformações congênitas mais graves do recém-nascido, uma vez que o sistema nervoso central tem início em um tubo que se desenvolve nas estruturas mais complexas do corpo humano. O defeito pode ocorrer na sua porção cranial, resultando em malformações como anencefalia e encefalocele ou na porção caudal resultando em malformações que em grupo são conhecidas como espinha bífida. A mielomeningocele é classificada como espinha bífida aberta e ocorre nas primeiras quatro semanas de gestação. O objetivo deste estudo foi identificar na literatura fatores maternos associados ao aparecimento da mielomeningocele. A coleta de dados foi realizada em outubro a novembro de 2021, nas bases de dados SciELO, Google acadêmico e BVS – Brasil utilizando as palavras chaves: “mielomeningocele”, “malformação tubo neural” e “fatores maternos”, sendo necessária também a pesquisa em livros específicos, constituindo uma amostra de 13 publicações. A deficiência de ácido fólico destacou-se como principal fator materno associado à ocorrência da mielomeningocele; além da ingestão materna de anticonvulsivantes, ingestão de fármacos antagonistas do ácido fólico, doenças como o diabetes e a obesidade, deficiência de zinco, baixas condições socioeconômicas e influências perturbadoras como a irradiação e a hipertermia materna. Conclui-se que medidas públicas no combate aos fatores maternos preveníveis são necessárias, uma vez que a mielomeningocele é uma patologia limitante, complexa, com impacto na qualidade de vida dos pacientes e de seus familiares além de requerer equipe especializada e multidisciplinar.Palavras-Chave: Mielomeningocele; Malformações; Espinha bífida. Abstract- Myelomeningocele is a primary defect of the most common neural tube, this defect is one of the most serious congenital malformations in newborns, since the central nervous system starts in a tube that develops in the most complex structures of the human body. The defect can occur in its cranial portion, resulting in malformations such as anencephaly and encephalocele, or in the caudal portion, resulting in malformations that, in group, are known as spina bifida. Myelomeningocele is classified as open spina bifida and occurs within the first four weeks of pregnancy. The aim of this study was to identify maternal factors associated with the onset of myelomeningocele in the literature. Data collection was carried out from October to November 2021, in the SciELO, Google Academic and BVS – Brazil databases using the keywords: “myelomeningocele”, “neural tube malformation” and “maternal factors”, also requiring the research in specific books, constituting a sample of 13 publications. Folic acid deficiency stood out as the main maternal factor associated with the occurrence of myelomeningocele; in addition to maternal intake of anticonvulsants, intake of drugs that are antagonists to folic acid, diseases such as diabetes and obesity, zinc deficiency, low socioeconomic conditions and disturbing influences such as radiation and maternal hyperthermia. It is concluded that public measures to combat preventable maternal factors are necessary, since myelomeningocele is a limiting and complex pathology, with an impact on the quality of life of patients and their families, in addition to requiring a specialized and multidisciplinary team.Keywords: Myelomeningocele. Malformations. Spina bifida.