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The NGDS Pilot Project University of Karachi |
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The
NGDS Pilot Project URL:
http://ngds-ku.org
The NGDS Pilot Project e-mail: info(at the rate of)ngds-ku.org
Results
Growth
Analysis
Scoliosis Detection
Growth Analysis
Case 1: An Obese Child
Case
2: A Severely Underweight Child
Case
1: An Obese Child
Date Format
Vital Statistics
Parents'
Heights
History
Physical
Examination
Anthropometry
Growth Profile
Summary of Findings
A parent
approached the NGDS Team for possible
short stature of her daughter. Here are the
measurements obtained during her four check ups.
Date Format
All dates are
given in the format Year-Month-Day
Vital Statistics
Name: A. S.
Date of Birth: 1994-07-27
Sex: Female
Parents’ Heights
Mother (measured): 150.8
cm on 2000-10-25
Father (reported): 5
feet 6 inches
History
Between her second and her third check up A. S. was
hospitalized. Mother reported weight loss.
Physical Examination
A. S. had normal heart sounds (standing and squatting
positions).
A. S. showed signs of anemia during her first three check ups.
Mother was asked to have Blood Hemoglobin done. Her condition considerably
improved during the fourth check up.
A. S. had her knees joining and showed signs of trunk deformity
during all her check ups. Mother was asked to have AP X ray (standing) of the
entire spine (external auditory meatus to hip joint), for the
detection of scoliosis, done. A moiré examination is scheduled at the time of
her fifth check up.
Anthropometry
First
Checkup on 1999-03-01
Height: 96.0 cm (child relaxed and
coöperative)
Mass: 13.5 kg (in short underpants)
Second
Checkup on 2000-10-25
Height: 107.2 cm (child relaxed
and coöperative)
Mass: 17.0 kg (in
short school uniform)
Third
Checkup on 2001-03-19
Height: 109.0 cm (child relaxed
and coöperative)
Mass: 19.0 kg (in
short school uniform)
Fourth
Checkup on 2002-04-06
Height: 115.9 cm (child relaxed
and coöperative)
Mass: 21.0 kg (in
street clothes)
Growth
Profile Tabular Form Graphical Form Bar-Chart Form
Reference Adult
Height: 152.72 cm (5
feet 0.1 inch)
Reference Adult Mass (Weight): 46.67 kg (102 lb 14.6 oz)
Reference CDC Growth Curves
Percentile: 5.5 (the child is expected to follow this curve)
Between
the First and the Second Checkup
Height-for-Age: 1.57 cm (0.62 inch) SHORT for age [STUNTED]
Height-Velocity-for-Age
[compared to reference]: Height
velocity 0.23 cm/year (0.09 inch/year) MORE than the reference value [growing
FAST]
Height prediction: 108.9 cm (3
feet 6.9 inches) at the age 6 years 6 months
Mass-for-Age (Weight-for-Age): 0.07 kg LESS mass for age (UNDERWEIGHT
for age by 2.6 oz)
Rate-of-Mass-Gain-for-Age
(Rate-of-Weight-Gain-for-Age): 0.08 kg/year (0.17 lb/year) LESSER than the reference value [rate
LOW]
Mass (Weight) Prediction: 17.54 kg
(38 lb 10.8 oz) at the age 7 years
Biomass Index (BMI): 0.31 kg/m2
MORE than the reference value [OBESE]
Mass-for-Height (Weight-for-Height)
[compared to reference]: 0.35 kg EXCESS mass for height
(OVERWEIGHT for height by 12.2 oz) [FAT]
Between the Second and the Third Checkup
Height-for-Age
[compared to reference]: 1.35 cm (0.53 inch) SHORT for age [STUNTED]
Height-Velocity-for-Age
[compared to reference]: Height
velocity 1.53 cm/year (0.60 inch/year) LESSER than the reference value
[growing SLOW]
Height prediction: 110.6 cm (3
feet 7.5 inches) at the age 7 years
Mass-for-Age (Weight-for-Age) [compared
to reference]: 0.93
kg EXCESS mass for age
(OVERWEIGHT for age by 2 lb 0.6 oz)
Rate-of-Mass-Gain-for-Age
(Rate-of-Weight-Gain-for-Age) [compared to reference]: 3.27 kg/year (7.20 lb/year) MORE than the reference value [rate
HIGH]
Mass (Weight) Prediction: 20.80 kg
(45 lb 13.8 oz) at the age 7 years
Biomass Index (BMI) [compared to
reference]: 1.61 kg/m2 MORE than the
reference value [OBESE]
Mass-for-Height (Weight-for-Height)
[compared to reference]: 1.89 kg EXCESS mass for height.
(OVERWEIGHT for height by 4 lb 2.7 oz)
[FAT]
Between
the Third and the Fourth Checkup
Height-for-Age [compared to
reference]: 1.06 cm (0.41
inch) SHORT for age [STUNTED]
Height-Velocity-for-Age
[compared to reference]: Height
velocity 1.03 cm/year (0.40 inch/year) MORE than the reference value [growing
FAST]
Height prediction at the age 8 years: 117.9 cm (3
feet 10.4 inches) at the age 8 years
Mass-for-Age (Weight-for-Age) [compared
to reference]: 1.53 kg excess
mass for age
(OVERWEIGHT for age by 3 lb 6.1 oz)
Rate-of-Mass-Gain-for-Age
(Rate-of-Weight-Gain-for-Age) [compared to reference]: 0.13 kg/year (0.29 lb/year) MORE than the reference value [rate
HIGH]
Mass (Weight) Prediction [at the age
8 years]: 21.58 kg (47 lb 9.3 oz)
Biomass Index (BMI) [compared to
reference]: 1.57 kg/m2 MORE than the reference value [OBESE]
Mass-for-Height (Weight-for-Height) [compared to
reference]: 2.07 kg
EXCESS mass for height.
(OVERWEIGHT for height by 4 lb 9.0 oz) [FAT]
The gap between reference height and
actual height is DECREASING. However, A. S. is OVERWEIGHT both for age and for
height.
Implications
The overweight condition may lead to
CARDIAC PROBLEMS. It may, also, cause EARLY PUBERTY, and, eventually,
STUNTING.
A. S. must be, closely, watched for signs of TRUNK
DEFORMITIES on a regular basis, using visual and moiré examinations. She must
indulge in FAT-BURNING ACTIVITIES to control her weight.
Case 2: A Severely
Underweight Child
Here is the case of a girl belonging to a well-to-do family. She
is studying in a private school, located in a posh area of Karachi. The child
is youngest of three children, pampered by all family members. The Clinical
Profile (sent to the child's pediatrician) and the Growth Profile (given and
explained to the child's parents; a copy also sent to the child's pediatrician)
are placed in the PDF Format. The child was examined by her pediatrician, who
agreed with the preliminary diagnosis.
Open Acrobat Reader before downloading these files.
Scoliosis
Detection
Many 'C' and 'S' curves were detected, while conducting the
checkups. A 'C' curve may be due to posture, but an 'S' curve is almost always pathological
resulting in PERMANENT DEFORMITY as well as effects on VITAL and
REPRODUCTIVE ORGANS.
In the photo
gallery one may examine the X ray of
a 6-year old child having a 5-degree C curve. This curve
was detected during the NGDS screening. All her 3 sisters (ages: 3 years, 9
years, 12 years) showed positive on forward-bending tests. These children are
to be followed up by the NGDS Team, using visual and moiré examinations (a sample
moiré is placed in the photo
gallery).
A 10-year old girl with a positive forward bending was referred for X ray. An
'S' curve was confirmed. All her siblings were screened. Her 9-year old brother
was checked. An 'S' curve was observed on physical examination. He was referred
for X ray. Her 5 ½-year old bother was negative on examination. Another 8-year
old girl had an 'S' curve confirmed on X ray. Her 5-year old sister was
positive on physical examination. The team met fathers of these children who
were advised to have the children examined by a pediatric orthopedist.
The NGDS Team strongly recommends screening all siblings if any child is tested
positive on both forward bending and visual examination of back.
Updated:
September 1, 2008 (0000h GMT)
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