This study suggests that the prevalence of SpLDs is at the higher side of previous estimations in India. The study is unique due to its large geographically representative design and identification of the problem using simplified screening approach and tools, which minimizes the number and time of specialist requirement and spares the expensive investigation. This approach and tools are suitable for field situations and resource scarce settings. Based on the authors' experience, they express the need for more prevalence studies, remedial education and policy interventions to manage SpLDs at main stream educational system to improve the school performance in Indian children.
Using a pre-post design, World Health Organization Essential Newborn Care community birth attendant training resulted in a significant reduction in perinatal mortality. In low-resource settings, the newborn care training package appears to be an effective intervention to decrease perinatal mortality.
Background and Objectives:Glutaric aciduria Type-I (GA-I) has characteristic clinical and neuroimaging features, which clinches the diagnosis in a majority of patients. However, there have been few case reports on GA-I from India. This study was undertaken to study the clinical presentations, metabolic profile, neuroimaging findings and outcome of patients with GA-I.Study Design:The present study was a retrospective study.Materials and Methods:Retrospective review of charts of patients with a diagnosis of GA-I was carried out from March 2008 to April 2010. The clinical, laboratory and neuroimaging findings were extracted in a predesigned proforma and the data was analyzed.Results:Eleven cases were found to have GA-1. Clinical presentation was quite varied. Follow-up of patients revealed that one patient with macrocephaly as the only clinical finding was developmentally normal. One patient with encephalitis-like illness steadily improved and started walking at 2 years. Two patients were bed ridden and had severe dystonia. One patient died during follow-up. The remaining six patients had dystonia and other abnormal movements, but had attained sitting without support and were not ambulatory.Conclusion:GA-I is not an uncommon disorder and diagnosis can be made easily based on clinical, laboratory investigations and neuroimaging findings. It is one of the treatable metabolic disorders and, if managed appropriately, favorable prognosis can be given.
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