Overview of Collaborative activities of pediatric Neuroscience - - PowerPoint PPT Presentation

Overview of Collaborative activities of pediatric Neuroscience & Neonatology department in the optimum neurodevelopmental outcome of high risk neonates in Dhaka Shishu Hospital

Dr Shayla Imam Kanta (RMO) (MD, MCPS) Paediatric neuroscience department

A majority of neonates present with histories

• f brain insult in the
• f brain insult in the

antenatal, natal and post natal periods

Identification, appropriate assessment and intervention are crucial for the best neurodevelopmental outcomes.

In DSH the Paediatric Neuroscience Department (PND) is working in this regard in the neonatal ward as well as in its Child Development Center (CDC) with a multi- disciplinary team of professionals

Objectives

To describe the activities of PND in the To describe the activities of PND in the management of high risk neonates.

Method

July 2017- December 2017

• every neonate admitted in the
• every neonate admitted in the

neonatal ward Rapid Neurodevelopmental Assessment (RNDA) tool by a Developmental Therapist

RNDA is a validated tool for neurodevelopmental assessment applied for ages between 0-16 Years.

RNDA is a set of unique tools which have been developed

• ver

several years by a team

• f

developed

• ver

several years by a team

• f

committed researchers so that single professionals are able to conduct the assessment on children’s universal functional abilities

Khan NZ, Muslima H, Begum D, et al. Validation of rapid neurodevelopmental assessment instrument for under-two-year-

• ld children in Bangladesh. Pediatrics 2010;125:e755–62

NRNDA applied on neonates during discharge

Moderate -Severe impairment No or mild impairment General developmental assessment By neurologist NRNDA Follow up

Follow up 1 , 3,6,9,12,18,24 months Follow up

Assessment of Gross motor

Assessment of primitive reflexes

Visual assessment Hearing assessment

Intervention

Treatment of neurological complications (like seizures,other treatable complications ). vitamin or micronutrients vitamin or micronutrients supplimentation Early intervention Feeding & nutritional advise

Advise for the parents

Please bring your child in child development centre on the scheduled date Please bring the yellow card Please bring the yellow card Notice the normal development of your child and please try to note down Please try to follow the advise by CDC.

Result

Figure : Term : Preterm

100 120 140 160 20 40 60 80 term preterm

Figure: Male : female ratio

male female 45% male 55%

Table : impairment grading in different domains(n=248) Table : impairment grading in different domains(n=248)

Colum total No(%) Mild(%) Moderate(%) Severe(%) p value Gross motor 50 31 9 10 .000⃰ Fine motor 57 32 5 6 .000⃰ Vision 63 24 9 4 .000⃰ Vision 63 24 9 4 .000⃰ Hearing 86 7 5 2 .038⃰ Primitive ref 43 39 9 9 .000⃰ Cognition 91 4 2 3 .217 P value < .05 is significant

Conclusion

Every neonate who is at high risk needs assessment, evaluation, intervention and follow-ups, which can prevent and follow-ups, which can prevent future impairments and disabilities.

This is possible by establishing a sound communication -between

Different sub-specialities with Different sub-specialities with neurology and child development services in tertiary care hospitals.

ACKNOWLEDGE:

• Prof Mahbubul Haque
• Dr Maksudur Rahman
• Developmental therapist
• Dr Moshiul azam
• Dr Moshiul azam
• Dr Selina Husna Banu

Thank you