The NGDS Pilot Project

University of Karachi

 

 

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The NGDS Pilot Project URL: http://ngds.uok.edu.pk                     
The NGDS Pilot Project e-mail: sakamal@uok.edu.pk


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

Implications
Recommendations

                                                                         
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: Z. R.
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 Z. R. was hospitalized. Mother reported weight loss.

 

Physical Examination
Z. R. had normal heart sounds (standing and squatting positions).
Z. R. 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.

Z. R. 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 was scheduled at the time of her fifth check up.

 

Anthropometry
Child relaxed and coöperative during all checkups

First checkup on 1999-03-01

Height: 96.0 cm
Mass: 13.5 kg

Second checkup on 2000-10-25

Height: 107.2 cm

Mass: 17.0 kg

Third checkup on 2001-03-19

Height: 109.0 cm

Mass: 19.0 kg

Fourth checkup on 2002-04-06

Height: 115.9 cm

Mass: 21.0 kg

 
Growth Profile     Tabular Form     Graphical Form     Bar-Chart Form

Adult-MP (Target) height: 152.72 cm (5 feet 0.1 inch) [MP stands for 'mid-parental']

Adult-MP mass (weight): 46.67 kg (102 lb 14.6 oz) [corresponding to MP height]

CDC-growth-curve percentile: 5.489 [corresponding to MP height]

 

Between the First and the Second Checkup

Height-for-age profile: 1.57 cm (0.62 inch) SHORT for age [STUNTED]

Height-velocity-for-age profile: 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) profile: 0.07 kg LESS mass for age (UNDERWEIGHT for age by 2.6 oz)

Rate-of-mass-gain-for-age (weight-gain-for-age) profile: 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 6 years 6 months

Obesity profile: Body-mass Index (BMI) 0.31 kg/m2 MORE than the reference value [OBESE]

Mass-for-height (Weight-for-height) profile: 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 Profile:
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) profile: 0.93 kg EXCESS mass for age

(OVERWEIGHT for age by 2 lb 0.6 oz)

Rate-of-mass-gain-for-age (weight-gain-for-age) profile: 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

Obesity profile: Body-mass Index (BMI) 1.61 kg/m2 MORE than the reference value [OBESE]

Mass-for-height (Weight-for-height) profile: 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 Profile:
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) profile: 1.53 kg excess mass for age

(OVERWEIGHT for age by 3 lb 6.1 oz)

Rate-of-mass-gain-for-age (weight-gain-for-age) profile: 0.13 kg/year (0.29 lb/year) MORE than the reference value [rate HIGH]

Mass (Weight) prediction: 21.58 kg (47 lb 9.3 oz) at the age 8 years

Obesity profile: Body-mass Index (BMI) 1.57 kg/m2 MORE than the reference value [OBESE]
Mass-for-height (Weight-for-height) profile: 2.07 kg EXCESS mass for height.
(OVERWEIGHT for height by 4 lb 9.0 oz) [FAT]

Summary of Findings

The gap between reference height and actual height is DECREASING. However, Z. R. 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. 


Recommendations

Z. R. 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. Source


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 given below. The child was examined by her pediatrician, who agreed with the preliminary diagnosis.

Open Acrobat Reader before downloading these files.

 

Clinical Profile of Z. L. Z. PDF

Growth Profile of Z. L. Z. PDF


Growth-and-Obesity Profiles of Children (after the first check up)  
M. Family PDF   U. Family PDF

 

Growth-and-Obesity Detailed Calculations (of the above profiles)   M. Family PDF   U. Family PDF
(for the benefit of researchers, teachers and graduate students)


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 were to be followed up by the NGDS Team, using visual and moiré examinations (a sample moiré is placed in the photo gallery). The backscatter-moiré of the spinal column (proposed on May 30, 2013 by the Project Director) seems to have the potential of going one step ahead in scoliosis management.

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: May 20, 2016 (0000h UTC)
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