CEREBRAL PALSY

PNEUMOTHORAX
ANEMIA

SUBMITTED BY: WALIJA AFZAL

SUBMITTED TO: DR. FAWAD

CASE HISTORY:-

A 3 years old child (Gender : male ) comes to clinic with his mother. Upon asking his
mother said that developmental delay and currently admitted for second round of
physiotherapy.
Antenatal History - Birth order : second child - Mother was 29 years old when she was
pregnant with the child. In first and second trimester folic acid and calcium supplements
were taken. No history of fever with rash. No history of drug intake or radiation exposure.
Two doses of tetanus toxoid injections taken. Mother was diagnosed to have hypertension
during one of her antenatal check-ups and she received medication for the same.
NAITAL HISTORY

• Baby did not cry immediately after birth. Baby was shifted to NICU soon after birth and his airway was
stabilized .Birth weight was 2 kg.
• Mother complains that child never attained head control, is unable to get up or even turn about in bed. -
Child’s first active movements were noticed by mother around 1.5 years of age. He had difficulty such
as pushing up on arms, sitting up or crawling. Feeding the child has been difficult because child’s
appetite is less. Two months back, when the mother was feeding him in the morning, she noticed
deviation of the left angle of the mouth, lasting for about 5 seconds. No history of loss of consciousness.
Mother took the child to hospital on the same day. Child was admitted and started on medications.
Mother was informed about the developmental delay and was told to start physiotherapy for her child.
Child was discharged and was given syrup for the seizures to be taken once daily at night.
 DIAGNOSIS

Cerebral palsy

Symptoms of cerebral palsy:-

Movement and coordination problems associated with cerebral palsy include:
Variations in muscle tone.
Spasticity and rigidity
Tremors or involuntary movements
Dragging a leg while crawling
Difficulty walking
Problems with swallowing
Delays in speech development or difficulty speaking
 CAUSES

• Cerebral palsy is caused by an abnormality or disruption in brain development. Factors that can lead to problems with brain
development include:
• Gene mutations that lead to abnormal development

• Maternal infections that affect the developing fetus

• Fetal stroke, a disruption of blood supply to the developing brain

• Infant infections that cause inflammation in or around the brain

• Traumatic head injury to an infant from a motor vehicle accident or fall

TREATMENT

• Medications that can lessen muscle tightness might be used to improve functional
abilities, treat pain and manage complications related to spasticity or other cerebral palsy
symptoms.
• Physical therapy. Muscle training and exercises can help your child's strength, flexibility,
balance, motor development and mobility.
• Occupational therapy
• Speech therapy
 PNEUMOTHORAX

• A pneumothorax is a collapsed lung. A pneumothorax occurs when air leaks

into the space between your lung and chest wall. This air pushes on the
outside of your lung and makes it collapse.

• Symptoms
• The main symptoms of a pneumothorax are sudden chest pain and shortness
of breath.
CAUSES

A pneumothorax can be caused by:

• Chest injury. Any blunt or penetrating injury to your chest can cause lung collapse.
• Lung disease. Damaged lung tissue is more likely to collapse. Lung damage can be caused
by many types of underlying diseases, including COPD, cystic fibrosis and pneumonia.
• Ruptured air blisters. Small air blisters (blebs) can develop on the top of the lungs. These
blebs sometimes burst — allowing air to leak into the space that surrounds the lungs.
 TREATMENT

The goal in treating a pneumothorax is to relieve the pressure on your lung, allowing it to re-expand.
Treatment options may include;
• Needle aspiration or chest tube insertion

If a larger area of your lung has collapsed, it's likely that a needle or chest tube will be used to remove the excess air.
• Needle aspiration.

A hollow needle with small flexible tube (catheter) is inserted between the ribs into the air-filled space that is pressing on
the collapsed lung. The needle is removed and a syringe is attached to the catheter so that excess air can be pulled.
• Chest tube insertion. A flexible chest tube is inserted into the air-filled space and may be attached to a one-way valve
device that continuously removes air from the chest cavity until your lung is re-expanded and healed.
CASE HISTORY

The female patient 78 years of age is being evaluated due to an Hgb level of 8.1 g/dL. She
is ambulatory with a rolling walker, generally alert, and oriented with some mild cognitive
impairment. Her medical history is positive for congestive heart failure, chronic obstructive
pulmonary disease (COPD), chronic kidney disease, and osteoarthritis. She is oxygen
dependent on 2 L/minute per nasal cannula.
Over the past year, she has been treated for, bronchitis and urinary tract infections. She
also had been hospitalized due to Pneumonia.
CONTINUE

• Patient ; chief complaint is of feeling tired and short of breath at times. She also
complains of arthritic pains in her neck and hands. Review of systems is notable for
hearing loss, dentures, glasses, and dyspnea, mostly with exertion. She has occasional
palpitations of the heart and orthopnea at times.
• Her heart rate is slightly irregular, with a soft systolic ejection murmur. Evaluation of her
lungs indicates diminished breath sounds in the bases. Neurologic assessment shows no
focal deficit.
•Blood is drawn and sent to the laboratory for CBC and a basic metabolic panel. The results are:
Leukocytes: 5,700 cells/mcL
RBC: 3.02 million cells/mcL
Hgb: 8.1 g/dL
Platelets: 150,000 cells/mcL
Glucose: 82 mg/dL
Blood urea nitrogen (BUN): 34 mg/dL
Creatinine: 1.4 mg/dL
GFR: 38 mL/minute/1.73 m2
DIAGNOSIS

she appears to have anemia, as evidenced by the low Hgb.

She has chronic kidney disease (stage 3), which may be contributing to the anemia.
Symptoms:-
Fatigue
Weakness
Pale or yellowish skin
Irregular heartbeats
Shortness of breath
Dizziness or lightheadedness
Chest pain
PREVENTION

• Iron. Iron-rich foods include beef and other meats, beans, dark green leafy vegetables, and dried
fruit.
• Folate. This nutrient, and its synthetic form folic acid, can be found in fruits and fruit juices, dark
green leafy vegetables, green peas, kidney beans, peanuts, and enriched grain products, such as
bread, cereal, pasta and rice.
• Vitamin B-12. Foods rich in vitamin B-12 include meat, dairy products, and fortified cereal and
soy products.
• Vitamin C. Foods rich in vitamin C include citrus fruits and juices, peppers, tomatoes, melons and
strawberries. These also help increase iron absorption.
Thankyou