Rickets, Spasmophilia, Food Allergies & Infant Development

Posted on Feb 16, 2025 in Physical Education

Rickets

Etiology

  • Vitamin D Deficiency due to:
  • 1-Reduced Synthesis in Skin
  • 2-Rapid growth
  • 3-Avoidance of sunlight
  • 4-Nutrient Deficiency
  • 5-Reduced Absorption

Pathophysiology

Vit D3 is Formed in Skin and hydroxylation in Liver by:

  • 1-Liver producing Calcidiol
  • 2-Kidney producing Caltriol

—>(+) Ca+ P absorption from intestine to Blood!

—>(+) Reabsorption of phosphate in kidney

Clinical Features

  • Bone and joint pain
  • Muscle weakness
  • Fractures
  • Harrison Groove (diaphragm)
  • Bowed Legs
  • Kyphosis (spine)
  • Rachitic Rosary
  • Frog Belly

Diagnosis

I-Lab: Depends on the Cause!

Acidosis

-Hypochromic Fe Def

II-X-ray Changes (radius ulna)

Treatment

  • Nutrition
  • Massage
  • Exercise
  • Vitamin D (Single dose 600K U) (Gradual 5K unit 2-3 M)
  • Calcium preparation

Vitamin D Prophylaxis

  • Vitamin D for full-term children – since 3rd week administer 500-1000 IU/d until 1.5 years old (dose of a year)
  • Preterm children – vit.D since 7th day till 1.5 years 1000-1500 IU/d
  • Children till 10 years old: 500 IU of vitamin D every day or One ampoule Vit. D3 B.O.N. in a year or ½ ampoule twice in a year

Spasmophilia

Etiology

  • Neuromuscular hyperexcitability due to excess Vit D
  • 6-15 Months

Pathophysiology

Clinical Features

Quiet Symptoms

  • Chvostek’s Sign
  • Trousseau sign
  • Liust Sign
  • ↓ Ca
  • ECG: Long QT

Sharp Symptoms

  • Carpopedal spasm
  • Laryngospasm
  • Eclampsia

Treatment

  1. Stop Vit D for a few days
  2. Laryngospasm
    • Stimulate Breathing
    • Artificial breathing
  3. For Spasm
    • Antispasmodic (diazepam)
    • Decrease alkalosis by tea/juice
  4. Resume Vit D in 2-4 Days!

Food Allergy

Adverse Drug Reactions of Food

  1. Skin (AD/Urticaria/angioedema)
  2. GI (colic/ IBD/Celiac disease)
  3. Resp: (Upper Obstruction/Lower Infection)
  4. Anaphylaxis

Clinical Features of Food Intolerance

  • Skin
  • GI
  • Resp
  • Headache/joint pain/Fatigue

Diagnosis

Skin Prick Test + IgE

Treatment

Avoidance

Food Causing Allergy

Allergy Food(+) Mast CellMediator in Food
  • Milk (Cow/goat)
  • Egg (Children)
  • Nuts
  • Fish
  • Shellfish
  • Peanut (adult)
  • Chocolate
  • Tomato
  • Egg
  • Fish
  • Shellfish
  • Strawberry
  • Tomatoes
  • Pineapples
  • +peppers
  • wine

Developmental Milestones

M1: Head lift/Move head from side to side/ Turns toward familiar object/ Blinks at bright Lights

M2: Smiles/ Tracks Objects with eyes/ Makes Noises/Make sounds like ooh

M3+4:

  • Grasps item with hands
  • Social Smile
  • Reaches for objects
  • Controls head
  • Try to sit alone
  • Recognizes people/Familiar things
  • Responds to color and Shades

M5+6:

  • Teething process
  • Sits by himself with minimal support
  • Experiments with cause + Effect
  • Opens Mouth for spoon

M7+8:

  • Gets into Crawling position
  • Can Self Feed
  • Turns in direction of voice
  • Plays peek-a-boo

M9+10:

  • Pull to standing
  • ID self in mirror
  • Transfers objects

M11+12:

  • Says Words like ”MAMA”, basically First words!
  • Shakes Head No
  • Afraid of strangers!

Psychomotor Development

1-Cephalocaudal Development:

-Head Before Arms Trunk

-Arms and Trunk Before Legs!

2-Proximodistal Development:

-Head Trunk, Arms, Hands & Fingers

I-Head to Foot! (Baby lifts head before Lifting chest)

II-From near To Far (Trunk of body outward, wave arms before grasping object)

III-From Simple To Complex! (Baby eats with fingers before using silverware)

Infant Motor Control

Large Motor Development:

-Allow infants More control over action and help them move around the Environment

-LEGS & ARMS

Small Motor Development:

Gives them more control over movement allow them to Reach, Grasp, handle objects

-Fingers & Toes

-Writing & Grasping!

The sequence of these developers is the Same However the Sequences Varies