DOCSLIB.ORG

Birth Defects in South-East Asia a Public Health Challenge Birth

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Birth Defects in South-East Asia a Public Health Challenge Birth Birth Defects In South-east Asia A Public Health Challenge SITUATION ANALYSIS SEA-CAH-13 Distribution: General Birth Defects in South-East Asia A public health challenge Situation Analysis Acknowledgement The collaboration and support provided by the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC) Atlanta, USA is gratefully acknowledged. The contribution of Dr I.C. Verma (Director Center of Medical Genetics, Sir Ganga Ram Hospital) and Dr Madhulika Kabra (Professor, Division of Genetics, Department of Paediatrics, All India Institute of Medical Sciences) for literature review and preparation of the initial manuscript of the document are acknowledged. The paintings used in this document are made by Mr Nitin, who is afflicted with Down syndrome. World Health Organization 2013 All rights reserved. Requests for publications, or for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – can be obtained from Bookshop, World Health Organization, Regional Office for South-East Asia, Indraprastha Estate, Mahatma Gandhi Marg, New Delhi 110 002, India (fax: +91 11 23370197; e-mail: [email protected]). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not men- tioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. This publication does not necessarily represent the decisions or policies of the World Health Organization. Printed in India Contents Abbreviations 1. Introduction 1 2. Definition,auses c and types of birth defects 3 3. Global scenario 5 4. Regional scenario 9 5. Country scenarios 14 • Bangladesh 15 • Bhutan 25 • Democratic People’s Republic of Korea 31 • India 35 • Indonesia 49 • Maldives 57 • Myanmar 63 • Nepal 71 • Sri Lanka 79 • Thailand 87 • Timor-Leste 99 6. Summary 103 7. References 113 ABBREVIATIONS AIIMS All India Institute of Medical Sciences, New Delhi ANC Antenatal care ART Assisted reproductive technology BCG Bacillus Calmette–Guérin CMV Cytomegalovirus CRS Congenital rubella syndrome CVD Cardiovascular diseases DCR Day-care room DQ Development quotient DTP Diphtheria-tetanus-pertussis G6PD Glucose-6-phosphate dehydrogenase GDP Gross domestic product Hb Haemoglobin Hb CS Haemoglobin Constant Spring HBV Hepatitis B virus Hib Haemophilus influenzae type b HKI Helen Keller International HMIS Health management information system ICD10 Tenth Revision of the International Classification of Diseases ICMR Indian Council of Medical Research IDD Iodine deficiency disorder IGMH Indira Gandhi Memorial Hospital, Male IMCI Integrated management of childhood illness IMR Infant mortality rate LMIC Low- and middle-income countries MDG Millennium Development Goal MMR Measles-mumps-rubella MOD March of Dimes NBE National Board of Examinations, India NE Neonatal encephalopathy NGO Nongovernmental organization NIP National Immunization Programme NPD Neonatal-perinatal database NTD Neural tube defects PEM Protein energy malnutrition PKU Phenylketonuria RMNCH Reproductive, maternal, newborn and child health RT-PCR Reverse transcription polymerase chain reaction SEA South-East Asia SEAR WHO South-East Asia Region TGP Total goiter prevalence TGR Total goiter rate UCI Universal child immunization UNESCAP United Nations Economic and Social Commission for Asia and the Pacific UNFPA United Nations Population Fund UNICEF United Nations Children’s Fund USA United States of America USAID United States Agency for International Development WHA World Health Assembly WHO World Health Organization X-ALD X-linkedadreno-leukodystrophy 1. INTRODUCTION There has been a significant decline in integrating effective interventions infant and childhood mortality rates in most that include comprehensive guidance, countries in the past two decades. This information and awareness-raising has primarily been due to extensive and to prevent birth defects, and care for successful use of immunization, control of children with birth defects into existing diarrhoeal disorders, acute respiratory tract maternal, reproductive and child health infections and improvement in health-care services and social welfare for all services through a focus on primary health individuals who need them; care. As a consequence, birth defects are • record surveillance data on birth defects responsible for a greater proportion of infant as part of national health information and childhood mortality (World Bank, 1993). systems; Indeed in developed countries birth defects • develop expertise and build capacity on cause 30–35% of perinatal, neonatal and the prevention of birth defects and care childhood mortality. In developing countries, of children with birth defects; they contribute to about 5–7% of mortality, • strengthen research and studies on and this proportion is progressively increasing. aetiology, diagnosis and prevention In 2010, the World Health Assembly (WHA), of major birth defects and to promote vide Executive Board agenda items EB125, 126 international cooperation in combating and 127 (WHO, 2010a), expressed concern them; and about the high number of stillbirths and • promote the collection of data on neonatal deaths occurring worldwide, and the global burden of mortality and the large contribution of neonatal mortality morbidity due to birth defects, and to under-five mortality. It recognized the to consider broadening the groups of importance of birth defects as a cause of congenital abnormalities included in stillbirths and neonatal mortality, and that the the classification when the International attainment of MDG 4 on reduction of child Statistical Classification of Diseases mortality will require accelerated progress and Related Health Problems (Tenth in reducing neonatal mortality, including Revision) is revised. prevention and management of birth defects. It was recommended that Member States should The Secretariat was therefore requested by be supported in developing national plans the Member States to carry out the following for implementation of effective interventions activities to: to prevent and manage birth defects within • raise awareness among all relevant their national maternal, newborn and child stakeholders, including government health plans. Support should also include officials, health professionals, civil strengthening health systems and primary care society and the public, about the (including improved vaccination coverage such importance of birth defects as a cause as for measles and rubella), food fortification of child morbidity and mortality; and other preventive strategies of birth defects, • set priorities, commit resources, promoting equitable access to such services, and develop plans and activities for and strengthening surveillance of birth defects. 1| These important recommendations in the (LMIC), the burden of birth defects is much 2010 resolution WHA63. 17 (WHO, 2010a & higher than in high-income countries. This is b), form the basis of initiatives by the WHO due to sharp differences in maternal health Office for the South-East Asia Region for the and other significant risk factors, including prevention of birth defects. poverty, a high percentage of older mothers (in some countries), a greater frequency of Why have birth defects not received consanguineous marriages etc. In LMIC, birth the attention they deserve to date from defects cause a tremendous drain on national policy-makers, funding organizations and resources, and urgent focus in these countries health-care providers? This is probably due should therefore be on prevention. The to the misperception that these disorders urgency is clear at the sight of a child bound are rare. In fact there is no nationally to a wheelchair because of being born with representative data in any of the Member spina bifida, or a child with mental retardation States on the magnitude of birth defects and due to hypothyroidism, or congenital rubella, their contribution to foetal loss and newborn or a family with two children with muscular or infant mortality. dystrophy. Every child who has a preventable birth defect is a failure of medical care and Another myth is that birth defects require public health systems that ignore available expensive and high technology interventions preventive measures. The failure to prevent for their care and prevention that are beyond birth defects is caused, in large measure, by the health budgets of low- and middle-income the lack of organized effort and political will countries
Load more

Recommended publications
  • Reorganisation of the Visual Cortex in Callosal Agenesis and Colpocephaly
    Journal of Clinical Neuroscience (2000) 7(1), 13–15 © 2000 Harcourt Publishers Ltd DOI: 10.1054/ jocn.1998.0105, available online at http://www.idealibrary.com on Clinical study Reorganisation of the visual cortex in callosal agenesis and colpocephaly Richard G. Bittar1,2 MB BS, Alain Ptito1 PHD, Serge O. Dumoulin1, Frederick Andermann1 MD FRCP(C), David C. Reutens1 MD FRACP 1Montreal Neurological Institute and Hospital and Department of Neurology and Neurosurgery, McGill University, Montreal, Canada 2Department of Anatomy and Histology, University of Sydney, Australia Summary Structural defects involving eloquent regions of the cerebral cortex may be accompanied by abnormal localisation of function. Using functional magnetic resonance imaging (fMRI), we studied the organisation of the visual cortex in a patient with callosal agenesis and colpocephaly, whose visual acuity and binocular visual fields were normal. The stimulus used was a moving grating confined to one hemifield, on a background of moving dots. In addition to activation patterns elicited by stimulation of each hemifield in the patient, the activation pattern was compared to that seen in six normal volunteers. fMRI demonstrated large scale reorganisation of visual cortical areas in the left hemisphere, and fewer activation foci were observed in both occipital lobes when compared with normal subjects. © 2000 Harcourt Publishers Ltd Keywords: functional magnetic resonance imaging, vision, colpocephaly, callosal agenesis, reorganisation INTRODUCTION showed interictal slow wave activity throughout the right hemi- sphere and seizures with onset in the right temporo-frontal region. An exciting application of non-invasive functional brain mapping Ictal Tc99m HMPAO single photon emission computed tomography techniques such as functional magnetic resonance imaging (fMRI) (SPECT) revealed a diffuse increase in perfusion within the right is the study of cortical sensory and motor reorganisation following cerebral hemisphere.
    [Show full text]
  • Colpocephaly Diagnosed in a Neurologically Normal Adult in the Emergency Department
    CASE REPORT Colpocephaly Diagnosed in a Neurologically Normal Adult in the Emergency Department Christopher Parker, DO University of Illinois College of Medicine, Department of Emergency Medicine, Wesley Eilbert, MD Chicago, Illinois Timothy Meehan, MD Christopher Colbert, DO Section Editor: Rick A. McPheeters, DO Submission history: Submitted July 25, 2019; Revision received September 18, 2019; Accepted September 26, 2019 Electronically published October 21, 2019 Full text available through open access at http://escholarship.org/uc/uciem_cpcem DOI: 10.5811/cpcem.2019.9.44646 Colpocephaly is a form of congenital ventriculomegaly characterized by enlarged occipital horns of the lateral ventricles with associated neurologic abnormalities. The diagnosis of colpocephaly is typically made in infancy. Its diagnosis in adulthood without associated clinical symptoms is exceptionally rare. We report a case of colpocephaly diagnosed incidentally in an adult without neurologic abnormalities in the emergency department. To our knowledge, this is only the ninth reported case in an asymptomatic adult and the first to be described in the emergency medicine literature. [Clin Pract Cases Emerg Med. 2019;3(4):421–424.] INTRODUCTION been treated at four different EDs in the two weeks prior to Colpocephaly is a rare form of congenital presentation for the headaches, but no imaging studies had ventriculomegaly often associated with partial or been performed. The patient had no psychiatric history. His complete agenesis of the corpus callosum. Diagnosis is highest level of education was a high school diploma, and typically made in infancy due to associated neurological he was unemployed. and neurodevelopmental disorders.1,2 Initial discovery On arrival, the patient was afebrile with pulse, blood in adulthood is exceedingly rare.3-9 When identified pressure, and respiratory rate all within the normal range.
    [Show full text]
  • Bilateral Posterior Periventricular Nodular Heterotopia: a Recognizable Cortical Malformation with a Spectrum of Associated Brain Abnormalities
    ORIGINAL RESEARCH PEDIATRICS Bilateral Posterior Periventricular Nodular Heterotopia: A Recognizable Cortical Malformation with a Spectrum of Associated Brain Abnormalities S.A. Mandelstam, R.J. Leventer, A. Sandow, G. McGillivray, M. van Kogelenberg, R. Guerrini, S. Robertson, S.F. Berkovic, G.D. Jackson, and I.E. Scheffer ABSTRACT BACKGROUND AND PURPOSE: Bilateral posterior PNH is a distinctive complex malformation with imaging features distinguishing it from classic bilateral PNH associated with FLNA mutations. The purpose of this study was to define the imaging features of posterior bilateral periventricular nodular heterotopia and to determine whether associated brain malformations suggest specific subcategories. MATERIALS AND METHODS: We identified a cohort of 50 patients (31 females; mean age, 13 years) with bilateral posterior PNH and systematically reviewed and documented associated MR imaging abnormalities. Patients were negative for mutations of FLNA. RESULTS: Nodules were often noncontiguous (n ϭ 28) and asymmetric (n ϭ 31). All except 1 patient showed associated developmental brain abnormalities involving a spectrum of posterior structures. A range of posterior fossa abnormalities affected the cerebellum, including cerebellar malformations and posterior fossa cysts (n ϭ 38). Corpus callosum abnormalities (n ϭ 40) ranged from mild dysplasia to agenesis. Posterior white matter volume was decreased (n ϭ 22), and colpocephaly was frequent (n ϭ 26). Most (n ϭ 40) had associated cortical abnormalities ranging from minor to major (polymicrogyria), typically located in the cortex overlying the PNH. Abnormal Sylvian fissure morphology was common (n ϭ 27), and hippocampal abnormalities were frequent (n ϭ 37). Four family cases were identified—2 with concordant malformation patterns and 2 with discordant malformation patterns.
    [Show full text]
  • A Strategic Urban Development Plan of Greater Yangon
    A Strategic A Japan International Cooperation Agency (JICA) Yangon City Development Committee (YCDC) UrbanDevelopment Plan of Greater The Republic of the Union of Myanmar A Strategic Urban Development Plan of Greater Yangon The Project for the Strategic Urban Development Plan of the Greater Yangon Yangon FINAL REPORT I Part-I: The Current Conditions FINAL REPORT I FINAL Part - I:The Current Conditions April 2013 Nippon Koei Co., Ltd. NJS Consultants Co., Ltd. YACHIYO Engineering Co., Ltd. International Development Center of Japan Inc. Asia Air Survey Co., Ltd. 2013 April ALMEC Corporation JICA EI JR 13-132 N 0 300km 0 20km INDIA CHINA Yangon Region BANGLADESH MYANMAR LAOS Taikkyi T.S. Yangon Region Greater Yangon THAILAND Hmawbi T.S. Hlegu T.S. Htantabin T.S. Yangon City Kayan T.S. 20km 30km Twantay T.S. Thanlyin T.S. Thongwa T.S. Thilawa Port & SEZ Planning調査対象地域 Area Kyauktan T.S. Kawhmu T.S. Kungyangon T.S. 調査対象地域Greater Yangon (Yangon City and Periphery 6 Townships) ヤンゴン地域Yangon Region Planning調査対象位置図 Area ヤンゴン市Yangon City The Project for the Strategic Urban Development Plan of the Greater Yangon Final Report I The Project for The Strategic Urban Development Plan of the Greater Yangon Final Report I < Part-I: The Current Conditions > The Final Report I consists of three parts as shown below, and this is Part-I. 1. Part-I: The Current Conditions 2. Part-II: The Master Plan 3. Part-III: Appendix TABLE OF CONTENTS Page < Part-I: The Current Conditions > CHAPTER 1: Introduction 1.1 Background ............................................................................................................... 1-1 1.2 Objectives .................................................................................................................. 1-1 1.3 Study Period .............................................................................................................
    [Show full text]
  • CONGENITAL ABNORMALITIES of the CENTRAL NERVOUS SYSTEM Christopher Verity, Helen Firth, Charles Ffrench-Constant *I3
    J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.74.suppl_1.i3 on 1 March 2003. Downloaded from CONGENITAL ABNORMALITIES OF THE CENTRAL NERVOUS SYSTEM Christopher Verity, Helen Firth, Charles ffrench-Constant *i3 J Neurol Neurosurg Psychiatry 2003;74(Suppl I):i3–i8 dvances in genetics and molecular biology have led to a better understanding of the control of central nervous system (CNS) development. It is possible to classify CNS abnormalities Aaccording to the developmental stages at which they occur, as is shown below. The careful assessment of patients with these abnormalities is important in order to provide an accurate prog- nosis and genetic counselling. c NORMAL DEVELOPMENT OF THE CNS Before we review the various abnormalities that can affect the CNS, a brief overview of the normal development of the CNS is appropriate. c Induction—After development of the three cell layers of the early embryo (ectoderm, mesoderm, and endoderm), the underlying mesoderm (the “inducer”) sends signals to a region of the ecto- derm (the “induced tissue”), instructing it to develop into neural tissue. c Neural tube formation—The neural ectoderm folds to form a tube, which runs for most of the length of the embryo. c Regionalisation and specification—Specification of different regions and individual cells within the neural tube occurs in both the rostral/caudal and dorsal/ventral axis. The three basic regions of copyright. the CNS (forebrain, midbrain, and hindbrain) develop at the rostral end of the tube, with the spinal cord more caudally. Within the developing spinal cord specification of the different popu- lations of neural precursors (neural crest, sensory neurones, interneurones, glial cells, and motor neurones) is observed in progressively more ventral locations.
    [Show full text]
  • Chiari Type II Malformation: Past, Present, and Future
    Neurosurg Focus 16 (2):Article 5, 2004, Click here to return to Table of Contents Chiari Type II malformation: past, present, and future KEVIN L. STEVENSON, M.D. Children’s Healthcare of Atlanta, Atlanta, Georgia Object. The Chiari Type II malformation (CM II) is a unique hindbrain herniation found only in patients with myelomeningocele and is the leading cause of death in these individuals younger than 2 years of age. Several theories exist as to its embryological evolution and recently new theories are emerging as to its treatment and possible preven- tion. A thorough understanding of the embryology, anatomy, symptomatology, and surgical treatment is necessary to care optimally for children with myelomeningocele and prevent significant morbidity and mortality. Methods. A review of the literature was used to summarize the clinically pertinent features of the CM II, with par- ticular attention to pitfalls in diagnosis and surgical treatment. Conclusions. Any child with CM II can present as a neurosurgical emergency. Expeditious and knowledgeable eval- uation and prompt surgical decompression of the hindbrain can prevent serious morbidity and mortality in the patient with myelomeningocele, especially those younger than 2 years old. Symptomatic CM II in the older child often pre- sents with more subtle findings but rarely in acute crisis. Understanding of CM II continues to change as innovative techniques are applied to this challenging patient population. KEY WORDS • Chiari Type II malformation • myelomeningocele • pediatric The CM II is uniquely associated with myelomeningo- four distinct forms of the malformation, including the cele and is found only in this population. Originally de- Type II malformation that he found exclusively in patients scribed by Hans Chiari in 1891, symptomatic CM II ac- with myelomeningocele.
    [Show full text]
  • Supratentorial Brain Malformations
    Supratentorial Brain Malformations Edward Yang, MD PhD Department of Radiology Boston Children’s Hospital 1 May 2015/ SPR 2015 Disclosures: Consultant, Corticometrics LLC Objectives 1) Review major steps in the morphogenesis of the supratentorial brain. 2) Categorize patterns of malformation that result from failure in these steps. 3) Discuss particular imaging features that assist in recognition of these malformations. 4) Reference some of the genetic bases for these malformations to be discussed in greater detail later in the session. Overview I. Schematic overview of brain development II. Abnormalities of hemispheric cleavage III. Commissural (Callosal) abnormalities IV. Migrational abnormalities - Gray matter heterotopia - Pachygyria/Lissencephaly - Focal cortical dysplasia - Transpial migration - Polymicrogyria V. Global abnormalities in size (proliferation) VI. Fetal Life and Myelination Considerations I. Schematic Overview of Brain Development Embryology Top Mid-sagittal Top Mid-sagittal Closed Neural Tube (4 weeks) Corpus Callosum Callosum Formation Genu ! Splenium Cerebral Hemisphere (11-20 weeks) Hemispheric Cleavage (4-6 weeks) Neuronal Migration Ventricular/Subventricular Zones Ventricle ! Cortex (8-24 weeks) Neuronal Precursor Generation (Proliferation) (6-16 weeks) Embryology From ten Donkelaar Clinical Neuroembryology 2010 4mo 6mo 8mo term II. Abnormalities of Hemispheric Cleavage Holoprosencephaly (HPE) Top Mid-sagittal Imaging features: Incomplete hemispheric separation + 1)1) No septum pellucidum in any HPEs Closed Neural
    [Show full text]
  • MR Imaging of N Euronal Migration Anomaly
    대 한 방 사 선 의 학 회 지 1991; 27(3) : 323~328 Journal of Korean Radiological Society. May. 1991 MR Imaging of N euronal Migration Anomaly Hyun Sook Hong, M.D., Eun Wan Choi, M.D., Dae Ho Kim, M.D., Moo Chan Chung, M.D., Kuy Hyang Kwon, M.D., Ki Jung Kim, M.D. Department o[ RadíoJogy. Col1ege o[ Medícine. Soonchunhyang University patients ranged in age from 5 months to 42 years with Introduction a mean of 16 years. The mean age was skewed by 2 patients with schizencephaly who were 35 and 42 Abnormalities of neuronal migration Sl re years old. characterized by anectopic location of neurons in the MR was performed with a 0:2T permanent type cerebral cortex (1-9). This broad group of anomalies (Hidachi PRP 20). Slice thickness was 5mm with a includes agyria. pachygyria. schizencephaly. 2.5mm interslice gap or 7.5mm thickness. Spin echo unilateral megalencephaly. and gray matter axial images were obtained. including Tl weighted hcterotopia. Patients with this anomaly present images (TIWI) with a repetition time (TR) of clinically with a variety of symptoms which are pro­ 400-500ms and echo time (TE) of 25-40ms. in­ portional to the extent of the brain involved. These termediate images of TR/TE 2000/38. and T2 abnormalities have been characterized pathologically weighted images (T2Wl) with a TR/TE of 2000/110. in vivo by sonography and CT scan (2. 3. 10-14. Occasionally. sagittal and coronal images were ob­ 15-21). tained. Gd-DTPA enhanced Tl WI were 려 so obtain­ MR appears to be an imaging technique of choice ed in 6 patients.
    [Show full text]
  • Dyskeratosis Congenita
    Brain MRI, Neurologic and Psychiatric Findings in the NCI DC Cohort Sonia Bhala, B.S. Neuroscience Clinical Genetics Branch Research Fellow Division of Cancer Epidemiology and Genetics Camp Sunshine September 2016 A few definitions ▪ Neurology – medical specialty dealing with the structure, function and disorders of the nervous system ▪ Psychiatry – the practice or science of diagnosing and treating mental disorders www.nichd.nih.gov/healthtopics A few definitions ▪ Developmental delay – when a child does not reach their developmental milestones at the expected time ▪ Intellectual and Developmental Disabilities – present at birth and negatively affect the trajectory of the individual’s physical, intellectual, and/or emotional development. These conditions may affect multiple body parts or systems www.nichd.nih.gov/healthtopics Medical problems may develop at different ages, with different severity, or not at all ▪ Liver Fibrosis ▪ Neurologic •Nail dystrophy ▪ Microcephaly •Oral leukoplakia ▪ Gastrointestinal •Skin Pigmentation ▪ Non-specific ▪ Cerebellar enteropathy hypoplasia •Bone Marrow ▪ Esophageal stenosis ▪ Development delay Failure & webs ▪ Psychiatric ▪ Urogenital ▪ Orthopedic •Pulmonary Fibrosis ▪ Urethral stenosis ▪ Osteoporosis •Cancer ▪ Ophthalmologic ▪ Avascular necrosis •Head & Neck ▪ •Leukemia Lacrimal duct ▪ Hair stenosis •Anogenital ▪ Early graying ▪ Exudative retinopathy ▪ Early alopecia Traditional diagnosis: Diagnostic Triad or 1 of the triad, + BMF + 2 other findings, Vulliamy et al, Blood, 2006, 107(7):2680-5 Brain
    [Show full text]
  • Senior General Than Shwe Welcomes Back Prime Minister General Thein Sein on His Return from Cambodia
    Established 1914 Volume XV, Number 231 9th Waning of Tazaungmon 1369 ME Monday, 3 December, 2007 Senior General Than Shwe welcomes back Prime Minister General Thein Sein on his return from Cambodia NAY PYI TAW, 2 Dec — Chairman of the State Peace and Devel- opment Council Com- mander-in-Chief of De- fence Services Senior General Than Shwe wel- comed back Prime Min- ister General Thein Sein, who arrived back here after paying a goodwill visit to Cambodia at the invitation of Prime Min- ister of Cambodia Samdech Akka Moha Sena Padei Techo Hun Sen, at Nay Pyi Taw Air- port at 3 pm today. Together with the Senior General were Vice- Chairman of the State Peace and Development Council Deputy Com- mander-in-Chief of De- fence Services Com- mander-in-Chief (Army) Vice-Senior General Maung Aye, Member of the SPDC General Thura Shwe Mann of the Minis- try of Defence, Secretary- Senior General Than Shwe welcomes back Prime Minister General Thein Sein at Nay Pyi Taw Airport. — MNA 1 of the SPDC Lt-Gen Thiha Thura Tin Aung Maj-Gen Thura Myint Minister for Commerce Myint Oo, members of the Aung, Commander of Nay Brig-Gen Tin Naing Timetable for 2008 Matriculation SPDC Lt-Gen Kyaw Win, Pyi Taw Command Maj- Thein, Minister for Cul- Lt-Gen Maung Bo and Lt- Gen Wai Lwin, Deputy ture Maj-Gen Khin Aung Examination announced Gen Aung Htwe of the Minister for Transport Col Myint, Minister for Ho- NAY P YI T AW, 2 Dec — The Myanmar Board of Examinations under the Nyan Tun Aung, senior tels and Tourism Maj- Ministry of Defence, Ministry of Education issued an announcement today that the Matriculation military officers, the di- Gen Soe Naing, Minister Commander-in-Chief Examination for 2008 will be held in March.
    [Show full text]
  • Chapter III: Case Definition
    NBDPN Guidelines for Conducting Birth Defects Surveillance rev. 06/04 Appendix 3.5 Case Inclusion Guidance for Potentially Zika-related Birth Defects Appendix 3.5 A3.5-1 Case Definition NBDPN Guidelines for Conducting Birth Defects Surveillance rev. 06/04 Appendix 3.5 Case Inclusion Guidance for Potentially Zika-related Birth Defects Contents Background ................................................................................................................................................. 1 Brain Abnormalities with and without Microcephaly ............................................................................. 2 Microcephaly ............................................................................................................................................................ 2 Intracranial Calcifications ......................................................................................................................................... 5 Cerebral / Cortical Atrophy ....................................................................................................................................... 7 Abnormal Cortical Gyral Patterns ............................................................................................................................. 9 Corpus Callosum Abnormalities ............................................................................................................................. 11 Cerebellar abnormalities ........................................................................................................................................
    [Show full text]
  • Syndromes with Lissencephaly
    JMed Genet 1996;33:319-323 319 Syndrome of the month J Med Genet: first published as 10.1136/jmg.33.4.319 on 1 April 1996. Downloaded from Syndromes with lissencephaly D T Pilz, 0 W J Quarrell Earl Walker's paper in 1942 represents a de- logical types, assigned these to previously de- tailed review of early described cases of lis- scribed cases or syndromes, and discussed sencephaly and states that Owen (On the possible genetic mechanisms.67 The two main Institute of Medical anatomy of vertebrates, vol 3, London: Genetics, Long- pathological types he described provide a useful University Hospital of mans, Green & Co, 1868) is said to have basis on which to review "syndromes with lis- Wales, introduced the term lissencephaly to describe sencephaly". Heath Park, an agyric brain, from the Greek words "lissos" Cardiff CF4 4XN, UK D T Pilz (smooth) and "encephalus" (brain).' Key word: lissencephaly. Further reports of lissencephaly followed by Centre for Human Miller,2 Dieker et al,3 Warburg,45 and others and Genetics, their contributions are recognised in syndromes Type I or classical lissencephaly 117 Manchester Road, PREVALENCE Sheffield S10 5DN, UK now known as Miller-Dieker syndrome and 0 W J Quarrell Walker-Warburg syndrome. The only epidemiological data on the pre- valence of type I lissencephaly come from The Correspondence to: In his detailed analysis in 1984/85, Dobyns Dr Pilz. categorised lissencephaly into different patho- Netherlands, with 11-7 per million births.8 PATHOLOGY AND NEUROIMAGING Type I lissencephaly results from a neuro- migrational arrest between 12 and 16 weeks' gestation, and histologically the cortex has four instead ofsix layers.
    [Show full text]