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Approach to Evaluating a Short Child

Dr. Vaman Khadilkar MD, DNB, MRCP, DCH (London). Consultant Pediatric

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Approach to Evaluating a Short Child

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    1. Approach to Evaluating a Short Child Dr. Vaman Khadilkar MD, DNB, CDH, MRCP Pediatric Endocrinologist, Jehangir Hospital, Pune Bombay Hospital, Mumbai

    2. Dr. Vaman Khadilkar MD, DNB, MRCP, DCH (London) Consultant Pediatric & Adolescent Endocrinologist Jehangir Hospital, Pune and Bombay Hospital, Mumbai Associate Professor, Pediatric Endocrinology, Bharati Vidyapeeth Medical College, Pune Doctorate (PhD) guide for Pune University DNB & MD guide Convenor Growth monitoring guidelines of IAP 2007 Trained at Great Ormond Street Hospital, London More than 45 Indexed publications in Pediatric Endocrinology and more than 200 Presentations in State, National and International conferences

    3. How Do I Know the Child Is Short? Measure on an accurate Stadiometer Measure both parents Use Appropriate Growth Charts Plot the Height and Weight

    4. Measurement of Height Without footwear Heels & back touching the wall Lower border of the eye socket in the same horizontal plane as external auditory meatus Looking straight ahead A right angled block slides down until touches the head Gentle but firm pressure upwards applied to the mastoids from underneath Record to last 0.1 cm

    5. Use Appropriate Growth Charts Many growth charts are available Examples IAP (IAP Growth Monitoring guidelines 2007) WHO (MGRS Study 2006) British 2005 ICMR 1989 Affluent Indian (Agarwal et al) 2009 Affluent Indian (Khadilkar et al) Use any chart but adjust for mid-parental height

    6. Correction for Mid Parental (Target) Height Male 9 years Height 119 cms and weight 20 kg Father is 157 cms, mother is 150 cms, Formula for target height in boys: (MH+FH+13)/2 Formula for target height in Girls: (MH+FH-13)/2 Target Height is 160 (152-168) Target range is 168-152 (8cm above and below TH)

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