Factors Related to the Development of Children's Motoric in Integrated Service Post

Motor development is a process of growing and development of motion ability of children's development conditions with the nerve and brain development of children so every simple movement is the results of complex interaction patterns of various and optimized particular systems. Motor development is connected with the growth process of motoric associated with knowledge, family income and attitudes of moms. The type of research used is observational research with the "cross sectional study" approach, to know the factors related to motor development of motorcycle of body in the integrated service post of Sawi Massamaturu village, popular district. Research results show that of the large 30 sample estimates, 14 children with normal motor development and 6 children that the motor development is disturbed. Conclusion in this research a significant relationship between knowledge, and attitude with the motoric development of family income not significant the development of children motoric

Factors Associated With Cardiac Dysfunction Following Anthracyline-Based Chemotherapy in Adults in a Tertiary Hospital in Nairobi

Introduction: Anthracyclines are known to improve survival in some malignancies, but may also be associated with irreversible cardiotoxicity, which is partly dose dependent. Early detection of cardiotoxicity provides an opportunity for treatment adjustment. Several parameters predict development of clinically manifest cardiac dysfunction. The study aimed to evaluate clinical and echocardiographic parameters which predict development of cardiac dysfunction in a sub-Saharan African population. Methods: Patients with a diagnosis of cancer and receiving anthracyclines at AKUH,N were evaluated if they met eligibility criteria (≥18years at first anthracycline administration, archived baseline echocardiogram, no prior history of heart disease or use of anthracyclines). Patients underwent echocardiographic, baseline clinical , drug therapy, radio-therapy and cardiovascular risk factor assessments. Echocardiographic global longitudinal strain (GLS), left ventricular (LV) ejection fraction and LV volumes were assessed. A relative decline from baseline in GLS of >15%, an absolute decline in LVEF >10 percentage points to <53%, or symptomatic absolute decline in LVEF of 6-10 percentage points to <53% defined LV dysfunction (cases). Factors associated with development ofLV dysfunction were compared between cases and controls (no LV dysfunction). Results: From 14-Oct-2013 to 11-Apr-2019, 504 patients who received anthracyclines were screened. 141 fullfilled inclusion criteria and were analysed (mean age, 47.7 years ± 11.2, Africans 95%, females 85.1%). Breast cancer patients were 82%, lymphoma 12%, sarcoma 5%, and leukaemia 1%. 39 (27.7%) had cardiac dysfunction, 30 of whom fulfilled the GLS criterion. Mean time interval between echocardiograms was 14.3 months (cases 16.4 ± 16.9; controls 14.4 ± 13.2), mean anthracycline dose was 244.7mg/m2 ± 72.2 (cases 254.5 ± 78.7; controls 241 ± 69.6), and mean symptom scores (DASI) were 50.0 ± 13.3 (cases 48.5 ± 13.4; controls 50.5 ± 13.2). Mean cardiotoxic doxorubicin equivalence dose was 236.7 mg/m2 ± 57.4 for cases and 217.3 ± 61.9 for controls [p = 0.033, OR = 1.00 (95% CI: 0.99 - 1.01)]. Cycle intervals, body surface area, body mass index, blood pressure, age, concomitant medication, radiation use and cardiovascular factors were similar. Echocardiographic parameters – E/a ratio and e’ were significantly reduced in cases (E/a 1.02 ± 0.33 for cases vs 1.16 ± 0.36 for controls, p =0.02: e’ 0.10 ± 0.05 for cases vs 0.11 ± 0.05 for controls, p =0.011). Conclusion: This is the first study evaluating early cardiotoxicity in an adult Sub-Saharan population receiving standard dose anthracyclines. The incidence of early cardiotoxicity was 27.7%, which was higher than in previously studied