- The patient is a 7-year-old female presenting with fever, cough, and breathlessness. Examination found features consistent with Ellis-van Creveld syndrome including short stature, short limbs, narrow chest, polydactyly, abnormal teeth, and congenital heart disease. Genetic testing confirmed mutations in EVC and EVC2 genes associated with this syndrome. Management is multidisciplinary and includes treatment for respiratory issues, cardiac support, orthopedic procedures, and dental care.
achondroplasia is genetic disorder that results in dwarfism
problem is not in forming cartilage but in converting it to bone.
This disorder usually results in the following: An average-size trunk; Short arms and legs, with particularly short upper arms and upper legs; Short fingers.
Mutation in FGFR3 on chromosome 4 is responsible for achondroplasia.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Es una presentación sobre el enfoque anestésico de las cardiopatías congénitas en función de su cortocircuito, asi como un resumen fisiopatológico de cada una de ellas
achondroplasia is genetic disorder that results in dwarfism
problem is not in forming cartilage but in converting it to bone.
This disorder usually results in the following: An average-size trunk; Short arms and legs, with particularly short upper arms and upper legs; Short fingers.
Mutation in FGFR3 on chromosome 4 is responsible for achondroplasia.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Es una presentación sobre el enfoque anestésico de las cardiopatías congénitas en función de su cortocircuito, asi como un resumen fisiopatológico de cada una de ellas
Dr Trevor Cole's presentation from Osteoporosis 2016: From family history to epigenetics of osteoporosis.
Find out more at: https://nos.org.uk/conference
details of klinfelter syndrome, noonan syndrome and diseases of pitutary and diseases of hypogonadism and cause of hypogonadism and primary hypogonadism and secondary hypogonadism
hypogonadism and diseases of hypogonadism and primary diseases of hypogonadism and secondary diseases of hypogonadism and diseases of gonads klinfelter syndrome and noonan syndrome and kallman syndrome
In this presentation we will discuss the role of sonographic imaging in evaluation of MSK dysplasias especially Lethal dysplasia.
We can suggest which is not compatible with life.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
1. ELLIS – VAN CREVELDELLIS – VAN CREVELD
SYNDROMESYNDROME
DR MANDARDR MANDAR
SPAN HOSPITALSPAN HOSPITAL
2. • VAIBHAVI S HIREMATHVAIBHAVI S HIREMATH
• 7 ys / FEMALE7 ys / FEMALE
• 1 st issue of non1 st issue of non
consangunous marriageconsangunous marriage
3. ComplainsComplains
• Fever - 15 daysFever - 15 days
• Cough - 8 daysCough - 8 days
• BREATHLESSNESS – 2 daysBREATHLESSNESS – 2 days
4. PAST HISTORYPAST HISTORY
• Repeated episodes of LRTIRepeated episodes of LRTI
• No H/O any contact with TbNo H/O any contact with Tb
patientspatients
5. BIRTH H/OBIRTH H/O
• Full term normal deliveryFull term normal delivery
• Birth wt was 2.8 kgBirth wt was 2.8 kg
• No h/o any NICU admissionNo h/o any NICU admission
6. • NO DELAY IN MENTAL ANDNO DELAY IN MENTAL AND
MOTOR MILE STONEMOTOR MILE STONE
DIET h/oDIET h/o
• ADEQUATEADEQUATE
Developmental H/ODevelopmental H/O
7. AntropometryAntropometry
ActualActual
• Head cir- 49cmHead cir- 49cm
• Chest cir-52cmChest cir-52cm
• Ht – 84 cmHt – 84 cm
• Wt – 9.5 kgWt – 9.5 kg
• Us/Ls-1.3:1Us/Ls-1.3:1
• Arm span< htArm span< ht
ExpectedExpected
• >51cm>51cm
• <3per<3per
• <3per<3per
• Us >LsUs >Ls
8. InterpretationInterpretation
• Wt for age – IAP classificationWt for age – IAP classification
- grade 5- grade 5
• Ht for age – Mac-Clarin classHt for age – Mac-Clarin class
- grade 3- grade 3
9. • Mid parentral ht – less thanMid parentral ht – less than
2 SD2 SD
12. Head to Toe examinationHead to Toe examination
• Malformation of toothMalformation of tooth
• POLYDACTYLYPOLYDACTYLY
• CHEST DEFORMITIESCHEST DEFORMITIES
• NO S/O SKIN CHANGES &NO S/O SKIN CHANGES &
NUTRITION DEFNUTRITION DEF
13. SYSTEMIC EXAMINATIONSYSTEMIC EXAMINATION
• RESPIRATORY SYSTEMRESPIRATORY SYSTEM
s/o respiratory distress +s/o respiratory distress +
B/L crepts + in lower lobeB/L crepts + in lower lobe
14. Cardio vascular examinationCardio vascular examination
• MitralMitral area- sarea- s11 ss22 –normal–normal
• Pulmonary area-split sPulmonary area-split s22
split is presentsplit is present
both in insiration andboth in insiration and
expirationexpiration
15. Cont..Cont..
• Early systolic murmur isEarly systolic murmur is
heard , grade 3 , radiating toheard , grade 3 , radiating to
the precordiamthe precordiam
16. PER ABDOMENPER ABDOMEN
• Soft , non tender, noSoft , non tender, no
organomegaly, BS+organomegaly, BS+
• CNS- WNLCNS- WNL
18. WRIST XRAY FOR BONE AGEWRIST XRAY FOR BONE AGE
• BA= CABA= CA
19. OTHER INVESTIGATIONOTHER INVESTIGATION
• Sr calciam, ALP, Phosp- wnlSr calciam, ALP, Phosp- wnl
• Other investigation-Other investigation-
sr electrolyte, blood cul ,sgptsr electrolyte, blood cul ,sgpt
20. Echo reportEcho report
• Large ASD, ejection fractionLarge ASD, ejection fraction
normal, require surgicalnormal, require surgical
correctioncorrection
(as adviced by cardiologist)(as adviced by cardiologist)
21. Approach to short statureApproach to short stature
Calculate MPH
Childs height at 18 yrs
with in 2 SD of MPH
Childs height at 18 yrs< -2
SD of MPH
Genetic short stature
Bone Age
Delayed Advanced
US: LS Ratio US: LS Ratio Rare:
1JRA
2Hemophilia
3Androgen/ Estrogen
Exposure
Proportional Disproportional
US> LS US<LS1IUGR
2Dysmorphic
syndrome
3Chromosomal syndrome
4Turner’s syndrome
Proportionate Disproportionate
1Constitutional Delay
2GH def
3Psychosocial Short stature.
4Chronic Systemic dis.
5Malnutrition
Hypothyroidism.
Rickets
Normal
Height< 3rd
centile of reference range
22. D/D OF US> LSD/D OF US> LS
• AcondroplasiaAcondroplasia
• HypocondroplasiaHypocondroplasia
• Osteogenesis imperfectaOsteogenesis imperfecta
• RicketsRickets
• Ellis van creveld syndromeEllis van creveld syndrome
23. OTHER FEATURESOTHER FEATURES
• POLYDACTYLYPOLYDACTYLY
• CONGENITAL HEARTCONGENITAL HEART
DISEASEDISEASE
• MALFORMED TOOTHMALFORMED TOOTH
• ABNORMAL SHAPE OFABNORMAL SHAPE OF
CHESTCHEST
• SHORT LIMBSHORT LIMB
30. PrevalancePrevalance
• 1 in 60,000 to 2,00,0001 in 60,000 to 2,00,000
• Common in – AmishCommon in – Amish
population, Pennsylvania,population, Pennsylvania,
Native population of australiaNative population of australia
31. GeneticsGenetics
• Mutation in EVC and EVC2Mutation in EVC and EVC2
genesgenes
• ECV gene maps onECV gene maps on
cromosome 4 short armcromosome 4 short arm
32. Radiological diagnosisRadiological diagnosis
• Acromesomelia (relative shortening of theAcromesomelia (relative shortening of the
distal and middle segment of the limbs) -distal and middle segment of the limbs) -
Most prominent in the hands, where theMost prominent in the hands, where the
distal and middle phalanges are shorterdistal and middle phalanges are shorter
than the proximal phalanxthan the proximal phalanx
• Polydactyly (ulnar side)Polydactyly (ulnar side)
33. • Thorax (short ribs, narrow)Thorax (short ribs, narrow)
• Other findings - Fusion of the hamate andOther findings - Fusion of the hamate and
capitate bonescapitate bones
supernumerary carpal bone centersupernumerary carpal bone center
34.
35. Genetic studyGenetic study
• Gene testing forGene testing for
mutational analysismutational analysis
ofof EVCEVC andand EVC2EVC2
36. Growth chart for EVCGrowth chart for EVC
• Verbeek et al developed growth charts forVerbeek et al developed growth charts for
males and females aged 0-20 yearsmales and females aged 0-20 years
The charts,reveal that 98% of patients with
Ellis–van Creveld syndrome will exhibit lower
height by age 10 years, compared with
unaffected children.
38. MEDICAL MANAGEMENTMEDICAL MANAGEMENT
• The management of Ellis–van CreveldThe management of Ellis–van Creveld
(EVC) syndrome is multidisciplinary.(EVC) syndrome is multidisciplinary.
• Care for respiratory distress, recurrentCare for respiratory distress, recurrent
respiratory infections, and cardiac failurerespiratory infections, and cardiac failure
is supportiveis supportive
39. SURGICAL MANAGEMENTSURGICAL MANAGEMENT
• Orthopedic procedures correct polydactylyOrthopedic procedures correct polydactyly
and other orthopedic malformations.and other orthopedic malformations.
• Cardiac surgery may be needed to correctCardiac surgery may be needed to correct
cardiac anomaliescardiac anomalies
40. CONT..CONT..
• Thoracic expansion has been attempted inThoracic expansion has been attempted in
some patients.some patients.
• Dental care is usually necessaryDental care is usually necessary
41. ACYIVITYACYIVITY
• Activities may be limited secondary toActivities may be limited secondary to
cardiorespiratory status or skeletalcardiorespiratory status or skeletal
anomalies.anomalies.