Dr Meena Natarajan | Annamali University (original) (raw)

Papers by Dr Meena Natarajan

IOSR Journal of Dental and Medical Sciences, 2014

Background: Neonatal brain injury due to intrapartum asphyxia is a significant cause of cerebralp... more Background: Neonatal brain injury due to intrapartum asphyxia is a significant cause of cerebralpalsy, mental retardation, and epilepsy. Despite advances in perinatal care over the pastthree decades, the incidence of cerebral palsy attributed to birth asphyxia has not changed. Indeveloping countries, the incidence of post asphyxiate neurological damage is particularly high. Results: We found improvement in the level of achievement of developmental domains in various stages of birth asphyxia infants with a better outcome in stage I HIE infants. Conclusion: The early interventional program on HIE infants in the neurodevelopmentaloutcome after one year of age investigated in this study was efficacious in infants who participated in thestudy.

Journal of Pharmaceutical Negative Results ¦ Volume 13 ¦ Special Issue 7 ¦ 2022, 2022

To find out the inter relationship between neurodevelopmental profile and feeding readiness in la... more To find out the inter relationship between neurodevelopmental profile and feeding readiness in late preterm neonates. Methods: Analytic cross-sectional study was conducted in one hundred and thirty-five healthy late preterm infants born between 34 to 36 weeks gestation who were recruited from Neonatal Intensive Care Unit (NICU) and Referred New Born unit (RNB) of a medical college hospital. Feeding readiness was assessed using Premature Oral Feeding Readiness Scale (POFRAS) and the neurodevelopmental profile was assessed using Hammersmith Neonatal Neurological Examination (HNNE) on day one of the infant's life. The inter relationship between neurodevelopmental profile and feeding readiness was statistically analysed. Results: The HNNE mean optimality score is 29.02 among the infants with good feeding ability, having POFRAS score more than 30. When the feeding score was below 30 the HNNE mean optimality score was 23.48. A high level of significant difference was noted in HNNE and POFRAS, between the feeding groups with cutoff scores above and below 30. Conclusion: The neurodevelopmental profile assessed through HNNE has a positive correlation with the feeding score obtained through POFRAS. Hence feeding readiness in late preterm neonates reflect the inter relationship in the level of neurological maturity.

Int J Physiother, 2020

Background: Cerebral palsy (CP) is one of the leading causes of childhood disability worldwide. T... more Background: Cerebral palsy (CP) is one of the leading causes of childhood disability worldwide. The exact etiology of CP is poorly understood, but many risk factors are related to problems during pregnancy, labor, and delivery. The age and sex-matched control study were done to evaluate the association of perinatal risk factors with the development of CP among children in a rural area. Methods: The study was conducted in the Division of Physical Medicine and Rehabilitation (PMR). Seventy clinically diagnosed CP children as cases and 70 children without CP as controls were included. Information regarding perinatal risk factors was collected from the parents of the children. Data were collected and statistically analyzed by using the Mc-Nemar chi-square test. Results: The study results suggested that children with male sex (53%) had a higher incidence of CP compared to female (47%) children. Spastic diplegia (60%) was the most common subtype of CP. The significant 'p' value (< 0.01) reveals that all the perinatal risk factors are associated with the development of CP. Conclusion: This study concluded that spastic diplegia was the most common subtype of CP. The perinatal risk factors such as preterm, low birth weight, birth asphyxia, and neonatal seizures had a significant association with the development of CP.

IOSR Journal of Dental and Medical Sciences (IOSRJDMS) ISSN : 2279-0853 Volume 1, Issue 2 (Sep-Oct. 2012), PP 29-34 www.iosrjournals.org, 2012

A prospective, controlled trial was conducted to assess the outcome of early physical therapy int... more A prospective, controlled trial was conducted to assess the outcome of early physical therapy intervention on preterm low birth weight infants during the first six months of life. A cohort of 100 preterm low birth weight infants who got admitted in neonatal intensive care unit (NICU) and referral newborn unit (RNB) of Raja Muthiah Medical College and hospital (RMMC&H) were included prospectively. Infants who received regular early physiotherapy intervention were assigned as interventional group (EI) & infants who were advised but did not turn up for early intervention as comparison group (NEI) .The Amiel-Tison neurologic examination and Denver developmental screening test (DDST) were used and results were compared. Results: Better performance of infants in EI group in neurologic and developmental outcome. Conclusion: The data suggest significant benefit of the use of EI program over NEI in the neurodevelopmental outcome of preterm LBW infants at 6 months of corrected age.

Background: Despite advances in perinatal care over the past three decades, the incidence of birt... more Background: Despite advances in perinatal care over the past three decades, the incidence of birth asphyxia has not changed. In developing countries, the incidence of post asphyxiate neurological damage is extremely high. Neonatal brain damage due to Birth asphyxia is a primary cause of cerebral palsy, mental retardation. Objective: To study the impact of early intervention in the developmental outcome of infants with birth asphyxia till one year of life. Design: This study had conducted on 48 newborns with birth asphyxia who got admitted in neonatal Intensive Care Unit (NICU) of Rajah Muthiah Medical College& Hospital (RMMC&H). Fifty normal newborns age and weight matched served as control. The infants in the study group received early intervention. Denver developmental screening test (DDST) had administered to both groups every four months of age till one year. The results have compared with regard to the various domains. Results: There is a significant difference with regard to four domains namely gross motor fine motor personal social and language. The magnitude of the observed domains differs significantly between the treated birth asphyxia infants and the normal infants. The difference in mean values of the four domains gradually narrowed by one year of life in birth asphyxia infants. Conclusion: The early physical therapy program for infants with birth asphyxia in developmental outcome after one year of age has improved when compared to normal infants.

International Journal of Physiotherapy

Background: The Lacey Assessment of Preterm Infants (LAPI) is used in clinical practice to identi... more Background: The Lacey Assessment of Preterm Infants (LAPI) is used in clinical practice to identify premature babies at risk of neuromotor impairments, especially cerebral palsy. There is a shortage of studies on the Lacey assessment despite its wide clinical use. This study attempted to find the diagnostic accuracy of the Lacey assessment of preterm infants to predict neuromotor outcomes of premature babies at 12 months corrected age and to compare their predictive ability with brain ultrasound. Methods: This prospective cohort study included 89 preterm infants (45 females & 44 males) born below 35 weeks gestation. An initial assessment was done using the Lacey Assessment of Preterm Infants (LAPI) after babies reached 33 weeks postmenstrual age. Follow up assessment on neuromotor outcomes was done at 12 months (±1 week) corrected age using two standardized outcome measures, i.e., Infant Neurological International Battery and Alberta Infant Motor Scale. Brain ultrasound data were collected retrospectively. Data were statistically analyzed, the diagnostic accuracy of the Lacey Assessment of Preterm Infants (LAPI) alone and in combination with brain ultrasound was calculated. Results: Fisher's exact test showed p<.01, indicating that there is an association between the Lacey Assessment of Preterm Infants (LAPI) and the neuromotor outcomes at one year corrected age. A combination of Lacey Assessment (LAPI) and brain ultrasound results showed higher sensitivity in predicting abnormal neuromotor outcomes than Lacey Assessment alone (80% vs. 66.7%, respectively). Lacey Assessment also showed high specificity (96.3%) and negative predictive value (97.5%). Conclusion: Results of this study suggest that the Lacey Assessment of Preterm Infants (LAPI) can be used as a supplementary assessment tool for premature babies to identify those at risk of abnormal neuromotor outcomes. These findings have applications to identify premature babies eligible for early intervention services.

International journal of innovative research and development, 2013

A prospective, controlled trial was conducted to assess the effect of early physical therapy inte... more A prospective, controlled trial was conducted to assess the effect of early physical therapy intervention on low birth weight infants during the first six months of life. A cohort of 100 low birth weight (LBW) infants who got admitted in neonatal intensive care unit (NICU) and referral newborn (RNB) of Raja Muthiah Medical College and hospital(RMMC&H) were included prospectively. Infants who received regular early physiotherapy intervention were assigned as interventional group (EI) & infants who were advised but did not turn up for early intervention as comparison group (NEI).The Amiel-Tison neurologic examination and Denver developmental screening test (DDST) were used and results were compared. Results: Better performance of infants was found in EI group in neurological and developmental domains. Conclusion: The data suggest significant benefit of the use of EI program over NEI in LBW infants.

International Journal of Physiotherapy, 2020

Indian Journal of Applied Research, 2013

Physiotherapy Research International, Aug 18, 2020

BACKGROUND Horse riding simulator (HRS) is an electronic horse, working under the principles of h... more BACKGROUND Horse riding simulator (HRS) is an electronic horse, working under the principles of hippotherapy. It is one of the advanced therapeutic methods to improve postural control and balance in sitting, which could be recommended in the rehabilitation of cerebral palsy if real horses are unavailable. OBJECTIVE To investigate the therapeutic effects of HRS on sitting motor function in children with spastic diplegia and evaluate the changes in sitting motor function at different periods of time (4, 8 and 12 weeks). METHODS This study is a randomized controlled trial conducted over a period of 12 weeks. Thirty children with spastic diplegia age between 2 and 4 years with Gross Motor Function Classification System (GMFCS) Level I-III were included and divided into two groups. The control group received the conventional physiotherapy while the experimental group received HRS along with conventional physiotherapy. Sitting motor function was assessed by Gross Motor Function Measure (GMFM)-88 (sitting dimension B) at baseline, 4, 8 and 12 weeks. Pre- and post-intervention scores were measured and analysed. RESULTS The baseline characteristics were similar in both groups before the intervention with p > .01. The observed mean value of GMFM in both groups improved over a period of 12 weeks. The results denote that the sitting motor function gradually improved over a period of time in both groups and the experimental group showed significant improvement (p < .01) than the control group in all the weeks. CONCLUSION The study results confirmed that gradual improvement in sitting motor function was observed in both groups. Children exposed to HRS show better improvement than the children in the control group. It was concluded that HRS is effective in improving the sitting motor function in children with spastic diplegia and the continuous provision of HRS in longer duration provide more benefits than the shorter duration.

Archives of Medicine and Health Sciences, 2021

Background and Aim: The Lacey Assessment of Preterm Infants (LAPI) is reported to have low sensit... more Background and Aim: The Lacey Assessment of Preterm Infants (LAPI) is reported to have low sensitivity but high specificity to predict neurological function. The study objective was to find the predictive validity of the LAPI of preterm infants (LAPIs) to predict neuromotor outcomes of infants born preterm at the corrected age of 3–4 months. Materials and Methods: In this prospective cohort study, infants born below 35 weeks' gestation were assessed using the LAPI before their discharge from the neonatal intensive care unit. Data were collected from Latifa Hospital, Dubai. Outcome assessment was done between 3 and 4 months corrected age using Prechtl's general movement assessment (GMA) and the Test of infant motor performance (TIMP). Results: A total of 125 infants completed the tests (45.6% females); their mean gestational age was 30.28 (standard deviation 2.59) weeks. LAPI showed 87.50% sensitivity (95% confidence interval [CI] =47.35%–99.68%), 96.58% specificity (95% CI = 91.48%–99.06%), and 99.12% negative predictive value (95% CI = 94.75%–99.86%) in predicting fidgety movements in the GMA. The specificity and negative predictive value of the LAPI to predict the motor outcome in the TIMP was 98.06% (95% CI = 93.16%–99.76%) and 88.60% (95% CI = 84.57%–91.67%) respectively whereas sensitivity was 40.91% (95% CI = 20.71%–63.65%). Developmental score in the LAPI showed a weak correlation (P = 0.02, r = 0.20) with the TIMP score. Conclusion: The results suggest that the LAPI can be used to reliably predict neurological function for infants born preterm at 3–4 months corrected age. LAPI can be used as a discharge assessment tool in neonatal units to identify candidates for early intervention services.

Archives of Medicine and Health Sciences

Conference Programme for the 6th International Women Playwrights Conference held in Manila in Nov... more Conference Programme for the 6th International Women Playwrights Conference held in Manila in November 2003. Featuring biographies on keynote speakers, playwrights and delegates including: Ellen Stewart, Fathia El Assal, Virginia Moreno, Jessica Hagedorn, Mangai, ...

Physiotherapy Research International, 2020