European Journal of Molecular & Clinical Medicine

Introduction: Cerebral palsy is actually an umbrella term for several different types of physical disabilities. The term "cerebral" refers to the area of the brain that is affected by the disease. The disease often includes other connections in the brain involving the cortex and parts of the cerebellum as well. The term "palsy" refers to the disorder of movement. Cerebral palsy causes damage to the motor control centers of the brain and can occur during different parts of pregnancy and birth. Approximately 75% of cerebral palsy cases occur during pregnancy and approximately 5% occur during birth. Additionally, it can occur after childbirth up to about age three. Cerebral palsy occurs in an average of 2 to 3 babies out of 1000 live births. There has also been a slight increase in these numbers in recent years. Cerebral palsy (C.P) describe a group of permanent disorders of the development of movements & posture causing activity limitation that are attributed to non-progressive disturbances that occurred in the developing fetal or the infant brain. The motor disorder of C.P are accompanied by disturbance of sensation, perception, cognition, communication & behaviour, epilepsy & by secondary musculoskeletal problems

Background: Traditionally Open Z-Plasty lengthening is the choice of the procedure for
treating Achilles tendon contracture seen in equinus deformity of the foot, which is
commonly seen in club foot, spastic cerebral palsy, polio myelitis, post traumatic and post
burn contractures etc. Percutaneous Achilles tendon lengthening by triple level tenotomy
technique is based on sliding of partially cut tendon preserving its biology, strength and
biomechanics. This study aims to evaluate the efficacy and safety of this new surgical
therapeutic method.
Methods: A retrospective analysis of the Achilles tendon contracture cases in our hospital
between 2015 and 2020 was conducted. Fifty-one cases of equinus deformities treated with
percutaneous triple level Achilles tendon tenotomy. Operative time required, hospital stay,
wound healing, Achilles tendon rupture and equinus recurrence were recorded and
statistically analysed. American Orthopaedic Foot & Ankle Society (AOFAS) scoring system
was used to assess the Foot and ankle function.
Results: The mean follow-up period was 20 months. The mean operative time was 6 minutes
and mean hospital stay was 2 days. No cases had infection or wound healing complications.
One patient had equinus recurrence which was minimal. The mean AOFAS score increased
from 53% points before procedure to 96% at final follow-up.
Conclusion: This method of Achilles tendon lengthening by Triple level percutaneous
tenotomy significantly reduces operative time, hospital stay and thus expenses. Also this
technique is much better in maintaining soft tissue biology, strength and biomechanics thus
helping in preventing rupture of the tendon and recurrence of the deformity.

Background: Preliminary evidence showed that school-based therapeutic interventions as related services implemented by special educators under supervision of therapists proclaims effectiveness to prevent physical ailments in Cerebral Palsy children. Apparently,barriers addressed by special educators in delivering physiotherapy services hinder the progress of children in curricular & co-curricular activities. Assuming the barriers, special educators intercepted about substitutive technological therapeutic approach delineating content and module of novelty in terms of inclusive Telephysiotherapy (i-TelePT) to combat physical ailments in educational settings.

Nowadays, neuroendocrine symptoms following twin brain injuries (twin brain injuries) are more common and negatively affect the outcome of Brain Double Injuries by reducing the overall quality of life. However, research from the scientific literature suggests that neuroendocrine dysfunctions, particularly hypopituitarism, play an important role in the etiology of complications. It has been found that postoperative hypopituitarism has been a clinically common phenomenon in the last twenty years and is likely to contribute significantly to these disorders, given the parallelism of adenohypophysis among those following neuroendocrine changes associated with hypopituitarism other than cerebral palsy. In this our scientific study, we sought to explore hypothesized pathophysiological mechanisms based on neuroendocrine anomalies after a Brain Double Injury through an overview, improved on the basis of an analysis of early diagnosis and treatment aspects

Cerebral palsy is a neuromuscular disease that is often complicated by
nutritional problems in children and adolescents. At the same time, violations of the
nutritional status are a frequent manifestation of the underlying disease, worsen its course
and reduce the effectiveness of rehabilitation. The currently used classification of forms of
cerebral palsy does not reflect the overall severity of the disease, expressed in the degree of
impairment of motor functions, which is important in clinical practice. The article
discusses the possibility of using the GMFCS classification to assess the severity of
movement disorders in children with cerebral palsy.

The article presents the results of a study of 52 children with various forms
of cerebral palsy. The analysis of risk factors for the development of cerebral palsy. The
diagnosis of cognitive impairment, including memory impairment in children with cerebral
palsy, is one of most significant tasks, since it determines the characteristics and prognosis of
both medical and social rehabilitation, while the differentiation of retardation of mental
retardation and marked retardation is extremely significant.

This article discusses severe forms of cerebral palsy in children of different ages
and the development of anemia in these children, and iron supplements are needed to treat
such children (III). The lack of data on this disease and the effect of ferric iron
preparations on the course and prognosis of infantile cerebral palsy served as the
relevance of the study.
The aim of the study. To evaluate the effectiveness of the use of ferric iron (Emfer)
preparations on the course and prognosis of infantile cerebral palsy.
Materials and research methods. To achieve this goal, the results of treatment of 67 sick
children with severe cerebral palsy were analyzed. Children age from 2 to 17 years old. All
patients were ranked by age groups in accordance with the age classification with the
GMFCS scale: up to 2 years old - 9 children (13.43%), 2-3 years old - 11 children (16.4%),
4-6 years old - 18 children (26.8%), 7-12 years old - 15 children (22.38%), 13-17 years old -
14 children (20.9%). The study group was divided into 3 subgroups of motor deficit
according to the GMFCS scale: level 3 - 16 children (23.88%), level 4 - 20 children
(29.85%), level 5 - 31 children (46.27%). All patients were divided into 2 groups - the main
group - 38 children (56.71%, age - 11.04 ± 6.3 years), for whom anemia was corrected
using the Emfer preparation based on ferric iron, and the comparison group - 29 children
(43.29%, age - 12.06 ± 5.1 years), who were treated without iron supplements.

Background: Epilepsy is the most prevalent neurological condition and is one of the most prevalent non-infectious diseases in the world. It has been reported that epilepsy is the commonest disorder encountered in most pediatric neurology clinics in the developing world.Epilepsy is a neurological disease characterized by two or more unprovoked seizures. It is an abnormal electrical firing of neurons. The morbid fear of having an unpredictable seizure not only affects the patients' physical function, but also emotional well-being, cognitive function, and social function, Epilepsy is a category of progressive and complicated neurological diseases characterized by epileptic seizures of an intermittent and crippling nature . It is the most prevalent non-infectious, neurological condition in the world. It has been reported that epilepsy is encountered in most pediatric neurology clinics, especially in the developing world. It is characterized by various neurological abnormalities, one of them is epilepsy. Epilepsy is difficult to control, as it is able to aggravate motor disorders and disrupt cognitive function, ultimately worsening the long-term outcome.
 Aim of the study: To Assessment of the traits of Epilepsy in Cerebral Palsy Children in the in the outpatient neurology clinics in Makkah, at Saudi Arabia 2019.
 Method:A cross-sectional study has be conducted using snowball sampling strategy. A self-administered questionnaire was designed and will be sending to the study participants through social media platforms and email. Study participants will be recruited across in the outpatient neurology clinics in Makkah in Saudi Arabia about awareness of the epilepsy in Cerebral Palsy Children and association with socioeconomic status in KSA. Our total participants were (120).
Results: In our study showed that the only (44.00%)of the participated were(25-35)years while (33.00%)were(<25)years, regarding the Education the majority of the participated school were (47.50%), the majority of the participant were Saudi  (65.00%) while non-Saudi were(35.00%) . The majority of the participated the family monthly income < 5000 SAR were (68.33%), followed by 5000 to 10000 SAR were(16.00%). 
Conclusion:the geographic variables were significantly associated with the risk of epilepsy in children with CP. Patients with epileptic CP had a higher odds ratio of several neuropsychiatric diseases, including mental retardation, ophthalmologic problems, hearing impairment, and hydrocephalus.