ICNC Abstracts, ICNC 2018

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Prevalence of smooth muscle dysfunction among children with Duchenne muscular dystrophy
Ranjith Kumar Manokaran, Biswaroop Chakrabarty, Prashant Jauhari, Rakesh Kumar, Sandeep Aggarwala, Arun Gupta, Manisha Jana, R M Pandey, Sheffali Gulati

Last modified: 2018-09-09



DMD patients suffer from smooth muscle related co-morbidities. With a need to unravel further, we embarked on a cross sectional study to evaluate smooth muscle dysfunction amongDMD patients.


To estimate prevalence of smooth muscle dysfunction in children with DMD (genetically /biopsy proven) aged 5 years and above in terms of vascular, upper gastrointestinal and bladder smooth muscle on basis of questionnaires using a pre-structured proforma(Pediatric bleeding questionnaire, dysfunctional voiding scoring system, pediatric gastroesophageal symptom questionnaire (PGSQ)). To estimate bleeding time (mean ± SD) using Duke`s method, prevalence of gastroesophageal reflux using technetium 99 gastroesophageal nuclear scintigraphy and prevalence of urodynamic abnormalities using uroflowmetric assessment


Prestructured proforma was administered among 99 patients. They underwent bleeding time test, GER scan, uroflowmetry and ultrasonographic evaluation for post void residual urine.


Prevalence of smooth muscle dysfunction in terms of vascular, upper GI and bladder smooth muscle by administering  a pre-structured proforma was 27.2 % (95 % C.I - 18.5 to 35.7). Nocturnal enuresis and urinary frequency were reported in 16 and 12 % respectively.Mean bleeding time was 387.5 seconds (Mildly prolongation). Prevalence of gastroesophageal reflux on GER scan was 21%.On uroflowmetry, we foundvoided volume/estimated bladder capacity  > 15 %  and abnormal flow curves were seen in 18.2 % and  9.7 % respectively. Excessive post void residual urine volume was seen in 25.6 %.


Smooth muscle dysfunctionwas seen in atleast one third of study population highlighting theneed for addressing these issues in patient care.


Smooth muscle dysfunction, Duchenne muscular dystrophy, children

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