MATERIALS AND METHODS: This was a retrospective descriptive study. All medical records of conjoined twins who were admitted to Hasan Sadikin Bandung General Hospital from January 1st, 2015, to June 30th, 2023, were reviewed for gender, conjoined type, birth order, risk factor and treatment.
RESULTS: Of the 28 conjoined twins, 21 were girls (75%), and 7 were boys (25%); 19 (67,85%) were of the thoracoomphalopagus type; 11 (39,28%) were born as first children; 18 (64,28%) were born at 37 weeks of gestational age; and 22 twins' (78,57%) parents were aged between 21 and 35 years. None of the mothers had used medication, 13 (46,42%) took folic acid on occasion, five (17,85%) used traditional herbs, nine (32,14%) smoked and none drank alcohol. Parents who live in industrial areas were 18 (64.28%). There was no history of conjoined twins in previous pregnancies or deliveries or in the parent's family. Liver separation had been done in four (14.28%). Emergency separation in one twin. Nine (21.42%) patients died before surgery due to a worsening condition.
CONCLUSION: The conjoined twins were more common in girls, predominantly of the thoracoomphalopagus type. Risk factors that were commonly found were the first child, a gestational age of less than 37 weeks, and living in an industrial area.
AIMS: (1) To investigate the association between birth weight and anthropometric measurements during adulthood; (2) to study the genetic and environmental influences on body measures including birth weight, weight and height among twins; and (3) to assess the variation in heritability versus environment among two cohorts of twins who lived in different geographical areas.
SUBJECTS AND METHODS: Twins were collected from two twin registers. Data on birth weight, adult weight and height in 430 MZ and 170 DZ twins living in two geographically distinct parts of the world were collected. A genetic analysis was performed using MX software.
RESULTS: Birth weight was associated with weight, height and BMI. Both MZ and DZ twins with low birth weight had shorter height during their adult life (p = 0.001), but only MZ twins with lower birth weight were lighter at adulthood (p = 0.001). Intra-pair differences in birth weight were not associated with differences in adult height (p = 0.366) or weight (p = 0.796). Additive genetic effects accounted for 53% of the variance in weight, 43% in height and 55% in birth weight. The remaining variance was attributed to unique environmental effects (15% for weight, 13% for height and 45% for birth weight and only 16% for BMI). Variability was found to be different in the two cohorts. The best fitting model for birth weight and BMI was additive genetic and non-shared environment and for weight and height was additive genetic, non-shared environment (plus common Environment).
CONCLUSIONS: Data suggests that the association between weight at birth and anthropometric measures in later life is influenced by both genetic and environmental factors. Living in different environments can potentially relate to variation found in the environment.
METHOD: A case series.
RESULTS: We present a case series of juvenile myasthenia gravis in a tertiary centre in Malaysia. Two of the three cases consist of a pair of twins who presented with ptosis of bilateral eyes; the first twin presented 4 months later than the second twin. These two cases were positive for anti-acetylcholine receptor antibodies and had generalized myasthenia gravis, whereas the other case was negative for receptor antibodies and was purely ocular myasthenia gravis.
CONCLUSION: Juvenile myasthenia gravis is relatively rare in toddlers. Early diagnosis and commencement of treatment is important to slow the progression of the disease and avoiding life-threatening events.