{"id":3783,"date":"2023-04-04T17:36:19","date_gmt":"2023-04-04T21:36:19","guid":{"rendered":"https:\/\/dev-telemed.pantheonsite.io\/?p=3783"},"modified":"2023-11-23T16:44:28","modified_gmt":"2023-11-23T21:44:28","slug":"tied-legs","status":"publish","type":"post","link":"https:\/\/telemedhub.org\/ar\/2023\/04\/04\/tied-legs\/","title":{"rendered":"Tied legs"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"3783\" class=\"elementor elementor-3783\">\n\t\t\t\t\t\t<section class=\"has_eae_slider elementor-section elementor-top-section elementor-element elementor-element-602f9b4e elementor-section-full_width elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no\" data-eae-slider=\"73649\" data-id=\"602f9b4e\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"has_eae_slider elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-5587928b\" data-eae-slider=\"99063\" data-id=\"5587928b\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-62ea07e4 elementor-widget elementor-widget-heading\" data-id=\"62ea07e4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Tied legs<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6890cbf elementor-widget elementor-widget-spacer\" data-id=\"6890cbf\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6984808 elementor-widget elementor-widget-video\" data-id=\"6984808\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;video_type&quot;:&quot;hosted&quot;,&quot;controls&quot;:&quot;yes&quot;}\" data-widget_type=\"video.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"e-hosted-video elementor-wrapper elementor-open-inline\">\n\t\t\t\t\t<video class=\"elementor-video\" src=\"https:\/\/dev-telemed.pantheonsite.io\/wp-content\/uploads\/2023\/04\/Konzo-Bambari-1.mp4\" controls=\"\" preload=\"metadata\" controlsList=\"nodownload\"><\/video>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3f6c7482 elementor-widget elementor-widget-heading\" data-id=\"3f6c7482\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">In Central African Republic, two girls were admitted for medical care on the same day, reporting they had suddenly started having difficulty walking.<\/h5>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-22fb2ec2 elementor-widget elementor-widget-text-editor\" data-id=\"22fb2ec2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-style: inherit; font-weight: inherit; background-color: var( --e-global-color-astglobalcolor5 ); color: var(--bs-body-color); font-family: var(--bs-body-font-family);\" data-contrast=\"none\">Though the girls were not from the same household, or even the same village, they were related. After further exploring their history, it became clear that other children in their villages had recently begun experiencing the same ailment. At examination the spastic gait was apparent. Further neurological examination only revealed brisk reflexes at the lower extremities. The rapid malaria test for both was positive. The working diagnosis of the local MSF team was an unknown kind of vitamin-deficiency. The case subsequently was sent to the TM platform.<\/span><span style=\"font-style: inherit; font-weight: inherit; background-color: var( --e-global-color-astglobalcolor5 ); color: var(--bs-body-color); font-family: var(--bs-body-font-family);\" data-ccp-props=\"{&quot;201341983&quot;:2,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:60,&quot;335559739&quot;:0,&quot;335559740&quot;:280}\">\u00a0<\/span><\/p><p><span data-ccp-props=\"{&quot;201341983&quot;:2,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:60,&quot;335559739&quot;:0,&quot;335559740&quot;:280}\">\u00a0<\/span><\/p><p><span data-contrast=\"none\">The TM pediatrician in the Netherlands and the TM pediatric neurologist in the United States recognized the rare presentation and quickly responded to the team: \u201cThis is KONZO!\u201d\u00a0 Konzo means \u2018tied legs\u2019 in the Yaka language in southwestern Democratic Republic of Congo, where the first cases were described in 1938, and aptly describes the spastic gait.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:2,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:60,&quot;335559739&quot;:0,&quot;335559740&quot;:280}\">\u00a0<\/span><\/p><p><span data-ccp-props=\"{&quot;201341983&quot;:2,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:60,&quot;335559739&quot;:0,&quot;335559740&quot;:280}\">\u00a0<\/span><\/p><p><span data-contrast=\"none\">The exact cause has not been fully elucidated, but there is a close association with a high intake of cyanide from a monotonous diet of improperly prepared bitter cassava. There is no known therapy. The neurological damage is permanent, though some spontaneous improvement over weeks can be expected.\u00a0<\/span><span data-ccp-props=\"{&quot;201341983&quot;:2,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:60,&quot;335559739&quot;:0,&quot;335559740&quot;:280}\">\u00a0<\/span><\/p><p><span data-ccp-props=\"{&quot;201341983&quot;:2,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:60,&quot;335559739&quot;:0,&quot;335559740&quot;:280}\">\u00a0<\/span><\/p><p><span data-contrast=\"none\">Immediately after confirmation of the diagnosis, the team went to the villages and identified more cases. The local market was found to be the most likely source of the improperly prepared cassava.\u00a0<\/span><span data-ccp-props=\"{&quot;201341983&quot;:2,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:60,&quot;335559739&quot;:0,&quot;335559740&quot;:280}\">\u00a0<\/span><\/p><p><span data-ccp-props=\"{&quot;201341983&quot;:2,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:60,&quot;335559739&quot;:0,&quot;335559740&quot;:280}\">\u00a0<\/span><\/p><p><span data-contrast=\"none\">After relevant information and education on cassava preparation was spread via the usual local channels, no more cases were seen. Though the girls could not be helped, telemedicine played a pivotal role in preventing others from acquiring this permanent crippling affliction.<\/span><\/p><p>\u00a0<\/p><p><em><span class=\"TextRun SCXW9052531 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW9052531 BCX0\" data-ccp-parastyle=\"Texte\" data-ccp-parastyle-defn=\"{&quot;ObjectId&quot;:&quot;150ebf05-8afb-483a-a9a5-fcdd86d7e07e|5&quot;,&quot;ClassId&quot;:1073872969,&quot;Properties&quot;:[469775450,&quot;Texte&quot;,201340122,&quot;2&quot;,134233614,&quot;true&quot;,469778129,&quot;Texte&quot;,335572020,&quot;99&quot;,201342448,&quot;1&quot;,469777841,&quot;Franklin Gothic Book&quot;,469777842,&quot;Franklin Gothic Book&quot;,469777843,&quot;Calibri&quot;,469777844,&quot;Franklin Gothic Book&quot;,469769226,&quot;Franklin Gothic Book,Calibri&quot;,335551500,&quot;0&quot;,268442635,&quot;24&quot;,335551547,&quot;1036&quot;,335559740,&quot;280&quot;,201341983,&quot;2&quot;,335559739,&quot;0&quot;,335559738,&quot;60&quot;,335551550,&quot;6&quot;,335551620,&quot;6&quot;,469778324,&quot;Normal&quot;]}\">By Dr Jaap Karsten<\/span><\/span><span class=\"EOP SCXW9052531 BCX0\" data-ccp-props=\"{&quot;201341983&quot;:2,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:60,&quot;335559739&quot;:0,&quot;335559740&quot;:280}\">\u00a0<\/span><\/em><\/p><p>\u00a0<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>In Central African Republic, two girls were admitted for medical care on the same day, reporting they had suddenly started having difficulty walking.<\/p>\n","protected":false},"author":9,"featured_media":7540,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"video","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"disabled","ast-breadcrumbs-content":"","ast-featured-img":"disabled","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center 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