Method for evaluating physical development in children and teenagers

FIELD: medicine, social hygiene, health care organization, pediatrics, hygiene, juvenile endocrinology.

SUBSTANCE: one should detect Rhorer's weight-height index (IR) by the following formula: W/H3 kg/cu. cm, where W - body weight (kg), H - body height (cm). At IR value ranged 10.7-13.7 kg/cu. cm it is possible to diagnose harmonic, normal or mean physical development in children, at IR being below 10.7 kg/cu. cm physical development should be considered as low, and at IR value being above 13.7 kg/cu. cm - one should diagnose high physical development in children and teenagers.

EFFECT: higher accuracy of evaluation.

3 ex

 

The invention relates to medicine, namely to the social hygiene and organization of health care, Pediatrics, hygiene, pediatric endocrinology.

Physical development is one of the most important indicators of the health of a growing organism. On the one hand, changes in physical development due to deficiency or excess body weight in children predispose to the development of a number of somatic diseases and disorders of physical development can themselves be a consequence of the pathology as internal organs, and the neuroendocrine system.

The study diagnosis of normal physical development and its deviations was the subject of many works in the 70-80-ies of XX century, but it remains relevant in the present time. There are various methods of estimation of physical development of children. Most of them are anthropometric data, the main of which are the weight (W) and body length or height (H). Currently, the most common found nonparametric, centile way of interpreting the results of anthropometry (body weight, body length and chest perimeter), it was shown abnormal distribution of body weight and chest circumference. For mass preventive examinations of children and adolescents Pets dimension they have only length and body mass, with the subsequent conclusion about F. the physical development. For characteristics body weight (normal, excessive or reduced) are also recommended index mass growth forms, which are of practical interest three: weight/height (W/H)weight/height2(W/H2) and weight/height3(W/H3). In adults, the most informative is the body mass index (W/H2or the index-Quetelet (Quetlet).

As a prototype of the invention, the authors used centile method of estimation of physical development of children and adolescents [Gosev SF Physical development of children /Sthose, Obediencia, Lukanova.: method. the allowance. - Tver, 2001. - 50 S.]recommended for screening. The assessment of body weight of the children was performed according to the table of the length of the body. Getting the desired body weight of the child in area 1 corridor (up to 3 centile) talked about very low values of the mass-growth in area 2 corridor [from 3 to 10 centile] - on the low zone 3 corridor [10 to 25] - o below average zone 4 [25 to 75] - on average, 5 [from 75 to 90] - above average, 6 [from 90 to 97] - high and in area 7 [over 97 centile] - is very high. Then the degree of physical development was assessed as average or normal (corridors 3, 4 and 5), low physical development through a low-power (1, 2) and high, due to high power (6, 7). The disadvantage of this method is basternae the presence centile tables, without which to assess children's physical development is not possible.

The authors offer a way of assessing the physical development of schoolchildren, which is based on the calculation of mass-growth index W/H3. Indicator W/H3, proposed Rohrer (Rhorer), has not found wide use in adults in our country [Muzychenko, V.G. Application of mass-growth relationships in clinical medicine /Doctor/. Case - 1984. No. 1. - P.21-23]. Information about the information content of mass-growth Rohrer index in children and adolescents insufficient and require clarification. In the available literature does not met values for this indicator during normal physical development and its abnormalities in children and adolescents.

Authors conducted the analysis showed that all anthropometric data and mass-growth indices were similar in boys and girls. Body weight and growth increased with the age of the children (for W-r=0,80; p<0,001, N-r=0,83; p<0,001). Indexes W/H and W/H2there were also correlated with age (W/H-r=0,66; p<0.001 and W/H2-r=0,49; p<0,001), while the index W/H3not to age (r=0.02) and therefore can be used in children of different age and sex. Additionally, this figure was less associated with growth (r=-0,14), allowing it to be used to assess body mass (reduced or increased). Considering all seizoenen, index W/H3(JNp) and was taken as a basis in assessing the degree of physical development of children and adolescents, regardless of their age and gender. The guidelines this indicator will facilitate the assessment of physical development in children and adolescents preventive anthropometric examinations.

Applicants screening was conducted anthropometric survey 2708 children and adolescents aged 7 to 17 years (boys 1326, the average age of 11.7±2,40 years and girls 1382, 11,9±2,53), most of which belonged to the I and II groups of health. All the children in the morning on an empty stomach measured the height or length of the body through vertical stadiometer, and body weight using a balance, and expected mass growth index INp. Depending on the values of sipthe children were divided into three groups. According to the literature harmonious (secondary) physical development is found in about 2/3 of the students, so in the main group consisted of 1835 surveyed with the average values of sip[it was they 11,9±0,82 (11.8 in) kg/m3]. The second group included 564 pupils with low values of W/H3[9,95±0,56 (10,1) kg/m3] and the third was 309 children with high values of sip[15,3±1,87 (14,7) kg/m3]. Then, using centile tables at 2648 children, it was concluded physical R the development. Thus, the average or normal physical development was diagnosed with 75.6% of the surveyed (75.7% of boys and 75.6% of girls), low in 14.3% (from 13.7 per cent and 14.9 per cent) and high - 10.1 per cent (10.6 per cent and 9.5 per cent). However, 88.4% of subjects with normal physical development were observed average values INpat 94.4% of children with low physical development was identified low INpand 95,1% of students with high physical development W/H3was also increased (r=0.82; p<0,001).

Values INpwere evaluated in children and adolescents with average or normal physical development according to the conclusion of using centile tables. It was a group from 2003 healthy children and average JNpthey amounted to 11.9±0,95 (11,75) kg/m3. By subsequent experimental studies were selected such values of the upper and lower bounds INpin children with normal physical development, which was awarded the highest sensitivity and alternative (specificity) of the new method. When the lower limit of 10.7 kg/m3sensitivity made 93.7%, and the specificity 94,1%, and at the upper limit of 13.7 kg/m3accordingly 95,1% and 97.8%. So, the values INp=10,7-13.7 kg/m3with the average or normal, harmonious physical development, INp<10.7 kg/m3testified low physical development, and IN p>13.7 kg/m3- on high. The results of estimation of physical development using normative values of sipat 2708 schoolchildren showed that the average or the harmonious development had 67,8% (67.5% of boys and 68.0% of girls) were examined, low physical development was in 20.8% (21.3% and 20,4%) children and high - 11,4% (11.2% and 11.6%respectively). The new method allows more subtle approach to the assessment of physical development in children and adolescents and to identify the border States, which is difficult when using data centile tables.

Clinical examples:

1. Boy M, 13 years old, has a weight 29 kg, height 141 cm, INp=29/1,413=10,3 kg/m3. When using centile tables (according to the body mass growth) body weight fell into 3 corridor, which indicates that the average physical development at this boy. However, INpthe child was reduced and corresponded to low physical development. This conclusion coincided with the clinical examination of the child, which showed that for his age he has a very low body weight and growth and needs further examination.

2. Girl L., age 9, has a body weight of 40 kg, height 142 cm, INp=40/1,423=14,0 kg/m3. Analysis of the physical development of the child centile tables showed normal physical development (body weight in relation to the Oia to growth came in 5 corridor). According to the new method (INp=14,0) physical development was assessed as high, which was confirmed by subsequent clinical examination, as well as data from other centile tables indicating the presence of the child high growth and high body mass, and required additional examination.

3. Girl K., age 12, has a weight 69 kg, height 162 cm, INp=69/1,623=16,2 kg/m3. On centile table weight with this growth came in 7 corridor, which indicates a very high physical development. INpthis little girl under the new method also indicates a high physical development. Subsequent clinical examination confirmed that girls this age have high growth and overweight, which requires additional examination.

Thus, proposed by the authors way of assessing the degree of physical development in children, based on the calculation of the index of Rohrer (JNp= weight/height3very simple, does not require special centile tables that must be updated every 5 years and may be different in different regions. It does not depend on gender, age and growth of children and can be widely used for screening, preventive examinations of children in schools, when measured only body mass and R is the art of the child. In addition, it allows to identify the border States, often using only centile tables match weight length fall into the normal physical development. Values INp=10,7-13.7 kg/m3match harmonious, normal or average physical development, INp<10.7 kg/m3indicate low physical development (at the expense of lean body mass), and INp>13.7 kg/m3- on a high (due to high body mass). Conclusions about the low and high physical development require additional surveys to clarify the cause of the violation of physical development.

The method of estimation of physical development of children and adolescents, including the determination of the degree of physical development for mass-growth relationships, characterized in that the determined mass-growth index Rohrer (IFF) by the formula W/H3kg/cm3, where W is body weight (kg), H is the growth of the body (m), and when the value IFF from 10.7 to 13.7 kg/m3diagnose harmonious, normal or average physical development of children, IFF less than 10.7 kg/m3physical development is assessed as low, and a value IFF more than 13.7 kg/m3diagnosed with high physical development in children and adolescents.



 

Same patents:

FIELD: medicine.

SUBSTANCE: method involves marking two points mapping distal coccyx and symphysis part positions. Ruler is applied to the points over the imaginary coccygeosymphyseal line between the points on skin. 10 cm long metal rod of 1.9 mm diameter having ticks from 1cm to 3 cm is introduced into anal canal. Anococcygeal angle is measured between the ruler and the metal rod. One angle side is segment binding a point belonging to distal coccyx part projection to anal canal axis and the other side is the continuation of this axis above anodermal surface. The coccygeal angle magnitude being greater than 90°, rectum obturation apparatus disorder is to be diagnosed.

EFFECT: high accuracy of early stage diagnosis.

1 dwg

FIELD: medicine.

SUBSTANCE: method involves marking two points mapping distal coccyx and symphysis part positions. Ruler is applied to the points over the imaginary coccygeosymphyseal line. Then, another ruler is taken for measuring anococcygeosymphyseal distance from external anal orifice point to the coccygeosymphyseal line in rest state and in straining effort state. The distance being from 0 to 1 cm large both in rest state and in straining effort state, norm is to be diagnosed. The anococcygeosymphyseal distance value being higher, perineal descent syndrome is considered to be the case.

EFFECT: avoided X-ray examination.

1 dwg

FIELD: medicine.

SUBSTANCE: method involves distinguishing four degrees in sexual development delay. Minimum sexual development delay degree is characterized by the following parameters. Uterus width and thickness corresponds to age-specific norm. Median uterine M-echo is recorded. Uterus neck is differentiated from uterus body with angle between them being well distinguished. All ovarian dimensions correspond to norm. Light sexual development delay degree is characterized as follows. All uterine dimensions are two years smaller, when compared to age-specific norm. Median uterine M-echo is recorded. Uterus neck is differentiated from the uterus body. Ovary length and thickness correspond to age-specific norm. Moderate sexual development delay degree is characterized as follows. All uterine dimensions are three-four years smaller, when compared to age-specific norm. Median uterine M-echo and reduced ovary length and thickness are recorded. Severe sexual development delay degree is characterized as follows. All uterine dimensions are six-eight years smaller, when compared to age-specific norm. No uterus neck is differentiation from the uterus body is available. No median uterine M-echo is recorded. Ratio coefficient of length and anteroposterior dimension of uterine body to length and anteroposterior dimension of uterus neck is additionally determined in each sexual development delay degree case. Uterine blood vessel lumen, ovary echostructure as number, diameter of minimum and maximum follicles in them are determined in energetic Doppler mapping mode. Uterus length having 1-2 years delay when compared to norm, ratio coefficient of uterus and neck dimensions being equal to 1.5-1.7, uterine blood vessel lumen being equal to 5-6 mm, follicle number being in norm, diameter of minimum and maximum follicles having 1-2 years delay when compared to age-specific norm, minimum sexual development delay degree is diagnosed (IA). Uterine blood vessel lumen being equal to 4-5 mm, coefficient of uterus and neck dimensions being equal to 1.3-1.5, follicle number being in norm, ovary width having 1-2 years delay when compared to norm, minimum follicles having 2 years delay when compared to age-specific norm, maximum follicles having 2-3 years delay, light sexual development delay degree is diagnosed (IB). All uterine dimensions being three-four years smaller, when compared to age-specific norm, uterus neck being differentiated from uterus body with angle between them being poorly distinguished, uterine blood vessel lumen being equal to 2-3 mm, ratio coefficient of uterus and neck dimensions being equal to 1.2-1.5, reduced follicle number having 1-2 years delay when compared to age-specific norm, ovary width having 2-3 years delay when compared to norm, minimum follicles diameter having 2 years delay when compared to age-specific norm, maximum follicles diameter having 2-3 years delay, moderate sexual development delay degree is diagnosed (II). Uterine blood vessel lumen diameter being equal to 1 mm, ovaries dimensions delay being of 2-3 years with lacking follicular apparatus in them, severe sexual development delay degree is diagnosed (III).

EFFECT: high accuracy and self-descriptiveness of the method.

FIELD: medicine, obstetrics.

SUBSTANCE: one should carry out clinical and ultrasound uterine testing, moreover, additionally, on the 3d and the 7th d of post-operational period it is necessary to detect conditional area of uterine sutures, systolo-diastolic ratio (SDR), percentage content of lymphocytes against total amount of cells in uterine aspirate to establish protein coefficient (PC) and leukocytic index of intoxication (LII) being necessary to state upon prognostic coefficients F1 and F2 by the following formulas: F1 = -6726.59 + 27.58 x K1 + 21.84 x K2 - 0.03 x K3 + 93.36 x K4 + 156.47 x K5 - 4.21 x K6 + 760.82 x K7 + 978.46 x K8 + 11.47 x K9 + 96.40 x K10 + 306.40 x K11 + 321.13 x K12 - 24.32 x K13 - 50.56 x K14; F2 = -57.81.76 + 35.89 x K1 + 26.50 x K2 + 0.00 x K3 + 96.81 x K4 + 146.78 x K5 - 3.89 x K6 + 500.76 x K7 + 651.60 x K8 + 4.83 x K9 + 34.83 x K10 + 276.16 x K11 + 535.35 x K12 - 14.26 x K13 - 17.28 x K14, where digital values - the constants of discriminant equation and discriminant coefficients, K1,2...14 - gradations and digital values of post-operational period flow: K1 - the length of uterine sutures on the 3d d, K2 - the width of uterine sutures on the 3d d, K3 - conditional area of sutures on the 3d d, K4 - the length of uterine sutures on the 7th d, K5 - the width of uterine sutures on the 7th d, K6 - conditional area of sutures on the 7th d, K7 - SDR right-hand on the 7th d, K8 - SDR left-hand on the 7th d, K9 - percentage content of lymphocytes against the total amount of cells in uterine aspirate on the 3d d, K10 - percentage content of lymphocytes against the total amount of cells in uterine aspirate on the 7th d, K11 - PC on the 3d d, K12 - PC on the 7th d, K13 - LII on the 3d d, K14 - LII on the 7th d, and at F1>F2 one should predict favorable nature in recovery of uterine wound and at F1<F2 - unfavorable nature.

EFFECT: higher accuracy and efficiency of evaluation.

2 ex

FIELD: veterinary science.

SUBSTANCE: during the first 1-3 h of life one should measure umbilical diameter and at its diameter being above 18 mm it is possible to diagnose earlier manifestation of omphalitis that, in its turn, enables to perform antibacterial therapy in due time and avoid mortality in animals.

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1 ex, 1 tbl

FIELD: medicine, oncourology.

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1 dwg, 3 ex

FIELD: medicine, neurology.

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3 ex

FIELD: medicine.

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EFFECT: high accuracy of the method.

3 dwg

FIELD: medicine.

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4 dwg

FIELD: medicine, cardiology, endocrinology, gynecology.

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EFFECT: higher accuracy of evaluation.

5 ex, 2 tbl

FIELD: medicine, cardiology, endocrinology, gynecology.

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EFFECT: higher accuracy of evaluation.

5 ex, 2 tbl

FIELD: medicine.

SUBSTANCE: method involves producing foot imprints on specially fixed flat-bed scanner capable to withstand human body weight load. Foot imprint processing is carried out by means of software for automating examination process. Operator marks foot image according to a pattern. The operator selects 12 key points with mouse unit and draws straight lines from point to point and calculates positions of calculatable points on foot image. Diagnostic values are calculated after having marked up the foot separately for anterior, median and posterior portions of the foot.

EFFECT: high diagnostic accuracy and accelerated examination.

4 dwg

FIELD: medicine.

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EFFECT: high accuracy of the method.

3 dwg

FIELD: medicine, neurology.

SUBSTANCE: the method deals with detecting an interferon status followed by medicinal therapy. Moreover, additionally one should determine patient's body area, and at observed degree I of interferon system suppression it is necessary to prescribe "Antilympholin Kz" preparation as medicinal therapy intravenously by drops at course dosage being (0.5-0.6)g x S, where S - patient's body area, every other day, and thioctacide preparation at the dosage of 300-600 mg intravenously by drops daily at a 6-8-d-long course. In case of degrees II and III of interferon system suppression one should prescribe "Antilympholin Kz" at course dosage being 0.4-0.5 g/sq. m and 0.3 -.4 g/sq. m, as for thioctacide - it should be applied at the dosage of 600-900 mg and 900-1200 mg, correspondingly. The method enables to selectively affect the immune system efficiently due to combined prescription of an immunimodulator and a preparation that accelerates its introduction at suppressing the activity of proinflammatory cytokines that prolongs disease remission due to preventing the development of immunological disorders.

EFFECT: higher efficiency of therapy.

3 ex

FIELD: medicine, oncourology.

SUBSTANCE: one should choose the number of points for biopsy : 1 point of biopsy/5 cu. cm of an organ, then it is necessary to detect the portion of cancerous parenchyma in bioptates in percentage morphometrically due to analyzing of not less than 1000 points minimum in 5 sections of preparation, the volume of cancerous parenchyma in an organ should be detected by the following formula:

where X - average value for the portion of cancerous parenchyma in an organ, in %; ΣA - the portion of cancerous parenchyma in bioptate in %; N - the number of bioptates. The present innovation enables to detect cancerous parenchyma both in case of interrupted and diffused forms of prostatic cancer.

EFFECT: higher accuracy of detection.

1 dwg, 3 ex

FIELD: veterinary science.

SUBSTANCE: during the first 1-3 h of life one should measure umbilical diameter and at its diameter being above 18 mm it is possible to diagnose earlier manifestation of omphalitis that, in its turn, enables to perform antibacterial therapy in due time and avoid mortality in animals.

EFFECT: higher accuracy of diagnostics.

1 ex, 1 tbl

FIELD: medicine, obstetrics.

SUBSTANCE: one should carry out clinical and ultrasound uterine testing, moreover, additionally, on the 3d and the 7th d of post-operational period it is necessary to detect conditional area of uterine sutures, systolo-diastolic ratio (SDR), percentage content of lymphocytes against total amount of cells in uterine aspirate to establish protein coefficient (PC) and leukocytic index of intoxication (LII) being necessary to state upon prognostic coefficients F1 and F2 by the following formulas: F1 = -6726.59 + 27.58 x K1 + 21.84 x K2 - 0.03 x K3 + 93.36 x K4 + 156.47 x K5 - 4.21 x K6 + 760.82 x K7 + 978.46 x K8 + 11.47 x K9 + 96.40 x K10 + 306.40 x K11 + 321.13 x K12 - 24.32 x K13 - 50.56 x K14; F2 = -57.81.76 + 35.89 x K1 + 26.50 x K2 + 0.00 x K3 + 96.81 x K4 + 146.78 x K5 - 3.89 x K6 + 500.76 x K7 + 651.60 x K8 + 4.83 x K9 + 34.83 x K10 + 276.16 x K11 + 535.35 x K12 - 14.26 x K13 - 17.28 x K14, where digital values - the constants of discriminant equation and discriminant coefficients, K1,2...14 - gradations and digital values of post-operational period flow: K1 - the length of uterine sutures on the 3d d, K2 - the width of uterine sutures on the 3d d, K3 - conditional area of sutures on the 3d d, K4 - the length of uterine sutures on the 7th d, K5 - the width of uterine sutures on the 7th d, K6 - conditional area of sutures on the 7th d, K7 - SDR right-hand on the 7th d, K8 - SDR left-hand on the 7th d, K9 - percentage content of lymphocytes against the total amount of cells in uterine aspirate on the 3d d, K10 - percentage content of lymphocytes against the total amount of cells in uterine aspirate on the 7th d, K11 - PC on the 3d d, K12 - PC on the 7th d, K13 - LII on the 3d d, K14 - LII on the 7th d, and at F1>F2 one should predict favorable nature in recovery of uterine wound and at F1<F2 - unfavorable nature.

EFFECT: higher accuracy and efficiency of evaluation.

2 ex

FIELD: medicine.

SUBSTANCE: method involves distinguishing four degrees in sexual development delay. Minimum sexual development delay degree is characterized by the following parameters. Uterus width and thickness corresponds to age-specific norm. Median uterine M-echo is recorded. Uterus neck is differentiated from uterus body with angle between them being well distinguished. All ovarian dimensions correspond to norm. Light sexual development delay degree is characterized as follows. All uterine dimensions are two years smaller, when compared to age-specific norm. Median uterine M-echo is recorded. Uterus neck is differentiated from the uterus body. Ovary length and thickness correspond to age-specific norm. Moderate sexual development delay degree is characterized as follows. All uterine dimensions are three-four years smaller, when compared to age-specific norm. Median uterine M-echo and reduced ovary length and thickness are recorded. Severe sexual development delay degree is characterized as follows. All uterine dimensions are six-eight years smaller, when compared to age-specific norm. No uterus neck is differentiation from the uterus body is available. No median uterine M-echo is recorded. Ratio coefficient of length and anteroposterior dimension of uterine body to length and anteroposterior dimension of uterus neck is additionally determined in each sexual development delay degree case. Uterine blood vessel lumen, ovary echostructure as number, diameter of minimum and maximum follicles in them are determined in energetic Doppler mapping mode. Uterus length having 1-2 years delay when compared to norm, ratio coefficient of uterus and neck dimensions being equal to 1.5-1.7, uterine blood vessel lumen being equal to 5-6 mm, follicle number being in norm, diameter of minimum and maximum follicles having 1-2 years delay when compared to age-specific norm, minimum sexual development delay degree is diagnosed (IA). Uterine blood vessel lumen being equal to 4-5 mm, coefficient of uterus and neck dimensions being equal to 1.3-1.5, follicle number being in norm, ovary width having 1-2 years delay when compared to norm, minimum follicles having 2 years delay when compared to age-specific norm, maximum follicles having 2-3 years delay, light sexual development delay degree is diagnosed (IB). All uterine dimensions being three-four years smaller, when compared to age-specific norm, uterus neck being differentiated from uterus body with angle between them being poorly distinguished, uterine blood vessel lumen being equal to 2-3 mm, ratio coefficient of uterus and neck dimensions being equal to 1.2-1.5, reduced follicle number having 1-2 years delay when compared to age-specific norm, ovary width having 2-3 years delay when compared to norm, minimum follicles diameter having 2 years delay when compared to age-specific norm, maximum follicles diameter having 2-3 years delay, moderate sexual development delay degree is diagnosed (II). Uterine blood vessel lumen diameter being equal to 1 mm, ovaries dimensions delay being of 2-3 years with lacking follicular apparatus in them, severe sexual development delay degree is diagnosed (III).

EFFECT: high accuracy and self-descriptiveness of the method.

FIELD: medicine.

SUBSTANCE: method involves marking two points mapping distal coccyx and symphysis part positions. Ruler is applied to the points over the imaginary coccygeosymphyseal line. Then, another ruler is taken for measuring anococcygeosymphyseal distance from external anal orifice point to the coccygeosymphyseal line in rest state and in straining effort state. The distance being from 0 to 1 cm large both in rest state and in straining effort state, norm is to be diagnosed. The anococcygeosymphyseal distance value being higher, perineal descent syndrome is considered to be the case.

EFFECT: avoided X-ray examination.

1 dwg

FIELD: medicine.

SUBSTANCE: method involves marking two points mapping distal coccyx and symphysis part positions. Ruler is applied to the points over the imaginary coccygeosymphyseal line between the points on skin. 10 cm long metal rod of 1.9 mm diameter having ticks from 1cm to 3 cm is introduced into anal canal. Anococcygeal angle is measured between the ruler and the metal rod. One angle side is segment binding a point belonging to distal coccyx part projection to anal canal axis and the other side is the continuation of this axis above anodermal surface. The coccygeal angle magnitude being greater than 90°, rectum obturation apparatus disorder is to be diagnosed.

EFFECT: high accuracy of early stage diagnosis.

1 dwg

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