N E W B O R N --S C R E E N I N G ----T E S T S .
Introduction:
Is it a must?. There are eight important bood biochemical&electrophoretic teststhat are recomended by scientists to detectearly abnormality if any.
They areas follows:
1)Congenital hypothyroidism.
2)Galectocaemia,
3)Haemoglobinopathies
4)Phenylketonuria
5)BIOTINIDASE deficiency.
6)Congenital adrenal hyperplasia
7)cystic fibrosis
8)Maplesyrup urine disease.
The most important of all the test is the first one. T3 T4 TSH.Thyroxine is a hormone essential for all round growth &developementespesially the brain.Baby born with thyroid deficiency, will suffer from mental redardation permanently if not recognised early &treated.Treatment of all eight defects if detected is life long.A 2 Yr old with hypothyroidism will suffer from severe brain damage as the brain developement is fastest at age 2.Further developement is based on the foundations only.Even if this child is treated at age 2 till age 5 the brain developement of the 5 Yr.old will be that of 3 yr old normal childONLY.It can not catch up &will be 2-3 yrs behind allways in academic performance.
2)G A L E C T O C A E M I A:
Breast milk contains galactose(sugar)THIS CAN NOT BE SPLIT &DIGESTED by those who have no enzyme galectAse SO THERE IS unsplit galectose circulating in the blood causing a diarrheal disoder(sugar intolerance) ALL other biochemical disorders will cause all round defective growth &developement,physical motor, & mental milestones in the unfortunate children. Any question & further details can be had through my E mail Id
C E R T A I N--D O S--& D O N T S.I N I N F A N C Y:
1)Never give a purgative-including native drugs
2)DONT make anal dilatations if child does not pass (poop)FOR one day.
3)Dont yield to superstitious habits.
4)Modern medicine treatment is essential for all suspected pox lesions(fever+rash+skineruptions)
5)when child developes diarrhoea,stop all milks sweets,electrolytes.consult doctor.
6)dont resort to self medication for baby's fever.Give tepid sponging continuously &consult doctor telephonically.
7)Avoid multiple immunisations on same day even if recomended by doctor.
8)Beware of malaria at all age groups in india.Try all anti mosquito prophylaxis(remember a mosqiuto bite can cause 50,differant type of fevers--diseases!
9)Dont use seekaikai powder(soap nut powder)for scalp wash even for adults as it is the most powerful respiratoryALLERGEN&can cause severe asthma. (common practice in India)
10)NEVER FEED when baby is in lying position.(aspiration chances more)
11)measure head circumferance periodicallyupto age 5.
12)vision for refractive error&hearing test,necessary to all school children at periodic interval or if their academic performance falls below average in the class.
13)Road to health chart to be maintained in order to detect obesity earlier.(there is no more under nutrition nowadays)
14)Hare lip cleft palate babies not to be operated at birth.
15)congenital talepes equinovarus(club foot)can be treated withoutsurgery,if strapping/pop done in the neonatal stage (first week)itself.
16)Minimum polio drops requirement at age one--8doses
WHAT are the immediate health problems a new born baby may be exposed?
Medical :
jaundice.MAJORITY DUE TOphysiological if it is after day 3.or due to blood group incompatibility(Rh negative mother&Rh positive babyif it is within 24 hrs after birth.
2)Anaemia .Occurs due to any cause that destroys R B CS or due to maternal or foetal blood loss.
3)Fits.Usually neonatal tetanus.Other cause like intracranial haemorrhage,or metabolic disorders& infection.
4)Meconium ileus syndrome.Can be managed medically&sometimes surgically.There is severe obstruction due to jamming of gum like meconium inside the bowels. child may maynot pass meconium+vomiting
5)Not passing urine stools in the first 24-48 hrs.
6)Anorectal anamaly. If there is no anus surgery is the treatment of choice,after x-ray in the judgement of solomen's position(upside down)
7)Bleeding tendency.skin,/nose/gum/lungs/other sites,due to coagulation defect (FACTOR
defficiency/platlets defficiency.
8)Breast engorgement:Can occur inboth sexes,duetomaternal estrogen circulaating in neonate's
blood.Village vaidhyas&grand p arents usually squeeze it &take the "milk" out of it.There were many instances of development of septicaemias& deathdue to this practice.
9)beedding P. V .--DUE TO maternal estrogen circulation.Treatment:Leave it alone.
10)congenital heart disease. cyanotic (blue baby) Needs surgery.Acyanotics also needsurgery
often.mortality &morbidity high.Parental management is diffcult.
NEONATAL SURGICAL PROBLEMS.
1)HARE-LIP,CLEFT PALATE-maxillo facial/plasticsurgery.
tracheo esophagial fistula
3)ddiaphramatic hernia.
4congenital hypertrophic pyloric stenosis
5)Meconium ileus syndrome.
6)anorectal anamaly
7)spinbifida--Meningo-myelocele
8)Ventriculo peritonealshunt surgeryfor hydro cephalus.
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