Friday, December 7, 2012

muscular dystrophy--continued--88

Though this is a muscle disease primarily--essentially it is a degenerative disease.All organs will appear normal and around 10-20years  their vim vigour vitality comes down and they start deteriorate slowly and their survival chance is quite less.(contact-001-7329858375-usa--email-drselvarajp@yahoo.com)




 

psuedomuscularhypertrophy(DUCHNNEY'S MUSCULAR DYSTROPHY)--87

Pitiable childhood fatal disorder.Easily diagnosed at around age 2 years..Affects male children exclusively(like the dangerous bleeding disorder( HAEMOPHILIA).GENETIC DISORDER,
Big calf muscle-reminds a footballer.develops equinus deformity so often falls on walking during toddler stage.At around age 5 -can not walk without support &can not get up himself from sitting position ,Learns to get up by using his own hands &legslike a ladder,this is called GOWER'S SIGN
diagnostic pathagnomonic&considered  sign  quo non of this disease,An experienced pediatrician does not need electromyography muscle boipsy,chromosomal analysisto clinch diagnosis
see the prominent calf muscle in the photograph of my case,

Wednesday, July 11, 2012

LOW ACADEMIC PERFORMERS -CONTINUED

THIRD GROUP
-----------------
THIS IS THE MOST IPORTANT GROUP.ADOESCENT STAGE.ANY LACK OF GUIDE LINES FROM PARENTS ,TEACHERS,WELLWISHERS,RELATIVES. WILL RUIN THE FUTURE OF CHILD'S PERFORMANCE.THIS IS THE AGE WHEN ALL THE BAD THINGS HAVE HIGH AFFINITY TO SMOKING ,DRINKING ,DRUG ADDICTION,SNAKE VENOM ADDICTION(SUPPOSED TO BE LATEST FORM OF ADICTION,MANDRAX &ALLIED DRUGS.IF CHILD IS AWAY FROM THESE DREADFUL THINGS, THIS ITSELF WILLTAKE THE CHILD IN THE RIGHT PATH. PARENTS HAVE A BIG ROLE TO WATCH THEIR WARDS STEALTHILY &DO CORRECTION IF NECESSARY.GIRL CHILDREN THOUGH NOT CONNECTED WITH SUCH ACTIVITIES THEY ARE MORE OFTEN DRIVEN TOWARDS COMMITTING SEX RELATED OFFENCES,DUE TO THEIR SHEER IGNORENCE,&TIMIDITY.SOME ARE DRIVEN TO COMMIT SUICIDE FOR A SCILLY THING.THIS OFTEN HAPPENS WHEN THEY DONT TRUST THEIR PARENTS OR DUE TO TERROR STRICKEN STATE,KEPT BY PARENTS.CAREFUL OBSERVATION WITH MASTERLY EXPECTANCY REQUIRED FOR BOY OR GIRL.
SUMMARY
-------------
IT IS THE SOCEITY &ENVIRINMENT THAT IS WHOLLY RESPONSIBLE FOR A CHILD'S UPBRINGING.PARENTS HAVE A LION'S ROLE,CHILDREN SHOULD HAVE A MIXED FEELING OF LOVE &FEAR TOWARDS PARENTS.IT IS THE PARENT'S DOTY TO SEE THAT CHILDREN PUT 100%CONFIDENCE,TRUST&LOVE TOWARDS PARENTS.IF PARENTS DONT KNOW THEY SOULD SEEK THE HELP OF SOME RELIABLE PERSON
DONT GIVE THEM TOO MUCH POCKET MONEY.CHECK THEM &DONT ENCOURAGE STEALING MONEY FROM HOME .IDENTIFYTROUBLE SHOOTERS WELL IN ADVANCE FIND OUT THEIR NEEDS, &IMPRESS UPON THEM THE NEED FOR BEING A USEFUL CITIZEN ,IN THE SOCEITY FOR A LIFE OF DIGNITY

Tuesday, July 10, 2012

LOW ACADEMIC PERFORMERS-FOR ATTENTION OF PARENTS

WE CAN DEVIDE THESE CHILDREN INTO 3 GROUPS

1)BIRTH-5YEARS  2)6-10 YEARS  3)11-15 YEARS.

THE FIRST GROUP IS ,IMPORTANT EVEN THOUGH ALL 3 GROUPS ARE FORMATIVE YEARS THIS BEING THE BASIC &MOST FLEXIBLE&EASY TOSHAPE THE CHARECTER.

1)COW'S MILK FED BABIES ARE LOW ACADEMIC PERFORMERS(GIVE FORMULA FEEDS)
2)T3 T4 TSH ASSESMENT SHOULD BE NORMAL(THYROID PROFILE) SLIGHTEST REDUCTION IN THYROXIN HORMONE LEVEL CAUSE BRAIN CELL DESTRUCTION &IS PERMANENT&IRREVERSIBLE
3)ALL THE 5 SPECIAL SENSES SHOULD BE INTACT.,SPECIALLY THE HEARING ASPECT
,BECUSE LEARNING INTELLIGENCE ARE DIRECTLY RELATED TO HEARING.
4)DISCIPLINE ENFORCEMENT SHOULD START FROM HERE.& IS MANDATORY IN THE
2nd,3rd GROUP ALSO
5)SHOULD BE ENCOURAGED TO PLAY ACTIVITIES,MOTE THAN ANY OTHER AGE GROUP
6)CHILD SHOULD BE NCOURAGED TOPARTICIPATE IN ALL HOUSEOLD ACTIVITIES,
THOUGH THIS IS MORE IMPORTANT IN THE 2nd 3rd GROUP.
7) I.Q ASSESSMENT ESSENTIAL INALL 3 AGE GROUPS.

SECOND GROUP
--------------------
)ALL THE GROUP ONE ACTIVITIES ARE APPLICABLE.
2)MORE DESCIPLINE TRAING REQUIRED.,BECAUSE DESCIPINE ENFORCEMENT IS DIFFICULTAFTER THIS AGE,CHILD SLOWLY BECOMES MORE DEFFIENT HERE.
3)AT ALL AGES PARENTS LOVE &AFFECTION SHOULD BE AVAILABLE IN ABUNDENCE
FATHER MUST ESENTIALLY PLAY AFTER RETURING HOME FROM WORK,
4)PARENTS SENSE OF SECURITY SHOULD BE AVAILBLE &THE CHILD SOULD KNOW
THAT100%.
5)PARENTS SHOULD DO LITTLE BIT OF SPY WORK &MONITER CHILD'S ACTIVITIES.
A)IS THE CHILD FRIENDLY WITH ANOTHER CHILD WITH GOOD BEHAVIOUR.
B)IS HE FRIENDLY WITH ANOTHER STUDIOUS CHILD
C)HOW IS HE TREATED BY TEACHER.
D)HOW IS HE TREATED BY OTHER CHILDREN/WORKERS IN SCHOOL.
E)ARE YOU SURE HE HAS ENOUGH SECURITY FEELING IN SCHOOL
F)DOES HE TRUST THE PARENTS FOR ANYTHING &EVERYTHING
G)DOES HE SHOW INTEREST IN GOING TO SCHOOL ITSELF, IN READING BOOKS/HOME
 WORKS
H)DOES HE SHOW ABILITY TO COMMUNICATE WITH TEACHER/FELLOW SCHOOLMATES.
I)FIND OUT REASON IF HE HAS NO COMPLAINT ABOUT TEACHER OR OTHERS--THERE WILL BE SOME COMLAINT USUALLY ONCE IN A WAY.





Thursday, July 5, 2012

SUCTON TECHNIC IN NEONATAL ASPIRATIONS

THIS IS A DANGEROUS CLINICAL CONDITION WARRANTING THE SERVICES OF A EXPERIENCED PEDIATRICIAN .A NEONATE CAN ASPIRATE FROM INSIDE UTERUS,DURING ITS PASSAGE PER VIA NATURALIS DURING LABOUR,AFTER DELIVERY(FIRST FEW FEEDINGS),EVEN AFTER A SUCCESSFUL RESUSCITATION.WHEN EVER THE LABOUR IS DELAYED FOR ANY REASON AMNIOTIC FLUID SWALLOWING OCCURS INVARIABLY.,DUE TO MULTIPLE REASONS(PLACENTA PREVIA, PREMATURE SEPERATION OF PLACENTA, INADEQUATE CONTRACTIONS OF UTERUS ,INADEQUATE DILATATIONS OF CERVIX OF UTERUS.SWALLOWED AMNIOTIC FLUID,IMPROPER FEEDING TECHNIQUE(NO BURPING), MAY LEAD TO ASPIRATION ASPIRATION PNEUMONIA, INSTANT DEATH.

IN THESE CASES THE RESUSCITATOR'S MAIN JOB IS MACHINE SUCTION OF RESPIRATORY TRACT,IN TOTO.AN XRAY CHEST WILL CONFIRM THE PRESENCE OF FLUID IN ONE OR BOTH LUNGS THESE CASES SHOULD BE IDEALLY SUBJECTED TO BRONCHOSCOPIC SUCTION.BUT PEDIATRIC BRONCHOSCOPE MAY NOT BE AVAILABLE IN 99%HOSPITALS.UNDER SUCH CIRCUMSTANCES THE AUTHOR'S SUGGESTION IS AS FOLLOWS:-

 1)DON'T USE ENDOTRACHEAL TUBE INTUBATION(MAY CAUSE REFLEX BRONCHO CONSTRICTION 2)SUCK OUT KEEPING THE SUCTION CATHETER(AFTER CUTTING THE TIP OBLIQUELY AT OPENING  OF TRACHEA WITH THE HALP LARYNGOSSCOPE.iNTHE ABSENCE OF LARYNGOSCOPE,KEEP THE TIP OF CATHETER ABOUT 3CM FROM THE LIPS OF NEONATE,MAKE TO &FRO MOVEMENT,AND WHEN YOU GET A PECULIER WHISTLING SOUND,MAITAIN THE TIP OF CATHTER AT THAT POSITION(OPENING OF TRACHEA)&KEEP SUCKING.IF YOU TAKE ANOTHER XRAY NOW THE CHEST WILL BE CLEAR.IF NOT REPEAT PROCEDURE

Saturday, June 30, 2012

MY EXPERIENCE

CLINICAL EXPERIENCE--47 YRS
PEDIATRICS EXPERIENCE-37 YRS
NEW BORN BABY EXPERIENCE-20 YRS.

For my biodata-pl visit my blog at my article "my complete profile"

RARE  CASES  TREATED  BY  ME-successfully.
------------------------------------------
1)2 yr old with fever -final diagnosis--UTI +chick-un-gunea+malaria.
2)severe dehydration over 15 %(often fatal) with aggressive treatment procedure,with double venesection +IV push fluids/drugs
3)coma case due to cobra bite-treated with conventional drugs,anti snake venom seerum,+blood transfusion from acompatible snake charming person,bitten by snake several times.
4)4 day old wih severe peripheral circulatory failure(body was ice cold on touch)
treated by venesction+lytic cocktail therapy--35 yrs back
5)2 month old with profuse bleeding from one eye--Bleeding diathesis.
6)revived a dead child due to pennicilin injection who had aspiration -successfully revivedwith
endotracheal tube intubation+iv drugs =venesection = iv fluids.--all done in 10 mts as all the equipments were available readily in my first aid pouch in hand,at GH Arakonam brought by a lady plastic surgeon from TI CYCLES INDIA from ambathur in the year-1978-79
7)there are another 50-60 such rare cases.

MY  SPECIAL INTEREST
-------------------------------
1)TO GIVE SECOND MEDICAL OPENION when first is doubtful(offered by another docter)
2)many novel ways to stimulate childrens intellectual potential
3)neonatal resucitation at nomal or caesarian delivery--at 100% success rate
4)any challanging type of case.

Wednesday, June 13, 2012

EVIDENCE OF INTELLIGENCE AT AGE ONE MONTH

1)HEAD CIRCUMFERANCE-BIRTH 35CM--1 MONTH-37 CM
2)USE OF SPECIAL SENSES.EYES/EARS/SKIN/SMELL/HEARING/VOCAL SOUND PRODUCTION 3)EYE CONTACT 4)HEARING REACTION5)SMELL REACION
6)ATTEMPT FOR COMMUNICATION (BODY LANGUAGE) 7)STRAINING DURING DEFECATION/MICTURITION8)CRY IN UNPLEASANT ATMOSPHERE.8)SOUND PRDUCTION REPEATEDLY &MEANING FULLY,AS IF PARTICIPATING IN A DIALOGUE

If all these or majority are not present even at age 3 months-baby needs complete evaluation
&assessment of intellctual capability so that correction if necessary can be done earlier--for example
if hypothyroid state is left un diagnosed there will be mental retardation due to BRAIN TISSUE DESTRUCTION-WHICH IS IRREVERSIBLE

HYGIEN&SANITATION-NEWBORN BABY

)for bath;-wait for seven days for umbillical stump to fall.2)till then clean baby with soapin wet cloth over axilla/neck/groin/genitals twice daily 3)elders with cough should wear mash 4)WASH FIRST
HANDSthen touch baby.5)DONT TOUCH BABY'S LIPS6).(CUT mother's knails twice a week)7)wash axilla ,change blouse before feeds 8)prevent mosquito bites(can cause 52 types of fevers)

VACCINATION-AGANST WHAT DISEASES:--
1)TUBERCULOSIS
2)POLIOMYELITIS
3)DIPHTHERIA
4)WHOOPING COUGH
5)TETANUS
6)MEASCLES
7)MUMPS
8)RUBELLA(GERMAN MEASCLES)--(DANGEROUS IN PREGNANCY)
9)CHICKEN POX
10)HIMOPHILUS INFLUENZA-TYPE B(AGAINST BRAIN/LUNG INFECTION)
11)TYPHOID
12)ROTO VIRUS DIARRHOEA

OTHER VACCINES
MENINGOCOCCAL--AGAINST BRAIN INFECTION
PNEUCOCCAL--AGAINST LUNG INFECTION(AT 2,4,6 MONTHSOF AGE ONLY)
HUMAN PAPPILLOMA VIRUS-AT
 AGE 12 FOR FEMALES PREFERABLY AGAINST CANCEROFCERVIX OF UTERUS.


DIET--UPTO AGE ONE YEAR
1)EXCUSIVE BREAST MILK UPTO AGE 3MONTHS(in case of non availability-formula feeds.)
2)BM +FORMULA UPTO 6 MONTHS.
3)BM+FORMULA+CEREAL AT AGE 6 MONTHS-I YR.
4)START EGG WHITE/FISH/DAL+GHEE AFTER 6 MONTHS ONCE DAILY+MILK I000 ML DAILY AFTER CHILDS WT AT8-10 KG
5)FULL FAMILY DIET AT AGE I YR.
^)FRUIT JUICE AFTER 6 MONTHS
7)AVOID FRESH COWS MILK/POCKET MILK ALLWAYS
8)WATER NOW &THEN FROM NEWBORN STAGE ONWARDS


CHILD HOOD ACCIDENTS
---------------------------------
1)STARTS FROM BIRTH ONWARDS--BY MULTIPLE MEANS
2)MILK ASPIRATION--DEADLIEST
3)SUDDEN INFANT DEATH SYNDROME
4)INSECTSTING
5)FALL FROM COT WINDOWS/HEIGHTS
6)BURNS /SCALDS/ DROWNING/ SUFFOCATIONWITH PLASTIC BAGS
7)PEER INDUCED DANGERS
8)BEWARE OF DOGS CATS  PETS RATS
9)MOSQUITONET
10)CHILD LIFTING
11)TABLET INGESTION
12)PHENYLE/DETTOL INGESTION.
13)KEROSENE OIL INGESTION
14)BIG WATER FILLED CONTAINERS WITHOUT LID
15)CHILD PROOFING ARRANGEMENTS-Eg-STAIR CASE.
16CHILD PROOFING WINDOWS-EgUSA HOUSES.
17)FIREIGN BODY-INGESTION/PUTTING INSIDE ,EAR/NOSE/THROAT
18)MANY MORE UN IMMAGINABLE WAYS

IMAGINABLE WAYS

Tuesday, June 12, 2012

HOW TO FEED THE NEW BORN BABY

1)Baby's position should be vertical
2)never feed baby in lying position(beware of aspiration-milk into respiratory pathway)-may lead to suffocation.3)dont give prolonged feeding-finish it in 10 mts.4)BURPING IS ESSENTIAL AFTER ALL FEEDS.5)PLACE BABY IN HEAD RAISED POSITION.6)MILK REQUIREMENT;-approximately 100 ml per kg per day in 8-10 devided dose7))breast feeding can be started after 2 hrs of delivery 8)first 3 days' milk is important,as it contains CHOLOSTRUM-a product not availble commercially,&it contains life savingchemical substance necessay to fight against disease producing microbes specially against neonatal diarrhoea.9)feeding bottle sterilisation is an art &learn it from adoctor.

Monday, June 4, 2012

LOOKING AFTER a new born baby

1) mother &grand mother alone should handle baby.
2)Avoid mosquito bite/flies sitting on baby's mouth
3)Those who cough should not come near the baby
4)put the baby on a hanging saree-better than other options
5)beware of scorpions/bees/pet animals/kidnappers
6)umbrella mosqito net helps in many ways

DELETERIOUS EFFECTS OF COW'MILK

1)ALERGY-SKIN,GASTROINTESTINAL TRACT(ABDOMINAL PAIN,VOMITING)
2)LACTOSE INTOLERANCE-CAUSES DIARRHOEL DISORDER IN INFANTS,SPECIALLY
NEW BORN BABIES3)ASTHMA-WHEEZY BRONCHITIS.4)COW'S MILK PROTIEN INDUCED ENTEROPATHY--DIARRHOEA(TREAT WITH SOYABEEN MILK)5)JUVENILE DELINQUENCY
--YOUNG CRIMINALS IN MINOR JAIL.6)POOR ACADEMIC PERFORMANCE---LOW MARKS IN SCHOOL/ SCHOOL DROP OUTS.(TREAT WITH FORMULA FEEDS UPTO AGE 5--AND NEVER WITH FRESH COW'S MILK/PACKET MILK)

Monday, April 23, 2012

mender of bad soles

1)itching-pruritis 2)painful soles #corn soles often give troubles to senior citizens,specially at nights--intolerable itching senseon soles of the feet.Though the problems are many like 1)itching-pruri tis2)painful soles 3)corn soles 4)numbness 5)loss of touch sense 6)hypersensitveness 7)ulcer feet due to diabetes mellitus with attendant complications.Many cases of dibetes diagnosed only after itching developed on the soles.now we will take up only itching sense for quick relief a reason for the same.
; In the older age group of persons many people suffer from&; arterial narrowing leading to 1)atherosclerosis(cholestrol blocking the vessel 2)calcium deposition  in the inner layer of blood arterial vessel wall of cappilaries. causing narrowing  leading to less blood supply to tissues-expressed as itching sense  specially at dead hour of the night disturbing.dermatologist will&; presc ribe a mosturising soap ,mosturising cream/lotion antihistamine tablet at night +tab trigobantin100 mg -od 10 DAYS,THEN 300 MG OD FOR FEW MONTHS

best solution:foot exercise& at 9-10; in lying position flexing &extending al 10 toews for 50 times thrice within 9-10 pm you will not have pruritis because the blood supply becomes adequate


Friday, April 6, 2012

pediatric medical camp

1) all new born baby problems
2)how to prevent AGE/PNEUMONIA
3)Immnisation procdures
4)NEW BORN SCREENING TESTS

PHENYL KETONURIA
mapple syrup urine disease
sickle cell disease
biotinase defficiency
congenital adrenal hyperplasia
hypothyroidism
galectosemia-blindness
toxoplamosiscystic fibrosis
tyrosinosis

5)how to detect intellectual develope ment
6)LBW BABY MANAGEMENT
7)feeding problems
8)bottle sterilisatinmanagement of cry problem
9)accidents
10)neonatal resusitation
11)asphyxia
12)prenatal advice to pregnanat mothers

inj-tt-2 doses
folicaciddd soya

eggs






complete rest
total rest if previous h/oabortion
cervical suturing
good food to increase baby weight
13)new born--prevent infection
14)immunisatione
aspiration/fall/sibblingcarrying the baby/ child lifting/smothering
18)diet
BM
formula
no fresh milk
egg white
lean fish
19)sleep-swoddling/gentle shaking/llullaby