HOW DOES BRAIN FUNCTION-NORMALLY

WHAT IS BRAIN?

--------------------

THIS IS A BUNDLE OF COLLECTION OF ELECTRICAL WIRES COMPOSED OF NEURONAL TISSUES,VERY COMPLEXLY INTERCONNECTED TO VARIOUS ORGANS &WITHIN ITSELF

&OWEN LKE A SWEATER, MILLION TIME MORE COMPLICATED.

2)HUNDRED &THOUSANDS OF NEURONS FUNCTION WITH OTHER NEURONS THROUGH INTER CONNECTIVITY.

3)THEY PRODUCE ELECTICITY CONSTANTLY

4)THEY TRANSMIT IMPULSES  TO DESIRED DESTINATIONS.THE NUEROTRANSMITTERS ACT LIKE CATALYST FOR FINAL TRANSMISSION OF IMPULSES AT TARGET LEVEL

5)DIFFERENT NEURONES
 DO THEIR FUNCTIONS INDEPENDANTLY &COORDINATE WITH OTHER FUNCTIONS TO ACHIEVE FINAL ACCOMPLISHMENT OF DESIRED WORK.

6)SOME FUNCTIONS ARE ,MOTOR,/SENSORY/EMOTIONAL/REFLEX

7)TO ACHIEVE THIS NORMAL SCORE NEURO ANATOMY,PHYSIOLOGY,&BIOCHEMISTRY,A GOOD BLOOD SUPPLY IS ESENTIAL& SHOULD BE PROVIDED AS SOON AS BIRTH OCCURS WITHIN 10-20 MINUTES(APGAR

SCORE DESIRED IS 10/10)

PATHO-PHYSIOLOGY

--------------------------

ALL BRAIN BLOOD VESSELS ARE NOT OPEN AT BIRTH.MANY ARE NOT PATANT.THEIR 

PATENCY IS OPENED ,BY INCREASE IN BLOOD PRESSURE DUE TO NEONATAL .LUXURIOUS CRY. ,RESULTING IN VARIOUS  GOOD CONNECTIVITY.  ABSCENCE OF SUCH CRY CAN CAUSE SIGNIFICANT DIFFICIENCY RESULTING IN VARIOUS DISABILITY OF WHICH

AUTISM IS VERY IMPORATANT(CONCEPT STESSED BY THIS AUTHER)

ROLE OF NEUROTRANSMITTERS.

----------------------------------------

SEROTONIN

---------------- SECRETION RESPONDS TO SENSORY INPUTS RECIEVED BY ALL 5 SPECIAL SENSES.

DOPAMINE:--TOO MUCH DOPAMINE SECRETION AFFECT EMOTIONAL STATE,ABILITY TO CONCENTRATE &ABILITY TO LEARN

GABA --PREVENTS OTHER AREA OF THE BRAIN FROM OVER STIMULATED BY BALANCING OTHER TRANSMITTERS

AUTISM-CAUSES

1)GENETIC--5-20 GENES AS CLUSTER GROUP
2)HYPER IMMUNE STATE
3)FRESH COW'S MILK(NOT IN FORMULA TINNED POWDER)
4)DRUGS TO ANTINATAL MOTHERS
5)ALL VACCINES FROM BIRTH-3 YEARS--SPECIALLY DPT CONTAINS ALUMINIUM
ALSO IMMUNOGLOBULIN MEDIATED ADVERSE REACTON
MULTIPLE VACCINES ON SAME DAY-SOME PRODUCE PLATLET DEFICIENCT CAUSING INTRA CRANIAL HAEMORRHAGE,LEADING TO NUERONAL DAMAGE

6) ANY DAIRY PRODUCT
7)GLUTEN--A PROTIEN CONTAINED IN WHEAT
8)IMPAIRED CORTICAL ACTIVITY--CONGENITAL/AQUIRED
9)FAILURE OF FUNCTION OF FOLLOWING COGNITIVE AREAS OF THE BRAIN
a)LANGUAGE COMPREHENSION
b)VISUO SPATIALPROCESSING
c)SOCIAL COGNITION
d)EXECUTIVE FUNGTIONING
11)DIFFERENT GUT FLORA(URINARY METABOLIC PHENOTYPING)
12)IRREGULAR WHITE MATTER TRACT LEADING TO REDUCED ANATOMICAL CONNECTIVITY OR FUNCTIONAL UNDER CONNECTIVITY WHICH MAY BE CONGENITAL OR AQUIRED.
13)INCREASED SIZE OF AMYGDALA,AROUND AGE ONE YEAR DISRUPTING CONECTIVITY(DIAGNOSIS BY FMRI)
14)ANOXIC BRAIN DAMAGE AT ANY AGE SPECIALLY DURING IMPROPER NEONATAL RESUSSITATION

NEONATAL RESUSSITATION--AUTHER'S STATISTICS

THE FOLLOWING ETIOLOGICAL FACTORS WERE ENCOUNTERED  FOR NEONATAL RESUSSITATION DURING A 5YEAR STUDY:--

CAUSE                                                        NO.OF CASES             PERCENTAGE
1)FOETAL DISTRESS
UNCASSIFIED                                           144                                 18.23
2)LSCS                                                         140                                 17.72
3)DIFFICULT LABOUR
PROLONGED PERINATAL PERIOD           72                                   9.11
4)EARLY RUPTURE OF MEMBRANE         64                                   8.10
5)PRETERMS                                                 144                                  18.23
6)CORD AROUND NECK                             62                                      7.8
7)AMNIOTIC FLUID ASPIRATION               40                                      5.06
8)BIG BABIES                                                   36                                     4.55
9)MECONIUM ASPIRATION                           30                                     3.79
10)LBW                                                               12                                     1.5
11)HAND PROLAPSE                                        16                                      2.02
12)CORD PROLAPSE                                         12                                      1.5
13)SHOULDER PRESENTATION                        6                                       0.75
14)BREACH(VAGINAL DELIVERY)                   6                                        0.75
15)TRANSVERSE LIE                                          6                                        0.75
------------------------------------------------------------------------------------------

SHOWING THERAPEUTIC EFFICACY OF RESUSSITATION TECHNIQUE


TACTILE STIMULATION                                  461                                     59.0
TRACHEAL SUCCTION                                    188                                     23.5
DRUG STIMULATION                                        141                                     17.5
TOTAL                                                                  790                                      1OO SUCCESS RATE                          

AUTISM--MOTOR EXERCISE FOR MOUTH& PHARYNX /STIMULATE SENSATIONS

AS THERE WILL BE ATLEAST A MINIMAL HYPOTONIA IN MAJORITY CASES , PHYSIOTHERAPY SHOULD BE GIVEN TO THE ENTIRE BODY /UPPER &LOWER EXTRIMITY

BESIDES CHILD MUST DO THE FOLLOWING

1)CHEWING MOVEMENTS  2)SWALLOWING MOVEMENTS 3)BLOWING AIR(BALOON WITH A TUBULAR STICK) 4)BLOCK CHILD'S NOSE--ALLOW TO BREATH THROUGH MOUTH 5)BLOCK MOUTH--ALLOW TO BREATH THROUGH NOSE.

ALL THE ABOVE  HELPS THE CHILD TO SWALLOW BETTER & FOR BETTER PHONATION

TO STIMULATE SENSORY SYSTEM

-------------------------------------------

POUR HOT WATER &COLD WATER ALTERNATIVELY ON LOWER &UPPER LIMBS FOR 

5 MINUTES IN THE MORNING &EVENING DAILY

AUTISM &EYECONTACT

WHAT IS AN EYE CONTACT?
WHEN TWO PEOPLE MEET &LOOK AT EACH OTHER'S EYES AN EYE CONTACT IS SAID TOHAVEBEEN ESTABLISHED.THIS IS AN IMPORTANT SIGN OF INTELLIGENCE IN A CHILD'S DEVELOPEMENT. THIS MAY BE PRESENT FROM 1-3 MONTHS OF AGE.IF NOT IT NEEDS DOCTORS OPENION.

IN THE CASE OF AN AUTISTIC CHILD  EYE CONTACT IS ABSCENT & IS A SIGN  QUO NON
OF A BEHAVIOURAL DISORDER EXISTING.

HOW TO ESTABLISH EYE CONTACT WHEN IT IS ABSCENT?
1)TRAINERS EYE MUST BE AT THE SAME LEVEL AS OF PATIENT.IMMOBILISE CHILD IN A CHAIR.ADJUST CHAIR HEIGHT ACCORDINGLY
2)TRAINER MUST HAVE A CATCHY EYE FRAME PREFERABLY DECORATED WITH TINY COLOUR BULBS.
3)TRAINER MUST TOUCH HIS OWN NOSE SEVERAL TIMES WHILE TEACHING
4)PASTE SOME SMALL STICKERS ON TRAINER'S FOREHEAD
5) BIG RINGS MAY HANG O THE EARS OF THE TRAINER TO ATTRACT ATTENTION OF CHILD
6)CHILD'S FACE SHOULD BE IMMOBILISED LIKE OPHTHAL MICROSCOPE EXAM
7))A THIN HARD BOARD BOX MAY BE DESIGNED LIKE HELMET WITH A PROJECTILE
SIIGHT OBSTRUCTION ON  BOTH EYES LATERALLY ONLY, SO THAT CHILD IS COMPELLED TO SEE STRAIGHT
 

SIGNS OF INTELGENCE IN CHILDREN

FOLLOWING ARE SIGNS OF INTELLIGENCE(SOI)AT VARIOUS AGE OF CHILDS
MENTAL DEVELOPEMENT:
A)30 DAYS)CAN FIX EYE CONTACT ,COMMUNICATE VISUALLY &VERBALLY &BY BODY LANGUAGE.CAN HEAR ALSO.
B)AGE 3 MONTHS--ALL THE ABOVE.IF NOT SUSPECT CNS DEFECT. KEEP YOUR OBSERVATION SHARP.CONSULT A DOCTOR.
C)1-2 YRS.--VOCAL SOUNDS MEANINGFUL WORDS LIKE MAMA DADA ,PAPA OR ANY OTHER WORD LIKE MMM, GA GA VERY GOOD EYE CONTACT.UNDERSTANDS WHO IS THE MOST IMPORTANT IN THE FAMILY
D)3 YRS.--SHOULD SPEAK MORE THAN 20 WORDS
E)CAN TELL STORIES IN 10 SENTANCES

ACHILD WHO DREAMS OFTEN LIKELY TO HAVE LESS MEMORY
A CHILD WHO GRINDS TEETH MAY HAVE LESS MEMORY.
A CHILD WITH SEIZURE(FITS) DISORDER  MAY HAVE TENDENCY FOR MENTAL DISORDER THESE CHILDREN CAN BE TREATED BY APPROPRIATE DRUGS ,BEHAVIURAL THERAPY &OCCUPATION THERAPY
drselvarajp@yahoo.com
AN  OFTEN CRYING CHILD NORMALLY HAS ABOVE NORMAL INTELLIGENCE
A CHILD WHO MAKESTHROATY VOICES EARLY COULD SPEAK EARLIER
A CHILD WITH EXCESS SALIVATION COULD SPEAK EARLIER
A THUMB SUCKING CHILD IS USUALLU FOUND TO HAVE ABOVE NORMAL IQ.

RESPIRATORY DISTRESS SYNDROME ( R D S)

This is common problem very often noticed  in very low to extremely low birth weight babies usually below 1200 Gms.The lungs of these babies  can not inflate or deflate like normal babies during respiration due to lack of elasticity in the finer bronchioles &alveoli & is due to a deficiency or abscence of a surfactant.This is in short due to a lack of pulmonary maturity in the intra uterine life where lungs dont breath & are liver like in consistancy. once the lung maturity is satisfactory it is ready for air entry &exit.this happens usually after 28 weeks of pregnancy or the foetal weight is above 1200-1500g.under such circumstances the obstetricians

usually push in inravenous steroids to expedite lung maturity,when the pregnancy threatens for a delivery.the obstetricians will adopt various ways to postpone delivery.If delivery is inevitable &the baby is born with a weight of below 1500 g,the neonate may develope RDS.Though the prognosis is bad mortality is high some surfactants are usually tried,intra tracheally through a catheter via endotracheal tube slowly  drop by drop to fecilitate breathing.The success rate is very small However the following drug may be tried(along with steroid

intravenously)(usually procured &kept ready,in anticipation of a premature delivery)

DRUGS USED IN SURFACTANT REPLACEMENT&THEIR DOSAGE.(can be repeated 6-12 hourly 

intra-tracheally)totally 4 to 8 doses can be given    ;

surventa(bovine)  100 mg /kg/dose                                MEDICAL ALERT 1-800-8170895

 infasurf(calf)        105mg/kg/dose

curosurf(porcine)  100-200mg/kg/dose

alveofact(bovine)   50mg/kg/dose

bles(bovine)          135mg/kg/dose

surfactan(bovine)   100mg/kg/dose                               drselvarajp@yahoo.com

CHILD WHO REFUSES TO EAT--CONTINUED

11.AVOID GIVIG SNACKS BEFORE MEAL TIME
12.ENCOURAGE TODDLER TO HELP YOU IN THE KITCHEN IN SMALL WAYS LIKE' PICK THAT ONION'HE MAY SHOW INTEREST TO EAT THE FOOD HE HAS HELPED.
13.SNACKS AT 10.30 &4.30.ONLY
14.EAT ALONG WITH YOUR CHILD.
15PREFERABLY NO TV DURING FOOD.
16.USE DIFFERENT COLOR PLATES EVERY DAY(ASK WHAT COLOR DO YOU LIKE TODAY)
17.GIVE HIS FAVOURITE SAUSE/KETCHUP/MAPLE SYRUP.THEY LIKE TO DIP FOOD IN JAM SAUSE.
18.ASK CHILD TO GIVE HIS CHOICE OF FOOD
19.AVOID OFFERING REWARD FOR EATING
20.AVOID PUNISHING FOR NOT EATING
21.TRY
TO DISTRACT ATTENTION BY SHOWING SOMETHING NEW OR A STORY &FEED WHEN HE IS UNAWARE
22.ALLOW ANOTHER NEIGHBOUR'S CHILD TO EAT ALONG WITH IF POSSIBLE
23.FIND OUT WHICH OF THE TRICKS MAKE HIM EAT &REPEAT SAME OFTEN
24.PULL OUT A BANGLE FROM YOUR ARM &PLACE IT OVER YOUR EARS.HE WILL ASK FOR THE SAME.DO IT.(ATTENTION DISTRACTED .NOW FEED HIM.
25)SHOW DRUM BEATING MONKEY TOY/JUMPING FROG TO DISTRACT ATTENTION.
26.IF  ALL ATTEMPTS FAIL-DONT GIVE UP HOPE.WAIT FOR ONE HOUR&RESTART EXERCISE OR WAIT TILL HE FEELS HUNGRY,&CRIES AS AN INDICATION.

drselvarajp @yahoo.com

CHILD WHO REFUSES TO EAT

THIS OCCURS FROM AGE 1-6 YRS.THIS THE CHIEF COMPLAIT OF ALL MOTHERS THROUGHOUT WORLD.A CHILD ALWAYS WANTS TO PLAY.
.WHAT ARE THE DOs &DONTs
DONTS.
1)DONT SHOUT AT CHILD
2)DONT BEAT CHILD
3)DONT DO FORCE FEEDING
$0EVEN IF YOU ARE ANGRY DONT SHOW.ACT AS IF YOUARE NOT
5)NEVER USE FRESH LIQUID / BOTTLED COW'S MILK
(PREFER FORMULA  POWDER MILK)
6)DONT PLAY TV AS THAT WOULD BECOME HABITUAL


DOs
-----
1. BE PATIENT.SHOW MORE LOVE & AFFECTION.HUG HIM KISS HIM
2.SHOW SURPRISES.BUY NEW TOYS .KEEP HIDING.
3 USE DIFFERENT COLOUR SPOONS/PLATES/CUPS.ASK CHILD WHICH COLOUR HE WANTS
4)ALWAYS EAT THE FOOD BEFORE GIVING TO CHILD.IT MAY BE UNDULY HOT /COLD/SALTISH/ NO SWEET
5)AT ABOUT 3 YRS OF AGE ,TELL SOME READY MADE STORIES..AFTER EACH 3LINES OF STORY GIVE FEED ,WHILE HE IS CONCENTRATING ON THE STORY.
6.INCULCATE DISCIPLINE BY FEW WORDS OF COMMANDS LIKE ,SIT STAND CLOSE EYES TOUCH SCALP,ETC
7 MAINTAIN ROAD TO HEALTH CHART.IF WEIGHT GAIN IS SATISFACTORY,DONT WORRY.
8.GIVE PROTIENS DAILY LIKE FISH/EGGS/ CEREALS/MILK/SOYABEEN MILK
9FEED TODDLER AT SAME TIME,SAME PLACE EVERY DAY
10.WAIT TILL HE GETS TIRED IF HE IS PLAYING
10.GIVE A CALM ATMOSPHERE PREFERABLY

BRAIN EATING AMOEBA (NAEGLERIAFOWLERI)

EVER SINCE ITS DISCOVERY IN 1965,THE DIAGNOSIS IS DIFFICULT & MORTALITY CONTINUES TO BE HIGH.
WHAT CAN WE DO TO BRING DOWN MORTALITY?
THE FIRST PHYSICIAN WHO TREATS THE CHILD OR ADULT SHOULD ASK HIM SELF WHEATHER THE FOLLOWING POINTS CHECKED.

1,FEVER.
2,HEADACHE-ANTERIOR/POSTERIOR/TEMPORAL/EYEPAIN.
3,VOMITING/BLURRING OF VISION.
4,FITS ( SERIOUS).
5,NECK STIFFNESS (SERIOUS).
6,DECREBRATE SPASM (SERIOUS).
7,H/O SWIMMING IN POND/POOL/LAKE/UNDER WATER WARM WATER POOL.
8,SYMPTOMS WITHIN 2-5 DAYS AFTER SWIMMING.
9,H/O NASAL ASPIRATION OF SWIM WATER (SPREADS THROUGH OLFACTORY NERVE ENDING)
10 CAREFUL OBSERVATION &MASTERLY EXPECTANCY TO DO A LUMBAR PUNCTURE FOR CSF EXAM&IF NECESSARY REPEATED LPs.ONCE THE DIAGNOSIS IS CONFIRMED OR SUSPECTED TREATMENT SHOULD BE STARTED AS FOLLOWS ON A SCIENTIFIC CONCEPT.MANY DRUGS ARE USED FROM SULPHADIAZINNE /COLLOIDAL MERCURY TO NEWER DRUGS RIFAMPICIN ,AMPHOTRESIN-B/OTHER ANTI FUNGALS LIKE FLUCALAZOLE OR ANTI-BREAST CANCER DRUGS--ALL ARE ONLY EMPIRICAL &NOT PROOVEN.SO FOR ONLY SUCCESS RATEIS 10-20%.UNDER SUCH CIRCUMSTANSES
WHY NOT WE TRY ANY TWO OF THE FOLLOWING DRUGS?
1PRAZIQUENTAL
2RIFAMYCIN(ORAL/INTRA THECAL)
3)CHLOROQUIN-ORAL
4)METRANIDAZOLE-I.V

PRAZIQUENTAL
DRUG OF CHOICE TO TREAT NUERO CYTICERCOSIS. WITH CYSTIDE ORALLY.THIS IS DOCUMENTED IN TWO MEDICAL TEXT BO0OKS
ONE OF THE BEST ANTIPARASITIC IF BRAIN IS INVOLVED.DRUG ANAPHYLAXIS IS COMMON

CHOROQUIN
USED FOR CEREBRA MALERIA &TO KILL ENTAMAEBA HITOLYTICA.I.V USE IS DANGEROUSMAY RESULT IN SEVERE ANAPHYLAXIS

RIFAMYSIN
GOOD ANTI TB DRUG..FREQUENTLY USED FOR NEONATAL PYO-MENINGO ENCAPHALITIS.USED INTRATHECALLY VIA ANTRERIOR FONTENELLE
ANY OF THIS CAN BE USED DISSOLVING IN WATER ,GIVEN THRO NASOGASTRIC TUBE

METRANIDAZOLE
.USED FOR EH 7LATER FOR ANAEROBIC SEPSIS USED BY IVDRIP IS BETTER..ANY TWO DRUG THERAPY CAN BE USED ON ANA EXPERIMENTAL BASIS.THIS ONLY A CONCEPTUAL THINKING.

drselvarajp@yahoo.com-----ph;9841354335

SPONTANEUS HUMAN COMBUSTION ---2 HYPERBARIC OXYGEN THERAPY

Though the condition itself is questioned by few as impossible the scientific concept is methane gas production from methogenic aerchibacteria which is an anerobe.

Hyperbaric oxygen: one of the theoritical approach is by use of hyperbaric oxygen which is when administered in recommended dose to affected patients the tissue concentration of will increase &kill this archibacteriawhich will die inthe presence of increased oxygenthat is inimical.HBO increases oxygen at cellular level for burns &wounds(already documented)possible side effect of HBO;--DAMAGE TO EARS &LUNGS&SAND MYOPIA.

ANOTHER THEORY FOR COMBUSTION:
During the flow of electricity any short circuiting can produce a spark&cause combustion.Human brain keeps producing electricity&transmits impulses throughout the body constantly.References available that short circuiting of electricity does occur in some individuals.Fits &heartirregularities are nothing but a kind of short circuiting,inbody's electricity flowThis could easily ignite a highly inflammable gas like methane produced by certain special microbes in the body decided by certain special genesfound in our ancesters who lived few hundred/thousand years ago.(A research study reveals that certain special chromosomes were found in Madurai(tamilnadu-india) humans that are found in certain humans who lived in Africa many hundred years ago.

SPONTANEOUS HUMAN COMBUSTION (SHC) &TREATMENT

REF;-AN INFANT ON TREATMENT AT KMC HOSPITAL FOR BURNS DUE TO SPONTANEOUS COMBUSTION-YESTER DAY
The causative methogenic microorganism is archaeobacteria which is an anaerobe(needs no oxygen to live)

Treatment:metranidazole is a time tested anaerobic antibiotic over 3 decades So theoritically this may be a logical treatment option Child may require along term prophylactic therapy with this drug

Recomended drug dose:7.5 mg 8hrly/kg for 7 days-iv/oral,followed by 4mg/kgdaily once oral for 7days,then 4mg/kg twice weekly for 6 weeksto make organisms impotent.May requirerepeat prophylaxis after skin &stool culturerepeatedly.Skin culture is necessary as the mathane gas evaporation is through skin..So like staph,strepto this methogenic organism's presence in the skin has to be ruled out

Auther's ID drselvarajp@yahoo.com---phone9841354335

a tribute to a GREAT MOTHER BY SON

AUTISM&APGAR SCORE--91

ABSTRACT :THIS IS A PEDIATRIC NEUROPSYCHOLOGICAL COMMUNICATION DISABILITY.CAN BE CONGENITAL/ACQUIRED .MORE THAN 13 CAUSATIVE FACTORS SAID TO BE RESPONSIBLE ABSENCE OF FIRST NEONATAL CRY IMMEDIATELY AFTER BIRTH OR ZERO APGAR SCORE AT 5 MINUTES AFTER BIRTH COULD BE A CAUSE FOR AUTISM (AUTHOR'S VIEW)SUCCESSFUL NEONATAL RESUSCITATION COULD PREVENT AUTISM,BECAUSE WHEN A NEONATE CRIES  WELL ,ALL THE BRAIN BLOOD VESSELS OPEN (OPENING  PATEN CY OF NON PATENT VESSELS IS IMPORTANT),LEADING TO GOOD TISSUE PERFUSION FOR AN ANATOMICAL,PHYSIOLOGICAL,&BIOCHEMICAL STABILITY OF ALL NEURONS &THEIR SYNAPTIC PATHWAYS &CONTROLLED PRODUCTION OF NUEROTRANSMITTERS.A GOOD CRY AT BIRTH &APGAR7-10 IN 10 MTS
,ESSENTIAL FOR A SUCCESSFUL RESUSCITATION FOR A NORMAL CNS FUNCTION
ZERO APGAR AT BIRTH &UPTO 10 MTS OF BIRTH OFTEN RESULTS IN  ANY CNS DISORDER& OFWHICH AUTISM IS GAINING IMPORTANCE IF WE LOOK INTO AMERICAN STATISTICS.

INTRODUCTION:-AUTISM SPECTRUM DISORDER NEEDS THOROUGH REVIEW.
LACK OF PROPER CRY  AT BIRTH RESULTS IN POVERTY.IN NUERAL TISSUE PERFUSION RESULTING IN SUCH DIABILITY.WHEN ABABY IS BORN WITH ZERO APGAR DOCTORS USUALLY TRY AMBU BAG/VENTILATTERS,&THE RESULTS ARE OFTEN NEGATIVE..WHERE AS SODABICARB+GLUCOSE GIVEN INTRA UMBILLICALLY(SOMETIMES BY UMBILLICAL VEIN CATHTERISATION,INTO  I V C
RESULTS IN SUCCESS.AUTHOR STRESSES THIS POINT BASED ON HIS 20 YRS PURE NEONATOLOGY EXPERIENCE.

MATERIALS &METHODS:

AUTHOR'SPEDIATICEXPERIENCE--40 YRS.DELIVERED OVER 500 BABIES IN 10 YEARS.
10% DEVLOPED SERIOUS PROBLEMS(MOSTLY URBAN AREA)--MOSTLY APNEIC SPELLS.
2% HAD ZERO APGAR,LASTING FROM 5-20 MINUTES.NO SYSTAMATIC STUDY,LIKE ESTIMATION OF BLOOD PH/ELECTROLYTES/PCO2,PULSE OXYMETER DUE TO WANT OF FACILITY.THE TREATMENT PROTOCOL WAS CHANGED BASED UPON THE OUTCOME
EVERY 2-3 YRS TILL THE FINALISED TREATMENT PROCEDURE GAVE 100% SUCCESS.
30% CASES FOLLOWEDUPTO ONE YEAR.THEY SHOWED GOOD  IQ/MQ REQUIRED FOR AN AVERAGE CHILD

DISCRIPTION OF DISORDER
MANIFEST IN MORE THAN 20WAYS.MOST IMPORTANT ARE
1)DO NOT HAVE DIRECT EYE CONTACT WITH OTHERS.THIS IS ALMOST A SIGN QUO NON OF AUTISM
2)EVADE ALL SOCIAL CONTACT,INCLUDING MOTHER


3)BEHAVE AS IF DUMB OR DEAF
4)DOING REPETITIVE MOVEMENTS
5)SOME DELAY IN THE DEVELOPEMENT OF MILE STONES
6)MANY CNS VARIATIONS IN BEHAVIOUR PATTERN
7)SCHOOL CHILDREN DONT SIT IN ITS PLACE OR OBEY TEACHER

A NORMAL CHILD CAN BE IDENTIFYED IN 1-3 MONTHS(AT THE MOST 6MONTHS)

ETIOLOGY
1)GENETIC--5-10 AS GROUPS/CLUSTERS
2)HYPERIMMUNE STATE
3)FRESH COWS MILK
4)DRUGS TO ANTINATAL MOTHERS
5)VACCINES--ALMOST ALL.--LITERATURE EVIDENCE FOR &AGAINST
6)ANY DIARY PRODUCT
7)GLUTEN
8)IMPAIRED CORTICAL ACTIVITY
9)FAILURE OF BRAIN FUNCTIONS IN CERTAIN AREAS
10)DIFFERENT GUT FLORA(URINARY METABOLIC PHONOTYPING)
11)IRREGULAR WHITE MATTER TRACT
12)INCREASED AMYGDALA SIZE AROUND AGE ONE(fMRI)
13) ANOXIC BRAIN DAMAGE AT ANY AGE SPECIALLY IMPROPER NEONATAL RESUSCITATION(AUTHOR'S VIEW)

PATHOPHYSIOLOGY
TO ACHIEVE NORMAL NUERO ANATOMY,PHYSIOLOGY &BIOCHEMISTRY A GOOD BLOOD SUPPLY IS ESSENTIAL&SHOULD BE PROVIDED AS SOON AS BIRTH TAKES PLACE  WITHIN 10-20 MTS OF NEONATAL RESUSCITATION.ALL BRAIN BLOOD VESSELS ARE NOT PATENT  AT BIRTH THEIR PATEN CY IS OPENED BY ANA INCREASE IN BLOOD PRESSURE
DUE TO NEONATAL CRY &ITS ABSENCE CAN CAUSE SIGNIFICANT DEFICIENCY, RESULTING IN VARIOUS DISABILITY OF WHICH AUTISM IS IMPORTANT


DISCUSSION
STATISTICS;--1 IN 50 CHILDREN  IN USA.---1 IN 100 IN   UK
23 % OF PEDIATRIC POPULATION,--IN USA--2006--(CDC)
300 000 SCHOOLCHILDREN DIAGNOSED IN USA--2003--2004
LIFE TIME COST OF EACH INDIVIDUAL--3 MILLION USD
8CASES ARE DIAGNOSED EVERY DAY AS AUTISM IN CALIFORNIA ALONE

IT IS TIME RESEARCHERS THINK OF PREVENTING THIS IF POSSIBLE.ONE SUCH CONCEPTUAL THOUGHT IS A REVIEW OF NEONATALRESUSITATION PROTOCOL BY AN APPROPRIATE EXPERT COMMITTEE  CORD CLAMP USUALLY TRIGGERS THE RESPIRATORY CENTER TO INITIATE RESPIRATION.IT FAILS IF ACIDOSIS IS MORE
THERE FORE WHILE SODABICARB WHILE CORRECTING BLOOD PH IT ALSO TRIGGERS RESPIRATORY CENTER,STIMULATING TO INITIATE RESPIRATION

INVESTIGATION/DIAGNOSIS/MANAGEMENT
THIS IS NOT PROBLEM AS THERE ARE LOT OF DEVIATION &MAJORITY OF CASES  DIRECTLY GO TO OCCUPATION THERAPISTS BY PARENTS(INDIA) THE TREATMENT IS PHYSIOTHERAPY,OCCUPATION THERAPY &SPEECH THERAPY EVERY CENTER HAS ITS OWN PROTOCOLS.WHAT IS IMPORTANT IS EARLY RECOGNITION OF THE CONDITION &EARLY INTERVENTION PROGRAMME ,PREFERABLY  BEFORE AGE 2.

DRUG THERPY
VARIOUS DRUGS ARE USED BY DOCTORS
FIRST LINE:RITALIN,ADDERALL VYVANSE(BUMATIDINE--LATEST)
SECOND LINE :ZOLOFT PROZAC WELBUTRIN
SAID TO HELP FIDGETING INATTENTIVENESS IRRITABILITY,TROBLE SLEEPING
 ENCOURAGE DISCIPLINE

SUMMARY
A CNS WITH DEFICIENT BLOOD SUPPLY AT BIRTH CAN NOT BE EXPECTED TO ACHIEVE ALL DESIRED FACULTIES LIKE COMMUNICATION SKILL THROUGH SPECIAL SENSES.
HENCE INEFFICIENT   NEONATAL RESUSCITATION COULD BE A POSSIBLE CAUSE FOR AUTISM  IF THE CRY &RESPIRATORY EXCURSIONS ARE ABSENT AT BIRTH. THIS IS PREVENTABLE BY GIVING SODA BICARB+GLUCOSE,THROUGH UMBILICUS(SOME TIMES BY UMBILICAL VEIN CATHETERISING AT A DOSE AS PER EXISTING ACIDOSIS
INVARAIBLY100% CASES CRY WITH GOOD RESPIRATION

A VERY GOOD NEONATAL CRY AT BIRTH IS CENTRAL POINT FOR WHOLE CONCEPTUAL THINKING BECAUSE MANY NEONATAL APNEA PERITATAL APNEIC SPELLS NEONATAL ASPHYXIA ARE MAINLY ABUSED FOR PRODUCTION OF CNS ABNORMALITY FROM CEREBRAL PALSY TO ALL FORMS OF MENTAL RETARDATION OR BEHAVIOUR ABNORMALITY INCLUDING AUTISM,LOW ACADEMIC PERFORMANCE,SCHOOL DROP OUTS.

CONCLUSION
IF THERE IS AN ACQUIRED CNS PROBLEM,USUALLY SOME EVIDENCE OF LACK OF BLOOD PERFUSION(OXYGEN) IN THE TISSUE.THE FIRST CRY OF A NEONATE DECIDE THE FATE OF  NEONATES CNS INTEGRITY.THOSE WHO DONT CRY UPTO 5-10 MINUTES AFTER BIRTH+ZERO APGAR,,OFTEN MEET WITH SOME PROBLEM,BIGGEST OF WHICH IS CEREBRAL PALSY,&THE SMALLEST IS AUTISM,BECAUSE NON PATENT CEREBRAL BLOOD VESSELS BECOME PATENT ONLY WHEN THE NEONATE CRIES INCREASING THE BLOOD PRESSURE OF HEAD &NECK,IMMEDIATELY AFTER DELIVERY

BEGGERMAID &THE KING--90

The begger maid &the king
----------------------------
this poem was in our syllbus for sslc 1954-55
I developed a taste for english literature after this poem.(I invite you to please visit my blog
"drpselvaraj.blogspot.com------my article AIDS in poetry--104 stanzas"I am greatly indebted to my father
v.parthasarathy.gupta.After 60 years Istill remember the poem.There are questions about the artist who painted the scenerio.I have some answers.The artist painted in vertical fasion, because the beggermaids beauty can be appreciated, from an above downwards view..There is another lady whoprobably from royal family is also appreciating.Lady appreciating another lady is a rarity.The king is at alower level showing his humility &;humbleness.I personally feel the begger maid should have had lesser dress,unable to cover her bosom even.The artist out of chivalry must have painted with adequqte dress(note the poet's words--arms across her breasts)She must have also had a wonderful anatomy as evident from the pondering lords in the palace,part by part of her body

Amazing king Capheuta.Ausome beggermaid

MILK BOTTLE CARRIES-NEW CONCEPT--89

THE ETIOLOGICAL FACTORS FOR FOR PEDIATRIC CARIES IS OFTEN BLAMMED TO STREPTOCOCCUS MUTANS &THE THE SWEETNESS OF MILK SUGAR WHICH TURNS SUGAR INTO ACID WHICH DESTROYS DENTINE CAUSING DEMINERALISATION CALCIUM IN TEETH FOR EASY ENTRY OF STREPTOCOCCUS MUTANS TO CAUSE DENTAL DECAY.
HUNDREDS OF REFERENCES IN MEDICAL LITERATURES SINGING THE SAME OLD ROTTEN SONGS,
AUTHER'S QUESTION:IF THE ABOVE SAID FACTORS ARE TRUE HOW NEARLY80-95%
CHILDRENESCAPE THIS ATTACK?ALMOST 100% OF YOUNG BABIES
(6-9 MONTHS) DO TAKE FREQUENT NIGHT MILKFEEDS, BE IT BREAST OR BOTTLE.

AUTHER'S CONCEPT:THERE ARE MANY CLINICAL CONDITIONS,ASSOCIATED WITH CALCIUM METABOLISM THAT COULD BE CORRELATED TO THIS PEDIATRIC CONDITION(CARIES)

1)A VARIANT OF OSTEOGENESIS IMPERFECTA
2)A VARIANT OF OSTEOPOROSIS
3)VITAMINE D3 DEFICIENCY
4)FLURIDE--EXCESS/DEFICIENCY
5)POSSIBLE VARIANT OF PRIMARY COMPLE(COMMONLY SEEN IN ANY COMUNITY WHERE TUBERCULOSIS IS COMMON)
6)HYPOCALCEMIC STATE
7)PARATHORMONE DEFICIENCY

ONLY A PROPER SYSTAMATIC,SCIENTIFIC, MULTICENTER STUDY COULD PROOVE OR DISPROOVE THE ABOVE FACTORS.

TILL THEN THE EXHISTING ETIOLOGY CA NOT BE ACCEPTED BLINDLY

email :  drselvarajp@yahoo.com