ASPHYXIA NEONATORUM

ASPHYXIA NEONATORUM
A SHORT CUT METHOD TO REDUCE MORTALITY & MORBIDITY.A NEW CONCEPTUAL THOUGHT PRACTICED BY THE AUTHOR FOR THE LAST 20 YEARS.

IF A NEONATE FAILS TO CRY LOUDLY WITHIN 5 MINUTES OF DELIVERY IT NEEDS TO BE RESUSCITATED AGGRESSIVELY.
FOLLOWING STEPS PREFERRED.

1)SUCTION AT LARYNGEAL OPENING.AMNIOTIC FLUID/MECONIUM/VERNICS CASSEOSA ASPIRATION
2)VIGOROUS SQUEEZING OF CHEST WITH THUMB & MIDDLE FINGER AT AXILLAE.
3)SODABICARB 7.5 %+DEXTROSE 10% .5+5=10 ML GIVEN INTRA UMBILLICALLY,THROUGH BUTTERFLY NEEDLE N0 24.
4)WAIT FOR 2-3 MINUTES.OBSERVE THE RESPONSE.TILL ACIDOSIS &HYPOGLYCAEMIA CORRECTION.
IF CRY IS NOT SATISFACTORY-REPEAT DRUGS ONE MORE TIME.
5)DO NT WASTE TIME BY GIVING OXYGEN(MAY BE HELPFUL ONLY FOR R D S.)INTUBATION BY AMBU BAG MAY BE WASTE OF TIME FOR VENTILATION SUPPORT.
6)IF STILL NEONATE DOES NOT CRY ,PUMP IN BECLOMETHASNE INHALER ENDOTRACHEALLY BY A SPECIAL METHOD THROUGH AN ADAPTER.YOUR SUCCESS RATE WILL BE 99%.
7)IF STILL BABY DOES NOT CRY, MILD ELECTRICAL STIMULATION IS WORTH ATTEMPTING THAT IS EQUIVALENT TO DEFIBRILLATION.
8)AN AGGRESSIVE NEONATAL RESUSCITATION SHOULD BE ANTICIPATED IN THE FOLLOWING CONDITIONS PRIOR TO DELIVERY SITUATION.

A)MOTHER HAVING HIGH B.P MEDICATIONS/ALCOHOLISM
B)MOTHER ON ANTI DIABETIC ANTI-CONVULSANT DRUGS
C)CORD AROUND THE NECK
D)MOTHER HAVING SPINAL SHOCK DUE TO DRUGS THROUGH L.P.
E)BIG BABY,TWINS,LBW BABIES,&PRECIOUS BABIES.
F)PROLONGED LABOUR(FOETAL DISTRESS)+/- CLINICAL HYPOGLYCAEMIA.

single visit/ONE JAB POLYIMMUNISATION

FOR JUNIOR PEDIATRICIANS:
Indian &American academy of pediatrics permit children to have vaccination for multiple vaccine preventable diseases,in one shot or two shots on the same day as patient compliance is better.DPT(TRIPLE ANTIGEN),MMR,CHICKENPOX ,Hib ,are usually combined.they have produced unwanted side effects in India&USA,though in a small number The chief ill effect is intracranial hemorrhage sub cutaneous bleeding with reduced platelet count(bone marrow depression).So it is better to give single than double trple in the same,though at different sites.Life is precious,specially for parents..Better to avoid the following combinations:1)Qvac,dtp+hepatitisB
2)PENTAVAC(dtp+hep.B .+Hib. 3)quadrivac(dpt+Hib+4)MMR+varicella.these two are preferably never combined with any other vaccine. DTaP IS PREFERRED OVER DPT.always LEAVE THE DOCTOR'S CLINIC 30 MINUTES AFTER INJECTION TO SEE IF THERE IS ANY IMMEDIATE ANAPHYLACTIC REACTIONS.There are many doctors who advocate multiple injections do no harm.Thes are purly author's views &experience.

single visit/ONE JABpoly immunisation

unpublished concepts in medicine

there are many.every experienced physician develops his own concept after seeing same cases repeatedly.for years1).mothers are immunised against tetanus,during 6,7,8,th month of pregnancy.if for some reason it was not given better to give late.than never..If no TT given till delivery ,a dose of tetanus immunoglobulin could be given to baby to prevent tetanus neonatorum.2)To all cases of clinical septicaemia,better to give dose of blood transfusion to supply immunoglobulin. 3)in certain selective cases of clinical radiological asthma,antihelminthic may be be given empirically&,as the chief offender is migrating larva repeatedly .4)In certain selective case of rhumatoid disease,where anti rheumatics fail,antimalarial are worth a trial.

UNPUBLISHED MEDICAL CONCEPT--2

CHILD'S BRAIN &MOTHER'S THYROXIN:
THE NEUROLOGICAL DEVELOPMENT IF HUMAN BRAIN GREATLY DEPENDS UPON THYROXIN HORMONE,IS AN ESTABLISHED FACT.THE DEVELOPING EMBRYO GETS ITS BLOOD SUPPLY,FROM MOTHER WHOSE THYROXIN LEVEL IN BLOOD SHOULD BE ADEQUATE THERE ARE MANY PREGNANT MOTHERS LIVING IN MANY VILLAGES,DRINK WATER WITH LESS IODINE, MAIN SOURCE OF WHICH IS WATER &SALT.AS A RESULT IF AN EMBRYO IS GROWING IN A BLOOD DEPRIVED OF IODINE WILL RESULT IN THE NEURAL TISSUE DEVELOPEMENT BEING QUALITATIVELY AFFECTED.UNLESS THE BLOOD LEVEL OF IODINE ARE MONITORED THRICE DURING PREGNANCY HYPOTHYROID STATE DEVELOPING BECOMES INEVITABLE.A BABY BELOW SUB CLINICAL LEVEL OF THYROXIN WILL NOT APPEAR LIKE A CRETIN,BUT WILL HAVE POOR ACADEMIC PERFORMANCE&ALSO EXHIBIT EVIDENCE OF LOWERED MENTAL MOTOR MILESTONES

ADHD-UNPUBLISHED CONCEPT

THE POSTULATED CAUSE IS METABOLIC DISORDER,IN A LOCALISED AREA OF THE BRAIN-THE PRE-FRONTAL CORTEX.BUT AT WHAT AGE(IMMEDIATE POSTNATAL?)IS NOT CLEARED BY INVESTIGATERS.ACTUALLY THIS IS A BEHAVIURAL DISORDER &THERE IS A NEURELOGICALLY DISORDERED MECHANISM SPREAD ALL OVER THE BRAIN,A CHILD'S DISORDERED BEHAVIUR IS NOT CONFINED TO ANY ONE CNS AREA DAMAGE..IT INVOLVES VISION HEARING ,MOTOR FUNCTION,SENSORY,CRANIAL NERVE FUNCTIONSWITH COORDINATION.SUCH WIDE SPREAD DISORDER IS POSSIBLE WITH MEASLES,.THIS CAN NOT BE PROOVED BY EEG ALSO.BUT ULTRAMICROSCOPIC CHANGES DUE TO BRAIN ENVIRONEMENTAL INTERFERENCE,BY VIRUS DRUGS ,INTRA,OR EXTRAUTERINE CAUSESCAN VERY WELL PRODUCE ADHD.THEREFORE IT IS POSSIBLE TO PREVENT THIS DISORDERBY IMMUNISATION,&NO MULTIPLE VACCINATION AT SINGLE SITTING,AS IT CAN CAUSE MICROSCOPIC INTRA-CRANIAL HEAMORRHAGES.BETTER NEONATAL RESUSITATIONIS NECESSARY,AS VERY MINIMALAPHYXIA NEONATORUMCAN ALSO CAUSE ADHD.

UNPUBLISHED MEDICAL CONCEPTS

1) YAWNING-A CLINICAL SIGNIFICANCE.
FROM FOETUS TO FATHER,ALL OF US YAWN MANY TIMES DURING OUR LIFE TIME .VARIOUS POSTULATIONS MADE .SOME ARE:1) OXYGEN LACK, 2) CARBONDIOXIDE ACCUMILATION IN THE BLOOD. 3)AN INVOLUNTARY ACT. 4)NEUROCHEMICAL TRANSMITTERS AFFECTING THE BRAIN TISSUE.5)ASSOCIATED WITH SEIZURE DISORDER LIKE EPILEPSY.6)AN EXPRESSION OF BOREDOM DUE TO PSYCHOLOGICAL DECOMPRESSION.7) A WAY TO REGULATE THE TEMPERATURE OF BLOOD CIRCULATING IN THE BRAIN8)EVEN COMPARED TO AN AIR COOLED ENGINE RADIATER AS IF AN YAWN IS ATHERMOREGULATER.

A U T H E R 'S C O N C E P T:

THOUGH THIS IS ALSO A CONCEPT, THIS CAN NOT BE DISMISSED UNLESS DISPROOVED
BY CERTAIN LAB STUDIES, SPECIALLY BACKED BY E.E.G. STUDIES, DURING WAKEFULNESS,DURING SLEEP, DURING YAWNING.FOLLOWING SCIENTIFICALLY PROOVEN FACTS CAN BE CONSIDERED TO UPHOLD THIS CONCEPT.
A) THIS IS A SLEEP RELATED PHYSICAL SIGN.B)A SIGN RELATED TO BRAIN STIMULATION BY VISION,HEARING,OR BOTH.C)A PREMONITARY SIGN PRIOR TO SEISURE DISORDER . IN ALL THE ABOVE,THERE IS DEFINITE CHANGE OF PATTERN OF E.E.G.,SPECIALLY THEETA WEAVES.

REFERENCES AVAILABLE TO THE EFFECT THAT THERE IS A 30% INCREASE IN THE HEART RATE AFTER YAWNING. BUT BEFORE &DURING YAWNING IT IS MOST LIKELY TO BE 30%LESS CONFIRMING,THAT THE ACT OF YAWNING ITSELF, IS NOTHING BUT A NEURALOGICAL MECHANISM THAT ARRESTS CIRCULATION FOR FEW SECONDS THEREBY PROOVING THAT THERE IS AN ELEMENT OF ELECTRICAL DYSRHYTHMIA
WHICH CAUSES YAWNING & IS AKIN TO A SEISURE DISORDER MOST OFTEN FOLLOWED OR PRECEDED BY SLEEP &CAN BE CONFIRME BY 24 HOUR E,E,G. YAWNING ITSELF IS CONSIDERED BY MANY CLINICIANS AS A VARAENT OF AN EPILEPTIC EQUIVALANT.YAWNING AS A PREMONITARY SIGN OF EPILESY IS WELL DOCUMENTED.

,