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
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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.

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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.

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