The following principles are applicable for triplets/quadriplets also.
Main principles;
beware of1)infection 2)aspiration 3)sids(sudden infant death syndrome)
prevention of infection: 1)use of mask on face by all elders.2)hand washing with antiseptics 3)fumigation of room (modified method)4)restrictd or absolute prevention
of outsiders/friends to enter baby room. 5)barrier nursing 6)nursing mother's hygiene/sanitation.
First 30 days are very important.brest milk contains cholostrum&it is a must for first week.It specifically prevents a neonatal diarrhoel disorder.
some pediatricians ,intra muscular human immunoglobulins on an empirical basis,
once a week for 6weeks in low birth weight babies if they are precious babies.
use of steroidinjection to mother can prevent possible lung immaturity.All said &done ,well trained pediatricians should be present for neonatal resucitation procedure.A good luxurious cry is a must&is the sign -quo-non against a possible
mental retardation.
5)warmth:maintanace of body emperature above normal is important There will not be any weight gain if there is any hypothermia.so room temperature maintanance is essential.
6)good nutrition vitamin ,minerals +iron are necessary.
7) neonatal screening test is necessary,specially thyroid status(T3 T4 TSH)THIS ESSENTIALLY TELLS UPON THE BABY'S INTELLIGENCE.
8)Any body coughing is not to be allowed into baby's room,as the main problem that can develope is respiratory infection.
9)modified fumigation of baby 's room
10) uMBILLICAL STUMP DRESSING .COMMENEST ROUTE OF ENTRY OF MICROORGANISMS .Absolute aseptic precaution for dressing umbillical cord stump till it falls down &even for one week later.Never touch stump with bare hands.Use gloves.
11)Betadine is best all purpose antiseptic.
12)never be hurry fora baby bath.sponge bath is sufficient.
BOTTLE STERILISATION;Unstrile practice will lead to diarrheal disorders,besides sugar intolerance /cow's milk intolerance ,breast milk intolerance (galectose intolerance) -all may contribute or agravate ehisting diarrhoea.Hence soya been milk is the preferred alternative ,in such state..Redness in the buttocks /anal region is the hall mark of sugar intolerance.
Not more than two people should handle babies.They should wear apron /over coats.
ASPIRATION :Single most common dangerous enemy to babies.It is nothing but milk getting into the respiratory tract,due to faulty feeding technique.causing severe cough ,respiratory distress.Prevention is stressed.treatment is done only in hospital,by a suction machine/broncoscopic aspiration
perfumes:Avoid all perfumes as it may cause allergic bronchiolitis leading to respiratory distress, /vomitingsleading to aspiration
Saturday, February 19, 2011
Wednesday, February 16, 2011
Aggressive Medical Treatment
AGGRESSIVE MEDICAL TREATMENT
Introduction :
Sometimes when a patient is very serious, conventional Text book treatment may not help. The medical ethics & scientific / statistical data often forces a physician to treat a patient as per therapeutic text book guidelines otherwise he is liable for a penal action for violating medico legal restrictions.
Definition :
No Text Book in medical literature gives precise method of treatment for any serious case. Then what constitutes an aggressive treatment. Text book of pediatrics (world renouned) by Waldoo Nelson says “any case which is very serious, should be subjected to aggressive medical treatment” no example of such aggressive treatment is available in any world medical literature.
Then how does a physician go about?
Hence an attempt is made to explore what is a serious case & what is aggressive treatments & how to identify, and what medical / surgical treatment would be best to revive that patient. All the case history examples given here, were treated by this author.
Actually, all the quoted cases need ICU like Treatment, but ICU facility is not available even in major District level hospitals. Hence the suggested modality of treatment.
Which is a serious case? Serious, very serious & extremely serious case depends upon the various clinical parameters which is one very abnormal from the normal.
Guide lines for assessment of a serious case.
Prognosis OK Bad Worse Worst
Parameters Normal Serious Very Serious Extremely serious
Consciousness Conscious Unconscious No response
to stlimuli Unconscious pupils slightly reacting to light
H R 80-120 120-200 > 200 fibrillation 400
R R 20-40 40-60 60-80
Acidotic Over 80
- same
Temp. 98.6
< 94
>104 < 90 cold
> 106 < 8006 ice cold
Other Physical Signs/ Symptoms
Fits No fits Continuous Status Epileptics Decerebrate spasm
Vomit No vomit Continuous
vomiting Haemetmesis Emesis + Acidotic breathing
Abd
Dis Nil Mild-moderate Mod-severe + Dyspnoea +
Tachypnoea All 3
Chest pain Nil Resostrernal Pain +
sweatings Pain + sweat +vomit + arrythmia
BP 130/80 Systolic 80
Diosystolic 60
Sys – 180
Dias – 100
Sys 60
Diast 0
Syst 200
Diasb 120
140 No BP
Recordable brady cond hypothermia.
Hydration Normal 5-10%
Dehydration 10-15%
Dehydration > 15% not revivable
Miclim “ Oliguria Anuria Anuria
Bun “ 50%
Increase 75%
Increase 100%
increase
Requires
Dialysis Requires
dialysis
Pulse oxymet 100% 80-90% 60-80% < 60 %
ECG Hh N Hh 60 40-60
40
Aim: When the physician is confronted with a very bad case, there are two options before him.
1. Treat the patient with drugs in the prescribed dosage, when the physician knows the outcome is likely to be poor & the progress is extremely bad, he may choose the second option.
2. Treat patient in the drugs which could be 4-8 times more than normal pharmacological level. This is most likely to yield a better result when the physician in his experience already knows the outcome with conventional dose.
3. Many experienced physicians (over 20-30 yrs service) can objectively & subjecting make assessment of a bad case as one that is not likely to survive even with best medical treatment.
4. When confronted with such a case, what is the harm in treating with a different way that may carry at least 5% chance for a survival? After all the treatment is absolutely scientific. Many bad cases are refused to be seen & ref. to government hospitals where the patients ultimately succumbs to his illness, or dies on the way to hospital & physicians refer such cases knowing fully well that the patient will die. How many physicians are there in the world to take up such cases as a challenge, and try to do their best, after informing the possible prognosis to the patients attender and also after getting his signature in an “informed consent paper.”
Meningo coccus attacks moninges & brain. But all the body organs are also affected as there is inter connection. When there is bacteremia / septicemia viraemia, then all body organs are simultaneously targeted when it is known as multi – organ failure syndrome (MOFS) where mortality rate is highest. So when there is a clinical / lab evidence of MOFS, why not a non conventional therapy instituted which may carry at least 5-10% good progress?
Here are some of the challenging type of cases treated by this author using the principle of Aggressive Medical treatment.
1. A 17 Years old boy sustained high voltage electric shock. (owning an electrical goods shop). Had status epileptics plus, decerebrate spasm. He was treatd with (1) Diazapam 20 mg Iv bolus + 20 mg in IV drip (2) Lasix 20 ml IV bolus 10 ml in drip (3) Dexamethprone 16 mg IV bolus + 16 mg in 20% glucose 200 ml IV drip. Ref to CMC Hospital 200 km away. The boy woke-up after 3 Hours asking for “Masala Dosai” a favourite eatable. The CMC doctors said, there is no need for further treatment. The boy is alive at Thiruvannamalai Tamil Nadu even this day.
2. An adult bitten by a poisonous cobra was treated by anti snake venom seerum. He was in coma for 3 days therefore he was given a blood transfusion donated by a snake-charmer who was bitten by poisonous snakes many number of times. Reason for such a selection of blood donar was that his blood was prescribed as it contain specific gama globlns against snake-venom and this immunoglobulin did he trick. He became conscious on day 5 & discharged on day 10.
3. 3 days old neonate stung by scorpion. Body was literally ice cold. Heart rate – could not be counted as it was so rapid (should be around 300 / mt.Lytic cock tail therapy started with spahenus venesection. Drug dosage was doubled & duration treatment doubled (4 days) steroid & diuretic were also added to exert an anticon vulsant anticerebral edema measures) & thwart – an acute renal failure. Discharged fit on day 7. Neonate had peripheral circulatory failure & treated by digoxin till heart rate came down to 140 / mt.
4. Diarrhoeal dehydration mortality in Children Hospital Egmore, Chennai, due to dehydration; is 15% aggressive - redehydration can bring about increased survival & reduced mortality rate. Author has treated 24 such cases & were successful. Method employed is double vaneseation done in all cases and fluid calculated at 400 ml / kg in 15% dehydration + acidosis + Hypo electrolytaemia. 100 ml / kg iv. Pushed very slowly for first 4 hrs. then 200 ml / kg IV pushed in the next 8 hrs. remaining 100 ml / kg allowed to drip slowly at 60 drops / mt. A dose of Lasix + Dexamethasone given to prevent pulmonary edema (6 cases out of 30 died of pulmonary / cerebral edema & is presumed to be due to sepsis & multi organ failure syndrome.
5. Generalised cyanosis in a normal new born. A new born baby suddenly developed cyanosis which was starting from periphery from all 4 links to abdomen thorax & then face. Cause could not be assessed by pediatrician, pediatric surgeon & Anesthetist (intensive case). Dexa methasone was given 3 doses within 1 hour & then Belamethesone inhaler was delivered into the lungs by a special technique through tube & chest compulsion. Baby became pink within 30 mts. Thereafter steroid was stopped in a tapering dose but baby developed bleeding though mouth & nose. A blood transmission was simultaneously given to arrest to bleeding. Baby became normal on day 3. The culprit was parents who administered thualsi-water from temple & that the baby got aspirated.
6. Poison ingerion – 20 year old boy. He took tab gradinal 60 mg, hargatil 50 mg & phenergan 25 mg – each 60 tables – total 180 tables at about 10 pm & attempted to commit suicide. He was seen at 8 a.m. next day when he was fully unconscious – comatose. No stomach wash given as it was too late (pupils dilated HR 60 mt RR 20 / mt). He was given (1) IV drip continues Isolyte P 6 bottles 24 hrs. (2) Inj Lasix 1000 mg IV bolus & 100 mg IV drip 12 X Hly. Bladder cathetrised periodically. Became conscious after 48 Hrs. & 50% dose given on day 3 discharged fit on day 5 when he could pass urine as before. Bladder control returned after 3 days. (3) Dexmethasone 16 mg IV bolus 16 mg IV drip for 4 days to prevent or relieve cerebral edema.
Diuresis & anticerebral edema measures alone were tried & is alive today.
7. Resuscitation of a just dead child. 1 year old injection penicillin given at TI cyeles India Arakonam, child cried & stopped breathing once for all. O/E no heart No respiration. Pupils dilated muscle tone – reflexes nil Inj adrenaline, Adsenalius & dexa & Deriphyllin & vensection for IV line. ET tube put & breathing attempted by blowing air like mouth to mouth, continues positive pressure ventilation – improvised method attempted. Child saved & is alive today child was brought by a lady doctor plastic surgeon from ticyeles to GH Arakonam – year 1977.
8. Neonatal Tetanus
Apart from many supportive treatment requirement, anti convulsant dosage above discussed. Venesection for IV line & Diaza pam 200 mg in IV drip. Initial rate 60 / dnps / mt . Later when convulsion is under controle dose reduced to 20 drops / mt. During recurrence of fits drip rae raised to 60/ mt.
In Dexametharone 0.5 mg Qid for 1 week & later tapered & stopped to prevent dextral edema.
The diazepam drug regimen was continued from 5-10 days & drug dosage reduced as pev clinical improvement.
2-3 small blood transfusion given (1) to supply in immunoglobulin (2) nutrition.
Milk was not given for 2 weeks for fear of aspiration.
Partial parenteral nutrition + blood transfusion helped to maintain nutritional status.
Author is not vouching that this is the correct treatment for these cases. But it is different from conventional drug – dosage practice in vogue.
The lesson learnt by the author is that when a case is dangerously ill & felt to be unlikely to survive the insult, very bold steps to be used with more drugs, higher dosage, of course very cautiously with masterly expectancy is required to produce better clinically rewarding results.
Introduction :
Sometimes when a patient is very serious, conventional Text book treatment may not help. The medical ethics & scientific / statistical data often forces a physician to treat a patient as per therapeutic text book guidelines otherwise he is liable for a penal action for violating medico legal restrictions.
Definition :
No Text Book in medical literature gives precise method of treatment for any serious case. Then what constitutes an aggressive treatment. Text book of pediatrics (world renouned) by Waldoo Nelson says “any case which is very serious, should be subjected to aggressive medical treatment” no example of such aggressive treatment is available in any world medical literature.
Then how does a physician go about?
Hence an attempt is made to explore what is a serious case & what is aggressive treatments & how to identify, and what medical / surgical treatment would be best to revive that patient. All the case history examples given here, were treated by this author.
Actually, all the quoted cases need ICU like Treatment, but ICU facility is not available even in major District level hospitals. Hence the suggested modality of treatment.
Which is a serious case? Serious, very serious & extremely serious case depends upon the various clinical parameters which is one very abnormal from the normal.
Guide lines for assessment of a serious case.
Prognosis OK Bad Worse Worst
Parameters Normal Serious Very Serious Extremely serious
Consciousness Conscious Unconscious No response
to stlimuli Unconscious pupils slightly reacting to light
H R 80-120 120-200 > 200 fibrillation 400
R R 20-40 40-60 60-80
Acidotic Over 80
- same
Temp. 98.6
< 94
>104 < 90 cold
> 106 < 8006 ice cold
Other Physical Signs/ Symptoms
Fits No fits Continuous Status Epileptics Decerebrate spasm
Vomit No vomit Continuous
vomiting Haemetmesis Emesis + Acidotic breathing
Abd
Dis Nil Mild-moderate Mod-severe + Dyspnoea +
Tachypnoea All 3
Chest pain Nil Resostrernal Pain +
sweatings Pain + sweat +vomit + arrythmia
BP 130/80 Systolic 80
Diosystolic 60
Sys – 180
Dias – 100
Sys 60
Diast 0
Syst 200
Diasb 120
140 No BP
Recordable brady cond hypothermia.
Hydration Normal 5-10%
Dehydration 10-15%
Dehydration > 15% not revivable
Miclim “ Oliguria Anuria Anuria
Bun “ 50%
Increase 75%
Increase 100%
increase
Requires
Dialysis Requires
dialysis
Pulse oxymet 100% 80-90% 60-80% < 60 %
ECG Hh N Hh 60 40-60
40
Aim: When the physician is confronted with a very bad case, there are two options before him.
1. Treat the patient with drugs in the prescribed dosage, when the physician knows the outcome is likely to be poor & the progress is extremely bad, he may choose the second option.
2. Treat patient in the drugs which could be 4-8 times more than normal pharmacological level. This is most likely to yield a better result when the physician in his experience already knows the outcome with conventional dose.
3. Many experienced physicians (over 20-30 yrs service) can objectively & subjecting make assessment of a bad case as one that is not likely to survive even with best medical treatment.
4. When confronted with such a case, what is the harm in treating with a different way that may carry at least 5% chance for a survival? After all the treatment is absolutely scientific. Many bad cases are refused to be seen & ref. to government hospitals where the patients ultimately succumbs to his illness, or dies on the way to hospital & physicians refer such cases knowing fully well that the patient will die. How many physicians are there in the world to take up such cases as a challenge, and try to do their best, after informing the possible prognosis to the patients attender and also after getting his signature in an “informed consent paper.”
Meningo coccus attacks moninges & brain. But all the body organs are also affected as there is inter connection. When there is bacteremia / septicemia viraemia, then all body organs are simultaneously targeted when it is known as multi – organ failure syndrome (MOFS) where mortality rate is highest. So when there is a clinical / lab evidence of MOFS, why not a non conventional therapy instituted which may carry at least 5-10% good progress?
Here are some of the challenging type of cases treated by this author using the principle of Aggressive Medical treatment.
1. A 17 Years old boy sustained high voltage electric shock. (owning an electrical goods shop). Had status epileptics plus, decerebrate spasm. He was treatd with (1) Diazapam 20 mg Iv bolus + 20 mg in IV drip (2) Lasix 20 ml IV bolus 10 ml in drip (3) Dexamethprone 16 mg IV bolus + 16 mg in 20% glucose 200 ml IV drip. Ref to CMC Hospital 200 km away. The boy woke-up after 3 Hours asking for “Masala Dosai” a favourite eatable. The CMC doctors said, there is no need for further treatment. The boy is alive at Thiruvannamalai Tamil Nadu even this day.
2. An adult bitten by a poisonous cobra was treated by anti snake venom seerum. He was in coma for 3 days therefore he was given a blood transfusion donated by a snake-charmer who was bitten by poisonous snakes many number of times. Reason for such a selection of blood donar was that his blood was prescribed as it contain specific gama globlns against snake-venom and this immunoglobulin did he trick. He became conscious on day 5 & discharged on day 10.
3. 3 days old neonate stung by scorpion. Body was literally ice cold. Heart rate – could not be counted as it was so rapid (should be around 300 / mt.Lytic cock tail therapy started with spahenus venesection. Drug dosage was doubled & duration treatment doubled (4 days) steroid & diuretic were also added to exert an anticon vulsant anticerebral edema measures) & thwart – an acute renal failure. Discharged fit on day 7. Neonate had peripheral circulatory failure & treated by digoxin till heart rate came down to 140 / mt.
4. Diarrhoeal dehydration mortality in Children Hospital Egmore, Chennai, due to dehydration; is 15% aggressive - redehydration can bring about increased survival & reduced mortality rate. Author has treated 24 such cases & were successful. Method employed is double vaneseation done in all cases and fluid calculated at 400 ml / kg in 15% dehydration + acidosis + Hypo electrolytaemia. 100 ml / kg iv. Pushed very slowly for first 4 hrs. then 200 ml / kg IV pushed in the next 8 hrs. remaining 100 ml / kg allowed to drip slowly at 60 drops / mt. A dose of Lasix + Dexamethasone given to prevent pulmonary edema (6 cases out of 30 died of pulmonary / cerebral edema & is presumed to be due to sepsis & multi organ failure syndrome.
5. Generalised cyanosis in a normal new born. A new born baby suddenly developed cyanosis which was starting from periphery from all 4 links to abdomen thorax & then face. Cause could not be assessed by pediatrician, pediatric surgeon & Anesthetist (intensive case). Dexa methasone was given 3 doses within 1 hour & then Belamethesone inhaler was delivered into the lungs by a special technique through tube & chest compulsion. Baby became pink within 30 mts. Thereafter steroid was stopped in a tapering dose but baby developed bleeding though mouth & nose. A blood transmission was simultaneously given to arrest to bleeding. Baby became normal on day 3. The culprit was parents who administered thualsi-water from temple & that the baby got aspirated.
6. Poison ingerion – 20 year old boy. He took tab gradinal 60 mg, hargatil 50 mg & phenergan 25 mg – each 60 tables – total 180 tables at about 10 pm & attempted to commit suicide. He was seen at 8 a.m. next day when he was fully unconscious – comatose. No stomach wash given as it was too late (pupils dilated HR 60 mt RR 20 / mt). He was given (1) IV drip continues Isolyte P 6 bottles 24 hrs. (2) Inj Lasix 1000 mg IV bolus & 100 mg IV drip 12 X Hly. Bladder cathetrised periodically. Became conscious after 48 Hrs. & 50% dose given on day 3 discharged fit on day 5 when he could pass urine as before. Bladder control returned after 3 days. (3) Dexmethasone 16 mg IV bolus 16 mg IV drip for 4 days to prevent or relieve cerebral edema.
Diuresis & anticerebral edema measures alone were tried & is alive today.
7. Resuscitation of a just dead child. 1 year old injection penicillin given at TI cyeles India Arakonam, child cried & stopped breathing once for all. O/E no heart No respiration. Pupils dilated muscle tone – reflexes nil Inj adrenaline, Adsenalius & dexa & Deriphyllin & vensection for IV line. ET tube put & breathing attempted by blowing air like mouth to mouth, continues positive pressure ventilation – improvised method attempted. Child saved & is alive today child was brought by a lady doctor plastic surgeon from ticyeles to GH Arakonam – year 1977.
8. Neonatal Tetanus
Apart from many supportive treatment requirement, anti convulsant dosage above discussed. Venesection for IV line & Diaza pam 200 mg in IV drip. Initial rate 60 / dnps / mt . Later when convulsion is under controle dose reduced to 20 drops / mt. During recurrence of fits drip rae raised to 60/ mt.
In Dexametharone 0.5 mg Qid for 1 week & later tapered & stopped to prevent dextral edema.
The diazepam drug regimen was continued from 5-10 days & drug dosage reduced as pev clinical improvement.
2-3 small blood transfusion given (1) to supply in immunoglobulin (2) nutrition.
Milk was not given for 2 weeks for fear of aspiration.
Partial parenteral nutrition + blood transfusion helped to maintain nutritional status.
Author is not vouching that this is the correct treatment for these cases. But it is different from conventional drug – dosage practice in vogue.
The lesson learnt by the author is that when a case is dangerously ill & felt to be unlikely to survive the insult, very bold steps to be used with more drugs, higher dosage, of course very cautiously with masterly expectancy is required to produce better clinically rewarding results.
Sunday, October 3, 2010
SWINE-FLU A(H1N1) PREVENTION-NEW RECOMMENDATIONS
SWINE FLU--TIPS FOR PREVENTION:
-----------------------------------------
1)Steam inhalation,after exposure.
2)Inhalation -2 hrly-four times daily.
3)Instantaneous relief of nasal irritation, post nasal drip,naso pharingeal irritability,internal ear-pain,irritability,blood stained mucus on spitting can be felt.But death of virus can not be expected in a day.symptoms persist till inflamation subsides.
4)continuous steam inhalation necessary for a week..
5)can offer better protection than vaccine
WHAT IS AN EXPOSURE?
---------------------------
1) An absolutely normal person developing sneezing ,throat,tosil,or nasopharyngeal pain after
entering into a crowded place or staying in an ac car with closed windows ,when one of the passenger is coughing or sneezing.symptoms start in2-6 hrs.
2)A suspected, infected person sneezes coughs in side a public escalater/lift
3)visiting a big shop,when floor is broomed.people with dust allergy,visiting such places.
4)hospital workers should protect with mask.
All this can not be proven as no scientific study was done.bUT ALL THE ABOVE ARE THEORITICALLY ACCEPTABLE,as viruses can no longer survive in steam exposure repeatedly.
THE PROOF OF THE PUDDING IS IN THE EATING.
-----------------------------------------
1)Steam inhalation,after exposure.
2)Inhalation -2 hrly-four times daily.
3)Instantaneous relief of nasal irritation, post nasal drip,naso pharingeal irritability,internal ear-pain,irritability,blood stained mucus on spitting can be felt.But death of virus can not be expected in a day.symptoms persist till inflamation subsides.
4)continuous steam inhalation necessary for a week..
5)can offer better protection than vaccine
WHAT IS AN EXPOSURE?
---------------------------
1) An absolutely normal person developing sneezing ,throat,tosil,or nasopharyngeal pain after
entering into a crowded place or staying in an ac car with closed windows ,when one of the passenger is coughing or sneezing.symptoms start in2-6 hrs.
2)A suspected, infected person sneezes coughs in side a public escalater/lift
3)visiting a big shop,when floor is broomed.people with dust allergy,visiting such places.
4)hospital workers should protect with mask.
All this can not be proven as no scientific study was done.bUT ALL THE ABOVE ARE THEORITICALLY ACCEPTABLE,as viruses can no longer survive in steam exposure repeatedly.
THE PROOF OF THE PUDDING IS IN THE EATING.
Saturday, August 28, 2010
NEW BORN BABY INTELLIGENCE-ALL ABOUT IT
INTRODUCTION:
A NEW BORN BAY' INTELLIGENCE DEPENDS UPON ITS INHERENT ABILITIES,&MANY OTHER EXTERNAL INFLUENCING FACTORS..ANY OR MANY OF THE FOLLOWING FACTORS MAY INTERFERE WITH THE THE BRAIN DEVELOPMENT &ITS INTELLIGENCE.
1)GENETIC MAKE UP
2)GOOD APGAR SCORE AT BIRTH.
3)INTRACRANIAL HEMORRHAGE.
4)CORD AROUND THE NECK PRIOR TO DELIVERY.
5)FETAL DISTRESS.
6)GOOD HEAD CIRCUMFERENCE AT BIRTH.
7)NO MATERNAL ANEMIA/HYPERTENSION/ MALNUTRITION.
8)GOOD VISION AT BIRTH.
9)GOOD HEARING CAPABILITY AT BIRTH.
10)EXTREMELY GOOD CRY AT BIRTH
(OPENS THE PATENCY OF ALL BRAIN BLOOD VESSELS)
11)GOOD THYROID STATUS (EU THYROID) IN MOTHER &BABY.
12)ENVIRONMENTAL STIMULATION-A CONTINUOUS PROCESS.
G E NE T I C M A K E U P
---------------------------
GENES ARE ULTRA(ELECTRON )MICROSCOPIC STRUCTURES.WHICH CARRY &PROPAGATE THE INTELLECTUAL CAPABILITY,OF ONE GENERATION TO ANOTHER GENERATION ALONG WITH MANY OTHER QUALITIES GOOD OR BAD ABOUT THE INDIVIDUALS CONCERNED.EDUCATION &INTELLIGENCE ARE NOT THE SAME .
AN EDUCATED PERSON NEED NOT BE INTELLIGENT&VICE VERSA.BUT EDUCATION DOES INCREASE THE INTELLECTUAL LEVEL.MANY UNEDUCATED MAY BE MORE INTELLIGENT THAN THE EDUCATED SO THE INTELLECTUAL TRAIT IS CARRIED FROM ONE GENERATION TO ANOTHER &OFTEN REFLECTED IN A CUMULATIVE MANNER,THROUGH THE GENES,CARRYING
TO POSITIVE PRINT IN THE NEXT GENERATION.TECHNICALLY THEY ARE REFERRED AS RNA,&DNA.THE FIRST GENERATION INDIVIDUAL MAY BE INTELLIGENT IN ONE WALK OF LIFE THE SECOND GENERATION COULD BE INTELLIGENT IN ANOTHER FIELD.THE THIRD GENERATION WILL HAVE INTELLIGENCE OF ITS OWN PLUS THE PREVIOUS TWO GENERATIONS INTELLIGENCE.THIS IS HOW THE INTELLIGENCE TREE KEEPS GROWING.
G O O D A P GA R S C O R E A T B I R T H.
----------------------------------------------
THIS MEANS THE CRY, COLOUR, ACTIVITY,REFLEXES,HEART RATE RESPIRATORY RATE ARE NORMAL WITHIN 10 Mts OF BIRTH&THAT THERE IS NO ASPHYXIA WHICH MEANS1)THE BRAIN BLOOD VESSELS ARE NOT PATENT ,OR NOT FULLY OPEN ,2)THERE IS NO ENOUGH OXYGEN SUPPLY TO THE BRAIN CELLS,3)THERE IS POOR GAS EXCHANGE IN THE LUNGS,WHICH MIGHT NOT HAVE EXPANDED FULLY.ULTIMATELY O2 SUPPLY TO BRAIN DECIDES THE NUMBER OF NEURONAL CELLS TO BE ACTIVE OR INACTIVE THE INACTIVE CELLS IF NOT PROPERLY OXYGENATED WITHIN 10-20 Mts WILL DIE & BECOME A SCAR THAT WILL LEAD ON TO THE DEVELOPMENT OF A CEREBRAL PALSY,LEADING TO MENTAL RETARDATION.
CEREBRAL PALSY MEANS ,PARALYSIS, OR MALFUNCTION,&PARTIAL OR TOTAL LOSS OF FUNCTION OF NEURONS AT CEREBRUM TO LACK OF BLOOD SUPPLY LEADING TO INSUFFICIENT OXYGEN ,TO NEURONS LEADING TO AN ALTERATION OF MUSCLE TONE&LOSS OF INTELLECTUAL FUNCTION LEADING TO,MENTAL RETARDATION OF VARIABLE DEGREES FROM POOR ACADEMIC PERFORMANCE TO TOTAL IDIOCY,OFTEN WITH INCREASED SPASTICITY OF ALL MUSCLES(ALSO KNOWN AS LITTLE'S DISEASE)(LITTLE WAS AN OUTSTANDING ORTHOPEDIC SURGEON IN THE WHOLE OF EUROPE WHO DISCOVERED THAT CEREBRAL PALSY IS DUE TO ASPHYXIA NEONATORUM &NOT PRIMARILY AN ORTHO CONDITION--THANKS TO DR LITTLE WHOSE OBSERVATION WAS BETTER THAN AN OBSTETRICIAN OF YESTER YEARS.
INTRA CRANIAL HAEMORRHAGE:
MANY NEW BORN BABIES SUFFER FROM THIS DISORDER, MAINLY DUE TOA A DEFICIENCY IN THE COAGULATION MECHANISM(FACTOR DEFICIENCY),AND THIS IS DUE TO A GENETIC DISORDER.THE HEMORRHAGE AGAIN IS VARIABLE AS PER THE QUANTITY OF THE DEFECT.INTRAVENTRICULAR HEMORRHAGE IS THE SEVEREST OF ALL,PRODUCING VERY MANY CNS COMPLICATIONS,SUCH AS FITS,SPASTICITY OF MUSCLES ,PARALYSIS,INTELLECTUAL DEFECT OF VARIABLE DEGREES.
FETAL DISTRESS:
OCCURS DURING ANTIPARTUM OR AT INTRAPARTUM PERIOD.SEVERE FETAL DISTRESS LEADS TO RESPIRATORY OR METABOLIC ACIDOSIS.CAN OCCUR IN THE FOLLOWING CONDITIONS:
1)INTRUTERINE GROWTH RETARDATION.
2)POST DATED GESTATION.
3)MATERNAL DIABETES MELLITUS
4)RHESUS SENSITISED PREGNANCY.
5)PREVIOUS H/O OF STILL BIRTH.
6)MATERNAL HYPERTENSION
7)FETAL HYPOXIA.
8)MATERNAL FEVER.
9)MATERNAL HYPERTHYROIDISM
10)FETAL ANEMIA, ARRHYTHMIA
11)PLACENTAL TRANSFER OF DRUGS
12)SLEEP STATE
13)PREMATURITY.
ALL THE ABOVE LEAD TO LESS BLOOD SUPPLY TO BRAIN RESULTING IN LESS OXYGEN SUPPLY TO CEREBRAL NEURONS THAT CAN JEOPARDISE THE INTELLECTUAL DEVELOPMENT
GOOD HEAD CIRCUMFERENCE AT BIRTH
---------------------------------------------
A BABY SHOULD HAVE AT LEAST 35 CM OF HEAD CIRCUMFERENCE.AT BIRTH.
1-2 CM LESS OR MORE ,MAY BE CONSIDERED AS VARIATIONS.ANYTHING LESSER MAY MEAN MICROCEPHALY &ANYTHING MORE MAY MEAN HYDROCEPHALUS, & NEEDS SERIAL MEASUREMENT FOR ASSESSMENT.&BOTH WILL AFFECT THE INTELLIGENCE GROSSLY.IN MICROCEPHALY IT IS NON DEVELOPEMENT,&IN HYDROCEPHALUS IT IS NEURONAL CELL DESTRUCTION BY THE SURROUNDING CSF PRESSURE THUS THE INTELLIGENCE DEVELOPMENT IS AFFECTED EVEN AT FOUNDATION LEVEL OF THE FUTURE CONSTRUCTION.
MATERNAL ANAEMIA/HYPERTENSION'S/MALNUTRITION.
MATERNAL ANAEMIA WILL LEAD TO FETAL ANAEMIA RESULTING IN POOR DELIVERY OF OXYGEN TO DEVELOPING NEURONAL CELLS THROUGH HEMOGLOBIN.AN ANOXIC CELL IS A WEEK CELL.HYPERTENSION WILL LEAD TO EXESS BLOOD FLOW&HEMORRHAGIC TENDENCY RESULTING IN CELL DEATH. MALNUTRITION WILL AFFECT CELL ANABOLISM AS PROTIEN IS NECESSARY FOR CONSTRUCTION&CARBOHYDRATE FOR FUEL.ALL THESE CONTRIBUTE FOR A POOR QUALITY NEURONAL CELL GROWTH &DEVELOPMENT OF INTELLIGENCE IS VERY DIFFICULT IN SUCH A DAMAGED CELL.
GOOD VISION AT BIRTH.
----------------------------
EYE IS SAID TO BE THE WINDOW OF THE BRAIN.MOST OF THE INFORMATION ENTERS INTO THE BRAIN VISUALLY&IS STORED LIKE A COMPUTER CHIP.INTELLIGENCE IS NOTHING BUT A COLLECTION OF INFORMATION,STORED, &RE UTILISATION OF THESE INFORMATION WHEN NECESSARY. OF THE NATURES FIVE GIFTED SPECIAL SENSES ,VISION IS BY FOR THE BEST.CHILDREN ARE GIVEN AUDIO VISUAL STIMULI TO IMPROVE THE INTELLECTUAL CAPACITY,DURING THEIR ATTEMPT TO LEARN.VARIOUS CONGENITAL EYE DEFECT MAY CONTRIBUTE DEFECTIVE VISION,LEADING TO INTERFERENCE WITH INTELLIGENCE FORMATION Eg :CONGENITAL CATARACT IN RUBELLA SYNDROME.
GOOD HEARING CAPABILITY :
WHEN DOES A NEWBORN START HEARING? WHEN CAN IT START SEEING?
BOTH ARE PRESENT AT BIRTH.IN FACT CAN HEAR &APPRECIATE SOUND WHEN IT IS IN UTERO WHEN A PREGNANT MOTHER SINGS THE BABY IS SUBJECTED TO THE VIBRATION TRANSMITTED THROUGH THE AMNIOTIC FLUID&THUS GETS USED TO SOUND APPRECIATION,UNLESS THERE IS A NEUROLOGICAL DEFICIT,OR A HYPOTHYROID STATE, AS SOON AS THE BABY IS BORN IT CAN OPEN THE EYES &SEE THE SURROUNDINGS AS IT WAS IN A DARK WORLD FOR NINE MONTHS&APPRECIATE THE PHOTIC STIMULATION OF THE EXTERNAL WORLD.BERA IS THE LATEST SOPHISTICATED TEST TO FIND OUT IF A BABY IS DEAF,THE TEST FINDS OUT IF THE SOUND WEAVES REACH THE BRAINCELLS.
USUALLY AT AGE 30 DAYS A NEW BORN BABY IS ABLE TO 1)VISUALISE AN OBJECT&FIX THAT OBJECT2)OR VISUALISE A SPOT FROM WHERE A SOUND IS COMING.3)IT CAN EVEN COMMUNICATE WITH AN OBJECT WHICH IS MAKING/CREATING A SOUND BY MAKING THROTY SYLLABLES .IF ALL THE THREE ABOVE FINDINGS ARE NOT PRESENT UPTO 90 DAYS A PEDIATRICIAN SHOULD SEE THE BABY.
EXTREMELY GOOD CRY AT BIRTH:
IT IS A SENSIBLE PRESUMPTION THAT IF A BABY CRIES VERY LOUDLY FOR A PROLONGED PERIOD &IF REPEATEDLY KEEPS CRYING THERE IS A THEORETICAL POINT THAT ALL BLOOD VESSELS IN THE BRAIN OPENS &BLOOD SUPPLY TO NEURONES MADE EASY. AT BIRTH ALLTUBES/DUCTS/VESSELS ARE NOT PATENT.SO THE ESTABLISHMENT OF PATENCY OF ALL BRAIN BLOOD VESSELS IMPERATIVE FOR ITS ULTIMATE INTELLECTUAL CAPABILITY DUE TO BETTER BLOOD SUPPLY THAT YIELDS BETTER OXYGEN WHICH IS THE MAIN FOOD FOR ALL CELLS ,SPECIALLY THE NERVE CELLS.
SO WE CAN PRESUME THAT A BABY AT BIRTH CRYING LOUDLY AT BIRTH IS DIFFERENT FROM A BABY NOT CRYING MUCH. THIS OF COURSE CAN BE PROOVED BY A RETROSPECTIVE STUDY.THE MORE LOUD THE BABY CRIES ,MORE PINK THE COLOUR WILL BE INDICATIVE OF BETTER LUNG FUNCTION/EXPANSION,BETTER OXYGEN CO2 DISSOCIATION, BETTER BLOOD SUPPLY TO ALL ORGANS OF BODY,INCLUDING BRAIN.IF THE OPPOSITE BEFALLS ,DEVELOPEMENT OF MENTAL RETARDATION IS A STRONG POSSIBILITY..
CORD ROUND THE NECK:
---------------------------
ABOUT 5-10% OF BABIES NECK GET ENTANGLED IN THE UMBILLICAL CORD WHILE FLOATING IN THE AMNIOTIC FLUID INSIDE THE SACK.SOMETIMES IT MAY LEAD TO A STRANGULATING EFFECT CAUSING FETAL DISTRESS SPECIALLY WHEN THE CORD GOES TWICE OR THRICE AROUND NECK..THIS CAN LITERALLY CAUSE ASPHYXIATION
IN UTERO OR PERINATALLY WHEN COMES OUT PER VIA NATURALIS.DEPENDING ON THE TIGHTNESS OF THE CORD AROUND THE NECK THE OUTCOME IS ALSO VARIABLE.MOST SUCH BABIES ARE BORN WITH VERY LOW OR ZERO APGAR SCORE WHEN IT BECOMES A CHALLANGING TASK FOR THE NEONATOLOGIST TO REVIVE &
RESUCITATE THE BABY. ONLY AN EXPERIENCED PERSON ALONE CAN SUCCESSFULLY RESUCITATE SUCH BABIES TO 100%
GOOD THYROID STATUS IN MOTHER &BABY
----------------------------------------------------
THYROID IS A DUCTLESS GLAND PRODUING THYROXIN A HORMONE INTRICATELLY INTEGRATED WITH INTELLIGENCE.NO THYROID MEANS NO INTELLIGENCE .ALSO IT HAS INFLUENCE OVER ALL THE BODY TISSUES. ITS ABSENCE WILL SELECTIVELY CAUSE BRAIN &BONE DAMAGE IN THE FORMATIVE YEARS.THYROID DIFFICIENCY CAN BE CLINICALLY DIAGNOSED IN 3-6 MONTHS AGE GROUP BABIES.&IS FULLY RECTIFIABLE BY CONTINUOUS THYROID TREATMENT.
Rh-INCOMPATIBILITY.
--------------------------
IF MOTHER IS Rh NEGATIVE, &FOETUS Rh POSITIVE,ABOUT 2-10 % BABIES CAN DEVELOP BLOOD GROUP INCOMPATIBILITY, LEADING TO RBC DESTRUCTION, &CONSEQUENT IRRVERSIBLE BRAIN DAMAGE WITH JAUNDICE ,MUSCLE SPASM, FITS, &MENTAL RETARDATION.
ENVIRONEMENTAL STIMULATION:MOST IMPORTANT CONTINUOUS PROCESS.
------------------------------------------------------------------------------------------
A CHILD'S BRAIN DEVELOPEMENT DEPENDS ON THE FOLLOWING GROSS FACTORS APART FRI=OM THE AFORESAID CAUSES.:-
1)BRAIN MASS MUST GROW &THE SKULL BONES MUST ALLOW THIS ENLARGEMENT/EXPANSION &ACCOMODATE BIGGER MASS BY SUITABLY INCREASING THE INNER SKULL SPACE.
2)THE VARIOUS NUTRITION FACTORS &THYROXIN HELP INTHE BRAIN MASS INCREASE.
3)BY APPROPRIATE STIMULATION OF ALL FIVE SPECIAL SENSES THE CORTICAL NEURONES STORE THE INFORMATIONS RECIEVED FROM TIME TO TIME IN THE FORM OF A' FUNCTIONAL' LAYER ,COMPARABLE TO A COMPUETOR CHIP.THE STIMULI RECIEVED KEEP INCREASING IN NUMBER &QUALITY AS TIME PROGRESSES. BEFORE LEARNING WORDS &SENTENCES BABY LEARNS THE SYLLABLES,LIKE A B C ,WITH PHONATION,THIS SYSTEMATIC WAY OF LEARNING IS A MUST TO SHOW GROWTH &PROGRESS.
STORY OF WOLF RAMAN
---------------------------
THIS IS A TRUE STORY OCCURED AT VELLORE-TAMILNADU-INDIA.
PUBLISHED ALL OVER THE WORLD IN ALL NEWSPAPERS 50 YEARS BACK.
A CHILD AGED ABOUT 5 WAS FOUND MAKING NOICE &JUMPING LIKE WOLF IN A JUNGLE SPOTTED BY FEW HUNTERS, WHO BROUGHT CHILD FROM JUNGLE TO CMC HOSPITAL.VARIOUS SPECIALITY DOCTORS FROM VARIOUS PARTS OF THE WORLD
POURED INTO CMC TO SEE &STUDY THE BABY.INTER NATIONAL SYMPOSIUM WERE CONDUCTED..EXCEPT FOR THE EXTERNAL FEATURES OF A HUMAN CHILD BOYHAD ALL THE CHARECTERS OF ANIMALS ONLY &DIED IN HOSPITAL IN ABOUT 2MONTHES PROBALY DUE TO ENVIRONMENTAL SEPERATION
DISCUSSION:
THIS CHILD MUST HAVE BEEN ABDUCTED FROM A VILLAGE BY A WOLF/FOX,OR MUST HAVE BEEN ABANDENED BY A MOTHER AFTER AN ILLEGITIMATE PREGNANCY.THIS CHILD NEVER HAD ANY STIMULATION FROM HUMANS AT ANY TIME..WHAT WAS STRICKINGLY OBVIOUS WAS IT POSSESSED ALL THE CHARECTERS OF ANIMAL&NOTHING FROM HUMANS..
THIS EXPLAINS HOW AN ENVIRONE MENT IS IMPORTANT IN SHAPING FOR ITS INTELLECTUAL STIMULATION,FOR ITS ULTIMATE BRAIN GROWTH QUQLITATIVELY EMOTIONALLY FOR ITS INTELLECTUAL OUTCOME.
----------------------------------------
A NEW BORN BAY' INTELLIGENCE DEPENDS UPON ITS INHERENT ABILITIES,&MANY OTHER EXTERNAL INFLUENCING FACTORS..ANY OR MANY OF THE FOLLOWING FACTORS MAY INTERFERE WITH THE THE BRAIN DEVELOPMENT &ITS INTELLIGENCE.
1)GENETIC MAKE UP
2)GOOD APGAR SCORE AT BIRTH.
3)INTRACRANIAL HEMORRHAGE.
4)CORD AROUND THE NECK PRIOR TO DELIVERY.
5)FETAL DISTRESS.
6)GOOD HEAD CIRCUMFERENCE AT BIRTH.
7)NO MATERNAL ANEMIA/HYPERTENSION/ MALNUTRITION.
8)GOOD VISION AT BIRTH.
9)GOOD HEARING CAPABILITY AT BIRTH.
10)EXTREMELY GOOD CRY AT BIRTH
(OPENS THE PATENCY OF ALL BRAIN BLOOD VESSELS)
11)GOOD THYROID STATUS (EU THYROID) IN MOTHER &BABY.
12)ENVIRONMENTAL STIMULATION-A CONTINUOUS PROCESS.
G E NE T I C M A K E U P
---------------------------
GENES ARE ULTRA(ELECTRON )MICROSCOPIC STRUCTURES.WHICH CARRY &PROPAGATE THE INTELLECTUAL CAPABILITY,OF ONE GENERATION TO ANOTHER GENERATION ALONG WITH MANY OTHER QUALITIES GOOD OR BAD ABOUT THE INDIVIDUALS CONCERNED.EDUCATION &INTELLIGENCE ARE NOT THE SAME .
AN EDUCATED PERSON NEED NOT BE INTELLIGENT&VICE VERSA.BUT EDUCATION DOES INCREASE THE INTELLECTUAL LEVEL.MANY UNEDUCATED MAY BE MORE INTELLIGENT THAN THE EDUCATED SO THE INTELLECTUAL TRAIT IS CARRIED FROM ONE GENERATION TO ANOTHER &OFTEN REFLECTED IN A CUMULATIVE MANNER,THROUGH THE GENES,CARRYING
TO POSITIVE PRINT IN THE NEXT GENERATION.TECHNICALLY THEY ARE REFERRED AS RNA,&DNA.THE FIRST GENERATION INDIVIDUAL MAY BE INTELLIGENT IN ONE WALK OF LIFE THE SECOND GENERATION COULD BE INTELLIGENT IN ANOTHER FIELD.THE THIRD GENERATION WILL HAVE INTELLIGENCE OF ITS OWN PLUS THE PREVIOUS TWO GENERATIONS INTELLIGENCE.THIS IS HOW THE INTELLIGENCE TREE KEEPS GROWING.
G O O D A P GA R S C O R E A T B I R T H.
----------------------------------------------
THIS MEANS THE CRY, COLOUR, ACTIVITY,REFLEXES,HEART RATE RESPIRATORY RATE ARE NORMAL WITHIN 10 Mts OF BIRTH&THAT THERE IS NO ASPHYXIA WHICH MEANS1)THE BRAIN BLOOD VESSELS ARE NOT PATENT ,OR NOT FULLY OPEN ,2)THERE IS NO ENOUGH OXYGEN SUPPLY TO THE BRAIN CELLS,3)THERE IS POOR GAS EXCHANGE IN THE LUNGS,WHICH MIGHT NOT HAVE EXPANDED FULLY.ULTIMATELY O2 SUPPLY TO BRAIN DECIDES THE NUMBER OF NEURONAL CELLS TO BE ACTIVE OR INACTIVE THE INACTIVE CELLS IF NOT PROPERLY OXYGENATED WITHIN 10-20 Mts WILL DIE & BECOME A SCAR THAT WILL LEAD ON TO THE DEVELOPMENT OF A CEREBRAL PALSY,LEADING TO MENTAL RETARDATION.
CEREBRAL PALSY MEANS ,PARALYSIS, OR MALFUNCTION,&PARTIAL OR TOTAL LOSS OF FUNCTION OF NEURONS AT CEREBRUM TO LACK OF BLOOD SUPPLY LEADING TO INSUFFICIENT OXYGEN ,TO NEURONS LEADING TO AN ALTERATION OF MUSCLE TONE&LOSS OF INTELLECTUAL FUNCTION LEADING TO,MENTAL RETARDATION OF VARIABLE DEGREES FROM POOR ACADEMIC PERFORMANCE TO TOTAL IDIOCY,OFTEN WITH INCREASED SPASTICITY OF ALL MUSCLES(ALSO KNOWN AS LITTLE'S DISEASE)(LITTLE WAS AN OUTSTANDING ORTHOPEDIC SURGEON IN THE WHOLE OF EUROPE WHO DISCOVERED THAT CEREBRAL PALSY IS DUE TO ASPHYXIA NEONATORUM &NOT PRIMARILY AN ORTHO CONDITION--THANKS TO DR LITTLE WHOSE OBSERVATION WAS BETTER THAN AN OBSTETRICIAN OF YESTER YEARS.
INTRA CRANIAL HAEMORRHAGE:
MANY NEW BORN BABIES SUFFER FROM THIS DISORDER, MAINLY DUE TOA A DEFICIENCY IN THE COAGULATION MECHANISM(FACTOR DEFICIENCY),AND THIS IS DUE TO A GENETIC DISORDER.THE HEMORRHAGE AGAIN IS VARIABLE AS PER THE QUANTITY OF THE DEFECT.INTRAVENTRICULAR HEMORRHAGE IS THE SEVEREST OF ALL,PRODUCING VERY MANY CNS COMPLICATIONS,SUCH AS FITS,SPASTICITY OF MUSCLES ,PARALYSIS,INTELLECTUAL DEFECT OF VARIABLE DEGREES.
FETAL DISTRESS:
OCCURS DURING ANTIPARTUM OR AT INTRAPARTUM PERIOD.SEVERE FETAL DISTRESS LEADS TO RESPIRATORY OR METABOLIC ACIDOSIS.CAN OCCUR IN THE FOLLOWING CONDITIONS:
1)INTRUTERINE GROWTH RETARDATION.
2)POST DATED GESTATION.
3)MATERNAL DIABETES MELLITUS
4)RHESUS SENSITISED PREGNANCY.
5)PREVIOUS H/O OF STILL BIRTH.
6)MATERNAL HYPERTENSION
7)FETAL HYPOXIA.
8)MATERNAL FEVER.
9)MATERNAL HYPERTHYROIDISM
10)FETAL ANEMIA, ARRHYTHMIA
11)PLACENTAL TRANSFER OF DRUGS
12)SLEEP STATE
13)PREMATURITY.
ALL THE ABOVE LEAD TO LESS BLOOD SUPPLY TO BRAIN RESULTING IN LESS OXYGEN SUPPLY TO CEREBRAL NEURONS THAT CAN JEOPARDISE THE INTELLECTUAL DEVELOPMENT
GOOD HEAD CIRCUMFERENCE AT BIRTH
---------------------------------------------
A BABY SHOULD HAVE AT LEAST 35 CM OF HEAD CIRCUMFERENCE.AT BIRTH.
1-2 CM LESS OR MORE ,MAY BE CONSIDERED AS VARIATIONS.ANYTHING LESSER MAY MEAN MICROCEPHALY &ANYTHING MORE MAY MEAN HYDROCEPHALUS, & NEEDS SERIAL MEASUREMENT FOR ASSESSMENT.&BOTH WILL AFFECT THE INTELLIGENCE GROSSLY.IN MICROCEPHALY IT IS NON DEVELOPEMENT,&IN HYDROCEPHALUS IT IS NEURONAL CELL DESTRUCTION BY THE SURROUNDING CSF PRESSURE THUS THE INTELLIGENCE DEVELOPMENT IS AFFECTED EVEN AT FOUNDATION LEVEL OF THE FUTURE CONSTRUCTION.
MATERNAL ANAEMIA/HYPERTENSION'S/MALNUTRITION.
MATERNAL ANAEMIA WILL LEAD TO FETAL ANAEMIA RESULTING IN POOR DELIVERY OF OXYGEN TO DEVELOPING NEURONAL CELLS THROUGH HEMOGLOBIN.AN ANOXIC CELL IS A WEEK CELL.HYPERTENSION WILL LEAD TO EXESS BLOOD FLOW&HEMORRHAGIC TENDENCY RESULTING IN CELL DEATH. MALNUTRITION WILL AFFECT CELL ANABOLISM AS PROTIEN IS NECESSARY FOR CONSTRUCTION&CARBOHYDRATE FOR FUEL.ALL THESE CONTRIBUTE FOR A POOR QUALITY NEURONAL CELL GROWTH &DEVELOPMENT OF INTELLIGENCE IS VERY DIFFICULT IN SUCH A DAMAGED CELL.
GOOD VISION AT BIRTH.
----------------------------
EYE IS SAID TO BE THE WINDOW OF THE BRAIN.MOST OF THE INFORMATION ENTERS INTO THE BRAIN VISUALLY&IS STORED LIKE A COMPUTER CHIP.INTELLIGENCE IS NOTHING BUT A COLLECTION OF INFORMATION,STORED, &RE UTILISATION OF THESE INFORMATION WHEN NECESSARY. OF THE NATURES FIVE GIFTED SPECIAL SENSES ,VISION IS BY FOR THE BEST.CHILDREN ARE GIVEN AUDIO VISUAL STIMULI TO IMPROVE THE INTELLECTUAL CAPACITY,DURING THEIR ATTEMPT TO LEARN.VARIOUS CONGENITAL EYE DEFECT MAY CONTRIBUTE DEFECTIVE VISION,LEADING TO INTERFERENCE WITH INTELLIGENCE FORMATION Eg :CONGENITAL CATARACT IN RUBELLA SYNDROME.
GOOD HEARING CAPABILITY :
WHEN DOES A NEWBORN START HEARING? WHEN CAN IT START SEEING?
BOTH ARE PRESENT AT BIRTH.IN FACT CAN HEAR &APPRECIATE SOUND WHEN IT IS IN UTERO WHEN A PREGNANT MOTHER SINGS THE BABY IS SUBJECTED TO THE VIBRATION TRANSMITTED THROUGH THE AMNIOTIC FLUID&THUS GETS USED TO SOUND APPRECIATION,UNLESS THERE IS A NEUROLOGICAL DEFICIT,OR A HYPOTHYROID STATE, AS SOON AS THE BABY IS BORN IT CAN OPEN THE EYES &SEE THE SURROUNDINGS AS IT WAS IN A DARK WORLD FOR NINE MONTHS&APPRECIATE THE PHOTIC STIMULATION OF THE EXTERNAL WORLD.BERA IS THE LATEST SOPHISTICATED TEST TO FIND OUT IF A BABY IS DEAF,THE TEST FINDS OUT IF THE SOUND WEAVES REACH THE BRAINCELLS.
USUALLY AT AGE 30 DAYS A NEW BORN BABY IS ABLE TO 1)VISUALISE AN OBJECT&FIX THAT OBJECT2)OR VISUALISE A SPOT FROM WHERE A SOUND IS COMING.3)IT CAN EVEN COMMUNICATE WITH AN OBJECT WHICH IS MAKING/CREATING A SOUND BY MAKING THROTY SYLLABLES .IF ALL THE THREE ABOVE FINDINGS ARE NOT PRESENT UPTO 90 DAYS A PEDIATRICIAN SHOULD SEE THE BABY.
EXTREMELY GOOD CRY AT BIRTH:
IT IS A SENSIBLE PRESUMPTION THAT IF A BABY CRIES VERY LOUDLY FOR A PROLONGED PERIOD &IF REPEATEDLY KEEPS CRYING THERE IS A THEORETICAL POINT THAT ALL BLOOD VESSELS IN THE BRAIN OPENS &BLOOD SUPPLY TO NEURONES MADE EASY. AT BIRTH ALLTUBES/DUCTS/VESSELS ARE NOT PATENT.SO THE ESTABLISHMENT OF PATENCY OF ALL BRAIN BLOOD VESSELS IMPERATIVE FOR ITS ULTIMATE INTELLECTUAL CAPABILITY DUE TO BETTER BLOOD SUPPLY THAT YIELDS BETTER OXYGEN WHICH IS THE MAIN FOOD FOR ALL CELLS ,SPECIALLY THE NERVE CELLS.
SO WE CAN PRESUME THAT A BABY AT BIRTH CRYING LOUDLY AT BIRTH IS DIFFERENT FROM A BABY NOT CRYING MUCH. THIS OF COURSE CAN BE PROOVED BY A RETROSPECTIVE STUDY.THE MORE LOUD THE BABY CRIES ,MORE PINK THE COLOUR WILL BE INDICATIVE OF BETTER LUNG FUNCTION/EXPANSION,BETTER OXYGEN CO2 DISSOCIATION, BETTER BLOOD SUPPLY TO ALL ORGANS OF BODY,INCLUDING BRAIN.IF THE OPPOSITE BEFALLS ,DEVELOPEMENT OF MENTAL RETARDATION IS A STRONG POSSIBILITY..
CORD ROUND THE NECK:
---------------------------
ABOUT 5-10% OF BABIES NECK GET ENTANGLED IN THE UMBILLICAL CORD WHILE FLOATING IN THE AMNIOTIC FLUID INSIDE THE SACK.SOMETIMES IT MAY LEAD TO A STRANGULATING EFFECT CAUSING FETAL DISTRESS SPECIALLY WHEN THE CORD GOES TWICE OR THRICE AROUND NECK..THIS CAN LITERALLY CAUSE ASPHYXIATION
IN UTERO OR PERINATALLY WHEN COMES OUT PER VIA NATURALIS.DEPENDING ON THE TIGHTNESS OF THE CORD AROUND THE NECK THE OUTCOME IS ALSO VARIABLE.MOST SUCH BABIES ARE BORN WITH VERY LOW OR ZERO APGAR SCORE WHEN IT BECOMES A CHALLANGING TASK FOR THE NEONATOLOGIST TO REVIVE &
RESUCITATE THE BABY. ONLY AN EXPERIENCED PERSON ALONE CAN SUCCESSFULLY RESUCITATE SUCH BABIES TO 100%
GOOD THYROID STATUS IN MOTHER &BABY
----------------------------------------------------
THYROID IS A DUCTLESS GLAND PRODUING THYROXIN A HORMONE INTRICATELLY INTEGRATED WITH INTELLIGENCE.NO THYROID MEANS NO INTELLIGENCE .ALSO IT HAS INFLUENCE OVER ALL THE BODY TISSUES. ITS ABSENCE WILL SELECTIVELY CAUSE BRAIN &BONE DAMAGE IN THE FORMATIVE YEARS.THYROID DIFFICIENCY CAN BE CLINICALLY DIAGNOSED IN 3-6 MONTHS AGE GROUP BABIES.&IS FULLY RECTIFIABLE BY CONTINUOUS THYROID TREATMENT.
Rh-INCOMPATIBILITY.
--------------------------
IF MOTHER IS Rh NEGATIVE, &FOETUS Rh POSITIVE,ABOUT 2-10 % BABIES CAN DEVELOP BLOOD GROUP INCOMPATIBILITY, LEADING TO RBC DESTRUCTION, &CONSEQUENT IRRVERSIBLE BRAIN DAMAGE WITH JAUNDICE ,MUSCLE SPASM, FITS, &MENTAL RETARDATION.
ENVIRONEMENTAL STIMULATION:MOST IMPORTANT CONTINUOUS PROCESS.
------------------------------------------------------------------------------------------
A CHILD'S BRAIN DEVELOPEMENT DEPENDS ON THE FOLLOWING GROSS FACTORS APART FRI=OM THE AFORESAID CAUSES.:-
1)BRAIN MASS MUST GROW &THE SKULL BONES MUST ALLOW THIS ENLARGEMENT/EXPANSION &ACCOMODATE BIGGER MASS BY SUITABLY INCREASING THE INNER SKULL SPACE.
2)THE VARIOUS NUTRITION FACTORS &THYROXIN HELP INTHE BRAIN MASS INCREASE.
3)BY APPROPRIATE STIMULATION OF ALL FIVE SPECIAL SENSES THE CORTICAL NEURONES STORE THE INFORMATIONS RECIEVED FROM TIME TO TIME IN THE FORM OF A' FUNCTIONAL' LAYER ,COMPARABLE TO A COMPUETOR CHIP.THE STIMULI RECIEVED KEEP INCREASING IN NUMBER &QUALITY AS TIME PROGRESSES. BEFORE LEARNING WORDS &SENTENCES BABY LEARNS THE SYLLABLES,LIKE A B C ,WITH PHONATION,THIS SYSTEMATIC WAY OF LEARNING IS A MUST TO SHOW GROWTH &PROGRESS.
STORY OF WOLF RAMAN
---------------------------
THIS IS A TRUE STORY OCCURED AT VELLORE-TAMILNADU-INDIA.
PUBLISHED ALL OVER THE WORLD IN ALL NEWSPAPERS 50 YEARS BACK.
A CHILD AGED ABOUT 5 WAS FOUND MAKING NOICE &JUMPING LIKE WOLF IN A JUNGLE SPOTTED BY FEW HUNTERS, WHO BROUGHT CHILD FROM JUNGLE TO CMC HOSPITAL.VARIOUS SPECIALITY DOCTORS FROM VARIOUS PARTS OF THE WORLD
POURED INTO CMC TO SEE &STUDY THE BABY.INTER NATIONAL SYMPOSIUM WERE CONDUCTED..EXCEPT FOR THE EXTERNAL FEATURES OF A HUMAN CHILD BOYHAD ALL THE CHARECTERS OF ANIMALS ONLY &DIED IN HOSPITAL IN ABOUT 2MONTHES PROBALY DUE TO ENVIRONMENTAL SEPERATION
DISCUSSION:
THIS CHILD MUST HAVE BEEN ABDUCTED FROM A VILLAGE BY A WOLF/FOX,OR MUST HAVE BEEN ABANDENED BY A MOTHER AFTER AN ILLEGITIMATE PREGNANCY.THIS CHILD NEVER HAD ANY STIMULATION FROM HUMANS AT ANY TIME..WHAT WAS STRICKINGLY OBVIOUS WAS IT POSSESSED ALL THE CHARECTERS OF ANIMAL&NOTHING FROM HUMANS..
THIS EXPLAINS HOW AN ENVIRONE MENT IS IMPORTANT IN SHAPING FOR ITS INTELLECTUAL STIMULATION,FOR ITS ULTIMATE BRAIN GROWTH QUQLITATIVELY EMOTIONALLY FOR ITS INTELLECTUAL OUTCOME.
----------------------------------------
Tuesday, January 12, 2010
SRM Specialty Hospital
SRM University
Ramapuram – Chennai
Tamilnadu – India
Neonatal Resuscitation New Concept
STATISTICS
1.Asphyxia > 900000/- year W.H.O 2000-2003.
2.23% of Neonatal deaths are Asphyxia Lancet 2005
3.4 million Neonatal death – World wide.
4.Neonatal death 20% China – 2005 developed countries have protocols/programmes like CME.
5.CPincidence – 2 per 1000 population
6.Asphyxia – Mortality More than morbidity.
7.CP- Prevalance 4 per 1000 live births.
8.One – out of 4 ‘bad’ babies – CP
ASPHYXIA
1. What is Asphyxia literally?
2. Is it a misnomer here?
3. Is it a CNS depression due to
bio-chemical metabolic change?
4. Can we call all cyanosis as
asphyxia?
5. What is asphyxia Neonatorum?
Pertinent Questions-NRT
►What is it?
►Where is it done?
►How is it done?
►Who can do it?
►What are the required Equipments?
►What is Asphyxia Neonatorum?
►Is “Asphyxia” a right word here?
►What are the ill effects of failure of NR (Littles’ disease)
►Can we correct it to 100% if so how?
Good Old Dictum – ABC
What is A/B/C?
If no cry or respiration
a) Intubations by ET tube.
b) Oxygen by catheter / mask / hood
c) Ambu bag inflation / deflation.
d) Positive pressure ventilation.
e) Neonatal intensive care unit admission
Is it all necessary?
Does it yield the desired fruit?
If not why should we dothe same?
Why should not we change for better?
New Technique (Designed by author)
“Old Order changeth,
Yielding place to new”
PNEUMONICS : TTDS (Forget ABC)
•T : Thirupathi
•T : Thirumala
•D : Devasthanam
•S : Sanctorum
Further Expansion
T FOR TACTILE - EMBRACES
a. Tapping Baby’s back
b. Tapping Baby’s soles
c. Tapping Baby’s Toes
d. Squeezing Baby’s Ear Lobe with gauze
e. Pushing left index finger into baby’s left molar
f. Squeezing chest through Axillae
g. “Feel of Bite” Sense: Massester Muscle Tone.
T For Tracheal - Embraces
•NG Tube Stimulation through Nose / Mouth.
•NG Tube Stimulation at Tracheal opening.
•Tracheal Suction without ET Tube
•Aim 1. Stimulation by touch
2. Suction of Aspirated
Amniotic fluid, Meconium,
Vernix casseosa
D For Drugs - Embraces
Drug stimulation by following drugs.
a.Glucose 10 – 20 %
b.Soda Bicarb 7.5% 99%
c.Beclamathasone inhaler by Special tubing + Thoracic Squeezing in Rhythmic fashion – 0.75%
d.Adrenalin
e.Deriphylline
f.Dexamethasone – Inj – If necessary
TTDS – Success rate 100% - If
1.FH was present 5 minutes before delivery
2.No cord around the neck more than Twice.
3.No cardiac / Pulmonary / CNS / Tracheobronchial anatomical abnormality.
4.No Hiatus hernia.
5.No birth weight below 1200 gms
6.No RDS / Foetal aspiration syndrome / HMD.
7.No previous H/O foetal death
8.No Maternal diabetes / hypertension / drug withdrawal
9.No Spinal shock due to spinal anaestheria
10.No Apgar score at 0 in first 5 mts.
11.No “feel of bite” at any time during resuscitation .
12.No Placenta Previa
A. Resuscitation Team - Work Assignment
1. Baby receiving
2.Baby positioning – Neck rest – head down
3.Warmer light
4.Suction machine – On / off
5.Chest compression / Tactile Stimulation.
B. Time Keeper
1.Notes birth time
2.Announces every minute by counts.
3.Announces HR / RR - Every Minute
4.Pulse Oxymeter Reader every minute
5.Venesection instruments.
6.umbilical cathetrisation – IV drip.
C. Equipment Procurement
1.Soda Bicarb
2.25% Glucose
3.Deriphylline
4.Dexamethasone
5.Beclamethasone Inhaler
6.Laryngoscope
7.suction catheters / Sterile Hand gloves - Size
8.NG tube size 5,8
9.Butterfly needle – No. 24
10. 20 ml / 5ml syringe
11. Needle No. 26.
12. Vitamin K
13. Styptochrome
14. Calcium
15. Diazapam
16. Epsolin
D. Resuscitator / commander / Chief coordinator (Doctor)
Baby Crying Score (designed by author as per the cry duration in seconds / minutes)
n0 - No cry at Birth and at any time
n1- 3 Average cry (5-10 Sec after each stimulus)
n4- 6 Good cry (> than 15 sec after stimulus interruptedly for 2 hrs)
n7- 9 Very Good luxurious cry > 30 seconds after each stimulus for 6 hrs or more.
Score 5 & above – Excellent cry - brain blood vessels – open fully.
If no cry - asphyxia develops? (cyanosis)
Asphyxia – causes CP / MR / Low academic performances
Behaviour problem like ADHD
Trump card of Neonatal Resuscitation if there is substandard cry
§Tracheal Suction
§Thoracic Squeezing
§Correction of Hypoglycemia
§Correction of Acidosis
§If child cries immediately after NaHCo3 it means uncorrected metabolic acidosis - now corrected
Drug Dose
ØFirst Shot : NaHCo3 (5ml) + 10% Glucose (5 ml) intra umbilically
ØSecond shot : If there is no satisfactory cry repeat same after 5 minutes.
ØRepeat Every 5 minutes for 3-5 times according to necessity.
Aggressive Neonatal Resuscitation Indication
Born as if still birth.
Born with low Apgar Below 5 after 5 minutes
Obvious Cyanosis
No cry for 5 minutes after delivery.
Gross Hypotonicity generalized
HR < 60 / Minute
RR < 16 / Minute
Precious Child
Procedure
Continuous chest compression & Tracheal Suction
Beclamethosone inhalar through tube
NaHCo3 + 25% Glucose – Large dose
Umbilical Venous Cathetrization
Defibrillation – When all measures fail.
Author’s
►Professional Experience : 45 years
►Pure Pediatrics experience : 35 years
►100% success rate in NRT : 20 years
Thank You
SRM University
Ramapuram – Chennai
Tamilnadu – India
Neonatal Resuscitation New Concept
STATISTICS
1.Asphyxia > 900000/- year W.H.O 2000-2003.
2.23% of Neonatal deaths are Asphyxia Lancet 2005
3.4 million Neonatal death – World wide.
4.Neonatal death 20% China – 2005 developed countries have protocols/programmes like CME.
5.CPincidence – 2 per 1000 population
6.Asphyxia – Mortality More than morbidity.
7.CP- Prevalance 4 per 1000 live births.
8.One – out of 4 ‘bad’ babies – CP
ASPHYXIA
1. What is Asphyxia literally?
2. Is it a misnomer here?
3. Is it a CNS depression due to
bio-chemical metabolic change?
4. Can we call all cyanosis as
asphyxia?
5. What is asphyxia Neonatorum?
Pertinent Questions-NRT
►What is it?
►Where is it done?
►How is it done?
►Who can do it?
►What are the required Equipments?
►What is Asphyxia Neonatorum?
►Is “Asphyxia” a right word here?
►What are the ill effects of failure of NR (Littles’ disease)
►Can we correct it to 100% if so how?
Good Old Dictum – ABC
What is A/B/C?
If no cry or respiration
a) Intubations by ET tube.
b) Oxygen by catheter / mask / hood
c) Ambu bag inflation / deflation.
d) Positive pressure ventilation.
e) Neonatal intensive care unit admission
Is it all necessary?
Does it yield the desired fruit?
If not why should we dothe same?
Why should not we change for better?
New Technique (Designed by author)
“Old Order changeth,
Yielding place to new”
PNEUMONICS : TTDS (Forget ABC)
•T : Thirupathi
•T : Thirumala
•D : Devasthanam
•S : Sanctorum
Further Expansion
T FOR TACTILE - EMBRACES
a. Tapping Baby’s back
b. Tapping Baby’s soles
c. Tapping Baby’s Toes
d. Squeezing Baby’s Ear Lobe with gauze
e. Pushing left index finger into baby’s left molar
f. Squeezing chest through Axillae
g. “Feel of Bite” Sense: Massester Muscle Tone.
T For Tracheal - Embraces
•NG Tube Stimulation through Nose / Mouth.
•NG Tube Stimulation at Tracheal opening.
•Tracheal Suction without ET Tube
•Aim 1. Stimulation by touch
2. Suction of Aspirated
Amniotic fluid, Meconium,
Vernix casseosa
D For Drugs - Embraces
Drug stimulation by following drugs.
a.Glucose 10 – 20 %
b.Soda Bicarb 7.5% 99%
c.Beclamathasone inhaler by Special tubing + Thoracic Squeezing in Rhythmic fashion – 0.75%
d.Adrenalin
e.Deriphylline
f.Dexamethasone – Inj – If necessary
TTDS – Success rate 100% - If
1.FH was present 5 minutes before delivery
2.No cord around the neck more than Twice.
3.No cardiac / Pulmonary / CNS / Tracheobronchial anatomical abnormality.
4.No Hiatus hernia.
5.No birth weight below 1200 gms
6.No RDS / Foetal aspiration syndrome / HMD.
7.No previous H/O foetal death
8.No Maternal diabetes / hypertension / drug withdrawal
9.No Spinal shock due to spinal anaestheria
10.No Apgar score at 0 in first 5 mts.
11.No “feel of bite” at any time during resuscitation .
12.No Placenta Previa
A. Resuscitation Team - Work Assignment
1. Baby receiving
2.Baby positioning – Neck rest – head down
3.Warmer light
4.Suction machine – On / off
5.Chest compression / Tactile Stimulation.
B. Time Keeper
1.Notes birth time
2.Announces every minute by counts.
3.Announces HR / RR - Every Minute
4.Pulse Oxymeter Reader every minute
5.Venesection instruments.
6.umbilical cathetrisation – IV drip.
C. Equipment Procurement
1.Soda Bicarb
2.25% Glucose
3.Deriphylline
4.Dexamethasone
5.Beclamethasone Inhaler
6.Laryngoscope
7.suction catheters / Sterile Hand gloves - Size
8.NG tube size 5,8
9.Butterfly needle – No. 24
10. 20 ml / 5ml syringe
11. Needle No. 26.
12. Vitamin K
13. Styptochrome
14. Calcium
15. Diazapam
16. Epsolin
D. Resuscitator / commander / Chief coordinator (Doctor)
Baby Crying Score (designed by author as per the cry duration in seconds / minutes)
n0 - No cry at Birth and at any time
n1- 3 Average cry (5-10 Sec after each stimulus)
n4- 6 Good cry (> than 15 sec after stimulus interruptedly for 2 hrs)
n7- 9 Very Good luxurious cry > 30 seconds after each stimulus for 6 hrs or more.
Score 5 & above – Excellent cry - brain blood vessels – open fully.
If no cry - asphyxia develops? (cyanosis)
Asphyxia – causes CP / MR / Low academic performances
Behaviour problem like ADHD
Trump card of Neonatal Resuscitation if there is substandard cry
§Tracheal Suction
§Thoracic Squeezing
§Correction of Hypoglycemia
§Correction of Acidosis
§If child cries immediately after NaHCo3 it means uncorrected metabolic acidosis - now corrected
Drug Dose
ØFirst Shot : NaHCo3 (5ml) + 10% Glucose (5 ml) intra umbilically
ØSecond shot : If there is no satisfactory cry repeat same after 5 minutes.
ØRepeat Every 5 minutes for 3-5 times according to necessity.
Aggressive Neonatal Resuscitation Indication
Born as if still birth.
Born with low Apgar Below 5 after 5 minutes
Obvious Cyanosis
No cry for 5 minutes after delivery.
Gross Hypotonicity generalized
HR < 60 / Minute
RR < 16 / Minute
Precious Child
Procedure
Continuous chest compression & Tracheal Suction
Beclamethosone inhalar through tube
NaHCo3 + 25% Glucose – Large dose
Umbilical Venous Cathetrization
Defibrillation – When all measures fail.
Author’s
►Professional Experience : 45 years
►Pure Pediatrics experience : 35 years
►100% success rate in NRT : 20 years
Thank You
Monday, December 21, 2009
CHILD PSYCHOLOGY FOR PARENTS.
PRACTICAL PEDIATRIC PSYCHOLOGICAL COUNSELLING FOR PARENTS.
We have to concentrate on 4important points only:
1)children hate parental control.
2)children have interest in socialisation.
3)bad society /bad friendship often turns good into spoiled children.
4)child gives priority to fraternal control than maternal.
PARENTAL CONTROL.
-----------------
EVERY CHILD STARTS LEARNING RIGHT FROM BIRTH SOMETHING EVERY HOUR &EVERY DAY
Parents have to provide suitable opportunity,for environmental stimulation for such learning&it is a continuous process,never ending as long as brain functions keep steering
in the normal way.Generally child wants to be independent age 2.They want to eat themselves,though they will do it in a clumsy way. they get used to in due course.
The 2-3 year age group is bestowed with boundless energy&they can be controlled only when their energy level comes down,after a physically tiresome play..When father returns home child will take the privilege of playing with father in an aggressive way.Father is expected to control his emotions.Sizable number of fathers return home fully boozed.Drunken man can not be expected to know how to behave with a child.The result is a gradual demoralisation of child ending up in a child with low I.Q.,OR LOW ACADEMIC PERFORMANCE,or become a school dropout.Beating such children will not only worsen the situation,but may lead to a psychological breakdown situation There after it is not retrievable most often&that is the end.
so prophylaxis is better than cure.
SOCIALISATION;
Animals are social&man is a social animal.From early child hood he wants to play with other children.or pet animals.This is not practicable in U.S.A..(Playing with pet animals is contraindicated)The culture in India differs in this respect with U.S.A
children US see other children only in parties once a month.otherwise there imprisoned inside
4 walls.only person to see is mother.few children are privileged to go to daycare centers.
JAMBOREE where they see other children&many play equipments..In major hospitals,specially teaching institutions,there is a department known as occupation therapy..meant for mentally &physically retarded children.Even normal children can be exposed to this department&can be found beneficial in sharpening the mental make up of children without any doubts
BAD FRIENDSHIP
Tell me your friend,I will tell your character,is an old proverb.Child grownup child,early adolesents dont know how to select good friends.It is the duty of parents to advise them about their friends&how to choose good from the bad.Children naturally make friendship with high scoring children only if they themselves are high scorers.this HAS TO BE CONFIRMED BY PARENTS,NOW &THEN
parents SHOULD ORGANISE PARTIES ONCE IN A WAY FOR THE CHILD'S SAKE.This provides an opportunity
to study the character of the child's "friends circle".
This should be maintained till child enters college ADOLESCENT AGE IS ONE OF THE MOST DIFFICULT PART OF A CHILD'S DEVELOPMENTAL STAGE.&IS OFTEN A CHALLENGING TASK.
Boy or girl,they are very defiant often &parents have to make right decision to have a good command &control over the child.If not they should seek the help of school teacher or headmaster, or a senior educated relative or even police as the last measure.If child is brought
up well &moulded properly from early childhood.all these things may not be necessary
CHILD IS MORE OBEDIENT TO FATHER THAN MOTHER
In the absence of father ,he very obedient to mother.When father returns home at 6 pm,he is relatively less obedient to mother.This should be considered as a sign of intelligence.&no abuse or threat to be used,towards the child.Obedience is one the most important mental faculty
required to be developed gradually.As age advances,different technique to be used to inculcate discipline.Abusing &beating should never be resorted to ,at any age,as it would only further deteriorate there situation.Parents should approach intellectually to control stubbornness.If they do not know let them go to a pediatric psychologist.Small threatening measures like "TIME OUT" may be practiced whenever they do a wrong thing,&to make them understand,what is right.Intelligence level keeps on increasing every year.&by about age 5 they should obey 100%IF CONTRARY IS FOUND,CONSULT PSYCHOLOGIST.Children like parents always to be smiling &playful towards them(irrespective of their own mental conflicts This may be difficult though.on such occasions parents require PATIENCE.Keep the children always in playful activity,or some kind of useful,intellectual occupation,so that children become less mischievous,or less boisterous.All these are easy to preach but difficult to practice.
We have to concentrate on 4important points only:
1)children hate parental control.
2)children have interest in socialisation.
3)bad society /bad friendship often turns good into spoiled children.
4)child gives priority to fraternal control than maternal.
PARENTAL CONTROL.
-----------------
EVERY CHILD STARTS LEARNING RIGHT FROM BIRTH SOMETHING EVERY HOUR &EVERY DAY
Parents have to provide suitable opportunity,for environmental stimulation for such learning&it is a continuous process,never ending as long as brain functions keep steering
in the normal way.Generally child wants to be independent age 2.They want to eat themselves,though they will do it in a clumsy way. they get used to in due course.
The 2-3 year age group is bestowed with boundless energy&they can be controlled only when their energy level comes down,after a physically tiresome play..When father returns home child will take the privilege of playing with father in an aggressive way.Father is expected to control his emotions.Sizable number of fathers return home fully boozed.Drunken man can not be expected to know how to behave with a child.The result is a gradual demoralisation of child ending up in a child with low I.Q.,OR LOW ACADEMIC PERFORMANCE,or become a school dropout.Beating such children will not only worsen the situation,but may lead to a psychological breakdown situation There after it is not retrievable most often&that is the end.
so prophylaxis is better than cure.
SOCIALISATION;
Animals are social&man is a social animal.From early child hood he wants to play with other children.or pet animals.This is not practicable in U.S.A..(Playing with pet animals is contraindicated)The culture in India differs in this respect with U.S.A
children US see other children only in parties once a month.otherwise there imprisoned inside
4 walls.only person to see is mother.few children are privileged to go to daycare centers.
JAMBOREE where they see other children&many play equipments..In major hospitals,specially teaching institutions,there is a department known as occupation therapy..meant for mentally &physically retarded children.Even normal children can be exposed to this department&can be found beneficial in sharpening the mental make up of children without any doubts
BAD FRIENDSHIP
Tell me your friend,I will tell your character,is an old proverb.Child grownup child,early adolesents dont know how to select good friends.It is the duty of parents to advise them about their friends&how to choose good from the bad.Children naturally make friendship with high scoring children only if they themselves are high scorers.this HAS TO BE CONFIRMED BY PARENTS,NOW &THEN
parents SHOULD ORGANISE PARTIES ONCE IN A WAY FOR THE CHILD'S SAKE.This provides an opportunity
to study the character of the child's "friends circle".
This should be maintained till child enters college ADOLESCENT AGE IS ONE OF THE MOST DIFFICULT PART OF A CHILD'S DEVELOPMENTAL STAGE.&IS OFTEN A CHALLENGING TASK.
Boy or girl,they are very defiant often &parents have to make right decision to have a good command &control over the child.If not they should seek the help of school teacher or headmaster, or a senior educated relative or even police as the last measure.If child is brought
up well &moulded properly from early childhood.all these things may not be necessary
CHILD IS MORE OBEDIENT TO FATHER THAN MOTHER
In the absence of father ,he very obedient to mother.When father returns home at 6 pm,he is relatively less obedient to mother.This should be considered as a sign of intelligence.&no abuse or threat to be used,towards the child.Obedience is one the most important mental faculty
required to be developed gradually.As age advances,different technique to be used to inculcate discipline.Abusing &beating should never be resorted to ,at any age,as it would only further deteriorate there situation.Parents should approach intellectually to control stubbornness.If they do not know let them go to a pediatric psychologist.Small threatening measures like "TIME OUT" may be practiced whenever they do a wrong thing,&to make them understand,what is right.Intelligence level keeps on increasing every year.&by about age 5 they should obey 100%IF CONTRARY IS FOUND,CONSULT PSYCHOLOGIST.Children like parents always to be smiling &playful towards them(irrespective of their own mental conflicts This may be difficult though.on such occasions parents require PATIENCE.Keep the children always in playful activity,or some kind of useful,intellectual occupation,so that children become less mischievous,or less boisterous.All these are easy to preach but difficult to practice.
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