Monday, July 15, 2013
Sunday, March 31, 2013
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
,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
Saturday, March 30, 2013
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
----------------------------
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
Thursday, January 3, 2013
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
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
Friday, December 7, 2012
muscular dystrophy--continued--88
Though this is a muscle disease primarily--essentially it is a degenerative disease.All organs will appear normal and around 10-20years their vim vigour vitality comes down and they start deteriorate slowly and their survival chance is quite less.(contact-001-7329858375-usa--email-drselvarajp@yahoo.com)
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