Pulmonary Function Tests or PFTs are a set of tests that are used to determine, measure or observe the functioning of the lungs. The most common pulmonary function tests used are spirometry, gas diffusion, and lung plethysmography. 

Highlights of pulmonary function tests

A spirometry test is used to measure the amount of air inhaled and exhaled. It also measures the amount of time taken to complete a respiration cycle.
A lung plethysmography measures the amount of air in the lungs after the patient has taken a deep breath. It also measures the amount of air that remains in the lungs after the patient has exhaled as much air as possible.
What does a Pulmonary Function Test measure?
Pulmonary function tests would not only check how well the person is breathing but also how effectively the lungs are able to conduct oxygen to the rest of the body. In addition to air flow, these tests would measure the size and volume of the lung and lung diffusion.

These tests can also be used to measure

Total Lung Capacity   the amount of air present in the lungs after breathing in deeply
Forced Vital Capacity   the amount of air that can be exhaled after breathing in deeply
Minute Volume   the amount of air exhaled per minute
Vital Capacity   the total volume of air that can be breathed out after inhaling as much as possible
Tidal Volume   the amount of air inhaled or exhaled when breathing normally
Maximum voluntary ventilation   the amount of air that can be inhaled and exhaled in one minute
Functional Residual Capacity   the amount of air that remains in the lungs when breathing normally
Forced Expiratory Flow   the flow or volume of air during an exhalation
Peak Expiratory Flow Rate   the rate at which a person can exhale
When are Pulmonary Function Tests recommended?
A physician might recommend a patient undergo a PFT as part of a routine physical check-up. This test would be advised if the patient is experiencing any symptoms associated with lung problems or disorders such as asthma, respiratory infections, chronic obstructive pulmonary disease, COPD. A doctor would also use these tests to monitor and check whether a certain treatment prescribed for a lung disease or condition is working effectively.

Pulmonary function tests are safe as they are non-invasive but it is important to follow the instructions of the doctor or technician before, after and during the test. It is important to make your doctor aware of any surgeries, respiratory infections, chest pains or heart attacks that you might have experienced before the test. If you are taking any medications you might need to follow the advice of the doctor as to whether you can take them before the test.

Your doctor would also advice you on how to prepare for the test such as not eating a large meal, avoiding caffeine and wearing loose-fitting clothes. If you have any doubts, concerns or queries discuss them with your doctor.

Pulmonary Function Tests - Why Is It Required?

Cleft palate or palatoschisis is a common genetic abnormality that leads to a horde of problems and is presently a growing challenge to medicine practitioners. The major developmental stages affected due to this particular irregularity include feeding, speech development, dentition and maxillofacial growth which are rather important to the normal overall developmental pace of an individual. Even though the cleft palate deformity was defined centuries ago, no fixed management algorithm exists for patients suffering from the condition in the present day scenario.

Cleft palate may be successfully fixed using reconstructive surgery. Multiple specialists are involved in the reconstruction surgery including plastic surgeons, otolaryngologists, nutritionists, oromaxillofacial surgeons and speech pathologists. Some hospitals also consider psychological therapy for the patient and the family to help get through the emotional trauma and the issues faced due to developmental backlogs.

The treatment for cleft palate usually begins around 9 to 12 months of age. If left untreated, it may cause major deformities. It takes about some years before the whole procedure is completed although it depends on the type and severity of the deformity.

The process involves the administration of anaesthesia after which the palate repair closes the inner, middle and final layers and at the same time realigning of the palatal muscles in a technique called anintravelarveloplasty is conducted. This ensures that the muscles are adjusted in a normal position which facilitates the best functioning of the palate during feeding, swallowing and speaking. It is possible that the child might require more than one surgery to completely close the palate.

Some of the risks involved during the process include:
1. Abnormal reactions to the medications
2. Bleeding
3. Problems in breathing
4. Need for more surgery
5. Infection

Although complicated and time consuming, cleft palate must be given immediate attention to avoid serious developmental issues. The reconstruction surgery and therapy combined ensures a normal development for the child in the longer run, given the surgery was done at the correct time. The child would be required to remain at the hospital for about 5-7 days. Complete recovery takes a time period of 4 weeks. Keeping the wound of the surgery clean is of the utmost importance and it should not be strained.

How to Surgically Treat Cleft Palate

4 Foods That Strengthen Your Child’s Teeth

Kids have a mind of their own when it comes to food. The unhealthier it is, the more they tend to like it. Most taste driven or sweet foods are harmful for your child’s oral hygiene. However not all foods that your children like to eat are as bad for their oral health, some even help strengthen their teeth.

Here are 4 foods that your children can have for healthy teeth and gums.

1) Sugarless Gum - It helps loosen plaque and increase the number of natural antibodies in the mouth. It also keeps the gums hydrated. While too much of anything is not good, these gums are good once in a while.

2)  Crispy Vegetables  - These might not be popular with children but can be made yummy with interesting dips to go with them. Raw carrots, celery, cauliflower, and green beans are chewing foods which clean the child's teeth and gums.

3) Natural Sugar - Sugar from milk, yoghurt and cheese are rich in vitamin D, phosphate and calcium. When consumed, they raise the pH level of the mouth which lowers the level of acids, hence reducing risk of tooth decay.

4) Vitamin C Rich Foods - Fruits like oranges, kiwis, strawberries, papayas and limes help kill bacteria that can cause gingivitis. They also aid a good supply of collagen in the child's gums. However, parents need to remember that one can eat citrus foods only after thirty minutes from brushing their teeth. This is because the citric acid in these foods can weaken the tooth enamel temporarily.


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4 Foods That Strengthen Your Child’s Teeth

Infantile spasm is a seizure-related disorder that is witnessed among infants and young children. The average age for getting affected with infantile spasm is four months, but some kids might experience this disorder within a month of the birth. This disease can have a subtle appearance, and as such it is difficult to recognize as a serious condition. While a full seizure in an adult is scary, the one observed among infants can be as little as a minor head drop, along with minor body shakes. This might appear to be that serious, but infantile spasm is more serious as compared to a full body convulsion in adults. Unfortunately, an infant suffering from infantile spasm is at great risk of developmental disability, if the condition is not detected and treated early.

Anticonvulsant Medication:
There are very few medicines that are approved by the FDA for treating infantile spasms. The two medicines that are widely used by doctors include Adrenocorticotropic hormone (ACTH) and Vigabatrin.

ACTH: This is the oldest approved medicine by the FDA that was first discovered in the year 1958. This injection needs to be pushed twice in a day. Children tend to gain weight and feel hungry when this injection is injected.
Vigabatrin: Vigabatrin is very well tolerated by young kids and has a successful track record of treating infantile spasms. Studies have proven that Vigabatrin can tackle tuberous sclerosis and plays an important role in improving developmental outcome.
Second line therapies:

Pyridoxine: Dependency on Pyridoxine as a cause of infantile spasm is very rare. High dosage of oral administration of pyridoxine has fetched good results for patients, who do not suffer from pyridoxine related seizures.
Valproic acid: Valproic acid has the best anecdotal rate of success. However, doctors do not recommend this medicine for kids less than 2 years of age because of possible complications.
Clonazepam: This is one of the earliest non-steroid medicine for the treatment of infantile spasm. Some of the popular medicines used are nitrazepam, benzodiazepines, and clonazepam.
Ketogenic Diet: This is a decade old practice that has come back to popularity again. Studies have shown that ketogenic diet can help 20-35 % patients of infantile spasm to keep the condition under control.
IVIG: High dosage of IVIG has been reported to be very helpful in tackling infantile spasms. The dosage ranges from 100-200 mg/kg/dose ranging for about 2-3 weeks at stretch.
Surgery: The final part of the therapy includes a surgery that removes the abnormal part of the brain. It should only be considered for patients who have not responded to therapies including Vigabatrin and ACTH. It should also be investigated whether the patient has any structural abnormalities of the brain.


Infantile Spasms - How They Can Be Treated?

Tooth eruption is not only a sign that your child is acquiring the ability to tear, bite, and chew food but it also effects the baby's weight gain, immunity strengthening and development of the brain indirectly.
It is observed that most babies get their first tooth at around 6 months after birth, but they may start gnawing as early as 3 months or as late as 14, and may vary from child to child.  This depends on many factors, one of them being as when the parents started sprouting teeth and whether or not your baby was a preemie. In case of premature and low birth weight babies there may be a delay in their first tooth eruption. Children should have a full set of primary teeth by the time they are almost three.
Babies generally undergo the following Teething Timeline:
6 months: lower central incisors
8 months: upper central incisors
10 months: lower and upper lateral incisors
14 months: first molars
18 months: canines
24 months: second molars
 Symptoms of Teething:
Babies start gnawing to relieve the pain of an emerging tooth.
Puffy and red gums
Excessive drooling
Irritation, especially at night
Tugging Ear
A change in eating habits
Methods to Soothe the Pain:
Teething is a physiological process, no major intervention is needed.
Distraction: You can often soothe your child simply by diverting their minds off the pain by any new toy.
You shouldn't use teethers and topical teething gels to soothe the pain as they might be toxic to babies.
Symptoms of teething usually disappear when the tooth breaks through the gum. In case your baby is teething and the pain prevails , the following signs and symptoms are seen - high fever, diarrhea, or vomiting, highly inflamed gums or blue gum (Cysts) or any kind of lesion or bumps on the gums. In such case you should consult the pediatrician for further guidance

When Will My Newborn Start Teething?

Behavior of a child should always be closely monitored during his/her early development. Sometimes signs of several personality disorders tend to show up early in life. Proper monitoring of the child's behavior helps to identify the signs and properly diagnose the condition if the child is suffering from any potential personality disorder. 

Here are a few facts you should keep in mind:

1. You might often find it difficult to differentiate between the normal and abnormal behavior of your child. You might consult the pediatrician in this case to compare the child's general behavioral patterns with that of other children in the same age group.

2. It is very important to understand your child's development process. It helps you to interpret his/her behavior and to identify signs of personality disorder.

3. There are a few common behavior patterns, which tend to act as a guide to understanding the behavior of your child. Some of these patterns should be encouraged as they lead to proper behavioral development of your child while patterns of negative behavior should be discouraged. 

4.  You should also consult a doctor if your child shows negative behavior persistently even after disciplining measures.

5. Being polite, doing chores on a regular basis, following instructions should be encouraged and rewarded as it helps in the proper personality development of your child.

6. Behavioral patterns like an inclination towards defensive, regressive and aggressive behavior should not be encouraged but can be tolerated in certain situations like illness or in times of stress.

7.  Behavioral patterns like an increased inclination to violence or an excessive competitive attitude towards their siblings should never be allowed. 

8.  Prejudice or racism, stealing or inclination towards substance abuse, angry outbursts point towards problems in the child's mental, physical or social well-being. You are also advised to take your child to a psychological expert to find out whether he/she is suffering from any sort of behavioral disorder. 

9.  Your behavior also plays a major role in development of your child and his/her behavioral patterns. It is often seen that if a child is subjected to excessive physical, mental or emotional abuse or is engaged in too many curricular and extracurricular activities, he/she is likely to develop several behavioral disorders over time.

Child Development and Behavior

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